Journal of Veterinary Behavior 46 (2021) 24–30

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Journal of Veterinary Behavior

journal homepage: www.journalvetbehavior.com

The effect of atopic dermatitis on quality of life of affected dogs

and their owners in Romania
Tiana Suici∗, Gheorghe DărăbuȘ, Narcisa Mederle, Cătălin Sîrbu, Mirela Imre,
Sorin Morariu
Faculty of Veterinary Medicine, Timișoara, Romania

a r t i c l e i n f o a b s t r a c t

Article history: In the last few years, atopic dermatitis (AD) has become widespread both in humans and dogs in Roma-
Received 10 April 2020 nia. This skin disease impairs the quality of life (QoL) of affected patients. AD is usually evaluated using
Revised 24 June 2021
clinical approach and pruritus score. Several studies have been done recently to establish disease-specific
Accepted 9 July 2021
questionnaires in order to assess both the QoL and health-related quality of life (HRQoL) in affected in-
Available online 24 July 2021
dividuals (children with AD and their parents, owners of atopic dogs and their pets). In this respect,
Keywords: 100 questionnaires aiming to evaluate QoL and HRQoL both in owners and their dogs, affected by atopic
atopic dermatitis dermatitis, were drafted and handed out to patients in Timișoara, Romania. A total of 54 (54%) valid
dogs questionnaires were received from owners. Answers were statistically analyzed to reveal the relationship
quality of life between the owner and his/her pet. In this study, this relationship was not influenced by the age of the
Romania, owners owner, and the higher the severity of the disease, the more severely the QoL is affected in both humans
and dogs. Euthanasia is not an option for pet owners from Timișoara, and the costs of establishing and
applying the treatment appear to be non-restrictive, thus disclosing a very close pet-owner relationship.
This is the first study of this kind conducted in Romania.
© 2021 The Author(s). Published by Elsevier Inc.
This is an open access article under the CC BY-NC-ND license
(http://creativecommons.org/licenses/by-nc-nd/4.0/)

Introduction an improvement of the owner-veterinarian interaction (Bottomley,

“Quality of life” (QoL) measures provide a tool used for the as-
sessment of general welfare, a concept that implies a subjective
evaluation of factors that contribute to overall well-being (Kiddie &
Collins, 2014; Velikova, 1999) or, practically, “the degree to which
an individual enjoys his or her life” (Noli, 2011). In healthcare
terms, QoL indicates the possible negative effects exerted by dis-
ease on the life of an individual. Health-related quality of life
(HRQoL) specifically refers to the influence of a medical condition
on the individual’s health status (Cella, 1992; Leidy et al., 1999),
thus helping medical staff to attain precious information related
to treatment-decision, prognostic information and also leading to
∗
Address for reprint requests and correspondence: TIANA SUICI, Faculty of Vet-
erinary Medicine, Calea Aradului 119, Timișoara 300645, Romania. Tel: 40 256
277190; Fax: 00 - 40 - (0)256 - 200296.
E-mail address: sujic.tijana@yahoo.com (T. Suici).
2005; McMillan, 2000; Milevoj, 2020; Rollin et al. 2006).
Atopic dermatitis (AD) is a chronic, pruritic and inflammatory
disease of the skin affecting both humans and animals (especially
dogs) (Olivry et al., 2001; Halliwell, 2006; Stepnik et al., 2012;
Brinkmann et al., 2013). The clinical implications of the disease in
humans, especially children, have led to the development of ques-
tionnaires that aimed to assess the quality of life (QoL) of affected
human individuals (Chamlin, 20 04; Chamlin, 20 06; Meads et al.,
2005) and, in the case of children affected by AD, also the QoL of
their parents (McKenna, 2008). Several surveys have been carried
out among children with AD and their parents (Lewis-Jones et al.,
20 01; Lewis-Jones, 20 05; McKenna &Doward, 20 08; Oranje et al.,
1997; Ricci et al., 2012; Stalder & Taieb, 1993) to assess the ex-
tent to which their lives and welfare are affected by the disease.
In what regards veterinary medicine, QoL is a very “fresh” con-
cept, barely introduced within the last decade, which comes along
with confusion among veterinarians between terms such as QoL
and welfare, for example. In order to shed light upon such unclar-

