Why do we need tools to objectively assess chronic pain?
Assessing the severity of chronic pain can be difficult for owners due to osteoarthritis being a degenerative disease and the symptoms often worsening slowly. The dog may not have an obvious lameness in one limb but instead may have multiple affected joints, therefore making it difficult to identify the exact locations of pain. Furthermore, owners will see their dog every day and may not notice small, subtle changes in their dog’s mobility or behaviour.
What is LOAD scoring?
The Liverpool Osteoarthritis in Dogs questionnaire is a clinical metrology instrument (CMI). CMIs are used by clinicians to objectively measure the response or efficacy of a treatment. The LOAD questionnaire consists of 13 questions for the owner to complete and is designed to be used before treatment starts to get a benchmark number, and then again at regular intervals to monitor improvement or deterioration.
The owner completes a series of questions about the dog’s history, lifestyle and mobility and gives an answer on a scale of 0-4. At the end of the questionnaire the total score is calculated, and this will indicate the severity of the symptoms.
Studies have shown that LOAD scoring is a reliable way of assessing the severity of osteoarthritis symptoms and is comparable to force plate analysis results.
The one slight downside of LOAD scoring is that it doesn’t account for caregiver placebo. As with all owner-reported results, the strength of bond between patient and owner and the owner’s desired outcome for their pet, may influence the scores.
The form comes in an electronic version, which can be emailed to the client before their appointment so precious time isn’t wasted during your therapy session.
Click here to download a copy of the LOAD questionnaire.
Other CMIs appropriate for canine osteoarthritis include The Helsinki Chronic Pain Index, The Canine Brief Pain Inventory and the Canine Orthopaedic Index.
Find out more about the different types of CMI here.