A method for estimating radioactive cesium concentrations in cattle blood using urine samples

In the region contaminated by the Fukushima nuclear accident, radioactive contamination of live cattle should be checked before slaughter. In this study, we establish a precise method for estimating radioactive cesium concentrations in cattle blood using urine samples. Blood and urine samples were collected from a total of 71 cattle on two farms in the ‘difficult‐to‐return zone’. Urine ¹³⁷Cs, specific gravity, electrical conductivity, pH , sodium, potassium, calcium, and creatinine were measured and various estimation methods for blood ¹³⁷Cs were tested. The average error rate of the estimation was 54.2% without correction. Correcting for urine creatinine, specific gravity, electrical conductivity, or potassium improved the precision of the estimation. Correcting for specific gravity using the following formula gave the most precise estimate (average error rate = 16.9%): [blood ¹³⁷Cs] = [urinary ¹³⁷Cs]/([specific gravity] ? 1)/329. Urine samples are faster to measure than blood samples because urine can be obtained in larger quantities and has a higher ¹³⁷Cs concentration than blood. These advantages of urine and the estimation precision demonstrated in our study, indicate that estimation of blood ¹³⁷Cs using urine samples is a practical means of monitoring radioactive contamination in live cattle.     

The use of a morantel sustained release bolus in the seasonal control of parasitic gastroenteritis in second-season cattle

The efficacy of a morantel sustained release bolus was evaluated during the 1980 summer grazing season in 216 yearling, second-season cattle in nine trials in West Germany. In five trials individual farms were used, in which medicated and control groups could be grazed on adjacent pastures. In four additional trials medicated and control groups were maintained on separate farms where the sites and management practice were matched as far as possible. Faecal worm egg counts, herbage larval counts and weight gain were monitored at regular intervals throughout the season. The faecal output of gastrointestinal nematode eggs was reduced by 55.8 percent in the medicated animals during the period from May to early August, while worm egg counts were equal to that of the control animals during the later part of the season. Herbage larval counts were similar on pastures grazed by medicated and nonmedicated cattle. In the five trials where individual farms were used the average daily weight gains over the entire grazing period were 900 (+/- 222) g/animal/day in the medicated group compared with 826 (+/- 263) g/animal in the nonmedicated cattle, a non-significant advantage. No advantage for the treated over the control groups was detected in the additional 4 trials but this was attributed largely to the difficulty in obtaining comparable groups of animals in comparable grazing conditions in "matching" farms, leading to inter-farm variation.     

Discrimination of “grazing milk” using milk fatty acid profile in the grassland dairy area in Hokkaido

Milk produced by the grazing system, referred to as “grazing milk” contains many components required for human health. The milk fatty acid (FA) profile is strongly associated with the diet on the farms. In the present study, based on the FA profile of farmer's bulk milk, we determined how to discriminate between milk produced on grazing and on a confinement system. A field survey was conducted four times (grazing and confinement season) in the Konsen (29 farms) and Okhotsk (25 farms) area in Hokkaido. Farmer's bulk milk samples and details of feeding management were collected and the FA profile of milk was measured. Milk produced during the grazing season contained less C16:0 and cis‐9 C16:0, and more C18:0, cis‐9 C18:1, trans‐11 C18:1, cis‐9,12 C18:2, cis‐9,trans‐11 C18:2 and cis‐9,12,15 C18:3 than milk produced during the confinement season. Discrimination analysis using 16 FA revealed that almost all milk samples were discriminated correctly (confinement season: 90% correct and 10% borderline, grazing season: 88% correct, 9% borderline and 3% incorrect). For farmers that were categorized incorrectly and were considered borderline in the grazing season, the dependency on pasture was low compared with that for farmers correctly discriminated. Therefore, to claim “grazing milk”, a high dependency on pasture is required for grazing dairy farmers.     

