Patient Condition and History

Pippa, a nine-year-old, 61lb spayed female Labrador Retriever hassuffered from Hip Dysplasia from a young age.

Hip Dysplasia is a common disease affecting mostly large breeddogs, but also smaller breed dogs and cats. It involves amalformation of the hip joint that causes laxity and subsequentdegeneration and inflammation. Dogs suffering from Hip Dysplasiamay experience chronic pain and require treatment.

A PetPace collar was placed on Pippa to assess her overall conditionand well-being in light of her Hip Dysplasia.

 

Monitoring Data

Statistical analysis of Pippa’s data, available through the PetPaceHealth Report, provided insights into Pippa’s condition. PetPacecompared Pippa’s values to average values for dogs of similarbreed, age, weight, and gender, and found:

Pulse – Pippa’s overall pulse values (average 74; range51-123) were slightly better than those typically seen infemale Labrador retrievers of her age and weight (average79; range 49-108).

Respiration – Her respiratory values (average 17; range10-26) were similar to the values of the reference group(average 20; range 9-29).

Resting – Pippa spent 90.8% of the time resting, which islower than the overall species average (81%) but similar toother Labradors of her age and weight (92%).

Positions – While most dogs like Pippa spend approximately13% of their rest time lying on the left side, Pippa laid only8% of the time on that side. This finding may suggest discomfort associated with lying on the left side, such as painfrom hip dysplasia.

HRV – all Heart Rate Variability indices, which are a potentialobjective markers for pain, were normal (e.g. VVTI average11.5)

All Pippa’s values, with the exception of HRV, showed little day-to-day variation. It is interesting to note that HRV on occasiondecreased to lower levels, possibly indicating intermittent pain ordiscomfort.

*Pippa's VVTI Vs. Pulse chart showing abnormally high amount of points below the normal range (red points).

*Pippa’s VVTI Vs. Pulse chart showing abnormally high amount of points below the normal range (red points).

To further investigate the possibility of intermittent pain, Pippa’scaregivers employed an additional analytical tool to examineminute-to-minute HRV. To create this chart, an HRV index calledVVTI (Vaso-Vagal Tonus Index) is plotted against the correspondingpulse data recorded at the same time. Preliminary data shows astatistical correlation between excessive numbers of plot pointsbelow the normal range (red dots) and various medical conditions.Pippa’s chart showed that 3.2%, a higher than normal percentageof data points (red points), fall below the normal range.

 

Discussion

While Pippa did not show overt signs of pain, the values recorded bythe PetPace collar indicated mild and intermittent pain. Her vitalsigns were normal or even slightly better compared to other dogs ofthe same breed, age and weight. However, the position data andthe HRV analysis revealed an underlying problem.

Pippa’s overall average HRV was normal, but a close look at detailedHRV data, revealed that she has ups and downs, which canindicate intermittent pain episodes which are common for pets withinflammatory joint diseases. Various internal and external factors,such as weather, exercise, diet, and more may exacerbate thebackground inflammatory condition, bringing about periods of pain.

The positions data also hint at possible chronic intermittent pain.Pippa adopted a behavior pattern that includes decreased amount oftime spent lying on the left side, which could be associated withincreased pain or discomfort specifically on that side.

The HRV and positions data are not specific for pain secondary tohip dysplasia. They are statistical parameters indicating that aproblem likely exists. However, Pippa’s owner Dr. Nitzan Kroter, a

veterinary surgeon from Enfield, UK, believes that no other medicalconditions are present and therefore the data indicates chronic,intermittent pain from her hip dysplasia.

Detecting chronic pain, especially if it is intermittent in nature, is achallenge in veterinary medicine. Pets learn to compensate and donot readily show signs of pain. They may continue to eat and sleepwell, appear happy and content and even be moderately active,said Dr. Asaf Dagan, DVM, Diplomate ABVP (Canine and Felinepractice), and PetPace’s Chief Veterinarian. The long term dataanalysis and comparisons provided by the PetPace collar can helpreveal these common pain conditions, that owners may not beaware of, he added.

Pippa is a happy dog despite her medical condition, said Dr. NitzanKroter, a senior partner in Medi-Vet, UK, and Pippa’s owner. Thecollar’s data help me detect those intermittent pain episodes andtreat them accordingly, he continued.

 

Conclusions

Detecting chronic pain in animals is challenging because pets tendto hide their symptoms and compensate for their discomfort.Nonetheless, it is important to treat the pain for both humane andmedical reasons. Pain has significant effect on the wellbeing of thepet and may also have negative influence on its health. Despitethis, surveys repeatedly show that pain is under-diagnosed in thepet population.

The PetPace collar helps detect chronic pain by monitoringphysiological and behavioral parameters associated with painassessment. PetPace uses both real-time and long-term analyticaltools to detect data values that deviate from the specific valuestypical for that pet. Such deviations can indicate acuteexacerbations of an existing painful condition. Finally, comparisonsto pets with similar attributes, such as breed, gender, age andweight, provide additional insights into the pet’s condition andwellbeing.

Hip Dysplasia, and similar joint diseases that are associated withchronic pain and inflammation, are very common in dogs and cats.Using the PetPace collar long-term on these pets can helpcaregivers detect chronic and intermittent pain, guiding treatmentfor pain relief and improving overall quality of life.