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Results showed poor agreement for muzzle tension and whiskers, good-to-excellent reliability for eye and ear position and excellent reliability for total ratio scores, and FGS totals decreased after analgesia, indicating responsiveness.",{"@graph":14,"@context":73},[15,34,56],{"@type":16,"itemListElement":17},"BreadcrumbList",[18,23,27,31],{"item":19,"name":20,"@type":21,"position":22},"https://docshare.wps.com","Home","ListItem",1,{"item":24,"name":25,"@type":21,"position":26},"https://docshare.wps.com/document/","Document",2,{"item":28,"name":29,"@type":21,"position":30},"https://docshare.wps.com/document/healthcare/","Healthcare",3,{"item":32,"name":10,"@type":21,"position":33},"https://docshare.wps.com/document/challenges-using-the-feline-grimace-scale-in-brachycephalic-cats-with-ocular-pain/430676/",4,{"url":32,"name":10,"@type":35,"image":36,"author":41,"headline":10,"publisher":44,"fileFormat":47,"inLanguage":8,"description":12,"dateModified":48,"datePublished":49,"encodingFormat":47,"isAccessibleForFree":50,"interactionStatistic":51},"DigitalDocument",{"url":37,"@type":38,"width":39,"height":40},"https://docshare.wps.com/thumbnails/challenges-using-the-feline-grimace-scale-in-brachycephalic-cats-with-ocular-pain/430676.png","ImageObject",300,407,{"name":42,"@type":43},"Kyle","Person",{"url":19,"name":45,"@type":46},"DocShare","Organization","application/pdf","2026-10-30","2026-09-29",true,{"@type":52,"interactionType":53,"userInteractionCount":55},"InteractionCounter",{"@type":54},"ViewAction",9,{"@type":57,"mainEntity":58},"FAQPage",[59,65,69],{"name":60,"@type":61,"acceptedAnswer":62},"What was the study’s main objective for the Feline Grimace Scale (FGS)?","Question",{"text":63,"@type":64},"To evaluate inter-rater reliability, agreement, and responsiveness of the FGS when assessing pain in brachycephalic cats with ocular pain.","Answer",{"name":66,"@type":61,"acceptedAnswer":67},"How was the FGS assessed in the study?",{"text":68,"@type":64},"Ninety-five images collected before and after ocular surgery were scored by four raters using the FGS and compared with real-time scores from the procedure.",{"name":70,"@type":61,"acceptedAnswer":71},"Were FGS scores sensitive to pain relief?",{"text":72,"@type":64},"Yes. Mean FGS total scores decreased significantly after analgesia both pre- and postoperatively, supporting the instrument’s responsiveness.","https://schema.org",{"og:url":32,"og:type":75,"og:title":10,"og:site_name":45,"og:description":12},"article",{"robots":77,"canonical":32},"index,follow",{"doc_id":79,"site_id":7},430676,1790765965,{"code":4,"msg":82,"data":83},"success",[84,88,92,96,101,106,110,115,119,122,126],{"id":22,"doc_module":4,"doc_module_name":25,"category_name":85,"show_sort_weight":86,"slug":87},"Story & Novel",90,"story-novel",{"id":26,"doc_module":4,"doc_module_name":25,"category_name":89,"show_sort_weight":90,"slug":91},"Literature",80,"literature",{"id":33,"doc_module":4,"doc_module_name":25,"category_name":93,"show_sort_weight":94,"slug":95},"Exam",70,"exam",{"id":97,"doc_module":4,"doc_module_name":25,"category_name":98,"show_sort_weight":99,"slug":100},5,"Comic",60,"comic",{"id":102,"doc_module":4,"doc_module_name":25,"category_name":103,"show_sort_weight":104,"slug":105},6,"Technology",50,"technology",{"id":107,"doc_module":4,"doc_module_name":25,"category_name":29,"show_sort_weight":108,"slug":109},7,40,"healthcare",{"id":111,"doc_module":4,"doc_module_name":25,"category_name":112,"show_sort_weight":113,"slug":114},8,"Research & Report",30,"research-report",{"id":55,"doc_module":4,"doc_module_name":25,"category_name":116,"show_sort_weight":117,"slug":118},"Religion & Spirituality",20,"religion-spirituality",{"id":117,"doc_module":4,"doc_module_name":25,"category_name":120,"show_sort_weight":117,"slug":121},"World Cup","world-cup",{"id":123,"doc_module":4,"doc_module_name":25,"category_name":124,"show_sort_weight":123,"slug":125},10,"Lifestyle","lifestyle",{"id":127,"doc_module":4,"doc_module_name":25,"category_name":128,"show_sort_weight":97,"slug":129},19,"General","general",{"code":4,"msg":82,"data":131},{"doc_id":79,"user_id":132,"nickname":42,"user_avatar":133,"doc_module":4,"category_id":107,"category_name":29,"doc_title":10,"doc_description":12,"doc_content":134,"file_id":135,"file_url":136,"file_type":137,"file_size":138,"view_count":55,"is_deleted":4,"is_public":22,"is_downloadable":22,"audit_status":22,"page_count":123,"language":139,"language_code":8,"site_id":7,"html_lang":8,"table_of_contents":140,"faqs":141,"seo_title":142,"seo_description":12,"update_tm":143,"read_time":144,"preview_page_count":4},3985741905716,"https://ap-avatar.wpscdn.com/davatar_994ba38a5ba835b3df7d355c54d3ed8d","Challenges using the Feline Grimace Scale in brachycephalic cats with ocular pain  \nSabrine Marangoni1, Derek Chow2,3,4 , Marta