Evaluation of a Quality-of-Life Tool for Cats with Diabetes Mellitus

Abstract

Background: Success in management of diabetes mellitus (DM) is defined as improvement of blood glucose concentrations and clinical signs. However, the psychological and social impact of DM and its daily treatment regimen on quality of life (QoL) of both animal and owner is uncertain. Hypothesis/Objectives: To design, validate, and apply a diabetic pet and owner‐centered, individualized measure of impact of DM (DIAQoL‐pet). Animals/Subjects: Two hundred and twenty‐one owners of insulin‐treated diabetic cats were recruited to complete the DIAQoL‐pet. Methods: Discussions and pilot surveys with clinicians and owners of diabetic cats led to the design of 29 specific DM‐associated QoL questions. Owners of diabetic cats completed the finalized survey. Each item was scored according to impact frequency and perceived importance. An item‐weighted impact score (IWIS) for each item was calculated, as was an average‐weighted impact score (AWIS) by averaging all IWISs. Principal component analysis and Cronbach's α calculation assessed the measure's reliability. Two overview questions measured overall QoL and diabetes‐dependent QoL. Results: The DIAQoL‐pet showed high reliability (Cronbach α 0.83). The AWIS was −1.76 ± 2.4 (mean ± SD). Areas reported as most negatively impacting QoL included: “boarding difficulties” (IWIS ± SD: −4.67 ± 5.3), “owner wanting more control” (−4.34 ± 4.7), “difficulties leaving cat with friends or family” (−4.21 ± 4.7), “worry” (−4.10 ± 3.9), “worry hypo” (−3.67 ± 3.5), “social life” (−3.48 ± 3.9), “costs” (−3.04 ± 3.8), and “work life” (−3.03 ± 3.7). Forty‐one percent of owners believed their cat's life would be “a little better” without DM. Conclusions and Clinical Importance: The DIAQoL‐pet proved robust and identified specific areas most negatively impacting on diabetic cats and their owners' QoL. This tool warrants further investigation for use in clinical or research settings.

Feline Diabetes Mellitus

“…221 cat owners from the United States, Canada, Australia, and various countries in Europe completed the survey. The factors with the most negative impact on quality of life were boarding difficulties, owners wanting more control on diabetes, difficulties leaving cat with friends or family, general worry about the cats' diabetes, worried about hypoglycemia, adapting social life, diabetes-related costs, and adapting work life (Niessen et al, 2010). The results of this study may help the veterinarian to address those issues and to make amendments to the treatment and monitoring protocol according to the needs of the individual owner (e.g., simplification of treatment if social life, work life, or costs are the major problems, access to home monitoring of blood glucose if owner wants more control, and avoidance of tight glucose regulation if owner is worried about hypoglycemia).…”

ISFM Consensus Guidelines on the Practical Management of Diabetes Mellitus in Cats

“…Thus, the main goals of management are twofold: on occasion, achieving both of these goals can be difficult. Given the negative impact hypoglycaemia can have on cats and the concern this causes owners, 30 it is preferable, in the Panel's opinion, to prioritise avoiding hypoglycaemia at the expense of allowing periods of hyperglycaemia. That said, in many cats, it may be possible to achieve good glycaemic control safely, particularly with good home monitoring by owners, and this in turn may also improve the prospects of diabetic remission (see below).…”

Update on insulin treatment of dogs and cats with non-complicated diabetes mellitus

“…In recent years there is a tendency to, at least partially, substitute the latter by owner-performed home monitoring of blood glucose concentrations. Thanks to the advancements of portable blood glucose meters (PBGMs) and the refinement of the techniques for blood sampling by the owner, such monitoring is feasible for many dogs and also for cats with DM (Niessen et al, 2010;Ford and Lynch, 2013). The use of PBGMs, their indications, the factors influencing their results and the techniques for blood sampling have been recently (2) reviewed (Athanasiou et al, 2014), and the interested reader is referred to that article.…”

“…The aims of the treatment are to: a) control the clinical manifestations of the disease, b) avoid complications of DM such as diabetic ketosis and acidosis, cataract formation (especially in dogs) and polyneuropathy (especially in cats), c) control blood glucose concentrations throughout the day, ideally below the renal threshold for glycosuria (i.e. 175-220 mg dl -1 for dogs and 210-290 mg dl -1 for cats), d) avoid treatment complications, especially hypoglycemia, e) improve the quality of life of the diabetic dog or cat and the owner, and f) achieve diabetic remission in cats (Martin and Rand, 2007a;Zerrenner et al, 2007;Marshall et al, 2009;Niessen et al, 2010Niessen et al, , 2012Smith et al, 2012;Caney, 2013).…”