https://doi.org/10.1016/j.jveb.2021.07.006
1558-7878/© 2021 The Author(s). Published by Elsevier Inc. This is an open access article under the CC BY-NC-ND license
(http://creativecommons.org/licenses/by-nc-nd/4.0/)
T. Suici, G. DărăbuȘ, N. Mederle et al.
ity, Taylor and Mills (2007) have redefined QoL and HRQol. Thus,
the first term (QoL) now refers to the perceived status of the an-
imal’s life at some point in time, while the second one (HRQoL)
corresponds to the subjective perception of the health status im-
pact on the physical, psychological and social functioning. When it
comes to animals, only the owner can assess these two terms, but
the relationship between the owner and his pet could influence the
assessment. Several studies have assessed the QoL of dogs suffer-
ing from various conditions such as cancer (Giuffrida & Kerrigan,
2014), cardiac disease (Freeman, 2005), spinal cord injury (Budke,
2008), chronic pain (Belshaw & Yeates, 2018; Wiseman-Orr et al.,
2004), diabetes mellitus (Niessen et al., 2012), epilepsy (Packer
&Volk, 2015) and skin diseases (Favrot, 2010; Noli, 2011a,2011b).
However, despite the visible impairment of QoL induced by pruri-
tus and pain which are commonly observed symptoms in canine
AD patients, only very few studies have focused on developing
a questionnaire that would help with the evaluation of QoL and
HRQoL in atopic patients (Finlay, 1997; Favrot, 2010; Noli, 2010).
Numerous studies (Anderson et al., 1992; Wood et al., 2015)
have examined the dog-owner relationship but very few have ex-
amined the overall wellbeing of the owner in relation to their sta-
tus as a dog owner (Oyama et al., 2017). Up to this point, most of
the studies focus on the positive effects of dog owner ship on QOL
(such as lowering the levels of stress hormones (Cole et al., 2007),
increasing levels of endorphins and oxytocin (Beetz et al., 2012),
beneficial effects on blood pressure (Anderson et al., 1992) or lev-
els of physical activity (Thorpe et al., 2006), with very few studies
that approach the negative effects (such as added responsibility or
financial costs) on QOL of dog owner-ship (Oyama et al., 2017).
The aim of this study was to measure QoL and HRQoL of pet
owners and their atopic dogs, assess the perception differences
that might occur among owners according to their age or sex, to
evaluate how the owners react to the idea of having a pet af-
fected by a life-long disease (whether they consider euthanasia or
whether the financial implications of therapy impact the owner’s
relationship with their pet), using questionnaires proposed by the
International Task Force on Canine Atopic Dermatitis (Hill et al.,
2007; Olivry et al., 2007; Favrot et al., 2010).
This is the first study of this kind conducted in Romania.
Materials and Methods
Questionnaires
A total of 100 questionnaires (Annex 1) (Favrot et al., 2010)
were prepared and distributed to the Dermatology Clinic at the
Faculty of Veterinary Medicine Timișoara (FVMT), Romania, and to
three private clinics from Timișoara. The trial was conducted dur-
ing a three-year period, starting September 2014 and until May
2017.
The questionnaires used in our the study were based on
the questionnaires developed by Favrot et al. (2010), with slight
amendments in terms of question order (the overall assessment
questions (OVA 1 and 2) are found at the middle of the question-
naire in our study and not at the beginning) and OVA3, as well as
all questions found in section 3 (regarding therapy) from the origi-
nal questionnaire, were left out from our study because we did not
focus on therapy. However, the contents of the included questions
are identical to those developed by Favrot et al. (2010). The ques-
tionnaire is composed of 10 initial questions, followed by two sec-
tions. The aim of the first 10 questions was to collect demograph-
ical data (age and sex) and to evaluate the relationship between
owners and their pets, using an owner-pet relation score (OPRS)
deduced from the answers to questions 1-8. The scores varied be-
tween -8 and +8, with -8 indicating a distant relationship between
25
Journal of Veterinary Behavior 46 (2021) 24–30
owner and pet and +8 indicating a close relationship. The follow-
ing 32 questions were divided into two categories (section I and II).
The first 16 questions (1-16), corresponding to section I, and OVA1,
were used to deduce the impact of the disease on the owner’s
quality of life (QoL) while the following 14 questions, correspond-
ing to section II, along with OVA2, targeted the health-related qual-
ity of life (HQoL) of pets affected by AD. Answers scoring >3.45 or
<0.55, and/or a standard deviation of <0.75 were considered irrel-
evant for this study, according to instructions by Favrot et al.2010.
Several questions (1, 2, 3, 6, and 10) aimed to evaluate the impact
of AD on the overall benefit of the owner, while others (17-30)
were connected to the pets’ activities and their welfare. Owners
were asked to answer all the questions, each answer being scored
from 0 (strongly disagree) to 4 (strongly agree).
Pruritus was also evaluated during the first visit to the practice,
using the basic severity scale (Hill et al., 2007), as part of routine
diagnostic.
Patients
The patient database included 54 dogs with atopic dermatitis
(Table 1) of different ages, breeds and sexes. From a total of 54
dogs, 19 (35%) were females and 35 (65%) were males; ages ranged
from 0.8 years to 7 years and breeds were distributed as follows:
French bulldogs- 14%, mixed breed- 14%, German shepherds- 11.5%,
golden retrievers- 9.25%, Maltese- 9.25%, Labrador retriever- 7.4%,
chow-chows- 5.5%, Pekinese- 3.7%, pug- 3.7%, Shi tzu- 3.7%, West
Highland white terrier- 3.7%, bullterrier- 1.85%, English bulldogs -
1.85%, husky- 1.85%, Rottweilers- 1.85%, schnauzer- 1.85%, shar-pei-
1,85%.
Statistical evaluation
The evaluation and comparison of the answers to all the ques-
tions was performed using the Mann-Whitney and Spearman (cor-
relation coefficient r, alpha level = 0.05) tests.
Mann-Whitney’s non-parametric test represents a statistical hy-
pothesis used to assess whether two independent samples have
similar values. In our study, one of the samples consists of the av-
erage score of each question from the first part of the question-
naire (OPRS) and the second and the third ones consist of the av-
erage scores of the questions from the first and second sections.
The other two sets correspond to the scores of the two global as-
sessment questions at the beginning of the second part (OVA1 and
OVA2).
Spearman’s rank correlation test is also a nonparametric test
that measures the statistical dependence between two variables.
The correlation coefficient ranges from -1 and +1. The negative
values close to -1 indicate an inverse correlation. Very small val-
ues of r, close to 0, suggest no significant association. To determine
whether the age and sex of the owners influenced the overall as-
sessment of the burden caused by the animal’s disease, these 2
parameters were compared for OVA1 and OVA2 using the Mann-
Whitney test. In addition, the correlation between the 2 OVA with
OPRS and pruritus score was done using Spearman’s rank cor-
relation test. Each question from Section I and II was compared
individually with the corresponding overall assessment questions
(OVA1 and OVA2) using Spearman’s rank correlation test. Spear-
man’s rank correlation between the score of each question and the
average score of OPRS questions aimed to determine which of the
questions were OPRS dependent.
T. Suici, G. DărăbuȘ, N. Mederle et al. Journal of Veterinary Behavior 46 (2021) 24–30

