Review Article| Volume 42, ISSUE 4, P727-748, July 2012

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Painful Decisions for Senior Pets

  • Steven M. Fox
    Fox Third Bearing Inc, 10821 Forest Avenue, Clive, IA 50325, USA
    Fox Third Bearing Inc, 10821 Forest Avenue, Clive, IA 50325, USA

    University of Illinois, Urbana, IL 61801, USA

    University of Tennessee, Knoxville, TN 37996, USA

    Massey University, Palmerston North, New Zealand
    Search for articles by this author
      In 2010, Fleming and colleagues
      • Fleming J.M.
      • Creepy K.E.
      • Promislow D.E.L.
      Mortality in North American dogs from 1984 to 2004: an investigation into age-, size-, and breed-related causes of death.
      reported on the mortality patterns of North American dogs. Their findings revealed that older dogs tend to die from neurologic and neoplastic causes. In addition, although neoplastic processes were the leading cause of death among adult dogs in the study, degenerative processes ranked 6th overall. Further, increasing breed size was associated with increasing risk of death because of musculoskeletal (or gastrointestinal) system disease. These data suggest a focus on pain management of degenerative joint disease and cancer in the senior/geriatric pet.
      • A mechanism-based approach to pain management is the most productive way to make significant advancements.
      • Osteoarthritis is a “total joint disease,” with many different tissue types contributing to the pain response.
      • Cyclooxygenase-2, prostaglandin E2, interleukin-1β, matrix metalliproteinase-13, inducible nitric oxide synthase, and tumor necrosis factor-α are all major players in the catabolic process of degenerative joint disease.
      • Osteoarthritis cannot be cured, but can be managed quite effectively with a multi-modal approach.
      • As cancer progresses, changing factors may complicate the pain state. Only through an understanding of the mechanisms associated with dynamic cancer pain, can we manage patients' pain with evidence-based confidence.


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