Quality of Life assessment tools

Published 31 August 2021| Updated 30 October 2025

Introduction

The purpose of this collection is to bring together published resources relating to the assessment of quality of life and to signpost validated assessment tools that may be useful in veterinary practice. The resources cover some general papers relating to the assessment of quality of life, the development and validation of assessment tools and examples of how these can be used to assess quality of life and improve animal welfare. The papers are grouped under general quality of life assessment tools, pain assessment tools and disease specific assessment tools.

Quality of life and animal welfare

As veterinary professionals we have a professional duty to make animal health and welfare our first consideration when attending animals. Meeting an animal’s basic welfare needs, including protection from pain, suffering, injury, and disease, is also enshrined in law through the Animal Welfare Acts. However, current thinking on animal welfare goes beyond just meeting basic needs to consider the impact of the physical and social environment on the animal’s mental (affective) state through the “five domains” and the concept of “a life worth living”.

• de Jong, I.C. et al. (2025) A review of existing scientific literature on welfare assessment of farmed species applied in commercial practice: identification of strengths, weaknesses, and areas for further development. Frontiers in Veterinary Science, 12. https://doi.org/10.3389/fvets.2025.1589462
• Littlewood, K.E., Heslop, M.V. and Cobb, M.L. (2023) The agency domain and behavioral interactions: assessing positive animal welfare using the Five Domains Model. Frontiers in Veterinary Science, 10, no. 1284869. https://doi.org/10.3389/fvets.2023.1284869
• Ede, T. and Parsons, T.D. (2023) Cognitive tasks as measures of pig welfare: a systematic review. Frontiers in Veterinary Science, 10, no. 1251070. https://doi.org/10.3389/fvets.2023.1251070
• Lee, V.E., Arnott, G. and Turner, S.P. (2022) Social behavior in farm animals: Applying fundamental theory to improve animal welfare. Frontiers in Veterinary Science, 9, no. 932217.  https://www.frontiersin.org/articles/10.3389/fvets.2022.932217
• Dupjan, S. and Dawkins, M.S.  (2022) Animal welfare and resistance to disease: interaction of affective states and the immune system. Frontiers in Veterinary Science, 9, no. 929805. https://doi.org/10.3389/fvets.2022.929805
• Holmes, T.Q and Brown, A.F. (2022) Champing at the bit for improvements: a review of equine welfare in equestrian sports in the United Kingdom. Animals, 12 (9), p. 1186.  https://doi.org/10.3390/ani12091186
• Talbot, S.R. et al. (2022) RELSA—A multidimensional procedure for the comparative assessment of well-being and the quantitative determination of severity in experimental procedures. Frontiers in Veterinary Science, 9, no. 937711. https://doi.org/10.3389/fvets.2022.937711
• Lamon,T.K. et al (2021) Welfare and quality of life assessments for shelter dogs: A scoping review. Applied Animal Behaviour Science, 244, p. 105490. https://doi.org/10.1016/j.applanim.2021.105490.
• Battini, M. et al (2021) Feasibility and Reliability of the AWIN Welfare Assessment Protocol for dairy goats in semi-extensive farming conditions. Frontiers in Veterinary Science, 8, p.1210. https://doi.org/10.3389/fvets.2021.731927
• Webster, J. (2016) Animal welfare: Freedoms, dominions and “a life worth living”. Animals, 6 (6), p.35. https://doi.org/10.3390/ani6060035
• Mellor, D.J. (2016) Updating animal welfare thinking: Moving beyond the “Five Freedoms” towards “a Life Worth Living”. Animals, 6 (3), p. 21. https://doi.org/10.3390/ani6030021
• Mellor, D.J. t al (2020) The 2020 Five Domains Model: Including Human–Animal Interactions in Assessments of Animal Welfare. Animals, 10 (10), p. 1870. https://doi.org/10.3390/ani10101870
• Sherwen, S.L. et al (2018) An animal welfare risk assessment process for zoos. Animals, 8 (8), p. 130. https://doi.org/10.3390/ani8080130
• Veasey, J.S. (2022) Differing animal welfare conceptions and what they mean for the future of zoos and aquariums, insights from an animal welfare audit. Zoo Biology, https://doi.org/10.1002/zoo.21677
• Littlewood, K.E. and Mellor, D.J. (2016) Changes in the welfare of an injured working farm dog assessed using the Five Domains Model. Animals, 6 (9), p. 58. https://doi.org/10.3390/ani6090058

Assessing quality of life

While the concept of quality of life is easily understood reliable measurement is more complicated. The following references discuss some of the challenges, and introduce the idea of using technology to help.

• Graat, E.A.M. et al. (2024) Can a digital application for animal welfare self-assessments by farmers help improve the welfare of free-range and organic pigs? Animals, 14 (23), 3374. https://doi.org/10.3390/ani14233374
• Long, M. et al. (2024) “How long is life worth living for the horse?” A focus group study on how Austrian equine stakeholders assess quality of life for chronically ill or old horses. BMC Veterinary Research, 20, no. 347. https://doi.org/10.1186/s12917-024-04211-8
• Plush, K. et al. (2024) A five domains assessment of sow welfare in a novel free farrowing system. Frontiers in Veterinary Science, 11. https://doi.org/10.3389/fvets.2024.1339947
• Linstädt, J., Thöne-Reineke, C. and Merle, R. (2024) Animal-based welfare indicators for dairy cows and their validity and practicality: a systematic review of the existing literature. Frontiers in Veterinary Science, 11. https://doi.org/10.3389/fvets.2024.1429097
• de Winkel, T. et al. (2024) Observational behaviors and emotions to assess welfare of dogs: A systematic review. Journal of Veterinary Behavior, 72. https://doi.org/10.1016/j.jveb.2023.12.007
• Wojciechowska, J.I. and Hewson, C.J. (2005) Quality-of-life assessment in pet dogs. Journal of the American Veterinary Medical Association, 226 (5), pp. 722-728. https://doi.org/10.2460/javma.2005.226.722
• Scott, E.M. et al (2007) Can we really measure animal quality of life? Methodologies for measuring quality of life in people and other animals. Animal Welfare, 16 (S) , pp. 17-24. https://www.ingentaconnect.com/content/ufaw/aw/2007/00000016/a00102s1/art00004  [Available from: https://www.newmetrica.com/wp-content/uploads/2016/09/Scott-et-al-2007.pdf, accessed 28 August 2021]
• Schneider, T.R. et al (2010) Multidimensional quality of life and human–animal bond measures for companion dogs. Journal of Veterinary Behavior, 5 (6), pp. 287-301. https://doi.org/10.1016/j.jveb.2010.06.002
• Spofford, N. et al (2013) Should the veterinary profession invest in developing methods to assess quality of life in healthy dogs and cats? Journal of the American Veterinary Medical Association, 243 (7), pp. 952-956. https://doi.org/10.2460/javma.243.7.952
• Mullan, S. (2015) Assessment of quality of life in veterinary practice: developing tools for companion animal carers and veterinarians. Veterinary Medicine: Research and Reports, 6, p. 203. https://doi.org/10.2147/VMRR.S62079
• Belshaw, Z. (2018) Quality of life assessment in companion animals: what, why, who, when and how. Companion Animal, 23 (5), pp. 264-268. https://doi.org/10.12968/coan.2018.23.5.264
• Belshaw, Z. and Yeates, J. (2018) Assessment of quality of life and chronic pain in dogs. The Veterinary Journal, 239, pp. 59-64. https://doi.org/10.1016/j.tvjl.2018.07.010
  A journal watch summary of this article is available
• Giammarino, M. et al (2021) Evaluation of Inter-Observer Reliability of Animal Welfare Indicators: Which Is the Best Index to Use? Animals, 11 (5), p. 1445. https://doi.org/10.3390/ani11051445
• Main, D.C.J. et al (2014) Best practice framework for animal welfare certification schemes. Trends in Food Science & Technology, 37 (2), pp. 127-136. https://doi.org/10.1016/j.tifs.2014.03.009
• Whay, H.R. et al (2003) Assessment of the welfare of dairy cattle using animal‐based measurements: direct observations and investigation of farm records. Veterinary Record, 153 (7), pp. 197-202. https://doi.org/10.1136/vr.153.7.197
• Neethirajan, S. (2021) The Use of Artificial Intelligence in assessing affective states in livestock. Frontiers in Veterinary Science, 8, p. 879. https://doi.org/10.3389/fvets.2021.715261
• Grandin, T. (2022) Practical application of the Five Domains Animal Welfare Framework for supply food animal chain managers. Animals, 12 (20), p. 2831. https://doi.org/10.3390/ani12202831
• Stokes, J.E. et al. (2022) A “Good Life” for dairy cattle: Developing and piloting a framework for assessing positive welfare opportunities based on scientific evidence and farmer expertise. Animals, 12 (19, p. 2540. https://doi.org/10.3390/ani12192540
• Thomann, B. et al. (2023) Development of a data-driven method for assessing health and welfare in the most common livestock species in Switzerland: The Smart Animal Health project. Frontiers in Veterinary Science, 10, no. 1125806. https://doi.org/10.3389/fvets.2023.1125806
• Stygar, A.H. et al (2021) A systematic review on commercially available and validated sensor technologies for welfare assessment of dairy cattle. Frontiers in Veterinary Science, 8, p. 177. https://doi.org/10.3389/fvets.2021.634338
• Russell, A.L. et al. (2023) Use of qualitative behavioural assessment to investigate affective states of housed dairy cows under different environmental conditions. Frontiers in Veterinary Science, 10, no. 1099170. https://doi.org/10.3389/fvets.2023.1099170
• Fulmer, A.E., Laven, L.J. and Hill, K.E. (2022)  Quality of Life measurement in dogs and cats: A scoping review of generic tools. Animals, 12 (3), 400. https://doi.org/10.3390/ani12030400
• Annan, R. et al. (2023) Racehorse welfare across a training season. Frontiers in Veterinary Science, 10. https://doi.org/10.3389/fvets.2023.1208744
• Rowland, M. et al. (2022) The welfare of traveller and gypsy owned horses in the UK and Ireland. Animals, 12 (8), p. 2402. https://doi.org/10.3390/ani12182402
• Tappe-Theodor, A. et al (2022) The “WWHow” Concept for Prospective Categorization of Post-operative Severity Assessment in Mice and Rats. Frontiers in Veterinary Science, 9, 841431. https://doi.org/10.3389/fvets.2022.841431
• Liu, J. et al (2022) Nonintrusive and automatic quantitative analysis methods for fish behaviour in aquaculture. Aquaculture Research, 53 (8), pp. 2985-3000. https://doi.org/10.1111/are.15828