Table 1 ˃60 y, OVA1 P = 0.912, OVA2 P = 0.683; 30-60 y and ˃60 y, OVA1
Patients admitted into study
P = 0.749, OVA2 P = 0.762). Table 2 and 3 show the influence of
No. Breed Age Sex age, sex and OPRS on OVA1 and OVA 2.
1. mixed breed 5y F The correlation between OPRS and OVA1 was significant (r = -
2. German shepherd 7y M 0.41) while the correlation between OPRS and OVA2 was not sig-
3. chow-chow 1y F nificant (r = -0.16) according to the Mann-Whitney test (where
4. Rottweiler 3y M r = rank-biserial).
5. golden retriever 1y M
Furthermore, the owner QoL was investigated and compared to
6. chow-chow 0.9 y M
7. Maltese 2y M OVA1, OVA2 and the OPRS (Table 4).
8. German shepherd 1y F
9. Labrador retriever 3y F Discussion
10. shar-pei 0.8 y F
11. mixed breed 2y F
12. Labrador retriever 6y F This questionnaire measures the impact of AD on quality of life
13. mixed breed 3y F of both animals and owners. Due to the fact that not only the
14. West Highland white terrier 7y M owner, but also the relationship between him and/or her and his
15. golden retriever 1 yr M and/or her pet may affect the perception of quality of life, the first
16. French bulldog 3y M
17. Labrador retriever 2y F
part of the questionnaire assessed data concerning the owner and
18. French bulldog 4y M his relationship with the pet. The results were then compared with
19. German shepherd 0.9 y F OVA1 and OVA2 revealing that, regardless of the owner’s gender or
20. French bulldog 5y M age, there was no influence on the quality of life perception.
21. English bulldog 0.6 y M
Although owner sex or age did not influence QoL
22. Shi tzu 2y M
23. Maltese 3y M scores, women of a younger age seemed to be significantly
24. schnauzer 1y M associated with more willingness to pay for the treatment as
25. Labrador retriever 6y M previously reported (Kunz et al., 1997).
26. mixed breed 1y M No significant differences were noticed between the extreme
27. Shi tzu 5y F
28. golden retriever 4y M
age groups of owners.
29. bullterrier 3y F Differences were noticed when comparing our results to those
30. German shepherd 1y F reported by Favrot et al. (2010). They obtained a significant differ-
31. Maltese 6y M ence between the answers provided by the owners aged under 30
32. French bulldog 0.8 y F
years and those over 60 years, whilst we did not have the same
33. mixed breed 4y M
34. West Highland white terrier 5y M results. Probably, the difference is due to the small number (4/54)
35. French bulldog 1y F of individuals included in the >60 years group in our study.
36. German shepherd 1.5 y M It was also found that there are different correlations of re-
37. Maltese 5y M sponses, both in OVA1 and OPRS. Perhaps these differences be-
38. mixed breed 3y F
39. French bulldog 5y M
tween our study and that conducted by Favrot et al. arose from the
40. Pekinese 3y F various pet-owner relationship perceptions seen throughout Euro-
41. Maltese 2y M pean countries.
42. chow-chow 2y M OVA1 was correlated with the relationship between the owner
43. French bulldog 3y M
and the pet, as it was assessed by the OPRS. Therefore, the closer
44. golden retriever 3y M
45. schnauzer 4y M the relationship between the two was, the more important the im-
46. pug 2y F pact of AD on the quality of life was as well and this aspect must
47. mixed breed 5y M be considered when assessing OVA1.
48. Pekinese 5y M In our study, OVA1 was better correlated than OVA2 with OPRS,
49. pug 5y M
50. golden retriever 4y M
compared to results described by Favrot et al. (2010), who re-
51. French bulldog 2y M ported a good correlation for both categories, but with an inter-
52. German shepherd 1y M esting anomaly in questions strongly correlated with OVA2 but not
53. husky 1y F correlated to OPRS.
54. mixed breed 6y M
Although four of the questions (2, 6, 10, and 15) seemed irrel-
evant because the majority of answers were similar and failed to
correlate with OVA1, most questions were correlated and discrim-
Results inatory. Four questions were also correlated with OPRS, meaning
they were influenced by the response, and, therefore, these ques-
Only 54 owners (54%) of dogs with clinical signs of AD com- tions can be used in future studies that target the assessment of
pleted the questionnaires. pet-owner relationships and how this relationship may influence
Out of the 54 processed questionnaires, 5 came from the Ve- the perception of the owner on the animal’s QoL .
timed Servcom SRL Clinic, 5 from Sal-Vet Clinic and the other 44 Scores obtained from questions 17-23 (most of them related to
from the FVMT Dermatology Clinic. the daily activities of the pet) were significantly higher than the
Twenty-nine women and twenty-five men filled in the 54 ques- ones reported by studies from Germany and Switzerland (Favrot et
tionnaires. There was no influence of sex on the answers given to al., 2010).
OVA1 and OVA2 questions (P= 0.72 and P= 0.145, respectively) According to OVA2, the majority of answers showed that the
Data were split into three sets according to the owner’s age disease frequently disrupts the pet’s daily activities significantly
(˂30 y, n = 15; 30-60 y, n = 35; ˃60 y, n = 4). They correspond to impairing the HRQoL of the dogs. This means that the main ac-
different periods of activity, therefore, their relationship with the tivities of the dog, even sleeping, are seriously affected by AD.
pet could have been different. Statistical analysis of these three The 29th question, concerning the daily routine of the pet, did
sets did not reveal major differences between answers (˂ 30 y and not correlate with OVA2 suggesting that the owner does not have

