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Animal welfare research is gradually moving towards inclusion of positive welfare, with the consideration of how animals can be provided a good life or a life worth living. The concept of quality of life, which originates from human medical sciences, definitely contributes to this. In this chapter the developers of the health-related quality of life tool for dogs share their expertise.

The contemporary approach to pain measurement in people and animals seeks to measure the affective (emotional) component of the pain experience using structured questionnaires with formal scoring methodology. Chronic pain has wide-ranging impacts which affects the quality of life (QOL) of the individual, whether that is a person or an animal. Accordingly instruments to measure chronic pain are designed to measure its impact on QOL and are called health-related quality of life (HRQL) instruments. In veterinary science instruments to measure pain are based on behavioural observation by the veterinary surgeon/nurse in the case of acute pain and by the owner in the case of chronic pain. The development of HRQL instruments is an expanding field in veterinary science, not just for the measurement of pain, but for other chronic diseases, and it has a wide application in pharmaceutical research and clinical practice to improve patient care. This review highlights the challenges involved in creating such measures for dogs and cats, seeking to provide the reader with an understanding of their development process. It then provides an overview of the current status with regard to acute and chronic pain measurement.

An article ‘Pain assessment in animals’ was previously published in In Practice (Reid and others 2013). This short article aims to bring the reader up to date with what we consider to be significant advances in the field of pain assessment in companion animals.

To describe the development and initial validation of a questionnaire measuring functional vision in dogs.A 17-item survey was designed to quantify functional vision in dogs. The Vision Impairment Score (VIS) was determined by summing responses to each question. Questions were assigned to one of five subcategories: overall vision, daily activities, peripheral vision, near vision, and distance vision. Content validity was established during development phases, and construct validity via comparing results of known groups (blind vs sighted; normal vs impaired vision; surgery to improve vision vs nonrestorative surgery), and through factor analysis. Concurrent criterion validity was determined with use of a validated health-related quality-of-life (HRQL) assessment tool. Reliability and responsiveness assessments were investigated using intraclass correlation coefficient (ICC) and effect size (ES), respectively.Responses (221) from 201 dog owners were included. Compared to sighted dogs (n = 153), blind dogs (n = 48) had a higher VIS and greater impairment in all subcategories. Among sighted dogs, a higher VIS was obtained in dogs with low vision compared to those with normal vision (P 0.001). A higher VIS was associated with poorer HRQL (P 0.001). Perfect reliability was obtained for 6/17 questions, and excellent reliability for 11/17 questions (intraclass correlation 1.0 and0.9, respectively), and the VIS was highly responsive to therapeutic intervention (effect size 1.46).Results suggest the VIS may be clinically useful in assessing and obtaining a quantifiable measure of functional vision in dogs. Ongoing validation of the tool for clinical use is needed.

Objectives The objective of this study was to develop a valid, reliable, web-based generic feline health-related quality-of-life (HRQoL) questionnaire instrument to measure the affective impact of chronic disease. Methods A large initial item pool, obtained through interviews with cat owners, was reduced using predetermined criteria, survey scores for relevance and clarity, and the ability of individual items to discriminate between healthy and sick cats when owners completed a prototype questionnaire. Using these data, factor analysis was used to derive a scoring algorithm and provide evidence for factorial validity. Validity was demonstrated further in a field trial using a ‘known groups’ approach (sick vs healthy cats will have a different HRQoL profile, and the HRQoL profile of cats will deteriorate as comorbidities increase). Test–retest reliability was assessed using intra-class correlation coefficients (ICCs). Results In total, 165 items were reduced to 20 and, on the basis of a factor analysis that explained 72.3% of the variation in scores input by 71 owners of 30 healthy and 41 sick cats using the prototype, these were allocated to three domains (vitality, comfort and emotional wellbeing [EWB]) with a scoring algorithm derived using item loadings. Subsequently, the owners of 36 healthy and 58 sick cats completed one or two (n = 48) assessments. Median scores (healthy vs sick) for all domains were significantly different ( P Conclusions and relevance This study provides initial evidence for the validity and reliability of a novel HRQoL instrument to aid the assessment and management of chronic diseases of cats.