Quality of life assessment tools

Quality of life is a complex construct which aims to provide a global assessment of animal welfare.

The papers below describe and demonstrate some of the tools that have been adopted for the assessment of the quality of life of animals. Although these tools all seek to measure quality of life they vary in terms of the types of animals and environmental conditions to which they are applied; whether they relate to healthy or sick animals and whether they are intended to be completed by professionals or owners. There is also a short section on temperament and behaviour testing in dogs, as behavioural problems have a major impact on quality of life and are a frequent cause of rehoming and euthanasia.

Animal Welfare Assessment Grid

The Animal Welfare Assessment Grid (AWAG) was developed for monitoring the welfare and cumulative lifetime experience of primates in research institutions. It has been adapted for other species and a web-based software application has been designed for capturing, storing and visualising animal welfare assessment data.

• Kim, J. et al. (2024) Simplifying the Animal Welfare Assessment Grid for enhanced accessibility. Frontiers in Veterinary Science, 11. https://doi.org/10.3389/fvets.2024.1459560
• Malkani, R., Paramasivam, S. and Wolfensohn, S. (2024) How does chronic pain impact the lives of dogs: an investigation of factors that are associated with pain using the Animal Welfare Assessment Grid. Frontiers in Veterinary Science, 11.  https://doi.org/10.3389/fvets.2024.1374858
• Malkani, R., Paramasivam, S. and Wolfensohn, S. (2024) A Multidimensional Evaluation of the Factors in the Animal Welfare Assessment Grid (AWAG) That Are Associated with, and Predictive of, Behaviour Disorders in Dogs. Animals, 14 (4), no. 528. https://doi.org/10.3390/ani14040528
• Animal Welfare Assessment Grid (AWAG) [N3CRs] [online] Available from: https://nc3rs.org.uk/crackit/animal-welfare-assessment-grid-awag [Accessed 19 August 2021]
• Welcome to the AWAG system GitHub Wiki! [Public Health England] [online] Available from: https://github.com/PublicHealthEngland/animal-welfare-assessment-grid/wiki [Accessed 19 August 2021]
• Honess, P. and Wolfensohn, S. (2010) The extended welfare assessment grid: a matrix for the assessment of welfare and cumulative suffering in experimental animals. Alternatives to Laboratory Animals, 38 (3), pp. 205-212. https://doi.org/10.1177/026119291003800304
• Malkani, R., Paramasivam, S. and Wolfensohn, S. (2022) Preliminary validation of a novel tool to assess dog welfare: The Animal Welfare Assessment Grid. Frontiers in Veterinary Science, 9, no. 940017. https://doi.org/10.3389/fvets.2022.940017
• Wolfensohn, S. et al (2015) Refinement of welfare through development of a quantitative system for assessment of lifetime experience. Animal Welfare, 24 (2), pp. 139-149. https://doi.org/10.7120/09627286.24.2.139
• Ma, S. et al (2022) Animal welfare assessment in 16 zoos in South Korea using the Modified Animal Welfare Assessment Grid. Frontiers in Veterinary Science, 9, 860741. https://doi.org/10.3389/fvets.2022.860741
• Justice, W.S.M. et al (2017) Adaptation of the animal welfare assessment grid (AWAG) for monitoring animal welfare in zoological collections. Veterinary Record, 181 (6), p. 143. https://doi.org/10.1136/vr.104309
• Ryan, M., Waters, R. and Wolfensohn, S. (2021) Assessment of the welfare of experimental cattle and pigs using the Animal Welfare Assessment Grid. Animals, 11 (4), p. 999. https://doi.org/10.3390/ani11040999

Welfare Quality Network

The Welfare Quality Network developed out of the European Welfare Quality Project (2004-2009) and constructed a multicriteria evaluation model based on four welfare principles (Good feeding, Good housing, Good health, and Appropriate behaviour).

• Assessment Protocols [Welfare Quality Network] [online] Available from: https://www.welfarequality.net/en-us/reports/assessment-protocols/ [Accessed 19 August 2021]
• Publications [Welfare Quality Network] [online] Available from: https://www.welfarequality.net/en-us/reports/publications/ [Accessed 19 August 2021]
• Fact Sheets [Welfare Quality Network] [online] Available from: https://www.welfarequality.net/en-us/reports/fact-sheets/ [Accessed 19 August 2021]
• Veissier, I. et al (2011) Highlighting ethical decisions underlying the scoring of animal welfare in the Welfare Quality® scheme. Animal Welfare, 20 (1), p. 89.
• de Vries, M. et al (2013) Evaluating results of the Welfare Quality multi-criteria evaluation model for classification of dairy cattle welfare at the herd level. Journal of Dairy Science, 96 (10), pp.6264-6273. https://doi.org/10.3168/jds.2012-6129
• Botreau, R., Veissier, I. and Perny, P. (2009) Overall assessment of animal welfare: strategy adopted in Welfare Quality®. Animal Welfare, 18 (4), pp. 363-370.
• Tuyttens, F.A.M. et al (2021) Using expert elicitation to abridge the Welfare Quality® Protocol for monitoring the most adverse dairy cattle welfare impairments. Frontiers in Veterinary Science, 8, p. 456. https://doi.org/10.3389/fvets.2021.634470
• Friedrich, L. (2019) Test−retest reliability of the ‘Welfare Quality® animal welfare assessment protocol for sows and piglets’. Part 1. Assessment of the welfare principle of ‘appropriate behavior’. Animals, 9 (7), p. 398. https://doi.org/10.3390/ani9070398
• Friedrich, L. (2018) Test−retest reliability of the Welfare Quality® animal welfare assessment protocol for sows and piglets In: European Federation for Animal Science 69th Annual Meeting. Dubrovnik 27-31 August 2018 [online] Available from: https://meetings.eaap.org/wp-content/uploads/2018/Session8/S08_03_Friedrich.pdf [Accessed 19 August 2021]

Health Related Quality of Life

The concept and measurement of Health Related Quality of Life is widely used in human medicine and there have been a number of tools developed for use in veterinary patients. Tools relating to specific conditions can be found in section 5. Disease specific assessment tools.