26
T. Suici, G. DărăbuȘ, N. Mederle et al. Journal of Veterinary Behavior 46 (2021) 24–30

Table 2
The influence of age, sex and pet-owner relationship on OVA1∗

n Mean Standard deviation Median CI 95%

Total no. of cases 54 1.55 1.42 1.56 0.86-2.25

Owner: Female 29 1.53 1.51 1.56 0.79-2.28
Owner: Male 25 1.59 1.31 1.56 0.95-2.23
Age: < 30 years 15 1.57 1.52 1.56 0.82-2.31
Age: 30 -60 years 35 2.02 1.28 1.71 1.52-2.56
Age > 60 years 4 1.96 1.52 1.89 1.16-2.76
∗
Overall assessment question 1, regarding QoL, CI= confidence interval

Table 3 ers with dogs suffering from various dermatological conditions, it

The influence of age, sex and pet-owner relationship on OVA 2∗
was observed that owner-perceived severity of disease correlated
n Mean SD Median IC 95% significantly with QoL1 and QoL2 (P = 0.002 and P = 0.015, re-
Total no. of cases 54 1.9 1.15 1.92 1.30-2.50 spectively). They also showed that the correlation between QoL
Owner: Female 29 2 1.28 2 1.32-2.67 and pruritus scores was high (>0.36), while that with CADESI-03
Owner: Male 25 2.03 1.26 2.03 1.37-2.69 (Germain et al., 2005; Olivry et al., 2008) was lower (<0.26).
Age: < 30 years 15 2.02 1.28 1.71 1.35-2.7 Out of all the questions, only two were correlated with OVA2.
Age: 30 -60 years 35 2.04 1.18 2.07 1.52-2.57
The other questions, referring to the pet’s activities, were not cor-
Age > 60 years 4 1.96 1.52 1.89 1.16-2.76
related with pruritus. However, the question referring to aggrava-
∗
overall assessment question 2, regarding HRQoL tions in the animal’s behavior (question 24) was correlated with
pruritus induced by AD. This fact shows that the owners are not
Table 4 very observant of the pet’s activities, but they noticed some be-
Correlation between OVA 1∗ and OVA 2∗ and OPRS∗ havior modifications caused by the skin disease.
OPRS OVA 1 OVA 2 Examining the answer to question 27, concerning punishments
MEAN 0.271 1.85 2.035
for the scratching habit of dogs, owners from Timisoara do not
SD 0.236 1.23 1.26 seem to punish their pets as frequently (average = 2.35) as owners
CORRELATION OVA1 -0.16 from Germany and Switzerland (average = 3.02).
CORRELATION OVA 2 -0.41 According to assessments of the overall quality of life, in the
∗
OVA 1-overall assessment question 1, ∗ OVA 2- overall assessment question 2, case of owners with dogs affected by AD, the quality of life seems
∗
OPRS-owner-pet relationship score to be affected by disease severity.
The mean value of answers to OVA 1 was 1.55 compared to
2.14 obtained in studies carried out in Germany and Switzerland,
to modify his/her daily activities due to the dog’s illness. Thus, if confirming a significant impact on the owners (Favrot et al., 2010).
the AD evolution is serious, the emotional impact on the owner Worthy of appreciation is the fact that, although the owners’ qual-
is higher. These data differ from those recorded by Favrot et al. ity of life is affected by their companions’ disease, very few (only
(2010). They are also different from those of Wojciechowska et al. 4) owners would consider euthanasia (mean of question 10 = 0.3)
(2005), who reported consistent answers in 27 questions out of 38. resulting in no significant differences compared to results reported
Except for questions 20 (r = 0.17), 21 (r = -0.13), 29 (r = -0.07) by Favrot et al. (2010) (mean of question 10 = 0.24).
and 30 (r =-0.06), all answers correlate with OVA2 and, therefore,
are considered relevant. Conclusions
In a 26-question qualitative interview (part 1) with owners of
dogs affected by severe skin diseases, Noli et al. (2011) noticed that The questionnaire offers meaningful information to veterinary
owner-perceived severity correlated significantly with QoL scores dermatologists regarding the QoL of owners and HRQoL of dogs af-
(P = 0.02). In other 200 interviews (Noli et al., 2011) of own- fected by atopic dermatitis in the context of daily practice. Such

