Validation of photographic fecal scoring in puppies

Diarrhea is a common issue in puppies and compromises the well-being of animals and their owners. To date, objective assessment of fecal consistency has relied on a fecal scoring scale applied to fresh feces; however, given the challenges associated with accessing fresh stool samples, digital scoring presents an interesting potential alternative. This study aimed to test the validity of using photographs to approximate the in situ fresh fecal scoring scale.

In a first experiment, 40 fresh feces were collected from puppies and scored in-situ with a 13-point fecal scale. Feces were then photographed and later assessed on picture. Agreement between the two scoring methods was evaluated using a Bland-Altman plot and kappa coefficients. In a second experiment, four observers scored independently 98 stool photographs. Intraclass correlation coefficient was calculated to assess inter-observer agreement. Intra-observer reproducibility was also explored with a Bland-Altman plot and kappa coefficients.

Our findings showed good agreement between the two methods (weighted kappa coefficient of 0.93 (95 % CI [0.87, 0.98]) and no significant bias in the Bland-Altman plot). Our study also showed good inter-observer (ICC of 0.83 (95 % CI [0.78, 0.87])) and intra-observer (weighted kappa coefficient of 0.93 (95 % CI [0.91, 0.96]) and no significant bias in the Bland-Altman plot) agreements.

The puppy fecal scoring scale employed in the present study appeared to be reliably applicable to photographs for objectively assessing fecal consistency in puppies. It is a promising solution for veterinary practices and future research studies.