Dogs

• Clark, N.L. et al. (2023) GenPup-M: A novel validated owner-reported clinical metrology instrument for detecting early mobility changes in dogs. PLoS ONE, 18 (12), no. e0291035. https://doi.org/10.1371/journal.pone.0291035
• Yeates, J.W. et al (2011) Promoting discussions and decisions about dogs’ quality‐of‐life. Journal of Small Animal Practice, 52 (9), pp. 459-463. https://doi.org/10.1111/j.1748-5827.2011.01094.x
• Roberts, C. et al. (2023) Awareness and use of canine quality of life assessment tools in UK veterinary practice. Animals, 13 (6), 1105.  https://doi.org/10.3390/ani13061105
• Mullan, S. and Main, D. (2007) Preliminary evaluation of a quality‐of‐life screening programme for pet dogs. Journal of Small Animal Practice, 48 (6), pp. 314-322. https://doi.org/10.1111/j.1748-5827.2007.00322.x
• Reid, J. et al (2013) Development, validation and reliability of a web‐based questionnaire to measure health‐related quality of life in dogs. Journal of Small Animal Practice, 54 (5), pp. 227-233. https://doi.org/10.1111/jsap.12059
• Lavan, R.P. et al. (2023) Development and validation of a canine health-related quality of life questionnaire and a human-canine bond questionnaire for use in veterinary practice. Animals, 13 (20), 3255.  https://doi.org/10.3390/ani13203255
• VetMetrica HRQL [NewMetrica] [online]. Available from: https://www.newmetrica.com/vetmetrica-hrql/ [accessed 28 August 2021]
• Davies, V. et al (2019) Optimising outputs from a validated online instrument to measure health-related quality of life (HRQL) in dogs. PLoS ONE, 14 (9), p. e0221869. https://doi.org/10.1371/journal.pone.0221869
• Reid, J., Wiseman‐Orr, L. and Scott, M. (2018) Shortening of an existing generic online health‐related quality of life instrument for dogs. Journal of Small Animal Practice, 59 (6), pp. 334-342. https://doi.org/10.1111/jsap.12772
• Rodger, S. et al (2021) Effect of Age, Breed, and Sex on the Health-Related Quality of Life of Owner Assessed Healthy Dogs. Frontiers in Veterinary Science, 8, p. 13. https://doi.org/10.3389/fvets.2021.603139
• Hamers, M.F.N. et al (2023)  Quality of life in dogs with idiopathic epilepsy and their owners with an emphasis on breed—A pilot study. Frontiers in Veterinary Science, 9, no. 1107315 https://doi.org/10.3389/fvets.2022.1107315

Cats

• Scott, E. M. et al. (2021) Validity and responsiveness of the Generic Health-Related Quality of Life Instrument (VetMetrica™) in cats with osteoarthritis: comparison of vet and owner impressions of quality of life impact. Frontiers in Veterinary Science, 8, p1124. https://doi.org/10.3389/fvets.2021.733812
• Noble, C.E. et al (2019) Development, initial validation and reliability testing of a web-based, generic feline health-related quality-of-life instrument. Journal of Feline Medicine and Surgery, 21 (2), pp.84-94. https://doi.org/10.1177/1098612X18758176
• Freeman, L.M. et al (2016) Development and initial validation of the Cat HEalth and Wellbeing (CHEW) Questionnaire: a generic health- related quality of life instrument for cats. Journal of Feline Medicine and Surgery, 18 (9), pp. 689-701. https://doi.org/10.1177/1098612X16657386

Owner questionnaires

• Wojciechowska, J.I. et al (2005) Development of a discriminative questionnaire to assess nonphysical aspects of quality of life of dogs. American Journal of Veterinary Research, 66 (8), pp. 1453-1460. https://doi.org/10.2460/ajvr.2005.66.1453
• Wojciechowska, J.I. et al (2005) Evaluation of a questionnaire regarding nonphysical aspects of quality of life in sick and healthy dogs. American Journal of Veterinary Research, 66 (8), pp. 1461-1467. https://doi.org/10.2460/ajvr.2005.66.1461
• Lavan, R.P. (2013) Development and validation of a survey for quality of life assessment by owners of healthy dogs. The Veterinary Journal, 197 (3), pp. 578-582. https://doi.org/10.1016/j.tvjl.2013.03.021
• Reid, J. (2013) Development, validation and reliability of a web‐based questionnaire to measure health‐related quality of life in dogs. Journal of Small Animal Practice, 54 (5), pp. 227-233. https://doi.org/10.1111/jsap.12059
• Tatlock, S. et al (2017) Development and preliminary psychometric evaluation of an owner-completed measure of feline quality of life. The Veterinary Journal, 228, pp. 22-32. https://doi.org/10.1016/j.tvjl.2017.10.005
• Hall, S.S., Brown, B.J. and Mills, D.S. (2019) Developing and assessing the validity of a scale to assess pet dog quality of life: Lincoln P-QoL. Frontiers in Veterinary Science, 6, p. 326. https://doi.org/10.3389/fvets.2019.00326

Temperament and behaviour tests

While the assessment of temperament and behaviour may not seem directly related to quality of life, assessment to ensure that the animal is suited to the environment and role expected and the high prevalence of “behaviour problems in dogs” make it appropriate to include here.

• Diederich, C. and Giffroy, J.M. (2006) Behavioural testing in dogs: A review of methodology in search for standardisation. Applied Animal Behaviour Science, 97 (1), pp. 51-72. https://doi.org/10.1016/j.applanim.2005.11.018
• Serpell, J.A. and Hsu, Y. (2001) Development and validation of a novel method for evaluating behavior and temperament in guide dogs. Applied Animal Behaviour Science, 72 (4), pp. 347-364. https://doi.org/10.1016/S0168-1591(00)00210-0
• Hsu, Y. and Serpell, J.A. (2003) Development and validation of a questionnaire for measuring behavior and temperament traits in pet dogs. Journal of the American Veterinary Medical Association, 223 (9), pp. 1293-1300. https://doi.org/10.2460/javma.2003.223.1293
• Taylor, K.D. and Mills, D.S. (2006) The development and assessment of temperament tests for adult companion dogs. Journal of Veterinary Behavior, 1 (3), pp. 94-108. https://doi.org/10.1016/j.jveb.2006.09.002
• MacTaggart, A.G. and Phillips, C.J.C. (2023) Validating a thoroughbred racehorse welfare index through horse behaviour and Trainers’ reports of welfare issues in their horses. Animals, 13 (2), no. 282. https://doi.org/10.3390/ani13020282

Kennelled / shelter dogs

• Kiddie, J.L. and Collins, L.M. (2014) Development and validation of a quality of life assessment tool for use in kennelled dogs (Canis familiaris). Applied Animal Behaviour Science, 158, pp. 57-68. https://doi.org/10.1016/j.applanim.2014.05.008
• Barnard, S. et al (2016) Development of a new welfare assessment protocol for practical application in long‐term dog shelters. Veterinary Record, 178 (1), pp. 18. https://doi.org/10.1136/vr.103336
• Valsecchi, P. et al (2011) Temperament test for re-homed dogs validated through direct behavioral observation in shelter and home environment. Journal of Veterinary Behavior, 6 (3), pp. 161-177. https://doi.org/10.1016/j.jveb.2011.01.002

Pain assessment tools

While freedom from pain is only one aspect of good welfare and quality of life it is a very important aspect, particularly in veterinary practice where we are frequently dealing with pain, as a result of injury and disease, and need to control and monitor pain that we may inflict as part of the procedures involved in veterinary treatment. There are a number of publications which discuss the recognition of pain, as well as a number of tools which have been developed to try to quantify the pain suffered in order to improve pain relief.

While there may be similarities in assessment tools, for example in the development of “Grimace Scales”, these are species specific. It is also important to consider whether the scale has been developed to assess acute or chronic pain.