Table 5
Correlation of questions from section I, OVA 1∗ and OPRS∗

Question no. Average Standard deviation Correlation with OVA 1∗ Probability Correlation with OPRS∗

1 3.61 0.62 -0.18 0 0.41

2 3.74 0.48 -0.09 0 0.19
3 3.2 0.89 0.11 0.0003 0.6
4 1.27 1.13 0.57 0.79 -0.1
5 1.5 1.27 0.55 0.25 0.1
6 0.38 0.83 0.38 0.004 0.15
7 3.24 0.93 -0.18 0 -0.03
8 1.33 1.04 0.43 0.87 -0.12
9 1.18 1.10 0.56 0.71 0.04
10 0.40 1.01 0.2 0.0005 0.3
11 0.88 1.16 0.57 0.031 0.0007
12 0.72 0.95 0.24 0.02 -0.05
13 0.96 0.95 -0.08 0.009 -0.08
14 0.74 0.91 -0.9 0.28 -0.25
15 0.62 0.95 0.35 0.004 0.07
16 1.20 1.17 0.24 0.07 0.41
∗
OVA 1-overall assessment question 1,∗ OPRS-owner-pet relationship score

27
T. Suici, G. DărăbuȘ, N. Mederle et al. Journal of Veterinary Behavior 46 (2021) 24–30

Table 6
Correlation of questions from section II with OVA 2 and OPRS

Question No. Average Standard deviation Correlation/OVA 2 Probability Correlation/ OPRS

17 1.85 1.23 0.71 0.45 -0.22

18 1.28 1.58 0.42 0.43 -0.24
19 2 1.41 0.55 0.83 -0.43
20 2.07 0.99 0.17 0.77 -0.16
21 1.42 0.85 -0.13 0.02 0.31
22 1.42 1.5 -0.22 0.0001 0.43
23 2 1.1 -0.21 0.003 0.37
24 1.5 0.85 0.75 0.07 -0.11
25 1.71 1.13 0.39 0.03 -0.12
26 1.42 1.0894 0.64 0.03 -0.42
27 2.35 1.33 0.44 0.19 0.26
28 2.5 1.09 0.31 0.17 -0.44
29 2.78 1.47 -0.07 0.0006 -0.21
30 2.35 0.49 -0.06 0.13 -0.10
∗
OVA 2- overall assessment question 2, ∗ OPRS- owner-pet relationship score.

data could be beneficial in providing better owner support and un-
derstanding the attitude that owners exhibit when facing the chal-
lenge of having to deal with a pet suffering from chronic illness.
In terms of QoL, HRQoL, and attitudes, the present study has iden-
tified no significant differences among the perceptions of owners
belonging to various age groups or the opposite gender. However,
it is clear from the results that QoL and HRQoL are both affected
by atopic dermatitis, demonstrating the need for further, extensive
investigations that could help build a more complex assessment of
the impact exhibited by this skin condition on the daily lives of
pets and their owners.
Authorship statement
All authors acknowledge that the material has not been pre-
viously published nor is it simultaneously under consideration by
any other journal. The contributions of the authors are as follows:
The experiments were designed by: Prof. Morariu Sorin, Prof.
Gheorghe Darabus, Prof. Mederle Narcisa. The experiments were
perfomed by: Suici Tiana, Sirbu Catalin. The data were analyzed
by Suici Tiana, Mirela Imre, Morariu Sorin. The paper was written
by: Suici Tiana, Morariu Sorin.
Ethical Approval
No ethical approval was required for the present study. Ques-
tionnaires were left available for whomever wished to complete
them and returned to a box. No identifying information and no
personal information beyond owner gender and age was requested.
Conflict of Interest statement
The authors have no conflict of interest to declare.
ANNEX 1
USAMVBT-FACULTY OF VETERINARY MEDICINE
USAMVBT-FACULTY OF VETERINARY MEDICINE, VETERINARY
DERMATOLOGY CLINIC
QUESTIONNAIRE FOR EVALUATING THE IMPACT OF ATOPIC
DERMATITIS ON QUALITY OF LIFE OF DOGS/CATS AND THEIR
OWNERS
I. Questionnaire about the animal owner and his relationship
with the dog (owner-pet relation score OPRS). Complete the ques-
tionnaire before the beginning of the treatment. Choose the answer
that best describes your situation. All questions must be answered.
1.Where does your dog spend most of its time? a)Most/all of
the time indoors; +1 b)Mostly indoors but has free access in the
garden; 0 c)Most/all of the time outdoors. -1
2.How many hours a day do you spend with your dog, when
you can observe your pet? a) Less than 2 hours; -1 b) 2-4 hours; 0
c) More than 4 hours; +1
3.Do you feed your pet by yourself? a) Never; -1 b) Sometimes;
0 c) In most cases. +1
4.Do you walk your dog? a) Never; -1 b) Sometimes; 0 c) In
most cases. +1
5.Does the dog sleep in your bedroom? a) Yes; +1 b) No. -1
6.How many people live in your house? a) I live by myself; +1
b) Two; 0 c) More than two. -1
7.How many dogs/cats live in your house? a) One dog; +1 b) A
dog and a cat; 0 c) Two dogs; 0 d) More than two animals (regard-
less of species). -1
8.Which of the following statements best describes what the
dog is for you? a) The dog is a member of the family; 0 b) The
dog is an animal; -1 c) The dog is like a child +1
9.How old are you? a) Below 30 years; b) Between 30 and 60
years; c) More than 60 years.
10.You are a : a)Man; b)Woman.
II. Please consider all the statements below.
Mark one out of 5 options (Totally against / Disagree/ Neither
pro, nor con /Agree /Totally agree) which best fit the given state-
ment.
OVA1. The condition of my dog has affected my or my fam-
ily’s quality of life. Totally against / Disagree/ Neither pro, nor con
/Agree /Totally agree
OVA2. The condition of my dog has affected the quality of his
own life? Totally against / Disagree/ Neither pro, nor con /Agree
/Totally agree
Section 2 I- Questions regarding you and your family.
1The dog makes me feel better.
Totally against / Disagree/ Neither pro, nor con /Agree /Totally
agree
2.It is a pleasure to spend time with my dog
Totally against / Disagree/ Neither pro, nor con /Agree /Totally
agree
3.I am more active thanks to my dog.
Totally against / Disagree/ Neither pro, nor con /Agree /Totally
agree
4.Caring for my dog’s skin condition is a burden.
Totally against / Disagree/ Neither pro, nor con /Agree /Totally
agree
5.My dog’s skin condition disturbs my sleep.