Abnormal Sysmex XT‐2000iV DIFF scattergram in a cat with a prominent mastocytemia

A 2‐year‐old neutered male domestic shorthair cat was presented to the emergency service of the National Veterinary School of Toulouse (France) for acute vomiting and diarrhea with lethargy, inappetence, and adypsia for the past 48 hours. Complete blood counts were performed with the ProCyte DX at the emergency department and with the Sysmex XT‐2000iV at the laboratory 2 weeks later. The scattergrams from the two analyzers revealed similar unusual and abnormal dot plots. The Sysmex XT‐2000iV DIFF scattergram also showed no clear separation between different leukocyte populations. The eosinophil cluster was in an abnormal location compared with that of the “typical” location in a normal cat. A blood smear evaluation revealed the presence of numerous mast cells. Thus, we hypothesized that the Sysmex XT‐2000iV had detected the mast cell population, and this led to errors in the differential counts. To explore this hypothesis, we manually gated on the DIFF scattergram and performed a manual differential on the blood smear. With this new gating strategy, the Sysmex XT‐2000iV and manual differentials were similar. Thus, in the case of systemic mastocytosis, mast cells can be located between the lymphocyte, monocyte, and eosinophil clusters on scattergrams.     

Seroprevalence of <Emphasis Type="Italic">Anaplasma marginale</Emphasis> and <Emphasis Type="Italic">Babesia bigemina</Emphasis> infections and associated risk factors in Machakos County,Kenya

Anaplasma marginale and Babesia bigemina are important tick-borne pathogens of cattle. A cross-sectional survey was undertaken to determine the seroprevalence of A. marginale and B. bigemina infections and identify associated risk factors on traditional smallholder farms in Machakos County, Kenya. A total of 421 cattle from 127 farms from four divisions in the county were sampled and visited between September and November 2007. The farms were selected by a proportional allocation approach based on the number of farms in the four divisions previously selected by stratified random sampling method. Information on animal and individual farm management variables was obtained using standardized questionnaires. Prevalence of serum antibodies due to A. marginale and B. bigemina pathogens was determined using the enzyme-linked immunosorbent assay (ELISA) technique. The relationship between the seropositivity and associated risk factors was assessed by multivariable analyses using standard logistic regression models. The overall estimation (and their 95% confidence intervals) of A. marginale and B. bigemina seropositivity at the animal level was 53.4% (48.5%, 58.2%) and 40.6% (35.8%, 45.4%), respectively. Two variables, “animal age” and “administrative division,” were significantly associated with the A. marginale seroresponse. Three variables, “animal age” “grazing system” and “administrative division” were significantly associated with the B. bigemina seroresponse. These findings suggest possible indicators of existence of endemic instability for the two infections. The study identifies characterization of environmental suitability for the vectors and how they interact with grazing systems to cause the infections as an area for further studies, for improved understanding of the infections and in designing disease control programs.     

Methicillin‐Resistant Staphylococcus aureus (MRSA) ST398 in Pig Farms and Multispecies Farms

During the last few years, methicillin‐resistant Staphylococcus aureus (MRSA) ST398 has been isolated frequently from livestock, especially from pigs and to a lesser extent from cattle and poultry. To gain insight into the distribution of this bacterium in pig farms versus multispecies farms, 30 Belgian farms (10 pig, 10 pig/poultry and 10 pig/cattle farms) were screened for the presence of MRSA. On each farm, 10 nasal swabs were taken from pigs. When present, cattle (n = 10) were sampled in the nares and poultry (n = 10) in the nares, earlobes and cloaca. A selection of the obtained isolates were further characterized using multilocus sequence typing (MLST), spa typing, SCCmec typing, pulsed field gel electrophoresis (PFGE), multiple‐locus variable‐number tandem repeat analysis (MLVA) and antimicrobial susceptibility testing. On 26 of 30 farms, MRSA was isolated from pigs. Furthermore, MRSA was also isolated from poultry and cattle on one pig/poultry and five pig/cattle farms, respectively. All tested MRSA isolates belonged to ST398. Eight spa types (t011, t034, t567, t571, t1451, t2974, t3423 and t5943) were detected, among which t011 predominated. SCCmec cassettes type IVa and V were present in 20% and 72% of the isolates, respectively. When combining the results of the two remaining typing methods, PFGE and MLVA, eighteen genotypes were obtained of which one genotype predominated (56% of the positive farms). All MRSA isolates were resistant to tetracycline. Resistance to trimethoprim, aminoglycosides, macrolides, lincosamides, fluoroquinolones and chloramphenicol was also observed. In conclusion, there was no effect of the farm type on the MRSA status of the pigs. A statistically significant difference was observed when comparing the pig/poultry or the pig/cattle MRSA status on the multispecies farms. Additionally, a wide variety of MRSA ST398 strains was found within certain farms when combining different typing methods.     