General references

• Clancy, N.J. (2025) Assessing and managing pain in cats and dogs. The Veterinary Nurse, 16 (5). https://doi.org/10.12968/live.vetn.2025.0016
• Mota-Rojas, D. et. al. (2025) | How facial expressions reveal acute pain in domestic animals with facial pain scales as a diagnostic tool. Frontiers in Veterinary Science, 12. https://doi.org/10.3389/fvets.2025.1546719
• Marco-Martorell, M. et al. (2024) Agreement of pain assessment using the short form of the Canine Glasgow Composite Measure Pain Scale between veterinary students, veterinary nurses, veterinary surgeons, and ECVAA-diplomates. Animals, 14 (16), no. 2310. https://doi.org/10.3390/ani14162310
• Chiavaccini, L., Gupta, A. and Chiavaccini, G. (2024) From facial expressions to algorithms: a narrative review of animal pain recognition technologies. Frontiers in Veterinary Science, 11. https://doi.org/10.3389/fvets.2024.1436795
• Monteiro, B.P. et al. (2023), 2022 WSAVA guidelines for the recognition, assessment and treatment of pain. Journal of Small Animal Practice, 64 (4), pp. 177-254. https://doi.org/10.1111/jsap.13566
• Mathews, K. et al (2014) Guidelines for recognition, assessment and treatment of pain. Journal of Small Animal Practice, 55 (6), pp .E10-E68. https://doi.org/10.1111/jsap.12200
• Epstein, M. et al (2015) 2015 AAHA/AAFP Pain Management Guidelines for Dogs and Cats. Journal of Feline Medicine and Surgery, 17 (3), pp. 251-272. https://doi.org/10.1177/1098612×15572062
• Reid, J. et al (2013) Pain assessment in animals. In Practice, 35 (2), pp. 51-56. https://doi.org/10.1136/inp.f631
• Costa, R.A. et al. (2022) The use of pain scales in small animal veterinary practices in the USA. Journal of Small Animal Practice, https://doi.org/10.1111/jsap.13581
• Reid, J., Scott, M. and Nolan, A. (2017) Pain assessment in companion animals: an update. In Practice, 39 (10), pp. 446-451. https://doi.org/10.1136/inp.j4513
• Reid, J., Nolan, A.M., and Scott, E.M. (2018) Measuring pain in dogs and cats using structured behavioural observation. The Veterinary Journal, 236, pp. 72–79. https://doi.org/10.1016/j.tvjl.2018.04.013
• Ellwood, B. and Murison, P.J.,  (2021) Investigating the effect of anxiety on pain scores in dogs. Veterinary Anaesthesia and Analgesia. https://doi.org/10.1016/j.vaa.2021.07.005
• Steagall, P.V. et al. (2022) 2022 ISFM consensus guidelines on the management of acute pain in cats. Journal of Feline Medicine and Surgery, 24 (1), pp. 4-30 https://doi.org/10.1177/1098612X211066268
• Mikoni, N.A. et al. (2023) Pain recognition and assessment in birds. Veterinary Clinics of North America: Exotic Animal Practice, 26 (10), pp. 65-81. https://doi.org/10.1016/j.cvex.2022.09.002
• Latney, L. V. (2023) Pain recognition in reptiles. Veterinary Clinics of North America: Exotic Animal Practice, 26 (10), pp. 27-41. https://doi.org/10.1016/j.cvex.2022.09.004

Species specific assessment tools

Dogs

Glasgow Composite Measure Pain Scale (CMPS-SF) 

The short form of the Glasgow Composite Measure Pain Scale (CMPS-SF) was designed as a practical decision-making tool for dogs in acute pain, and can be applied quickly and reliably in a clinical setting. There are 30 descriptor options within 6 behavioural categories, including mobility

• Testa, B. et al. (2021) The short form of the Glasgow Composite Measure Pain Scale in post-operative analgesia studies in dogs: a scoping review. Frontiers in Veterinary Science, 8, p. 1084.  https://doi.org/10.3389/fvets.2021.751949
• Holton, L. et al (2001) Development of a behaviour‐based scale to measure acute pain in dogs. Veterinary Record, 148 (17), pp. 525-531. https://doi.org/10.1136/vr.148.17.525
• Morton, C.M. et al (2005) Application of a scaling model to establish and validate an interval level pain scale for assessment of acute pain in dogs. American Journal of Veterinary Research, 66 (12), pp. 2154-2166. https://doi.org/10.2460/ajvr.2005.66.2154
• Reid, J. et al (2007) Development of the short-form Glasgow Composite Measure Pain Scale (CMPS-SF) and derivation of an analgesic intervention score. Animal Welfare, 16 (S1), pp. 97-104.    https://www.ingentaconnect.com/contentone/ufaw/aw/2007/00000016/a00102s1/art00014 [Available from: https://www.newmetrica.com/wp-content/uploads/2016/09/Reid-et-al-2007.pdf, accessed 28 August 2021]
• Acute pain measurement [NewMetrica] [online]. Available from: https://www.newmetrica.com/acute-pain-measurement/ [accessed 28 August 2021]
• Pain assessment in the dog: the Glasgow Pain Scale [Royal Canin] [online]. Available from: https://vetfocus.royalcanin.com/en/scientific/pain-assessment-in-the-dog-the-glasgow-pain-scale [accessed 28 August 2021]
• Short Form of the Glasgow Composite Pain Scale for dog owners [ISRVA] [online]. Available from: https://www.isvra.org/PDF/SF-GCPS%20eng%20owner.pdf [accessed 28 August 2021]

Chronic pain and health related quality of life

• Wiseman-Orr, M.L. et al (2004) Development of a questionnaire to measure the effects of chronic pain on health-related quality of life in dogs. American Journal of Veterinary Research, 65 (8), pp. 1077-1084. https://doi.org/10.2460/ajvr.2004.65.1077
• Wiseman-Orr, M.L. et al (2006) Validation of a structured questionnaire as an instrument to measure chronic pain in dogs on the basis of effects on health-related quality of life. American Journal of Veterinary Research, 67 (11), pp. 1826-1836. https://doi.org/10.2460/ajvr.67.11.1826

Other

• Boesch, J.M. et al (2021) The Canine Postamputation Pain (CAMPPAIN) initiative: a retrospective study and development of a diagnostic scale. Veterinary Anaesthesia and Analgesia, 48 (6), pp. 861-870. https://doi.org/10.1016/j.vaa.2021.07.003
• Ellwood, B. and Murison, P. (2022) Investigating the effect of anxiety on pain scores in dogs Veterinary Anaesthesia and Analgesia. 49 (1), pp. 135-142. https://doi.org/10.1016/j.vaa.2021.07.005

Cats

• Kogan, L.R., Currin-McCulloch, J. and Hellyer, P. (2024) Behaviors suggestive of pain: the perceptions and veterinary-related decisions of cat guardians in the USA.  Journal of Feline Medicine and Surgery, 26 (10). https://doi.org/10.1177/1098612X241272885
• Cheng, A.J. et al. (2023) Construct validity, responsiveness and reliability of the Feline Grimace Scale in kittens. Journal of Feline Medicine and Surgery, 25 (12). https://doi.org/10.1177/1098612X231211765
• Adami, C. et al. (2023) Inter-observer reliability of three feline pain scales used in clinical practice. Journal of Feline Medicine and Surgery, 25 (9).  https://doi.org/10.1177/1098612X231194423
• Merola, I. and Mills, D.S. (2016) Systematic review of the behavioural assessment of pain in cats. Journal of Feline Medicine and Surgery, 18 (2), pp. 60-76. https://doi.org/10.1177/1098612X15578725
• Lamon, T.K. et al (2023) Welfare and quality of life assessments for shelter cats: A scoping review. Applied Animal Behaviour Science, 258, no. 105797.  https://doi.org/10.1016/j.applanim.2022.105797

Grimace scale

• Robinson, A.R. and Steagall, P.V. (2024) Effects of training on Feline Grimace Scale scoring for acute pain assessment in cats.  Journal of Feline Medicine and Surgery, 26 (10). https://doi.org/10.1177/1098612X241275284
• Evangelista, M.C. et al (2019) Facial expressions of pain in cats: the development and validation of a Feline Grimace Scale. Scientific Reports, 9, no. 19128. https://doi.org/10.1038/s41598-019-55693-8
• Evangelista, M.C. and Steagall, P.V. (2021) Agreement and reliability of the Feline Grimace Scale among cat owners, veterinarians, veterinary students and nurses. Scientific Reports, 11, no. 5262 . https://doi.org/10.1038/s41598-021-84696-7
• Holden, E. et al (2014) Evaluation of facial expression in acute pain in cats. Journal of Small Animal Practice, 55 (12), pp. 615-621. https://doi.org/10.1111/jsap.12283
• Watanabe, R. et al. (2020) Inter-rater reliability of the Feline Grimace Scale in Cats undergoing dental extractions. Frontiers in Veterinary Science, 7, p. 302. https://doi.org/10.3389/fvets.2020.00302
  A journal watch summary of this article is available.
• Steagall, P.V. and Monteiro, B.P. (2019) Acute pain in cats: Recent advances in clinical assessment. Journal of Feline Medicine and Surgery, 21 (1), pp. 25-34. https://doi.org/10.1177/1098612X18808103
• Brondani, J.T. et al (2011) Refinement and initial validation of a multidimensional composite scale for use in assessing acute postoperative pain in cats. American Journal of Veterinary Research, 72 (2), pp. 174-183. https://doi.org/10.2460/ajvr.72.2.174
• Monteiro, B.P. et al (2023) Can cat caregivers reliably assess acute pain in cats using the Feline Grimace Scale? A large bilingual global survey. Journal of Feline Medicine and Surgery, 25 (1) https://doi.org/10.1177/1098612X221145499

Glasgow Feline Composite Measure Pain Scale

• Glasgow Feline Composite Measure Pain Scale: CMPS – Feline [WSAVA] [online]. Available from: https://wsava.org/wp-content/uploads/2020/01/Feline-CMPS-SF.pdf [accessed 28 August 2021]
• Reid, J. (2017) Definitive Glasgow acute pain scale for cats: validation and intervention level. Veterinary Record, 108 (18), p. 449. https://doi.org/10.1136/vr.104208
  A journal watch summary of this article is available.
• Calvo, G. et al (2014) Development of a behaviour‐based measurement tool with defined intervention level for assessing acute pain in cats. Journal of Small Animal Practice, 55 (12), pp. 622-629. https://doi.org/10.1111/jsap.12280
• Monteiro, B.P. and Steagall, P.V. (2019) Chronic pain in cats: Recent advances in clinical assessment. Journal of Feline Medicine and Surgery, 21 (7), pp. 601–614. https://doi.org/10.1177/1098612X19856179
  A journal watch summary of this article is available.
• Goldberg, M.E. (2018) Pain scoring systems for cats. Feline Focus, 4 (1), pp. 15-21.