28
T. Suici, G. DărăbuȘ, N. Mederle et al.
Totally against / Disagree/ Neither pro, nor con /Agree /Totally
agree
6.I regret having this dog due to its condition
Totally against / Disagree/ Neither pro, nor con /Agree /Totally
agree
7.The dog’s condition upsets me.
Totally against / Disagree/ Neither pro, nor con /Agree /Totally
agree
8. My dog’s skin condition has changed my usual family life.
Totally against / Disagree/ Neither pro, nor con /Agree /Totally
agree
9.My dog’s skin condition has changed my leisure activities.
Totally against / Disagree/ Neither pro, nor con /Agree /Totally
agree
10.Sometimes I think that it would be best to put my dog to
sleep due to its condition.
Totally against / Disagree/ Neither pro, nor con /Agree /Totally
agree
11.I see my friends’ relatives more rarely due to my dog’s illness
Totally against / Disagree/ Neither pro, nor con /Agree /Totally
agree
12.I cannot allow others to look at my dog due to its skin con-
dition.
Totally against / Disagree/ Neither pro, nor con /Agree /Totally
agree
13.I avoid places where I could meet other dog owners due to
its skin condition.
Totally against / Disagree/ Neither pro, nor con /Agree /Totally
agree
14.I am embarrassed by my dogs appearance and smell.
Totally against / Disagree/ Neither pro, nor con /Agree /Totally
agree
15.The scratching, chewing or licking of the dog makes me
agressive.
Totally against / Disagree/ Neither pro, nor con /Agree /Totally
agree
16.I have to limit other expenses to pay for my dog’s treatment.
Totally against / Disagree/ Neither pro, nor con /Agree /Totally
agree
Section two II- Questions regarding your pet
17.The dog interrupts play to scratch, lick or bite itself.
Totally against / Disagree/ Neither pro, nor con /Agree /Totally
agree
18.The dog interrupts the walk to scratch, lick or bite itself.
Totally against / Disagree/ Neither pro, nor con /Agree /Totally
agree
19.The dog interrupts eating to scratch, lick or bite itself.
Totally against / Disagree/ Neither pro, nor con /Agree /Totally
agree
20.The dog interrupts sleep to scratch, lick or bite itself.
Totally against / Disagree/ Neither pro, nor con /Agree /Totally
agree
21.My dog is happy.
Totally against / Disagree/ Neither pro, nor con /Agree /Totally
agree
22.My dog is playful and active.
Totally against / Disagree/ Neither pro, nor con /Agree /Totally
agree
23.My dog sleeps well.
Totally against / Disagree/ Neither pro, nor con /Agree /Totally
agree
24.The skin condition has worsened my dog’s behaviour.
Totally against / Disagree/ Neither pro, nor con /Agree /Totally
agree
25.My dog is anxious.
29
Journal of Veterinary Behavior 46 (2021) 24–30
Totally against / Disagree/ Neither pro, nor con /Agree /Totally
agree
26.The dog is tired due to its condition.
Totally against / Disagree/ Neither pro, nor con /Agree /Totally
agree
27.I scold my dog when he starts scratching or licking.
Totally against / Disagree/ Neither pro, nor con /Agree /Totally
agree
28.The treatment (shampoos, pills) is a major burden for my
dog.
Totally against / Disagree/ Neither pro, nor con /Agree /Totally
agree
29.I reduced the frequency/ length of my dog’s walks.
Totally against / Disagree/ Neither pro, nor con /Agree /Totally
agree
30.The treatment has side effects on my dog.
Totally against / Disagree/ Neither pro, nor con /Agree /Totally
agree
References
Anderson, W.P., Reid, C.M., Jennings, G.L., 1992. Pet Ownership and Risk-Factors for
Cardiovascular-Disease. Med. J. Aust. 157, 298–301.
Beetz, A., Uvnas-Moberg, K., Julius, H., Kotrschal, K., 2012. Psychosocial and psy-
chophysiological effects of human–animal interactions: the possible role of oxy-
tocin. Front. Psychol. 3, 234.
Belshaw, Z., Yeates, J., 2018. Assessment of quality of life and chronic pain in dogs.