Pathological characteristics of thyroid glands from Japanese Black Cattle living in the restricted area of the Fukushima Daiichi Nuclear Power Plant accident

To study the effect of ionizing radiation on thyroid glands, 66 Japanese Black cattle residing in the restricted area of the Fukushima Daiichi Nuclear Power Plant in 2013–2017 were pathologically examined. There were no clinical symptoms of thyroid disease in these cattle. Three cases of goiter and seven of atrophy were found in two among the four farms examined. Cases of goiter exhibited normal morphological structure without mass or nodule formation in thyroid glands. Cellular atypia or capsular invasion of the follicular epithelium was absent. The estimated integrated dose of external radiation in goiter cases ranged from maximum 797 mSv to minimum 24 mSv. All lobules in the seven atrophic thyroid glands were affected, but pathological findings, such as inflammatory cell infiltration or stromal fibrosis, were not observed. The estimated integrated dose of external radiation in atrophic thyroids ranged from maximum 589 mSv to minimum 8 mSv. Immunohistochemical analysis of anti‐nitroguanosine and the TUNEL method in goiter and atrophic thyroid glands did not reveal any positive findings. The present study indicates that there was no significant relationship between a radiation effect and pathological findings in any thyroid glands.     

Pathological findings of Japanese Black Cattle living in the restricted area of the Fukushima Daiichi Nuclear Power Plant accident, 2013–2016

Fifty‐one Japanese black cattle from four farms in the evacuation zone of the Fukushima nuclear accident were examined pathologically during the period, 2013–2016. We found no evidence of a radiation effect on pathological findings in any of these autopsy cases, although nine cases (3.7%) of enzootic bovine leukosis (EBL) and three cases (1.2%) of goiter were diagnosed. Estimated integrating dose of external exposure in EBL cases ranged from a maximum of 1200 mSv to a minimum of 72 mSv. Clinically, five cases showed wobble, dysstasia or paralysis. Exophthalmos was observed in three cases. Macroscopically, enlarged lymph nodes, multiple irregular masses of intra‐abdominal and intrapelvic adipose tissue, diffuse thickening of the abomasal submucosa with ulceration, and numerous white nodules of myocardium were observed. Histologically, neoplastic lymphoid cells were extensively proliferated and infiltrated in the lesions. Lymphoid tumor cells showed mature or large lymphoblastic appearance. Immunohistochemically, tumor cells were positive for BLA‐36, CD20 and CD5, and negative for CD3. Three cases showed diffuse enlargement of the thyroid gland with no mass or nodule lesion. Histologically, diffuse proliferation of follicular epithelium was observed with preservation of normal structures. There were no malignant findings such as cellular atypia or invasion to capsule.     

Hemogram changes in lactating dairy cows given human recombinant granulocyte colony stimulating factor (r-MethuG-CSF).

As a prelude to mammary gland challenge experiments, this investigation was implemented to assess the hematologic changes in lactating dairy cattle induced by two dosage regimes of human recombinant colony stimulating factor (Hr-GCSF). This study documents the capability of the human recombinant colony stimulating factor to produce hematologic changes in both a time and dose dependent manner when administered to the adult lactating bovine. A screening dose of 1 microgram/kg of Hr-GCSF administered to three study subjects produced a three- to four-fold increase in peripheral blood mature neutrophil counts (P less than 0.043) by day 12 of the trial. The priming dose treatment group of four lactating cows (3 micrograms/kg of Hr-GCSF) exhibited a three- to five-fold increase in peripheral blood mature neutrophil counts (P less than 0.05) and two- to three-fold increases in white blood cell counts by day 5 of the trial. Hematologic examinations of the control group (n = 4; no Hr-GCSF administration) did not detect significant changes in their neutrophil counts over baseline values. The milk somatic cell counts did not statistically shift over baseline values in any of the control or Hr-GCSF treatment groups. When attempting to alter the course of infectious disease processes, potential applications of colony stimulating factors provide interesting speculations about new therapeutic modalities.     