Rabbits

• Haddad Pinho, R. et al (2022) Validation of the rabbit pain behaviour scale (RPBS) to assess acute postoperative pain in rabbits (Oryctolagus cuniculus). PLoS ONE, 17 (5), p. e0268973. https://doi.org/10.1371/journal.pone.0268973
• Shaw, D., Parkes, J. and Reynolds, H. (2020) Assessing pain in rabbits: how well does the Rabbit Grimace Scale work in the veterinary practice? The Veterinary Nurse, 11 (6), pp. 282-287. https://doi.org/10.12968/vetn.2020.11.6.282
• Banchi, P. et al (2020) Reliability and construct validity of a composite pain scale for rabbit (CANCRS) in a clinical environment. PLoS ONE, 15 (4), p. e0221377. https://doi.org/10.1371/journal.pone.0221377
  An inFOCUS summary of this article is available.
• Benato, L., Murrell, J. and Rooney, N. (2022) Bristol Rabbit Pain Scale (BRPS): Clinical utility, validity and reliability. BMC Veterinary Research, 18, no. 341. https://doi.org/10.1186/s12917-022-03434-x
• Banchi, P. et al. (2022) A composite scale to recognize abdominal pain and its variation over time in response to analgesia in rabbits. Veterinary Anaesthesia and Analgesia. https://doi.org/10.1016/j.vaa.2021.09.020
• Miller A. L. et al. (2022) Evaluating pain and analgesia effectiveness following routine castration in rabbits using behavior and facial expressions. Frontiers in Veterinary Science, 9, 782486. https://doi.org/10.3389/fvets.2022.782486

Horses

• Luna, S.P.L. (2025) A review of pain behaviour assessment scales in horses. UK-Vet Equine, 9 (3). https://doi.org/10.12968/ukve.2024.0045
• van Loon, J.P.A.M. et. al. (2025) Objective assessment of acute pain in foals using a facial expression-based pain scale. Equine Veterinary Journal. https://doi.org/10.1111/evj.14481
• Sidwell, A.E. et al. (2024) Application of the horse grimace scale in horses with dental disease: Preliminary findings. Veterinary Record, 196 (3), e4800. https://doi.org/10.1002/vetr.4800
• Howard, D.L., Lancaster, B. and de Grauw, J. (2024) Development and preliminary validation of an equine brief pain inventory for owner assessment of chronic pain due to osteoarthritis in horses. Animals, 14 (2), no. 181. https://doi.org/10.3390/ani14020181 
• Jodzio, D. et al. (2023) Pain scoring systems in hospitalized horses with ocular disease. Journal of Veterinary Internal Medicine.  https://doi.org/10.1111/jvim.16933
• Ask, K. et al. (2022) Performance of four equine pain scales and their association to movement asymmetry in horses with induced orthopedic pain. Frontiers in Veterinary Science, 9, 938022. https://www.frontiersin.org/articles/10.3389/fvets.2022.938022
• Gómez Álvarez, C.B. and Oosterlinck, M. (2023) The ongoing quest for a validated, universally accepted visual lameness grading scale. Equine Veterinary Journal, 55 (1) pp. 5-8. https://doi.org/10.1111/evj.13896
• Ladewig, J. et al. (2022) A review of the ridden horse pain ethogram and its potential to improve ridden horse welfare. Journal of Veterinary Behavior, 54, pp, 54-61. https://doi.org/10.1016/j.jveb.2022.07.003
• Ortolani, F. et al (2021) Development and preliminary validation of a pain scale for ophthalmic pain in horses: The Equine Ophthalmic Pain Scale (EOPS). The Veterinary Journal, 278, p. 105774. https://doi.org/10.1016/j.tvjl.2021.105774
• Gleerup, K.B. and Lindegaard, C. (2016) Recognition and quantification of pain in horses: A tutorial review. Equine Veterinary Education, 28 (1), pp. 47-57. https://doi.org/10.1111/eve.12383
• Agne, G.F. et al. (2023) Horse Grimace Scale does not detect pain in horses with equine gastric ulcer syndrome. Animals, 13 (10), no. 1623. https://doi.org/10.3390/ani13101623
• Dalla Costa, E. et al (2014) Development of the Horse Grimace Scale (HGS) as a pain assessment tool in horses undergoing routine castration. PLoS ONE, 9 (3), p. e92281. https://doi.org/10.1371/journal.pone.0092281
• van Loon, J.P. and Van Dierendonck, M.C. (2015) Monitoring acute equine visceral pain with the Equine Utrecht University Scale for Composite Pain Assessment (EQUUS-COMPASS) and the Equine Utrecht University Scale for Facial Assessment of Pain (EQUUS-FAP): a scale-construction study. The Veterinary Journal, 206 (3), pp. 356-364. https://doi.org/10.1016/j.tvjl.2015.08.023
• Ladewig, J. et al. (2022) A review of The Ridden Horse pain Ethogram and its potential to improve ridden horse welfare. Journal of Veterinary Behaviour, 54, pp. 54-61. https://doi.org/10.1016/j.jveb.2022.07.003
• Dyson, S. et al (2018) Development of an ethogram for a pain scoring system in ridden horses and its application to determine the presence of musculoskeletal pain. Journal of Veterinary Behavior, 23, pp. 47-57. https://doi.org/10.1016/j.jveb.2017.10.008
• Dyson, S. and Van Dijk, J. (2020) Application of a ridden horse ethogram to video recordings of 21 horses before and after diagnostic analgesia: reduction in behaviour scores. Equine Veterinary Education, 32, pp. 104-111. https://doi.org/10.1111/eve.13029
• Lanci, A. et al (2022) Development of a composite pain scale in foals: a pilot study. Animals. 12 (4), 439. https://doi.org/10.3390/ani12040439

Farm animals

• Tomacheuski, R.M. et. al. (2025) Bovine pain scale: A novel tool for pain assessment in cattle undergoing surgery in the hospital setting. PloS ONE. https://doi.org/10.1371/journal.pone.0323710
• Wiseman-Orr, M.L., Scott, E.M. and Nolan, A.M. (2011) Development and testing of a novel instrument to measure health-related quality of life (HRQL) of farmed pigs and promote welfare enhancement (Part 1). Animal Welfare, 20 (4), pp. 535-548 https://www.ingentaconnect.com/contentone/ufaw/aw/2011/00000020/00000004/art00008. Available from: https://www.newmetrica.com/wp-content/uploads/2016/09/Wiseman-orr-Scott-Nolan-2011-p1.pdf [accessed 29 August 2021]
• Wiseman-Orr, M.L., Scott, E.M. and Nolan, A.M. (2011) Development and testing of a novel instrument to measure health-related quality of life (HRQL) of farmed pigs and promote welfare enhancement (Part 2). Animal Welfare, 20 (4), pp. 549-558 https://www.ingentaconnect.com/contentone/ufaw/aw/2011/00000020/00000004/art00009. Available from: https://www.newmetrica.com/wp-content/uploads/2016/09/Wiseman-orr-Scott-Nolan-2011-p2.pdf [accessed 29 August 2021]
• Viscardi, A.V. et al (2017) Development of a piglet grimace scale to evaluate piglet pain using facial expressions following castration and tail docking: a pilot study. Frontiers in Veterinary Science, 4, p. 51. https://doi.org/10.3389/fvets.2017.00051
• McLennan, K.M. et al (2016) Development of a facial expression scale using footrot and mastitis as models of pain in sheep. Applied Animal Behaviour Science, 176, pp. 19-26. https://doi.org/10.1016/j.applanim.2016.01.007
• Fischer-Tenhagen, C., Meier, J. and Pohl. A. (2022) “Do not look at me like that”: is the facial expression score reliable and accurate to evaluate pain in large domestic animals? A systematic review. Frontiers in Veterinary Science, 9.  https://doi.org/10.3389/fvets.2022.1002681
• Tomacheuski, R. M. et al (2023) Measurement properties of pain scoring instruments in farm animals: A systematic review using the COSMIN checklist. PLoS ONE, 16 (5), no. e0251435. https://doi.org/10.1371/journal.pone.0280830
• Ginger, L. et al. (2023) A six-step process to explore facial expressions performances to detect pain in dairy cows with lipopolysaccharide-induced clinical mastitis. Applied Animal Behaviour Science, 264, no. 105951. https://doi.org/10.1016/j.applanim.2023.105951