Vet. J. 239, 59–64.
Bottomley, A., Flechtner, H., Efficace, F., Vanvoorden, V., Coens, C., Therasse, P.,
Greimel, E., 2005. Health related quality of life outcomes in cancer clinical trials.
Eur. J. Cancer 41, 1697–1709.
Brinkmann, L., Gerken, M., Riek, A., 2013. Effect of long-term feed restriction on the
health status and welfare of a robust horse breed, the Shetland pony (Equus
ferus caballus). Res. Vet. Sci. 94, 826–831.
Budke, C.M., Levine, J.M., Kerwin, S.C., Gwendolyn, J.L., Hettlich, F.B., Slater, M.R.,
2008. Evaluation of a questionnaire for obtaining owner-perceived, weighted
quality-of-life assessments for dogs with spinal cord injuries. J. Am. Vet. Med.
Assoc. 233, 925–930.
Cella, D.F., 1992. Quality of life: The Concept. Eur. J. Palliat. Care. 8.
Chamlin, S.L., Frieden, I.J., Williams, M.L., Chren, M.M., 2004. Effects of atopic der-
matitis on young American children and their families. Pediatrics 114, 607–611.
Chamlin, S.L., 2006. The psychosocial burden of childhood AD. Dermatol. Ther. 19,
104–107.
Cole, K.M., Gawlinski, A., Steers, N., Kotlerman, J., 2007. Animal-assisted therapy in
patients hospitalized with heart failure. Am. J. Crit. Care. 16, 575–585.
Favrot, C., Linek, M., Mueller, R., Zini, E., 2010. Development of a questionnaire to as-
sess the impact of atopic dermatitis on health-related quality of life of affected
dogs and their owners. Vet. Dermatol. 21, 64–70.
Finlay, A.Y., 1997. Quality of life measurement in dermatology: a practical guide. Br.
J. Dermatol. 136 (3), 305–314.
Freeman, L.M., Rush, J.E., Farabaugh, A.E., Must, A., 2005. Development and evalua-
tion of a questionnaire for assessing health-related quality of life in dogs with
cardiac disease. J. Am. Vet. Med. Assoc. 226, 1864–1868.
Germain, P.A., Prelaud, P., Bensignor, E., 2005. CADESI (Canine Atopic Dermatitis Ex-
tent and Severity Index) reproducibility. Rev. Méd. Vét. 156, 382–385.
Giuffrida, M.A., Kerrigan, S.M., 2014. Quality of life management in prospective stud-
ies of cancer treatments in dogs and cats. J. Vet. Intern. Med. 28, 1824–1829.
Halliwell, R., 2006. Revised nomenclature for veterinary allergy. Vet. Immunol. Im-
munopathol. 114, 207–208.
Hill, P.B., Lau, P., Rybnicek, J., 2007. Development of an owner-assessed scale to mea-
sure the severity of pruritus in dogs. Vet. Dermatol. 18, 301–308.
Kiddie, J.L., Collins, M.L., 2014. Development and validation of a quality of life as-
sessment tool for use in kennelled dogs (Canis familiaris). Appl. Anim. Behav.
Sci. 158, 57–68.
Kunz, B., Oranje, A.P., Labreze, L., Stalder, J.F., Ring, J., Taieb, A., 1997. Clinical vali-
dation and guidelines for the SCORAD index: Consensus report of the European
Task Force on Atopic Dermatitis. Dermatology 195, 10–19.
Leidy, N.K., Revicki, D.A., Geneste, B., 1999. Recommendations for evaluating the
validity of quality of life claims for labelling and promotion. Value Health 2,
113–127.
Lewis-Jones, M.S., Finlay, A.Y., Dykes, P.J., 2001. The infants’ dermatitis quality of life
index. Br. J. Dermatol. 144, 104–110.
Lewis-Jones, S., 2005. Measuring the burden of atopic eczema in young children and
the family unit. J. Invest. Dermatol. 125, viii–viix.
McKenna, S.P., Doward, L.C., 2008. Quality of life of children with AD and their fam-
ilies. Curr. Opin. Allergy. Cl. Immunol. 8, 228–231.
McMillan, F.D., 20 0 0. Quality of life in animals. J. Am. Vet. Med. Assoc. 216,
1904–1910.
T. Suici, G. DărăbuȘ, N. Mederle et al.
Meads, D.M., McKenna, S.P., Kahler, K., 2005. The quality of life of parents of chil-
dren with AD: interpretation of PIQoL-AD scores. Qual. Life Res. 14, 2235–2245.
Milevoj, N., Tozon, N., Licen, S., Lampreht Tratar, U., Sersa, G., Cemazar, M., 2020.
Health-related quality of life in dogs treated with electrochemotherapy and/or
