For Cat Owners |
The FMPI—Origins and Features
The Feline Musculoskeletal Pain Index (FMPI) was developed at the Comparative Pain Research and Education Centre at the North Carolina State University (NCSU) College of Veterinary Medicine. The Centre’s goal is to produce valid tools for owners and vets to assess animals’ pain, physical function, and quality of life. These tools are targeted at measuring one or more of the impacts of pain:
- Pain (adverse sensory and emotional experience)
- Mobility (the quality of moving freely)
- Activity (the ability to perform specific activities)
- Affective Effects (mood, feelings, behavior)
- Cognitive Function
The FMPI was specifically developed to measure chronic pain in cats when used by an observer (owner or vet) performing measurements of these aspects of feline behavior.
Of particular relevance to pet owners, the FMPI is a tool that can be used in the diagnosis and management of musculoskeletal pain in cats. Cats, by their nature, show hard-to-detect symptoms associated with painful degenerative diseases.
During an animal’s course of treatment, owners and veterinarians can use the FMPI to:
- Initially measure and establish the cat’s baseline condition,
- Develop an initial treatment strategy based on its results,
- Monitor progress, and
- Assess the effectiveness of different medicines and other prescribed treatments.
JOINT PAIN IN CATS
Diseases of joints are common in companion animals. Joint pain, particularly associated with degenerative joint disease (DJD) (often referred to as osteoarthritis (OA)), is common in cats. DJD involves deterioration of all the components of the joint, and this deterioration (of cartilage and the underlying supporting bone) results in inflammation and pain. In cats, the pain is most common in the hips, knees, hocks (ankles), lower back, and elbows. The condition is chronic and, with time, the pain may be so debilitating as to lead to a poor quality of life for the cat. Importantly, with time, pain that is not controlled can lead to changes in the pain-sensing system, resulting in a neuropathic type of pain in these cats.
DJD results in reduced mobility and lower levels of activity. DJD is also associated with spontaneous and induced pain, often in multiple areas of the body.
DIAGNOSING CATS IN PAIN
Pain is an adversive experience associated with actual or potential tissue damage, or described in such terms. Humans can describe it as a feeling. Cats, unfortunately, cannot describe the quality and intensity of their pain for us.
However, the effects of pain can be measured through measuring behavior. A cat without osteoarthritis moves in a very fluid and (usually) graceful fashion. Pain associated with joint disease results in reduced or altered mobility, uneven or jerky movement, impaired ability to perform activities, and altered behavior. It is thought to disrupt sleep and impair cognitive function (thinking). All these multidimensional effects of pain appear similar to the effects in humans, and anything that pain affects can potentially be measured in order to measure the level of pain.
Chronic joint pain affects a cat’s behavior. It affects mobility and the ability to perform activities of daily living. People living with cats are best at assessing these changes. These changes can be captured using the FMPI questionnaire. It often takes a little time to “tune in” to what to look for, and a few trial uses of the FMPI can help.
MANAGING FELINE PAIN AND INFLAMMATION
The dominant approach to treatment of joint pain associated with DJD in cats revolves around medical management, with surgery being indicated occasionally. As for any chronic pain condition, a multimodal drug and non-drug approach is usually recommended to manage joint pain. Multimodal approaches use combinations of drugs with different actions (different modes of action). They also use non-drug therapies that work in different ways (such as dietary omega-3 fatty acids, massage therapy, and acupuncture). Some vets also prescribe the use of non-pharmaceutical anti-inflammatory devices, such as laser, therapeutic ultrasound, and pulsed electromagnetic field (PEMF) therapies. The reason for taking a multimodal approach is that chronic pain is complex and difficult to treat, especially in cats where drug toxicity and pilling challenges are common.
Unfortunately, little is known in veterinary medicine about what truly works to alleviate chronic pain in cats, although there is a lot of ongoing clinical research in this area.
Such clinical research has told us that, just as in people, non-steroidal anti-inflammatories (NSAIDs) are effective for managing chronic joint pain, and that adding omega-3 fatty acids to the diet may also help alleviate joint pain. New classes of drugs are in development and veterinarians are regularly informed by pharmaceutical companies when new therapies are approved by the FDA. One of the most exciting new therapies on the horizon is a felinized version of anti-nerve growth factor (the human version is being developed for chronic pain in people).
Your vet is your best source of advice about how new drug therapies may help manage your cat’s chronic musculoskeletal pain.