Decreased expression of L‐selectin (CD62L) on lymphocytes in enzootic bovine leukaemia

Expression of L‐selectin was determined by single‐ and two‐colour immunofluorescence on granulocytes, peripheral blood mononuclear cells (PBMC) and blasts of bovine origin by means of a monoclonal antibody IVA94 which recognizes bovine L‐selectin (CD62L). Cells were separated from peripheral blood of healthy cattle and colleagues infected with bovine leukaemia virus (BLV). BLV‐infected animals comprised lymphocytotic and non‐lymphocytotic cows. L‐selectin was expressed on 90–98 % of granulocytes in all tested animals. The percentage of PBMC expressing L‐selectin was lower in cattle with persistent lymphocytosis than in non‐lymphocytotic or BLV‐free cattle, and inversely correlated with lymphocyte counts. The ratio of B lymphocytes stained for L‐selectin was significantly decreased from 60.2 ± 1.9 % in BLV‐free cattle to 43.8 ± 3.6 and 22.5 ± 5.7 % in non‐lymphocytotic and lymphocytotic cattle, respectively. B‐lymphocytes stained for L‐selectin exhibited about 50 % reduction in L‐selectin expression in BLV‐infected cattle compared with BLV‐free cattle, as judged by the mean fluorescence intensity (MFI). The percentage of L‐selectin‐positive PBMC not bearing surface immunoglobulin M (predominantly T lymphocytes) was comparable in BLV‐free and BLV‐infected cattle. However, L‐selectin expression on T lymphocytes was reduced (about 50 %) in BLV‐infected cattle, as judged by the MFI. We suppose that BLV infection results in a decreased L‐selectin expression on lymphocytes, and accordingly, it may contribute to deregulation of the host immune system.     

Effect of strategic deworming of village cattle in Uganda with moxidectin pour-on on faecal egg count and pasture larval counts

Strategic application of moxidectin pour-on (Cydectin) was evaluated in Uganda for its effect on pasture larval counts and gastrointestinal nematode faecal egg counts in village cattle kept under tethering (semi-intensive) grazing management. The strategic deworming schedule involved treating cattle twice at an interval of 2 months, at the end of the 1st wet season and during the 2nd wet season. Two groups of 30 cattle, each consisting of a treated and a control group, were examined for nematode infections every 4 weeks from June 1999 to January 2000. The treated group had significantly lower mean faecal egg counts than the untreated groups (t-value = 2.47, P < 0.05). Generally, the pasture larval counts on treated farms were lower than on untreated ones, but not significantly so (t-value = 2.22, P = 0.068). Pasture larval counts with different nematode species on treated farms were lower than on untreated ones, but the differences were not significant for Haemonchus spp. (t-value = 1.68, P = 0.145), Oesophagostomum spp. (t-value = 1.87, P = 0.111), Trichostrongylus spp. (t-value = 1.93, P = 0.102), Dictyocaulus spp. (t-value = -0.74, P = 0.485) and Cooperia spp. (t-value = -1.00, P = 0.356). Treated farms did, however, have significantly lower pasture larval counts of Bunostomum spp. (t-value = 4.64, P < 0.05). This study has revealed that the application of moxidectin pour-on on cattle has an effect on faecal egg count and pasture contamination under the tethering grazing system. Moxidectin pour-on and the strategic deworming schedule evaluated here could be used for the control of gastrointestinal nematode infections in cattle by small-scale farmers who practise tethering or semi-intensive grazing management in Uganda and other tropical countries, especially where there is a bimodal rainfall pattern.     

Effectiveness of strategic anthelmintic treatments in the control of gastrointestinal nematodes and <Emphasis Type="Italic">Fasciola gigantica</Emphasis> in cattle in Iringa region,Tanzania

A longitudinal field trial was conducted to determine the effectiveness of strategic anthelmintic treatments in the control of gastrointestinal (GI) nematodes and Fasciola gigantica in cattle. A total of 167 cattle (6–18 months) from three large-scale dairy farms, four traditional farms and nine small-scale dairy farms were randomly selected. The selected animals on each farm were ear tagged and allocated into three groups based on live weight and treated as follows: Group T4 was treated with albendazole 10% drench at 10 mg/kg four times a year (mid rainy, end of the rain, mid dry and late dry/early rainy season). Group T2 was treated with albendazole 10% drench at 10 mg/kg two times a year (mid rainy and late dry/early rainy season). Group UT remained as untreated control. Faecal, blood and pasture samples were taken every month for 13 months. In addition, individual body weight (BWT) was measured on every sampling date. Results showed that two and four strategic treatments significantly reduced faecal egg counts (FEC) by 49.5% and 62.3% respectively compared to untreated control animals (P < 0.001). Two and four strategic treatments per year significantly reduced the proportion of animals passing Fasciola eggs in faeces by 30.6% and 51.7% (P < 0.001), respectively. Animals treated two and four times a year significantly outgained untreated animals by 14.8 kg and 17.7 kg respectively at the end of the trial (P < 0.05). The management system had a significant effect on packed cell volume and the proportion of animals passing Fasciola eggs in faeces (P < 0.05). The programme of two strategic treatments per year was only effective in controlling GI nematodes. It is concluded that a programme of four strategic treatments per year was effective in controlling GI nematodes and F. gigantica and improved weight gain.     

