Health-related quality of life assessment tool for cats with hyperthyroidism

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Hyperthyroidism is the most common endocrine disease in middle-aged to older cats¹ and occurs when the thyroid gland produces too many hormones. This leads to symptoms like weight loss despite eating more, vomiting, hyperactivity, increased urination and drinking, diarrhea, breathing problems, and changes in their coat.² These symptoms can greatly affect a cat's quality of life (QoL) in addition to creating more stress for the cat and the owner. Researchers on a new study published in the Journal of Veterinary Internal Medicine,³ have seen a lack of tools to evaluate health-related quality-of-life (HRQoL) in cats suffering from hyperthyroidism. The study was aimed at measuring the HRQoL and the impact for owners.

The assessment being studied included 28 questions relating to the HRQoL of hyperthyroid cats and the influence their cat's disease might have on owners was created. Researchers initially showed their first set of questions to a group of 11 veterinarians who work with hyperthyroidism, some in general practice and others in specialty referral hospitals (3 diplomates of an EBVS accredited college, 2 primary care veterinarians, 6 internal medicine clinicians working at referral practices).³ This was structured to gain feedback from these veterinarians about the questions being included in the questionnaire. Each question consisted of 2 subquestions: (1) “how often does the item apply”; (2) “how strongly does the item affect HRQoL.”

The assessment was then made available online for owners of cats suffering from hyperthyroidism or other diseases as well as cats without any known diseases (there were no exclusion criteria regarding the eligible cats). Researchers later divided responses into 2 groups being the HT-group (cats with hyperthyroidism) and the NHT-group (cats without hyperthyroidism).

Owner-related questions ranged from how their cat’s health or diseases impact their daily life with emotional, physical, and financial burdens they take on as a result. Cat-related questions focused more on the potential symptoms the animals were experiencing and also the cat’s mood and behavior.

There were 551 valid questionnaire responses, of which 229 (41.6%) were by owners of cats in the HT-group and 322 (58.4%) by owners of cats in the NHT-group. Responses from the HT-group had a median cat age of 14 years. The final HRQoL tool produced a score between 0 and 382, zero being the best possible HRQoL and 382 the worst. The median HRQoL score for HT-group was 87.5 points and was significantly higher than in the NHT-group at 27 points. Researchers also concluded that owners of cats in the NHT-group generally rated their cat's QoL better than owners of cats in the HT-group.³

After reviewing responses, the researchers decided to remove 3 questions that posed repetitive results as they were worded very similarly. This brought the final HRQoL assessment down to a 25-question tool.³ Researchers also concluded that hypothyroidism negatively affects a cat’s QoL and owner’s lives are impacted through vicarious distress.

Researchers are hoping this hyperthyroidismQoL-cat tool can be easily used by practitioners as an owner take home survey. It can be completed online as it was done in this study or printed on paper for an owner to fill out.

References

1. McLean JL, Lobetti RG, Schoeman JP. Worldwide prevalence and risk factors for feline hyperthyroidism: a review. J S Afr Vet Assoc. 2014; 85: 1-6.
2. Khare DS, Khare R, Gupta DK, et al. Feline hyperthyroidism: an overview. J Entomol Zool Stud. 2018; 6: 418-423.
3. Blunschi F, Schofield I, Muthmann S, Bauer NB, Hazuchova K. Development and validation of a questionnaire to assess health-related quality-of-life in cats with hyperthyroidism. J Vet Intern Med. Published online April 22, 2024. doi:10.1111/jvim.17083