Neurology/Neurosurgery Resident University of Florida Gainesville, Florida, United States
Abstract:
Background: Nociception is the most reliable indicator for prognosis of functional recovery following disc extrusions. Currently, objective indicators are lacking for evaluation of nociception.
Objective: Evaluate utility of percent change in heart rate from baseline measured via smart watch as an indicator for presence of nociception in paraplegic dogs with T3-L3 intervertebral disc herniation. The secondary objective was to explore the diagnostic performance of percent change in heart rate as an indicator of nociception in paraplegic dogs using traditional auscultation and smart watch technology. Animals: 14 client-owned paraplegic dogs (7 with intact and 7 with absent nociception), presented for naturally occurring T3-L3 disc extrusion, confirmed via imaging and surgery. Materials and methods: Blinded assessment of nociception was performed with 3 trials per limb. Heart rate was recorded via smart watch and auscultation at baseline and following each nociception trial.
Results: Using heart rate change >25% from baseline as the diagnostic threshold, auscultation demonstrated specificity of 100% and sensitivity of 85.7% with an AUC of 0.954. For smart watch data, the AUC was 0.5. The positive predictive value ranged from 99-100% with changing prevalence of deep pain positive cases. The negative predictive value was high for lower prevalence of deep pain positive cases and low for higher prevalence of deep pain positive cases. Conclusions and clinical importance: Heart rate change of >25% from baseline is a reliable indicator for nociception in paraplegic dogs. Smart watch technology was not useful in measuring change in heart rate in this setting.