Differences in genetic structure assessed using Y‐chromosome and mitochondrial DNA markers do not shape the contributions to diversity in African sires

Up to 173 African sires belonging to 11 different subpopulations representative of four cattle groups were analysed for six Y‐specific microsatellite loci and a mitochondrial DNA fragment. Differences in Y‐chromosome and mtDNA haplotype structuring were assessed. In addition, the effect of such structuring on contributions to total genetic diversity was assessed. Thirty‐five Y‐chromosome and 71 mtDNA haplotypes were identified. Most Y‐chromosomes analysed (73.4%) were of zebu origin (11 haplotypes). Twenty‐two Y‐haplotypes (44 samples) belonged to the African taurine subfamily Y2a. All mtDNA haplotypes belonged to the “African” taurine T1 haplogroup with 16 samples and nine haplotypes belonging to a recently identified subhaplogroup (T1e). Median‐joining networks showed that Y‐chromosome phylogenies were highly reticulated with clear separation between zebu and taurine clusters. Mitochondrial haplotypes showed a clear star‐like shape with small number of mutations separating haplotypes. Mitochondrial‐based F_ST‐statistics computed between cattle groups tended to be statistically non‐significant (p > .05). Most F_ST values computed among groups and subpopulations using Y‐chromosome markers were statistically significant. AMOVA confirmed that divergence between cattle groups was only significant for Y‐chromosome markers (Φ_CT = 0.209). At the mitochondrial level, African sires resembled an undifferentiated population with individuals explaining 94.3% of the total variance. Whatever the markers considered, the highest contributions to total Nei's gene diversity and allelic richness were found in West African cattle. Genetic structuring had no effect on patterns of contributions to diversity.     

A PROPOSED RADIOGRAPHIC CLASSIFICATION SCHEME FOR CONGENITAL THORACIC VERTEBRAL MALFORMATIONS IN BRACHYCEPHALIC “SCREW‐TAILED” DOG BREEDS

Congenital vertebral malformations are common in brachycephalic “screw‐tailed” dog breeds such as French bulldogs, English bulldogs, Boston terriers, and pugs. The aim of this retrospective study was to determine whether a radiographic classification scheme developed for use in humans would be feasible for use in these dog breeds. Inclusion criteria were hospital admission between September 2009 and April 2013, neurologic examination findings available, diagnostic quality lateral and ventro‐dorsal digital radiographs of the thoracic vertebral column, and at least one congenital vertebral malformation. Radiographs were retrieved and interpreted by two observers who were unaware of neurologic status. Vertebral malformations were classified based on a classification scheme modified from a previous human study and a consensus of both observers. Twenty‐eight dogs met inclusion criteria (12 with neurologic deficits, 16 with no neurologic deficits). Congenital vertebral malformations affected 85/362 (23.5%) of thoracic vertebrae. Vertebral body formation defects were the most common (butterfly vertebrae 6.6%, ventral wedge‐shaped vertebrae 5.5%, dorsal hemivertebrae 0.8%, and dorso‐lateral hemivertebrae 0.5%). No lateral hemivertebrae or lateral wedge‐shaped vertebrae were identified. The T7 vertebra was the most commonly affected (11/28 dogs), followed by T8 (8/28 dogs) and T12 (8/28 dogs). The number and type of vertebral malformations differed between groups (P = 0.01). Based on MRI, dorsal, and dorso‐lateral hemivertebrae were the cause of spinal cord compression in 5/12 (41.6%) of dogs with neurologic deficits. Findings indicated that a modified human radiographic classification system of vertebral malformations is feasible for use in future studies of brachycephalic “screw‐tailed” dogs.     

