Assessment of menace response in neurologically and ophthalmologically healthy cats

Abstract

Objectives Assessment and interpretation of menace response (MeR) in cats can be challenging. The prevalence of abnormal MeR in healthy cats is unknown. The aim of this study was to prospectively evaluate MeR in visually healthy cats. Methods Fifty cats without history or clinical evidence of neurologic or ophthalmologic disease were assessed by two examiners: standing behind (mode A), in front of (mode B) and in front of the cat (mode C), covering the contralateral eye. MeR was scored from 1 to 5 (absent, weak, moderate, strong, complete). Examination modes were compared concerning presence and score (descriptive statistic, 95% confidence interval, χ test). This was compared to a three-level scoring system (negative, reduced, positive). Score reproducibility between the two examiners was assessed (Cohen's kappa test). Video footage allowed self re-evaluation and evaluation of the second examiner (kappa analysis). Learning/tiring effect (McNemar test), influence of age, body weight (Spearman's rho test), skull type (χ test) and being an indoor or outdoor cat (Mann-Whitney U-test) were evaluated. Results MeR was always elicited with at least one technique. Comparable results were obtained with the five- and three-level scoring system. Mode A achieved strong/complete (positive) MeR in 84.5%, mode B in 82% and mode C in 60%. Exact score reproducibility between the two examiners was slight to fair (κ = 0.208-0.281). Intra-rater agreement for video self-assessment (κ = 0.544-0.639), as well as inter-rater agreement (extrinsic video assessment), was moderate to substantial (κ = 0.584-0.645). No learning/tiring effect ( P = 0.530) or association with body weight ( P = 0.897), age ( P = 0.724), skull type ( P >0.05) and being indoor/ outdoor cat ( P = 0.511) was evident. Conclusions and relevance The majority of visually healthy cats revealed a strong/complete MeR when the contralateral eye remained uncovered, but 40% failed when the contralateral eye was covered. The most reliable examination mode was achieved standing behind the cat.

Comparison of interobserver agreement between the evaluation of bicipital and the patellar tendon reflex in healthy dogs

“…This study represents a logical consequence of the current subjective statements in the veterinary literature regarding the use of reflexes in the neurological evaluation of dogs, and this study provides baseline information on the assessment of reflex accuracy. Additionally, other studies that assessed the answer of different reflexes examined only healthy probands and thus our study design is comparable among the literature [11, 39, 40, 51, 52].…”

“…Nevertheless, it is important to clarify that assessing the accuracy of these reflexes in detecting a lesion within their reflex arc was not the aim of the study. In our opinion before being able to assess the reflex evaluation for its accuracy in detecting a lesion in the associated reflex arc, the IA and thereby its diagnostic utility has to be defined, especially since the evaluation of reflexes is based on subjective assessment [51, 52]. This study represents a logical consequence of the current subjective statements in the veterinary literature regarding the use of reflexes in the neurological evaluation of dogs, and this study provides baseline information on the assessment of reflex accuracy.…”

“…Objectification of the neurological examination is a major topic of current veterinary research [15, 18, 20, 45, 46, 51, 52, 55] with increasing recognition of the importance of evaluating the reliability and therefore the utility of different neurological examination parameters. Our results highlight the need to objectively evaluate the neurological examination and to consider the many factors that might influence its assessment and therefore decrease its reliability.…”

Assessment of menace response in neurologically and ophthalmologically healthy cats: methodological issue

“…We read with interest the article recently published OnlineFirst in the Journal of Feline Medicine and Surgery entitled ‘Assessment of menace response in neurologically and ophthalmologically healthy cats’. 1 The aim of the authors was to evaluate menace response (MeR) in cats and to define the most reliable and reproducible mode of examination. For this purpose, 50 cats without history or clinical evidence of neurological or ophthalmological disease were assessed by two examiners.…”

“…MeR was scored on a scale of 1–5 and then, to assess a more practical option for the clinical setting, a three-level scoring system was applied comparing modes of examination relative to their presence and score. 1…”