Species specific assessment tools

• Mota-Rojas, D. et al (2020) The utility of grimace scales for practical pain assessment in laboratory animals. Animals, 10 (10), no. 1838. https://doi.org/10.3390/ani10101838
• Oliver, V. et al (2014) Psychometric assessment of the Rat Grimace Scale and development of an analgesic intervention score. PLoS ONE, 9 (5), no. e97882. https://doi.org/10.1371/journal.pone.0097882
• Reijgwart, M.L. (2017) The composition and initial evaluation of a grimace scale in ferrets after surgical implantation of a telemetry probe. PLoS ONE, 12 (11), no. e0187986. https://doi.org/10.1371/journal.pone.0187986
• Aulehner, K. et al. (2022) Grimace scale, burrowing, and nest building for the assessment of post-surgical pain in mice and rats—A systematic review. Frontiers in Veterinary Science, 9, p. 930005. https://doi.org/10.3389/fvets.2022.930005

Disease specific assessment tools

Rhein, F.F. et al. (2025) Instruments to assess disease-specific quality of life in dogs: a scoping review. Animals, 15 (12), no. 1780. https://doi.org/10.3390/ani15121780

Arthritis / DJD – pain assessment

Reid, J. (2024) Measuring quality of life in dogs and cats with osteoarthritis. Companion Animal. https://doi.org/10.12968/coan.2024.29.Sup9.17

Dogs

• Gildea, E. et al. (2024) Development and validation of a quality of life and treatment satisfaction measure in canine osteoarthritis. Frontiers in Veterinary Science, 11. https://doi.org/10.3389/fvets.2024.1377019
• McMullin, K. M. et al. (2024) Timed up and go demonstrates strong interrater agreement and criterion validity as a functional test in geriatric dogs. American Journal of Veterinary Research, 85 (8). https://doi.org/10.2460/ajvr.24.03.0062
• Innes, J.F., Morton, M.A. and Lascelles, B.D.X. (2023) Minimal clinically-important differences for the ‘Liverpool Osteoarthritis in Dogs’ (LOAD) and the ‘Canine Orthopedic Index’ (COI) client-reported outcomes measures. PLOS ONE, 18 (2), no. e0280912. https://doi.org/10.1371/journal.pone.0280912
• Alves, J.C. and Innes, J. (2023) Minimal clinically-important differences for the “Liverpool Osteoarthritis in Dogs” (LOAD) and the “Canine Orthopedic Index” (COI) in dogs with osteoarthritis. PLOS ONE, 18 (9): e0291881. https://doi.org/10.1371/journal.pone.0291881
• Smith, M., Mendl. M. and Murrell, J.C. (2022) Associations between osteoarthritis and duration and quality of night-time rest in dogs. Applied Animal Behaviour Science, 253, p. 105661 . https://doi.org/10.1016/j.applanim.2022.105661
• Alves, .C. et al. (2022) Evaluation of four clinical metrology instruments for the assessment of osteoarthritis in dogs. Animals, 12 (20), p. 2808. https://doi.org/10.3390/ani12202808
• Radke, H., Joeris, A. and Chen, M. (2022) Evidence‐based evaluation of owner‐reported outcome measures for canine orthopedic care – a COSMIN evaluation of 6 instruments. Veterinary Surgery, 51 (2), pp. 244-253. https://doi.org/10.1111/vsu.13753  
• Wright, A et al (2022) Identification of canine osteoarthritis using an owner‐reported questionnaire and treatment monitoring using functional mobility tests. Journal of Small Animal Practice. https://doi.org/10.1111/jsap.13500 
• Roberts, C. et al. (2021) Construction of a conceptual framework for assessment of Health-Related Quality of Life in dogs with osteoarthritis. Frontiers in Veterinary Science, 8, p1107. https://doi.org/10.3389/fvets.2021.741864
• Hudson, J.T. et al. (2004) Assessing repeatability and validity of a visual analogue scale questionnaire for use in assessing pain and lameness in dogs. American Journal of Veterinary Research, 65 (12), pp. 1634-1643. https://doi.org/10.2460/ajvr.2004.65.1634
• Clark, N. and Comerford, E. (2023) An update on mobility assessment of dogs with musculoskeletal disease. Journal of Small Animal Practice. https://doi.org/10.1111/jsap.13650

Canine Osteoarthritis Staging Tool (COAST)

• Stabile, M. et al (2022) Observational study of the clinical value of the canine osteoarthritis staging tool. The Veterinary Journal, 283, p. 105832.  https://doi.org/10.1016/j.tvjl.2022.105832
• Cachon, T. et al (2018) Face validity of a proposed tool for staging canine osteoarthritis: Canine OsteoArthritis Staging Tool (COAST). The Veterinary Journal, 235, pp. 1-8. https://doi.org/10.1016/j.tvjl.2018.02.017

Helsinki Chronic Pain Index
The Helsinki Chronic Pain Index (HCPI) is a multidimensional pain scale including 11 questions which can be used by veterinary professionals and owners.

• Hielm-Björkman, A.K., Rita, H. and Tulamo, R.M. (2009) Psychometric testing of the Helsinki chronic pain index by completion of a questionnaire in Finnish by owners of dogs with chronic signs of pain caused by osteoarthritis. American Journal of Veterinary Research, 70 (6), pp. 727-734. https://doi.org/10.2460/ajvr.70.6.727
• Hielm-Björkman, A.K., Kapatkin, A.S. and Rita, H.J. (2011) Reliability and validity of a visual analogue scale used by owners to measure chronic pain attributable to osteoarthritis in their dogs. American Journal of Veterinary Research, 72 (5), pp. 601-607. https://doi.org/10.2460/ajvr.72.5.601

Canine Brief Pain Inventory
The Canine Brief Pain Inventory is an owner completed questionnaire that measures the severity and impact of chronic pain in dogs.

• Wells, J.R. et al (2021) Linguistic Validation of the Canine Brief Pain Inventory (CBPI) for Global Use. Frontiers in Veterinary Science, 8, p. 1442. https://doi.org/10.3389/fvets.2021.769112
• Brown, D.C. et al (2007) Development and psychometric testing of an instrument designed to measure chronic pain in dogs with osteoarthritis. American Journal of Veterinary Research, 68 (6), pp. 631-637. https://doi.org/10.2460/ajvr.68.6.631
• Brown, D.C. et al (2008) Ability of the canine brief pain inventory to detect response to treatment in dogs with osteoarthritis Journal of the American Veterinary Medical Association,233 (8), pp. 1278-1283. https://doi.org/10.2460/javma.233.8.1278
• Canine Brief Pain Inventory (Canine BPI) [PennVet, University of Pennsylvania] [online]. Available from: https://www.vet.upenn.edu/research/clinical-trials-vcic/our-services/pennchart/cbpi-tool [accessed 29 August 2021]
• The Canine Brief Pain Inventory: User guide [PennVet, University of Pennsylvania] [online]. Available from: https://www.vet.upenn.edu/docs/default-source/VCIC/canine-bpi-user%27s-guide-2017-07 [accessed 29 August 2021]
• Modified Canine Brief Pain Inventory (CBPI)© [The Royal (Dick) School of Veterinary Studies, University of Edinburgh] [online]. Available from: https://www.ed.ac.uk/files/atoms/files/modified_canine_brief_pain_inventory_1.3.17_edinburgh.pdf [accessed 29 August 2021]

Liverpool osteoarthritis in Dogs (LOAD)
The Liverpool Osteoarthritis in Dogs (LOAD) questionnaire is a13-item clinical metrology instrument (CMI) used to assess canine articular disorders like osteoarthritis. Individual question scores are summed to provide an overall “LOAD score” suggestive of the animal’s disease presence and severity.

• Hercock, C.A. et al (2009) Validation of a client‐based clinical metrology instrument for the evaluation of canine elbow osteoarthritis. Journal of Small Animal Practice, 50 (6), pp. 266-271. https://doi.org/10.1111/j.1748-5827.2009.00765.x
• Walton, M.B. et al (2013) Evaluation of construct and criterion validity for the ‘Liverpool Osteoarthritis in Dogs’(LOAD) clinical metrology instrument and comparison to two other instruments. PLoS ONE, 8 (3), no. e58125. https://doi.org/10.1371/journal.pone.0058125
• Introducing the LOAD questionnaire: understanding, administering, and incorporating LOAD into clinical practice [University of Liverpool] [online]. Available from: https://assets-us-01.kc-usercontent.com/933a959d-47e3-0014-e47a-1fff3fc5607e/fe234e9b-ff1c-4a1f-982e-1ac489452957/Printable_LOAD_Form.pdf [Accessed 23 August 2021]

Canine Orthopaedic Index
The Canine Orthopaedic Index is a psychometrically sound owner completed instrument that can assess 4 domains in dogs with osteoarthritis: stiffness, gait, function, and quality of life.

