Pain behaviors before and after treatment of oral disease in cats using video assessment: a prospective, blinded, randomized clinical trial

Abstract

Background: Specific behaviors associated with pain in cats with oral disease have not been consistently studied. The aim of this exploratory study was to identify pain-induced behaviors in cats before and after treatment of oral disease using video assessment. Twenty-four cats (6 ± 3.3 years old; 4.9 ± 1.7 kg) were included in a prospective, blinded, randomized clinical trial. Cats were equally divided into minimal (G1: minimal dental treatment) or severe (G2: multiple dental extractions) oral disease groups. After acclimation at day 0, they underwent oral examination, radiographs, scaling, and dental extractions under general anesthesia (anesthetic protocol: acepromazine, hydromorphone, propofol, isoflurane, meloxicam, and local anesthetic blocks; day 1), and were discharged at day 6. Cats were filmed remotely for 10 min using a wide-angle glass lens camera before surgery (baseline) and throughout the study at different time points (36 h of video recording). The videos consisted of four parts namely general, playing, feeding and post-feeding behaviors. A board-certified behaviorist evaluated the duration/ frequency of different behaviors based on an ethogram, which were analyzed using linear mixed models and a generalized linear model, respectively (p < 0.05). Results:In comparison with baseline, duration of "not pawing the face" was significantly shorter at day 3 in G2. These cats spent significantly longer time "standing" and "laying" at days 3 and 6, respectively; G1 spent significantly less time "walking" and "standing" at days 3 and 4, respectively and significantly longer time "immobile" at day 3. Duration of "no/slow tail movement" was significantly longer in G2 than G1 at day 5. Duration of "pawing the ribbon" (playing) was significantly shorter in G2 than G1 at day 1. Feeding and post-feeding behaviors with soft food were not significantly different between groups or over time. Frequency of "difficulty grasping dry food" was significantly higher in G2 than G1 up to day 6. Frequency of post-feeding "head shaking" was significantly higher in both groups at day 6 when compared with baseline.Conclusions: This study identified pain-induced behaviors in cats undergoing treatment of oral disease. These behaviors may be used to differentiate painful versus pain-free cats in clinical practice.

Inter-Rater Reliability of the Feline Grimace Scale in Cats Undergoing Dental Extractions

“…Reliability of the AUs ears and head position (0.68 and 0.74, respectively) were lower than the previous study (0.87 and 0.90, respectively) (6). In the present study, the camera was positioned to film the cats' behaviors for another study (3), and the height and angle of the video camera (set higher in the cage) may have not been ideal to capture the frontal image of the cat and further FGS scoring. If the camera angle is not optimal, the visualization, and interpretation of AUs could change between raters.…”

“…There are some limitations in this study. First, this was an exploratory study and the materials were obtained from previous reports (2,3). As a result, sub-optimal image quality played an important role as discussed above.…”

“…Oral disease is often observed in veterinary medicine (1). Our laboratory revealed that cats with severe oral disease requiring multiple tooth extractions had specific pain-induced behaviors, higher pain scores, changes in serum inflammatory cytokines, and lower food intake when compared with cats with no/minimal oral disease (2,3). There are three pain scales with validation for feline pain assessment: Glasgow Composite Measure Pain Scale-Feline (CMPS-F) (4), UNESP-Botucatu multidimensional composite pain scale (5) and the recent Feline Grimace Scale (6,7).…”

“…Data for this study were obtained from a previously reported clinical trial involving dentistry, nutrition, pain management and behavior in cats before and after dental extractions (2,3). The study was approved by the Institutional Animal Care and Use Committee of the Université de Montréal (protocol 17-Rech-1890) and performed at the Centre hospitalier universitaire vétérinaire (CHUV), Faculty of Veterinary Medicine, Université de Montréal, between July 2017 and February 2018.…”

“…Cats were moved to a specific cage for video recording that included better lighting. After a 5-min acclimation to the new cage, 10-min videos were recorded for assessment of general (without the observer in the ward), playing, feeding and post-feeding behaviors (with the observer in room) for the purpose of studying different aspects of oral pain-induced pain behaviors (3). Briefly, the recordings of general and playing behavior were aimed to observe behaviors without interaction with the observer and the behaviors during playing with the observer using a ribbon toy, respectively.…”