What is your veterinary background?
I graduated from the Royal (Dick) School of Veterinary Sciences Edinburgh in 2012 before working in both mixed and small animal practices. I started at the University of Bristol in 2015 investigating the welfare of farm and pet cats, where my interest in the assessment of quality of life in pets began. I am now undertaking a PhD looking at how veterinary professionals assess the quality of life of dogs in their practice and how it can help improve the welfare of dogs.
What does quality of life mean?
Quality of life (QOL) is very difficult to define, especially in animals. Although many people associate quality of life in dogs with physical health, it actually incorporates many other aspects of life including physcological, social and environmental factors. Additionally, it is a highly individual concept and what improves the QOL of one dog may not be the same for another.
Why do you need to assess QOL?
Perhaps the most common discussion of quality of life occurs towards the end of a dog’s life, where it can help to make a difficult final decision. However, there are many uses for vets and owners to assess QOL before that point. Monitoring of chronic diseases, such as osteoarthritis or epilepsy, is one important area. We can assess whether treatment or husbandry changes are improving the overall life of the dog and can check for any areas of deterioration. QOL assessments can also be used in healthy dogs as a screening tool to highlight issues such as behaviour problems or an inappropriate diet.
How do you assess QOL in dogs? Why is it difficult?
Since QoL is subjective, the best person to assess the QoL of an individual is themselves. This is impossible in animals, so a human has to act as a proxy, usually the owner. We therefore have to judge QOL based on the behaviour of the dog, and our own knowledge of what is ‘normal’. It also means that alongside the QOL of the dog, we also have to consider the relationship between the dog and its owner, and the impact that any issues or diseases are having on the owner.
Vets use their experience and scientific knowledge to assess QOL every time they ask an owner a broad question like ‘How is your dog today?’ Sometimes they may even quantify it, for example on a scale of 1-5. These methods are an informal way of measuring QOL, but much can be gained by more formal assessment tools.
What tools are available?
There are numerous QoL assessment tools available, some aimed at specific issues such as osteoarthritis or epilepsy, and some more holistic. Some are published in journals; these are often subject to some form of validation, for example by testing if different people get the same results for each dog.
How do you choose which tool to use?
The selection of a tool would depend on the intended purpose. For example, a validated tool would be better when undertaking a clinical trial to compare the impact of two different treatments on the QOL of dogs, but when assessing an individual over time validation may be of less importance. A holistic screening tool will be useful for healthy animals, whereas a more health-focussed tool might be chosen for a dog with a specific disease.
What is the aim of using an assessment tool?
The overall aim of assessment should be to improve the quality of life of the dog, or to maintain a good quality of life for as long as possible. Assessments should therefore be made regularly and adjustments to environment, medications and so on made when necessary.
What are the barriers to use of QOL tools in practice?
Although many tools have been available for a while, the actual uptake in veterinary practice has been low. For a start, there is currently a low awareness among vets and vet nurses that these tools exist and what their purpose is.
For vets and nurses who know about them, the main barrier to using these tools in veterinary practice is time. In a normal consultation it is hard to fit in a discussion about quality of life, so veterinary professionals often focus on the issue for which the dog is presented. Formal assessment tools also require time for interpretation, and time for recording the results on the practice computer system.
What are you doing in your PhD?
There appears to be a disconnect between the development of tools and their translation into practice. My PhD, funded by Dogs Trust Canine Welfare Grants, aims to provide that link; to investigate what issues arise during implementation of a QOL assessment scheme and how to overcome them. I am speaking to vets and vet nurses about their experiences with quality of life assessment, what areas they feel a tool could be useful and what features of a QOL tool would encourage them to use it in practice.
In the next stage, I will be going into veterinary practices and using a participatory approach to implement a formal QOL scoring scheme. A participatory approach means that staff at the practice will be invested and involved right from the beginning – from deciding the purpose of their scheme through to assessment of the success of their scheme.
I hope that this will provide vets and nurses in practice with advice on how and why to implement their own schemes in practice, to benefit canine welfare in their practices.
Can we get involved?
I am still looking for vets and nurses from all over the UK to partake in an informal half hour interview with me to chat about the subject. I am also recruiting practices within 2-3 hours of Bristol who are interested in implementing a quality of life assessment scheme in their practice.
I would also like to know the views of dog owners on this topic and hope to interview some owners soon!
I can be contacted on firstname.lastname@example.org or you can follow us on twitter @K9QOL