interleukin-12 gene electrotransfer. Vet. Med. Sci. 6, 290–298.
Niessen, S.J.M., Powney, S., Guitian, J., Niessen, A.P.M., Pion, P.D., Shaw, J.A.M.,
Church, D.B., 2012. Evaluation of a quality-of-life tool for dogs with diabetes
mellitus. J. Vet. Intern. Med. 26, 953–961.
Noli, C., Colombo, S., Cornegliani, L., Ghibaudo, G., Persico, P., Vercelli, A., Galzer-
ano, M., 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. Vet. Dermatol. 22, 344–351.
Noli, C., Minafo, G., Galzerano, M., 2011. Quality of life of dogs with skin diseases
and their owners. Part 1: development and validation of a questionnaire. Vet.
Dermatol. 22, 335–343.
Olivry, T., Dunston, S.M., Murphy, K.M., Moore, P.F., 2001. Characterization of the
inflammatory infiltrate during IgE-mediated late phase reactions in the skin of
normal and atopic dogs. Vet. Dermatol. 12, 49–58.
Olivry, T., Marsella, R., Iwasaki, T., Mueller, R., 2007. Validation of CADESI-03, a
severity scale for clinical trials enrolling dogs with atopic dermatitis. Vet. Der-
matol. 18, 78–86.
Olivry, T., Mueller, R., Nuttall, T., Favrot, C., Prélaud, P., 2008. Determination of CADE-
SI-03 thresholds for increasing severity levels of canine atopic dermatitis. Vet.
Dermatol. 19, 115–119.
Oranje, A.P., Stalder, J.F., Taieb, A., Tasset, C., De Longueville, M., 1997. Scoring of
atopic dermatitis by SCORAD using a training atlas by investigators from differ-
ent disciplines. Pediat. Allergy Immunol. 8, 28–34.
Oyama, M., Citron, L., Shults, J., Cimino Brown, D., Serpell, J.A., Farrar, J.T., 2017. Mea-
suring quality of life in owners of companion dogs: development and validation
of a dog owner specific quality of life questionnaire. Anthrozoös 30, 61–75.
30
Journal of Veterinary Behavior 46 (2021) 24–30
Packer, R.M.A., Volk, H.A., 2015. Epilepsy beyond seizures: a review of the impact of
epilepsy and its comorbidities on health-related quality of life in dogs. Vet. Rec.
177 (12), 306–315.
Ricci, G., Bellini, F., Dondi, A., Patrizi, A., Pession, A., 2012. Atopic dermatitis in ado-
lescence. Dermatol. Rep. 4 (1), e1.
Rollin, B.E., 2006. Euthanasia and quality of life. J. Am. Vet. Med. Assoc. 228,
1014–1016.
Stalder, J.F., Taieb, A., 1993. Severity scoring of atopic dermatitis: The SCORAD in-
dex. Consensus report of the European Task Force on Atopic Dermatitis (1993).
Dermatology 186, 23–31.
Stepnik, C.T., Outerbridge, C.A., White, S.D., Kass, P.H., 2012. Equine atopic skin dis-
ease and response to allergen-specific immunotherapy: a retrospective study at
the University of California-Davis (1991-2008). Vet. Dermatol. 23, 29–35.
Taylor, K.D., Mills, D.S., 2007. Is quality of life a useful concept for companion ani-
mals? Anim. Welf. 16, 1–11.
Thorpe Jr., R.J., Kreisle, R.A., Glickman, L.T., Simonsick, E.M., Newman, A.B.,
Kritchevsky, S., 2006. Physical activity and pet ownership in year 3 of the Health
ABC study. J. Aging. Phys. Act. 14, 154–168.
Velikova, G., Stark, D., Selby, P., 1999. Quality of life instruments in oncology. Eur. J.
Cancer 35, 1571–1580.
Wiseman-Orr, M.L., Nolan, A.M., Reid, J., Scott, E.M., 2004. Development of a ques-
tionnaire to measure the effects of chronic pain on health-related quality of life
in dogs. Am. J. Vet. Res. 65, 1077–1084.
Wood, L., Martin, K., Christian, H., Nathan, A., Lauritsen, C., Houghton, S., Kawachi, I.,
McCune, S., 2015. The pet factor—Companion animals as a conduit for get-
ting to know people, friendship formation and social support. PloS ONE 10 (4),
e0122085.
Wojciechowska, J.I., Hewson, C.J., Stryhn, H., Guy, N.C., Patronek, G.J., Timmons, V.,
2005. Development of a discriminative questionnaire to assess nonphysical as-
pects of quality of life of dogs. Am. J. Vet. Res. 66, 1453–1460.