Veterinary medicine is veering further towards prolongation of life at all costs, without the safeguard of being able to robustly measure quality of life. Jacky Reid, Andrea Nolan and Marian Scott discuss major steps forward in the ability to measure changes in health-related quality of life.

Attitudes to pain in animals have changed dramatically over the past two decades, with marked advances in its treatment. However, while the importance of measuring animal pain in a valid and reliable manner has been acknowledged for some time, veterinary scientists have been slow to recognise the important contribution of the psychometric approach to the construction of measurement instruments. Well established in human medicine, psychometric methods, which ensure that the end product is valid, reliable and, where required, responsive to clinical change, are the ‘gold standard’ in instrument design. In addition to discussing the particular challenges veterinary scientists face when designing instruments to measure pain in animals, this article describes the psychometric approach and, using the dog as an example, demonstrates how this approach can be used to produce scientifically robust pain scales for non-human species.

Obesity is thought to affect quality of life, but limited objective data exist to support this supposition. The current study aim was to use a questionnaire to determine health-related quality of life (HRQOL) both before and after weight loss, in obese client-owned dogs. Fifty obese dogs were included, and represented a variety of breeds and genders. Prior to weight loss, owners were asked to complete a validated standardised questionnaire to determine HRQOL. Thirty of the dogs successfully completed their weight loss programme and reached target, and owners then completed a follow-up questionnaire. The completed questionnaire responses were transformed to scores corresponding to each of four factors (vitality, emotional disturbance, anxiety and pain), and scored on a scale of 0–6. Changes in the scores were used to explore the sensitivity of the questionnaire, and scores were correlated with responses to direct questions about quality of life and pain, as well as weight loss. Dogs that failed to complete their weight loss programme had lower vitality and higher emotional disturbance scores than those successfully losing weight (P = 0.03 for both). In the 30 dogs that completed, weight loss led to an increased vitality score (P < 0.001), and decreased scores for both emotional disturbance (P < 0.001) and pain (P < 0.001). However, there was no change in anxiety (P = 0.09). The change in vitality score was positively associated with percentage weight loss (rP = 0.43, P = 0.02) and percentage body fat loss (rP = 0.39, P = 0.03). These results indicate demonstrable improvement in HRQOL for obese dogs that successfully lose weight.

Objective—To establish interval level measurement in a prototype composite measure pain scale (CMPS) for assessment of acute pain in dogs and to investigate the scale's validity. Animals—20 clinically normal dogs, 20 dogs with medical conditions, and 117 dogs undergoing surgery. Procedure—First, a scaling model was applied to the CMPS descriptors to establish weights for each and create a continuous scale. Subsequently, 5 observers independently used the scale to score signs of pain in 4 groups of dogs (control dogs, dogs with medical conditions, and 40 dogs undergoing soft tissue or orthopedic surgery). Scores from each group and from groups of conditions perceived to cause no, mild, moderate, and severe pain were compared. In addition, the scale was applied to 77 dogs undergoing orthopedic or soft tissue surgery and scores were compared with simultaneously derived numeric rating scale (NRS) scores; comparisons were made between surgical groups and with time after surgery. Results—Calculated scale descriptor weights ranged from –2.0 to 2.0 and were transformed to create a continuous scale from 0 to 10. Median CMPS scores differed significantly among the 4 study groups and among pain severity groups and were typically greater with increasing perceived pain severity. Agreement was determined between CMPS and NRS scores, and there was a significant and expected time effect and difference between the CMPS scores of dogs undergoing orthopedic and soft tissue surgery. Conclusions and Clinical Relevance—Results indicate that this interval level measurement scale is a valid measure of acute pain in dogs. (Am J Vet Res 2005;66:2154–2166)