• Brown, D.C. (2014) The canine orthopedic index. Step 1: devising the items. Veterinary Surgery, 43 (3), pp. 232-240. https://doi.org/10.1111/j.1532-950X.2014.12142.x
• Brown, D.C. (2014) The canine orthopedic index. Step 2: psychometric testing. Veterinary Surgery, 43 (3), pp. 241-246. https://doi.org/10.1111/j.1532-950X.2014.12141.x
• The ACVS Canine Orthopedic Index [PennVet, University of Pennsylvania] [online]. Available from: https://www.vet.upenn.edu/research/clinical-trials-vcic/our-services/pennchart/canine-orthopedic-index [Accessed 23 August 2021]

Cats

• Zamprogno, H. et al (2010) Item generation and design testing of a questionnaire to assess degenerative joint disease–associated pain in cats. . American Journal of Veterinary Research, 71 (12), pp. 1417-1424. https://doi.org/10.2460/ajvr.71.12.1417
• Gruen, M.E. et al (2015) Criterion validation testing of clinical metrology instruments for measuring degenerative joint disease associated mobility impairment in cats. PLoS ONE, 10 (7), no. e0131839. https://doi.org/10.1371/journal.pone.0131839
• Enomoto, M., Lascelles, B.D.X. and Gruen, M.E. (2020) Development of a checklist for the detection of degenerative joint disease-associated pain in cats. Journal of feline medicine and surgery, 22 (12), pp. 1137-1147. https://doi.org/10.1177/1098612X20907424
  A journal watch summary of this article is available.

Feline Musculoskeletal Pain Index (FMPI)
Developed for owner assessment of the severity and impact of musculoskeletal pain. It contains 17 items involving mobility, ability to perform daily activities (e.g. jumping up and down, playing with toys, grooming, using the litter box) and interaction with other pets and people.

• Benito, J. et al (2013) Reliability and discriminatory testing of a client-based metrology instrument, feline musculoskeletal pain index (FMPI) for the evaluation of degenerative joint disease-associated pain in cats. The Veterinary Journal, 196 (3), pp. 368-373. https://doi.org/10.1016/j.tvjl.2012.12.015
• Benito, J. et al (2013) Feline musculoskeletal pain index: responsiveness and testing of criterion validity. Journal of Veterinary Internal Medicine, 27 (3), pp. 474-482. https://doi.org/10.1111/jvim.12077
  Supplementary material
  o Appendix S1. Instructions read to owners each time the FMPI was completed
  o Appendix S2. Details of the Feline Musculoskeletal Pain Index (FMPI)
• Enomoto, M. et al (2021) Refinement of the Feline Musculoskeletal Pain Index (FMPI) and development of the short-form FMPI. Journal of Feline Medicine and Surgery, https://doi.org/10.1177/1098612X211011984

Client Specific Outcome Measures (CSOM)
A tool designed to measure the pet owner’s assessment of difficult it is for their cat to perform certain specific activities. It has been used to evaluate the impact of osteoarthritis or degenerative joint disease associated pain in cats.

• Lascelles, B.D.X. et al (2007) Evaluation of client‐specific outcome measures and activity monitoring to measure pain relief in cats with osteoarthritis. Journal of Veterinary Internal Medicine, 21 (3), pp. 410-416. https://doi.org/10.1111/j.1939-1676.2007.tb02983.x

Montreal Instrument for Cat Arthritis
A clinical metrology instrument that comes in two forms:

Montreal Instrument for Cat Arthritis Testing for use by veterinarian (MI-CAT(V))  containing 25 items involving body posture, gait, willingness and ease of horizontal movements, jumping and a general lameness score:

Klinck, M.P. et al (2015) Preliminary Validation and Reliability Testing of the Montreal Instrument for Cat Arthritis Testing, for Use by Veterinarians, in a Colony of Laboratory Cats. Animals, 5 (4), pp. 1252-1267 [see Supplementary File 1]. https://doi.org/10.3390/ani5040410

Montreal Instrument for Cat Arthritis Testing for use by caretaker (MI-CAT(C)) containing 38 items including agility; social, play and exploratory behaviours; self-maintenance; and physical condition:

MI-CAT(C)-v1 – Montreal Instrument for Cat Arthritis Testing (Caretaker) – Version 1 [online]. Available from: https://ars.els-cdn.com/content/image/1-s2.0-S0168159117303271-mmc1.pdf [accessed 29 August 2021]

MI-CAT(C)-v2 – Montreal Instrument for Cat Arthritis Testing (Caretaker) – Version  2. [online]. Available from: https://ars.els-cdn.com/content/image/1-s2.0-S0168159117303271-mmc2.pdf [Accessed 29 August 2021]

• Klinck, M.P. et al (2015) Preliminary validation and reliability testing of the Montreal Instrument for Cat Arthritis Testing, for use by veterinarians, in a colony of laboratory cats. Animals, 5 (4), pp. 1252-1267.  DOI: 10.3390/ani5040410
• Klinck, M.P. et al (2018) Development and preliminary validity and reliability of the montreal instrument for cat arthritis testing, for use by caretaker/owner, MI-CAT (C), via a randomised clinical trial. Applied Animal Behaviour Science, 200, pp. 96-105. https://doi.org/10.1016/j.applanim.2017.11.013
• Klinck, M.P. (2018) Refinement of the Montreal Instrument for Cat Arthritis Testing, for Use by Veterinarians: detection of naturally occurring osteoarthritis in laboratory cats. Journal of Feline Medicine and Surgery, 20 (8), pp. 728-740. https://doi.org/10.1177/1098612X17730172

Cancer – Quality of Life assessment

• Giuffrida, M.A. and Kerrigan, S.M. (2014) Quality of life measurement in prospective studies of cancer treatments in dogs and cats. Journal of Veterinary Internal Medicine, 28 (6), pp. 1824-1829. https://doi.org/10.1111/jvim.12460
• Lynch, S. et al (2011) Development of a questionnaire assessing health‐related quality‐of‐life in dogs and cats with cancer. Veterinary and Comparative Oncology, 9 (3), pp. 172-182. https://doi.org/10.1111/j.1476-5829.2010.00244.x
• Iliopoulou, M.A., Kitchell, B.E. and Yuzbasiyan-Gurkan, V. (2013) Development of a survey instrument to assess health-related quality of life in small animal cancer patients treated with chemotherapy. Journal of the American Veterinary Medical Association, 242 (12), pp. 1679-1687. https://doi.org/10.2460/javma.242.12.1679
• Mellanby, R.J., Herrtage, M.E. and Dobson, J.M. (2002) Owners’ assessments of their dog’s quality of life during palliative chemotherapy for lymphoma. Journal of Small Animal Practice, 43 (3), pp. 100-103. https://doi.org/10.1111/j.1748-5827.2002.tb00037.x
• Vøls, K.K. et al (2017) Quality of life assessment in dogs and cats receiving chemotherapy–a review of current methods. Veterinary and Comparative Oncology, 15 (3), pp. 684-691. https://doi.org/10.1111/vco.12242
• Hamilton, M.J. et al (2012) Questionnaire‐based assessment of owner concerns and doctor responsiveness: 107 canine chemotherapy patients. Journal of Small Animal Practice, 53 (11), pp. 627-633. https://doi.org/10.1111/j.1748-5827.2012.01269.x
• Yazbek, K.V. and Fantoni, D.T. (2005) Validity of a health-related quality-of-life scale for dogs with signs of pain secondary to cancer. Journal of the American Veterinary Medical Association, 226 (8), pp.1354-1358. https://doi.org/10.2460/javma.2005.226.1354
• Brown, D.C. et al (2009) A novel approach to the use of animals in studies of pain: validation of the canine brief pain inventory in canine bone cancer. Pain Medicine, 10 (1), pp. 133-142. https://doi.org/10.1111/j.1526-4637.2008.00513.x

Other conditions

Spinal cord injuries

• Hölscher, J. et al. (2025) Correlation of mechanical thresholds, Glasgow Composite Measure Pain Scale, and Sharp and Wheeler Grading Scale in dogs with acute thoracolumbar disc extrusions. Animals, 15 (15), no. 2176. https://doi.org/10.3390/ani15152176
• Budke, C.M. et al (2008) Evaluation of a questionnaire for obtaining owner-perceived, weighted quality-of-life assessments for dogs with spinal cord injuries. Journal of the American Veterinary Medical Association, 233 (6), pp. 925-930. https://doi.org/10.2460/javma.233.6.925
• Levine, J.M. et al (2008) Owner-perceived, weighted quality-of-life assessments in dogs with spinal cord injuries. Journal of the American Veterinary Medical Association, 233 (6), pp. 931-935. https://doi.org/10.2460/javma.233.6.931