Garbin1, Kelly St Denis5 , Tim Bosmans6 , Syed S U H Bukhari2,3 , Maria Vanore1 and Paulo V Steagall1,2,3   \nJournal of Feline Medicine and Surgery 1–10  \n© The Author(s) 2026  \nArticle reuse guidelines: [sagepub.com/journals-permissions](sagepub.com/journals-permissions)[ ](sagepub.com/journals-permissions)[DOI: 10.1177/1098612X251401338](DOI: 10.1177/1098612X251401338)[ ](DOI: 10.1177/1098612X251401338)[journals.sagepub.com/home/jfm](journals.sagepub.com/home/jfm)  \nThis paper was handled and processed by the European Editorial Office for publication in JFMS  \nAbstract  \nObjectives This study investigated the inter-rater reliability, agreement and responsiveness of the Feline Grimace Scale (FGS) in brachycephalic cats.  \nMethods A total of 28 brachycephalic cats (mean age 6.6 ± 4.4 years, mean weight 4.2 ± 1.0 kg) undergoing ocular surgery were included in a prospective, randomised, blinded study. Cats presenting fear-anxiety behaviours were not enrolled. In total, 95 images of these cats were collected from video recordings pre-and postoperatively (before/ after analgesia), scored by four raters using the FGS and compared with real-time scores. Limits of agreement (LoAs) and bias were evaluated using the Bland–Altman method (good or poor agreement if bias \u003C0.1 or >0. 1, respectively) . Inter-rater reliability was assessed using the intraclass correlation coefficient (ICC; \u003C0.50 = poor, 0.50– 0.75 = moderate, 0.76–0.90 = good and >0.90 = excellent reliability) . Generalised linear mixed models evaluated responsiveness (P \u003C0.05) .  \nResults Inter-rater reliability (ICCsingle) was poor for muzzle tension (0.47, 95% confidence interval [CI] 0.36–0.58) and whiskers change (0 .34, 95% CI 0.22–0.46), good for ear (0 .81, 95% CI 0.74–0.86) and eye position (0 .84, 95% CI 0.79–0.88), moderate for head position (0 . 71, 95% CI 0.59–0. 79) and good for FGS total ratio scores (0 . 76, 95% CI 0.68–0.82) . LoAs were in the range of –0.37 to 0.22 with a bias of –0 .08, suggesting that some cats could have their scores affected in comparison with real-time scores. Mean FGS total scores decreased after analgesia pre-(0 .56 ± 0.10 vs 0.38 ± 0. 15; P = 0.005) and postoperatively (0 .60 ± 0.18 vs 0.36 ± 0. 15; P \u003C0.001) .  \nConclusions and relevance The FGS is a responsive pain-scoring instrument in brachycephalic cats with ocular pain, with good agreement and excellent inter-rater reliability for total ratio scores. Pain may be overestimated using image assessment in some brachycephalic cats.  \nPlain language summary  \nChallenges using the Feline Grimace Scale in brachycephalic cats with ocular pain  \nThis study examined how consistent, accurate and sensitive the Feline Grimace Scale (FGS) is for evaluating pain in brachycephalic (flat-faced) cats undergoing ophthalmological (ie, eye) surgery. The FGS is a facial  \n1Department of Clinical Sciences, Université de Montréal, St-Hyacinthe, Canada  \n2Department of Veterinary Clinical Sciences, City University of Hong Kong, Hong Kong SAR, China  \n3Centre for Animal Health and Welfare, City University of Hong Kong, Hong Kong SAR, China  \n4Veterinary Specialty Hospital, Hong Kong SAR, China  \n5St Denis Veterinary Professional Corporation, Powassan, ON, Canada  \n6Small Animal Department, Faculty of Veterinary Medicine, Ghent University, Belgium  \nCorresponding author:  \nPaulo V Steagall DVM, MSc, PhD, DACVAA, Department of Veterinary Clinical Sciences, Jockey Club College of Veterinary Medicine and Life Sciences, City University of Hong Kong, Hong Kong SAR, China  \nEmail: [pmortens@cityu.edu.hk](pmortens@cityu.edu.hk)  \nCreative Commons Non Commercial CC BY-NC: This article is distributed under the terms of the Creative Commons Attribution-NonCommercial 4.0 License ([https://creativecommons.org/licenses/by-nc/4.0/) which permits non-commercial use, reproduction and distributi","cbCaivXIRRDTYwVT","https://ap.wps.com/l/cbCaivXIRRDTYwVT","pdf",1139240,"English","# Abstract\n# Objectives\n# Methods\n# Results\n# Conclusions and relevance\n# Plain language summary","[{\"question\":\"What was the study’s main objective for the Feline Grimace Scale (FGS)?\",\"answer\":\"To evaluate inter-rater reliability, agreement, and responsiveness of the FGS when assessing pain in brachycephalic cats with ocular pain.\"},{\"question\":\"How was the FGS assessed in the study?\",\"answer\":\"Ninety-five images collected before and after ocular surgery were scored by four raters using the FGS and compared with real-time scores from the procedure.\"},{\"question\":\"Were FGS scores sensitive to pain relief?\",\"answer\":\"Yes. Mean FGS total scores decreased significantly after analgesia both pre- and postoperatively, supporting the instrument’s responsiveness.\"}]","Challenges using the Feline Grimace Scale in brachycephalic cats with ocular pain | PDF",1790653440,25]