Effect of terbufos poisoning on the blood cholinesterase and hematological values in a dairy herd

This report describes the effects of a sublethal dose of terbufos (counter 15G formulation) in a dairy herd. Ingestion of terbufos depressed whole blood cholinesterase activity. No recovery of this enzyme was evident until 30 days after ingestion after which a constant rate (0.65%/day) increase was observed.

There was a good correlation between blood cholinesterase levels and clinical signs. Normal cholinesterase levels were reached at approximately 150 days after exposure. Cholinesterase levels in animals, ill prior to exposure, were slow to recover, while levels of healthy cattle surpassed those of control animals. Anemia was observed in some cows at approximately 30 days after exposure. The degree of anemia paralleled the severity of poisoning. The increase in packed cell volume paralleled the return of blood cholinesterase activity.

     

Epidemiological observations of Zimbabwean theileriosis: disease incidence and pathogenicity in susceptible cattle during Rhipicephalus appendiculatus nymphal and adult seasonal activity.

Fifty-nine Hereford cattle susceptible to tick-borne diseases were used as tracer animals to assess the tick challenge and pathogenicity of Theileria parva under field conditions in Zimbabwe. They were moved periodically in groups of five to three commercial farms (one group consisted of four) during seasons of Rhipicephalus appendiculatus nymphal and adult activity. All tracer cattle were herded together with the farm cattle but were not dipped. The nymphal tick counts were high on two of the farms (up to 2000 per animal) but were very low on the third farm (less than ten per animal). On the three farms, 19 out of 24 (76%) tracers had patent Theileria schizonts. There was a range of clinical manifestations of theileriosis with acute and fatal infections occurring on one farm. The adult R. appendiculatus infestations during the wet season numbered 120-800 per animal on the three farms. The disease transmitted by the adults was very pathogenic on the three farms; 30 out of 35 (86%) had severe theileriosis infections. Cattle, which survived the nymphal diseases challenge, showed various degrees of immunity to subsequent T. parva challenge transmitted by adult ticks. Therefore, 13 out of 18 (72%) of these cattle had a second disease episode and the case fatality rate on the three farms was 46%. The factors which determined the epidemiological status of Theileria challenge on the farms, such as the farming systems and presence of wild animals, are discussed.     

Evaluation of a Quality‐of‐Life Tool for Cats with Diabetes Mellitus

Background: Success in management of diabetes mellitus (DM) is defined as improvement of blood glucose concentrations and clinical signs. However, the psychological and social impact of DM and its daily treatment regimen on quality of life (QoL) of both animal and owner is uncertain. Hypothesis/Objectives: To design, validate, and apply a diabetic pet and owner‐centered, individualized measure of impact of DM (DIAQoL‐pet). Animals/Subjects: Two hundred and twenty‐one owners of insulin‐treated diabetic cats were recruited to complete the DIAQoL‐pet. Methods: Discussions and pilot surveys with clinicians and owners of diabetic cats led to the design of 29 specific DM‐associated QoL questions. Owners of diabetic cats completed the finalized survey. Each item was scored according to impact frequency and perceived importance. An item‐weighted impact score (IWIS) for each item was calculated, as was an average‐weighted impact score (AWIS) by averaging all IWISs. Principal component analysis and Cronbach's α calculation assessed the measure's reliability. Two overview questions measured overall QoL and diabetes‐dependent QoL. Results: The DIAQoL‐pet showed high reliability (Cronbach α 0.83). The AWIS was ?1.76 ± 2.4 (mean ± SD). Areas reported as most negatively impacting QoL included: “boarding difficulties” (IWIS ± SD: ?4.67 ± 5.3), “owner wanting more control” (?4.34 ± 4.7), “difficulties leaving cat with friends or family” (?4.21 ± 4.7), “worry” (?4.10 ± 3.9), “worry hypo” (?3.67 ± 3.5), “social life” (?3.48 ± 3.9), “costs” (?3.04 ± 3.8), and “work life” (?3.03 ± 3.7). Forty‐one percent of owners believed their cat's life would be “a little better” without DM. Conclusions and Clinical Importance: The DIAQoL‐pet proved robust and identified specific areas most negatively impacting on diabetic cats and their owners' QoL. This tool warrants further investigation for use in clinical or research settings.