These case studies show how monitoring a veterinary patients vital signs with a Fitbit-style smart device can guide decisions about pain management.
Activity or lack thereof can indicate different things in dogs. Stillness might mean a patient is resting comfortably after surgery, while restlessness signals discomfort. Immobility in an osteoarthritic dog likely means the pet is experiencing pain, while movement indicates a good response to NSAIDs or other therapies. An activity monitor attached to a collar can track both these scenarios. (Shutterstock.com.)
This is the year of pet wearables! A slew of new tracking and monitoring devices has hit the veterinary world, with companies finding all kinds of ways to use them to optimize pet health and well-being (see dvm360.com/wearables).
But some trackers have been around for a while, paving the way for followers to learn from their successes-or failures, as the case may be. (Voyce and Voyce Pro have closed up shop, but not before contributing to the body of knowledge in this arena.) Here are a handful of case studies showing how patients-specifically, those experiencing pain-and their doctors and owners have benefited from data derived from these devices.
Nix, a 4-year-old spayed female pit bull mix weighing 43 pounds, had a torn ligament in her right knee. After a tibial-plateau-leveling osteotomy (TPLO) at TotalBond Veterinary Hospital in Gastonia, North Carolina, the veterinary team used a smart collar (PetPace) to monitor Nix's status. The collar helped the team detect whether Nix was experiencing postoperative pain and responding to analgesics.
Pulse. Nix rested comfortably for almost three hours after surgery. But then the collar registered a rise in her pulse rate at the same time that she started displaying signs of pain (restlessness and vocalization). The veterinarian administered a dose of morphine, which helped Nix relax and continue healing.
Cornell study examines dogs with osteoarthritis using remote monitoring
Cornell University's College of Veterinary Medicine is using an electronic monitoring collar to track heart rate, repiratory rate and activity levels in a study of dogs with osteoarthritis. Researchers are evaluating whether there's a difference in participating dogs' pain response before and after the dogs are given an oral pain medication-either a nonsteroidal anti-inflammatory drug (NSAID) or joint health supplement.
“We're interested in evaluating objective data to assess and better diagnose pain, as well as treatment efficacy,” says Joseph J. Wakshlag, DVM, PhD, DACVN, DACVSMR, Cornell's chief researcher in the study. “Our overall intention is to enhance both client compliance and outcomes for our canine patients, and to determine whether or not remote monitoring improves those results.”
Heart rate variability (HRV). HRV measures the difference in times between heartbeats, and low HRV correlates with pain in both people and animals. The smart collar detected a sharp decrease in Nix's HRV, which coincided with the clinical assessment of pain. After the morphine injection, her HRV returned to normal levels.
Activity. Accelerometers that trace movements can also help assess pain in dogs. Along with the rise in pulse rate and drop in HRV, Nix's smart collar showed an acute increase in her activity level, indicating restlessness. After the administration of an analgesic, Nix's activity level fell back to zero.
Kalin Mayberry, a veterinary technician with VCA Eads Animal Hospital in Eads, Tennessee, knew from her professional expertise that her 8-year-old dog, Lady, was suffering from osteoarthritis. Brianna Letaw, DVM, at the time also with VCA Eads, prescribed pain medication and suggested using a health monitor collar from Voyce (RIP) to keep a closer eye on the German shepherd's progress in a way that was objective and data-driven.
The team established a baseline of three days' worth of data to begin pain medication and also capture heart rate and activity levels, both indicators of a dog's comfort level, through the collar's management system interface. Mayberry also recorded observations of Lady at home.
Over the next few months, Dr. Letaw fine-tuned the pain medication, and through the data from the collar and Mayberry's subjective notes, they saw that Lady's heart rate had steadily decreased from 76 bpm to 68, an 11 percent decrease-indicating an increase in her comfort level. As she started to feel better, Lady moved more often and with less effort and boosted her levels of activity, intensity of activity and distance traveled.
“I would not have believed the medication was helping Lady as much as it did without the objective data,” Mayberry says.