The FMPI |
The Feline Musculoskeletal Pain Index (FMPI)
WHAT IT IS, WHAT IT DOES
The Feline Musculoskeletal Pain Index (FMPI) is a “Clinical Metrology Instrument.” It is a scale, or tool, for scoring the degree to which a cat is suffering pain associated with a chronic musculoskeletal disorder. As a pain-scoring tool (in this case, a questionnaire), it measures the relevant clinical features of a cat’s mobility, agility, and disposition that are associated with chronic pain. Developed by NC State University’s College of Veterinary Medicine, the FMPI is the only clinically validated instrument for diagnosing and monitoring feline chronic pain arising from degenerative joint disorders.
The FMPI questionnaire may be administered by veterinary professionals and by cat owners. The sum of the scored observations measures the degree to which the cat suffers from pain associated with long- term, degenerative osteoarthritis (OA) or related neuromuscular and orthopedic conditions.
There are an estimated 80 million cats in the US. Almost half suffer from chronic and debilitating pain associated with the above conditions. Only a small percentage of these 40 million affected cats have been properly diagnosed and are under a vet’s care. The barrier to delivering needed professional care: the inherent difficulty in diagnosing chronic pain in a species that has successfully evolved because of its ability to mask such pain as a form of protection against predators.
See the For Owners and For Vets sections of this website for more details about the origins and features of the FMPI. The Using the FMPI section of this website contains instructions for administering the instrument. The “FMPI Login” section contains a downloadable and an on-line version of the FMPI for use by cat owners and veterinary professionals.
HOW TO USE THE FMPI
- The following instructions should be read to owners by the operator each time the FMPI is administered:
“This questionnaire asks you questions about your cat’s ability to do various activities. Please read the questions and carefully check or fill in the appropriate circle. If the activity does not apply, such as if you do not have stairs in your home, check or fill in the circle on the far right.”
Owners should be encouraged to answer all questions at every evaluation, and only select “Not applicable” if the question or activity truly does not apply to their cat.
- Upon completion of the questionnaire, the owner should return the questionnaire to the administrator.
- FMPI scores are calculated by assigning whole integer scores from 0 to 4 to each question 1-17. Scores are assigned with 0 representing the option on the furthest left of the scale (the least affected option) and 4 representing the option on the furthest right of the scale (the most affected option). If “Not applicable” is checked, no score is assigned to that question. For each question answered “Not applicable,” reduce the total possible score by 4. Subsequent FMPI forms that are completed should not include answers to any questions that were initially checked as “Not applicable”. Questions 18-21 are scored so that No = 0 and Yes = 1.
- The total FMPI score is the sum of scores across all questions. Higher totals indicate more impairment, with a possible range of 0-72. Recommendations on analysis will be available once field testing is complete for version 11.
If repeat FMPI scores are acquired from an individual owner, they should not see their previous scores or responses prior to completing the questionnaire.
We welcome feedback on the FMPI. Please contact Dr. Duncan Lascelles using: Duncan_Lascelles@ncsu.edu
The Comparative Pain Research Laboratory is very grateful to Morris Animal Foundation, Novartis Animal Health, Boehringer Ingelheim Vetmedica, Inc., and Nexvet for sponsoring the work that has led to the development and validation of the current version of the FMPI.
FREQUENTLY ASKED QUESTIONS
How do I know if my cat has pain from degenerative joint disease?
Answer: Any change in your cat’s normal behavior can be a sign of pain. To help identify these behavioral indicators, compare your cat’s daily behaviors and reactions in various situations to when they were young adults. Ask yourself if they are slowing down. Think about changes in their temperament; changes in how they move around their environment, such as using pieces of furniture to get up onto higher places rather than jumping up; changes in their response to petting; changes in the way they move, such as not moving easily or fluidly. Sometimes changes in litter box use habits can be an indicator of joint pain, and limping or lameness can suggest joint pain. Of course, many other painful conditions and diseases can also cause similar changes in behavior, so seeking veterinary evaluation is important.
My cat is slowing down – isn’t that just old age?
Answer: Certainly, cats slow down somewhat as they get older. But a lot of the slowing down you see in older cats is due to joint pain, making performing daily living activities more difficult to do, and making cats reluctant to do them. If you are wondering whether your cat is slowing down due to age, or whether there is joint pain present, check in with your veterinarian, and consider answering the FMPI questionnaire.
What are the most common reasons for limping or lameness in cats?
Answer: Limping and lameness can mean a lot of different things – from decreased use of a single limb through abnormality of movement (e.g., moving more stiffly). By far, the most common reason for limping and lameness problems in cats is degenerative joint disease or osteoarthritis. In fact, degenerative joint disease is present in up to 90% of all cats – young and old are affected. Not all disease is painful. But, in about half of the cases, there is pain present.
What should I do if I notice my cat limping or showing lameness?
Answer: Sometimes, limping occurs due to a temporary tissue sprain or overuse of a muscle; however, this should settle down within a day or two. If the lameness persists, you should get your pet evaluated by a veterinarian. Make sure the visit will be a stress-free one for you and your cat by calling your veterinarian and asking what they do to minimize stress for feline patients.
What can I do to make my arthritic cat more comfortable?
Answer: There are several things you can do to make your cat more comfortable, but do not give any medicines you have or take to your cat – some medicines used in people, such as Tylenol, are toxic in cats. Your veterinarian will talk to you about the best drug and non-drug options. You can ease life for your cat by making the environment easier to move around in – place furniture to help him or her move to the places they want to go. Make sure access to the litter box is easy (no high sides), and the litter box is in an easily accessible part of the house, near where your cat spends the most time, and does not have to perform strenuous activities to get there (e.g., having to climb upstairs to find the litter box). Make sure food and, more importantly, water are within easy access. Also, keep your cat slim – the extra bodyweight makes it more difficult to move around on painful joints.
“At what age is degenerative-joint-disease-associated pain seen?”
Answer: Degenerative joint disease is common across all ages of cats. And, while almost all cats greater than 10 years of age have joint pain, so do many young cats, even as young as 6 months old.
Is it important to treat joint pain?
Answer: In people, mobility is considered one of the most important determinants of quality of life. We believe that is the same for cats, and so it is important to treat joint pain. In addition, untreated pain can have many other deleterious effects that decrease a cat’s quality of life, and untreated pain gradually gets worse until pain becomes a disease in its own right.
I don’t like taking my cat to the vet because he/she gets stressed, so what can I do?
Answer: Having your cat evaluated by a veterinarian is important in order to effectively and safely treat joint pain (and other conditions). There are several things you can do to make the trip to the vet easier for your cat, including calming drugs you can give before the trip. So ask your veterinarian about those, and also speak to your vet to see if they take special measures to make the visit to the clinic stress-free, such as being a Cat Friendly Practice. Established by the American Association of Feline Practitioners (AAFP) and the International Society for Feline Medicine (ISFM), the Cat Friendly Practice® program is a global initiative designed to elevate care for cats by reducing the stress for the cat and the caregiver.
How can I monitor my cat’s progress on treatment?
Answer: You can use the FMPI tool to monitor your cat’s progress with response to treatment.
For more help, email us at help@painfreecats.org