In part 1 of this 2-part series on bone diseases in growing puppies, Dr. Karen Becker discussed angular limb deformities.
In today's follow-up, she explains three other common bone diseases: panosteitis, hypertrophic osteodystrophy (HOD), and osteochondritis dissecans (OCD).
By Dr. Becker
Today in the second half of my 2-part series, I want to discuss three common bone diseases in puppies and young dogs:
- Hypertrophic osteodystrophy (HOD)
- Osteochondritis dissecans (OCD)
Panosteitis is a common condition in several large breed dogs.
It typically occurs between 6 and 18 months of age, and more often in males than females.
Symptoms can last from two to five months, but can actually go on for as long as 18 months in certain breeds.
Breeds that are predisposed to panosteitis include German shepherds, Great Danes, Dobermans, Golden retrievers, Labradors, Rotties and Basset hounds.
The cause of panosteitis is unknown, but there have been lots of cause-and-effect theories debunked over the years, including bacterial and viral infections.
Most vets agree that because the condition primarily occurs in large, heavy-boned, giant breed dogs, there are probably components of genetics, growing pains, nutrition, and metabolism involved.
Acute sudden lameness that isn't a result of trauma is the most common symptom of panosteitis. Lameness can be intermittent and move from leg to leg. This shifting leg lameness can range from a mild limp to the dog choosing to not bear weight on the leg at all to avoid significant pain.
Episodes can last for two to three weeks or can continue for months at a time. The dog may show hesitance to walk, run, jump, or exercise. If the affected bone is squeezed, the dog will exhibit pain as well.
Some dogs run a low-grade fever during episodes of panosteitis. Others have elevated white blood cell counts. The condition typically affects the radius, ulna, humerus, femur, and tibia, but once in a while the condition can affect the foot and pelvic bones as well.
In addition to observing a dog's symptoms, x-rays are used to confirm a diagnosis of panosteitis.
In the early stages, the condition can result in a slight increase in bone density in the center part of bones. Midway through the course of the disease, the bones can appear irregular and blotchy, with a rough exterior. As the condition clears up or resolves, the bones can remain somewhat blotchy looking, but otherwise take on a more normal appearance.
Treatment for Panosteitis
Unfortunately, there is no magic cure for panosteitis. It has to run its course, but pain -- when it's present -- should be carefully controlled. There's no indication for antibiotics or steroids with this particular condition.
I have found proteolytic enzymes are very beneficial for dogs to naturally control pain and inflammation.
I also use homeopathic calcarea carbonica and arnica with really good success, as well as Standard Process Musculoskeletal Support.
I discourage intense play or exercise on hard surfaces during a puppy's active growth phase.
I also recommend feeding a balanced, species-appropriate diet that promotes slow but consistent growth versus any type of high calorie puppy chow that promotes rapid skeletal development.
Hypertrophic Osteodystrophy (HOD)
HOD is another type of bone disease affecting young, large-breed dogs. It has several other names. The most common is HOD, but we also call it skeletal scurvy, Moller-Barlow disease, and osteodystrophy type 2.
Dogs who develop this disease have severe lameness and pain, and unfortunately, it develops in multiple legs simultaneously. It most commonly occurs in puppies between three and six months of age. Like other bone diseases, it is more common in males than in females.
There's no specific large or giant breed dog that is more likely to acquire HOD than another, and there doesn't seem to be evidence of a strong genetic link at this time.
Puppies with HOD will have painful swelling of the growth plates in the leg bones, most commonly the radius, ulna, and tibia.
There may be lameness and reluctance to move. Lethargy and loss of appetite are also common, along with intermittent fever that can actually get quite high.
Like panosteitis, symptoms often come and go, ultimately resolving on their own in most cases. However, if a dog has swelling of the growth plates that goes on long enough, permanent damage to those plates can occur.
A definitive cause of HOD hasn't been determined.
Bone infection can be present, but dogs suffering from this condition have also shown lower blood levels of vitamin C than healthy dogs, so there seems to be a nutritional component to the disorder.
Interestingly, excessive dietary supplementation has also been implicated, pointing out the important fact that animals need balanced nutrition and not wads of vitamin and mineral supplements that can actually cause nutritional imbalances.
During the active growth phase, it is critical that puppies are fed a complete diet that does not include mega-doses (over supplementation) of any one vitamin or mineral.