Chiari‐like malformation and syringomyelia

• Rutherford, L. et al (2012) Questionnaire-based behaviour analysis of Cavalier King Charles spaniels with neuropathic pain due to Chiari-like malformation and syringomyelia. The Veterinary Journal, 194 (3), pp. 294-298. https://doi.org/10.1016/j.tvjl.2012.05.018
• Sparks, C.R. et al (2018) Questionnaire‐based analysis of owner‐reported scratching and pain signs in Cavalier King Charles Spaniels screened for Chiari‐like malformation and syringomyelia. Journal of Veterinary Internal Medicine, 32 (1), pp. 331-339.  https://doi.org/10.1111/jvim.14856

Cardiac disease

• Pennington, C. et al. (2022) Use of the Functional Evaluation of Cardiac Health questionnaire to assess health-related quality of life before and after mitral valve repair in dogs with myxomatous mitral valve disease. Journal of the American Veterinary Medical Association. https://doi.org/10.2460/javma.22.02.0053
• Freeman, L.M. et al (2005) Development and evaluation of a questionnaire for assessing health-related quality of life in dogs with cardiac disease. Journal of the American Veterinary Medical Association, 226 (11), pp. 1864-1868. https://doi.org/10.2460/javma.2005.226.1864
• Freeman, L.M. et al (2012) Development and evaluation of a questionnaire for assessment of health-related quality of life in cats with cardiac disease. Journal of the American Veterinary Medical Association, 240 (10), pp. 1188-1193. https://doi.org/10.2460/javma.240.10.1188

Renal disease

• Lorbach, S.K. et al. (2025) Evaluation of health-related quality of life in cats with chronic kidney disease. Journal of Feline Medicine and Surgery, 27 (9). https://doi.org/10.1177/1098612X251367535
• Bijsmans, E.S. et al (2016) Psychometric validation of a general health quality of life tool for cats used to compare healthy cats and cats with chronic kidney disease. Journal of Veterinary Internal Medicine, 30 (1), pp. 183-191. https://doi.org/10.1111/jvim.13656

Skin disease

• Dembele, V. et. al. (2025) A prospective study evaluating the impact of chronic otitis on the quality-of-life of dogs and their owners and assessment of the short-term impact of specialist intervention. Veterinary Dermatology. https://doi.org/10.1111/vde.13347
• Wells, J.R. et al. (2024) Development and validation of a questionnaire to assess owner and canine quality-of-life and treatment satisfaction in canine allergic dermatitis. Veterinary Dermatology. https://doi.org/10.1111/vde.13242
• Colombo, S. (2022) Development and validation of an owner-assessed Visual Analog Scale for feline pruritus severity scoring (VAScat). Veterinary Dermatology, 33 (5), pp. 407– 413. https://doi.org/10.1111/vde.13103
• Noli, C. (2019) Assessing quality of life for pets with dermatologic disease and their owners. Veterinary Clinics of North America: Small Animal Practice, 49 (1), pp. 83-93. https://doi.org/10.1016/j.cvsm.2018.08.008
• Linek, M. and Favrot, C. (2010) Impact of canine atopic dermatitis on the health‐related quality of life of affected dogs and quality of life of their owners. Veterinary Dermatology, 21 (5), pp. 456-462. https://doi.org/10.1111/j.1365-3164.2010.00899.x
• Favrot, C. et al (2010) Development of a questionnaire to assess the impact of atopic dermatitis on health‐related quality of life of affected dogs and their owners. Veterinary Dermatology, 21 (1), pp. 64-70. https://doi.org/10.1111/j.1365-3164.2009.00781.x
• Noli, C., Minafò, G. and Galzerano, M. (2011) Quality of life of dogs with skin diseases and their owners. Part 1: development and validation of a questionnaire. Veterinary Dermatology, 22 (4), pp. 335-343. https://doi.org/10.1111/j.1365-3164.2010.00954.x
• Noli, C. et al (2011) Quality of life of dogs with skin disease and of their owners. Part 2: administration of a questionnaire in various skin diseases and correlation to efficacy of therapy. Veterinary Dermatology, 22 (4), pp. 344-351 https://doi.org/10.1111/j.1365-3164.2011.00956.x
• Noli, C. et al (2016) Development and validation of a questionnaire to evaluate the quality of life of cats with skin disease and their owners, and its use in 185 cats with skin disease. Veterinary Dermatology, 27 (4), pp. 247-e58. https://doi.org/10.1111/vde.12341
• Suici, T. et al (2021) The effect of atopic dermatitis on quality of life of affected dogs and their owners iIn Romania. Journal of Veterinary Behavior. https://doi.org/10.1016/j.jveb.2021.07.006
• Strzok, E. et al. (2022) Validation of the 0–10 verbal numeric scale for assessment of pruritus severity in dogs. Veterinary Dermatology. https://doi.org/10.1111/vde.13062
• Kotnik, T. (2023) Quality of life of allergic dogs treated with allergen-specific immunotherapy – a  retrospective study. Veterinary Sciences, 10 (2), np. 72. https://doi.org/10.3390/vetsci10020072

Obesity

• German, A.J. (2012) Quality of life is reduced in obese dogs but improves after successful weight loss. The Veterinary Journal, 192 (3), pp. 428-434. https://doi.org/10.1016/j.tvjl.2011.09.015
• Yam, P.S. et al (2016) Impact of canine overweight and obesity on health-related quality of life. Preventive Veterinary Medicine, 127, pp. 64-69. https://doi.org/10.1016/j.prevetmed.2016.03.013

Endocrine disease

• Blunschi, F. et al. (2025) Comparison of the changes in quality-of-life of cats with hyperthyroidism treated with radioiodine or antithyroid drugs—a preliminary study. Veterinary Sciences, 12 (6), no. 572. https://doi.org/10.3390/vetsci12060572
• Bouquet, A. et. al. (2025) Development of a health-related quality-of-life assessment tool for equines with pituitary pars intermedia dysfunction. Equine Veterinary Journal. https://doi.org/10.1111/evj.14513
• Hupfeld, J. et al. (2022) Effect of long-term management of hypoadrenocorticism on the quality of life of affected dogs and their owners. Veterinary Record, e1977. https://doi.org/10.1002/vetr.1977
• Corsini, A. et al. (2022) Quality of life and response to treatment in cats with hypersomatotropism: the owners’ point of view. Journal of Feline Medicine and Surgery,  https://doi.org/10.1177/1098612X221098718
• Niessen, S.J.M. et al (2012) Evaluation of a quality‐of‐life tool for dogs with diabetes mellitus. Journal of Veterinary Internal Medicine, 26 (4), pp. 953-961. https://doi.org/10.1111/j.1939-1676.2012.00947.x
• Niessen, S.J.M. et al (2010) Evaluation of a quality‐of‐life tool for cats with diabetes mellitus. Journal of Veterinary Internal Medicine, 24 (5), pp. 1098-1105. https://doi.org/10.1111/j.1939-1676.2010.0579.x
• Schofield, I. et al (2019) Development and evaluation of a health-related quality-of-life tool for dogs with Cushing’s syndrome. Journal of Veterinary Internal Medicine, 33 (6), pp. 2595– 2604. https://doi.org/10.1111/jvim.15639

Miscellaneous

• Russell, K.J., Mondino, A., Fefer, G., Griffith, E., Saker, K., Gruen, M.E., Olby, N.J. (2024) Establishing a clinically applicable frailty phenotype screening tool for aging dogs. Frontiers in Veterinary Science. https://doi.org/10.3389/fvets.2024.1335463
• Köcher, C. et al. (2023) Evaluation of the health-related quality of life in dogs following intracranial meningioma resection using a specifically developed questionnaire. Veterinary and Comparative Oncology. https://doi.org/10.1111/vco.12956
• Pailler, S. et al. (2022) Owner-reported long-term outcomes, quality of life, and longevity after hospital discharge following surgical treatment of pyometra in bitches and queens. Journal of the American Veterinary Medical Association. 260 (S2), pp. s57-s63. https://doi.org/10.2460/javma.20.12.0714

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Evidence collections bring together collections of published papers on topics of interest and importance to the veterinary professions. Papers are chosen for relevance and accessibility, with the full text of articles either being available through the RCVS Knowledge library, on open access or from other publications to which a significant number of veterinary professionals are likely to have access. This means that there may be relevant evidence that is not included.

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