Inter- and intra-observer reliability of quantitative sensory testing performed with the SMall animal ALGOmeter (SMALGO) to evaluate pain associated with feline gingivostomatitis

Abstract

Objectives The aim of this study was to evaluate the inter- and intra-observer reliability of quantitative sensory testing performed with the SMall animal ALGOmeter (SMALGO) in healthy cats and in cats with chronic gingivostomatitis (CGS), and to evaluate the SMALGO as a tool to detect and quantify pain in cats with CGS. Methods Thirty cats from a private shelter were included and assigned to one of two groups: group C (healthy cats; n = 15) or group CGS (cats with CGS; n = 15). In all cats the mechanical thresholds were measured with the SMALGO, with the sensor tip applied to the superior lip above the canine root, by two independent investigators (A, experienced; B, unexperienced), on two different occasions (day 1 and day 2) with a 24 h interval. A CGS scale was used in the diseased cats to assess the severity of the condition. For the reliability analysis, intra-class correlation coefficients (ICCs) were calculated. Other statistical tests used were Pearson correlation coefficient and a paired t-test. Results The inter- and intra-observer levels of agreement were fair (ICC = 0.50) and good, respectively (ICC = 0.73 for investigator A; ICC = 0.60 for investigator B). However, the thresholds measured in healthy cats (169 ± 59 g) did not differ from those obtained from diseased cats (156 ± 82 g; P = 0.35). There was no correlation between the scores of the CGS scale and the thresholds measured in diseased cats (Pearson correlation coefficient = 0.047; P = 0.87). Conclusions and relevance Quantitative sensory testing performed with the SMALGO in cats is repeatable and reliable, regardless of the expertise of the investigator. However, the findings of this study suggest that the mechanical thresholds measured with the SMALGO may not be a valuable indicator of pain in cats with CGS.

Use of mechanical thresholds in a model of feline clinical acute pain and their correlation with the Glasgow Feline Composite Measure Pain Scale scores

“…The maximal cutoff force was set at 400 g, based on previous studies. 11 The force measured was recorded as MT.…”

“…11 When used to assess cats with chronic gingivostomatitis, the MT measured with this device did not correlate with the severity of the disease. 11 To our knowledge, the SMALGO has yet to be investigated in a model of feline acute pain.…”

“…In both healthy cats and cats with chronic pain, the SMALGO has been shown to give repeatable results from users with different backgrounds and degree of expertise in pain assessment. 11 When used to assess cats with chronic gingivostomatitis, the MT measured with this device did not correlate with the severity of the disease. 11 To our knowledge, the SMALGO has yet to be investigated in a model of feline acute pain.…”

“…10 Nociceptive threshold testing techniques have been investigated in cats as a complementary tool for pain assessment, attempting to reduce the level of intra-and inter-assessor variability and therefore provide a higher degree of objectivity. [10][11][12][13][14] Sensory mechanical thresholds (MT) are obtained by applying and measuring either a force or a pressure on a targeted area of the body of the animal until a specific, predefined behavioural response is observed. Various mechanical ALGOmeter have been used in feline experimental and clinical models.…”

“…Various mechanical ALGOmeter have been used in feline experimental and clinical models. [11][12][13][14][15] Among these, the Small Animal ALGOmeter (SMALGO; Bioseb) was originally developed for use in laboratory rodents. In both healthy cats and cats with chronic pain, the SMALGO has been shown to give repeatable results from users with different backgrounds and degree of expertise in pain assessment.…”