HOD Diagnosis and Treatment
A definitive diagnosis is made with x-rays of the growth plates. Evidence of HOD is a very thin, dark line at the ends of the involved bones.
The condition causes a vascular impairment that leads to the ossification failure of cartilage. This means bones don't harden as they should, and don't grow as strong as they should.
Occasionally, HOD causes changes in the skull and teeth, but the problem is much more commonly seen in the long bones.
Unfortunately, there isn't a specific treatment for HOD. The condition is very painful, so pain relief and inflammation management is really important. I use the same safe plant sterols, proteolytic enzymes, homeopathics, and musculoskeletal support for HOD as I do for panosteitis. EFAC1 can also be used in these cases.
It is important that you restrict exercise, and I certainly recommend you feed a naturally anti-inflammatory diet to help control this condition.
A consistent, slow growth rate is a much better approach to help reduce the incidence of HOD than a fast growth rate in puppies and developing dogs that are large or giant breeds.
Osteochondritis Dissecans (OCD)
The third condition I want to discuss is osteochondritis dissecans, also called OCD. OCD is actually a disease of the cartilage around various joints in a dog's body.
A joint is the point where two bones meet and move against each other. This meeting point of the joints has a smooth covering of cartilage that actually acts as a buffer to protect underlying bone. If anything interferes with the smooth cartilage surface, it causes pain when the joints move.
Dogs with OCD have abnormal cartilage production. Instead of attaching to the bone, the cartilage separates, dries out, and loses its integrity. This unhealthy cartilage can develop cracks or flaps that can eventually break off and float around the joint space. These pieces that break off are referred to as 'joint mice.'
OCD is primarily a condition of large and giant-breed dogs, and like panosteitis and HOD, it is more common in males than females. The age it begins to occur is typically between 4 and 10 months.
OCD is thought to be caused by many factors, including trauma to the joints, genetics, rapid growth, hormone imbalances, and nutritional imbalances. There appears to be a clear link between parents and offspring, and certain breeds and lineages are much more likely to develop the condition.
OCD is usually seen in the shoulder, elbow, knee, or ankle (the ankle is also called the tarsus in pets), with the shoulder and the knee the most common sites. Some dogs barely limp -- you can hardly tell there's a problem -- while other dogs are unable to put any weight on the affected limb.
Lameness gets worse after exercise and improves with rest. If the shoulder is affected, often there will be a shortened forelimb stride, which is a really common symptom.
Sometimes OCD strikes both limbs at once, making the dog totally reluctant to walk or sometimes unable to move at all.
Changes in the bone beneath the damaged cartilage are often visible on x-ray, which is how the condition is most frequently diagnosed.
OCD is treated either medically or with surgery. Conservative treatment for dogs with early mild symptoms involves strict rest for one to two months, with no running or playing allowed.
If there's pain, anti-inflammatories and pain medications are given, and surgery to remove the defective cartilage is often recommended for dogs with severe symptoms or large lesions.
Preventing OCD and Other Bone Diseases in Puppies
Reducing the likelihood these skeletal diseases will develop is of course the best approach.
- I recommend a slow growth diet, which means you have to skip the grains and carbohydrates -- these are energy dense foods that promote rapid growth.
- I also recommend that you don't over-vaccinate your puppy. With two to three well-timed puppy vaccines, most dogs are protected for life from parvo, distemper, and adenovirus.
- I recommend you take care exercising your puppy, and I discourage jumping activities until all growth plates are closed, which usually occurs after the dog is a year old.
- I also recommend you take extra care to avoid any type of trauma or injury to the limbs, including covering slick floors with runners. Puppies are clumsy. Their bodies are loose and cartilaginous, and they tend to be uncoordinated.
I have found in my practice that puppies who slip, trip, and fall regularly are much more inclined to develop bone growth problems, so covering those slick floors is an important part of reducing trauma to the growth plates.
I also don't recommend keeping puppies housed on hard surfaces like concrete.
- I do encourage maintenance chiropractic care for your growing pup every three months during the period when his frame is developing. By keeping your dog's growing body aligned, you can help prevent compensatory changes and joint stress.
- Last but not least, I strongly recommend that you supply chondroprotective agents, which are joint supplements (without added minerals) such as eggshell membrane, that nourish cartilage and improve the integrity of your growing puppy's joints.