Caregiver placebo effect in dogs with osteoarthritis lameness

Abstract

OBJECTIVE: To document the caregiver placebo effect in owners and veterinarians of dogs with lameness from osteoarthritis. DESIGN: Prospective, randomized, double-blinded, placebo-controlled, multicenter clinical trial. ANIMALS: 58 dogs with lameness secondary to osteoarthritis. PROCEDURES: Dogs enrolled in the placebo arm of an FDA-approved study were evaluated to determine the relationship between subjective (caregiver responses) and objective (force platform gait analysis) patient outcome measures. RESULTS: A caregiver placebo effect for owners evaluating their dog's lameness occurred 39.7% of the time. A caregiver placebo effect occurred 44.8% of the time when veterinarians examined dogs for lameness at a walk, 44.8% of the time when veterinarians examined dogs for lameness at a trot, and 43.1% of the time when veterinarians evaluated dogs for signs of pain on palpation of the joint. This effect was significantly enhanced with time. Mean ground reaction forces (GRFs) remained unchanged for dogs during treatment with the placebo. Individually, of 58 dogs, 5 had GRFs that worsened by ≥ 5% over 42 days, 7 had GRFs that improved by ≥ 5% over 42 days, and 46 had GRFs that remained unchanged. CONCLUSIONS AND CLINICAL RELEVANCE: A caregiver placebo effect was common in the evaluation of patient response to treatment for osteoarthritis by both pet owners and veterinarians. Force platform gait analysis was an unbiased outcome measure for dogs with lameness from osteoarthritis. A caregiver placebo effect should be considered when interpreting owner and veterinary reports of patient response to treatment.