Triggers Lameness and a World of Hurt, Please Don't Ignore

Analysis by Dr. Karen Shaw Becker


Story at-a-glance -

  • Panosteitis, otherwise known as “growing pains,” is a condition that sometimes occurs in the long bones of large breed puppies
  • Symptoms typically develop in pups from 6 to 18 months of age, and acute sudden lameness not related to trauma is the most common
  • There is no cure for panosteitis; as it runs its course, pain and inflammation should be monitored and carefully controlled
  • To help your puppy avoid panosteitis, it’s important to avoid rigorous play or exercise on hard surfaces during the active growth phase, provide joint support supplements and arrange for regular chiropractic care
  • Another very important prevention step is to ensure your pup remains lean, with controlled growth, by feeding a nutritionally balanced, fresh food diet with appropriate amounts of calcium, phosphorus and other minerals

Panosteitis is a condition characterized by “growing pains” that sometimes occurs in the long bones of developing puppies. Panosteitis typically affects the radius, ulna, humerus, femur or tibia, but once in a while the condition can affect the foot and pelvic bones as well.

Most of a young dog's growth occurs between 4 and 8 months of age. The bones grow and lengthen, which is a process made possible by the growth plates at the end of long limb bones. At around the age of 1, the growth plates naturally seal closed, at which point the risk for panosteitis resolves.

Panosteitis (Pronounced “pan-aw-stee-eye-tis”)

Panosteitis, or “Pano” for short (also called "fibrous osteodystrophy," or enostosis), is a bone inflammation that sometimes occurs in several large dog breeds.

The problem is most commonly seen in puppies between 6 and 18 months of age, and more often in males than females. Predisposed breeds include German Shepherds, Great Danes, Doberman Pinschers, Golden Retrievers, Labrador Retrievers, Rottweilers and Basset Hounds.

The cause of panosteitis is unknown, but there have been many cause-and-effect theories discredited over the years, including bacterial and viral infections. Most veterinarians agree that because the condition primarily occurs in large, heavy-boned dogs, there are probably components of genetics, “growing pains,” nutrition and metabolism involved.

Symptoms to Watch For

Acute sudden lameness that isn't a result of trauma is the most common symptom. Lameness can be intermittent and move from leg to leg, and can range from a mild limp to the puppy choosing not to put weight on the leg to avoid significant pain. Dogs with the condition may be reluctant to walk, run, jump or exercise. If the affected bone is squeezed, the pup will exhibit pain as well. Some dogs run a low-grade fever during flare-ups; others have elevated white blood cell counts.

Episodes of lameness can last for two to three weeks or can continue for months at a time. From start to finish, symptoms can last from two to five months or go on for as long as 18 months in certain breeds.

Diagnosing Panosteitis

If you have a young, growing puppy and you know he's been injured, it's important to have him seen by your veterinarian right away. Early diagnosis of traumatic bone injuries is essential if your pup is to have a good treatment outcome.

Traumatic injury to growth plates in young dogs can result in several angular limb deformities that can permanently affect a dog’s quality of life. Since it can take a few weeks after your puppy is injured for an angular limb deformity to become obvious, it's extremely important to know if your pet has sustained an injury.

It’s also important that you continuously compare the length and straightness of a potentially damaged leg to the length and straightness of the uninjured leg.

The diagnosis of panosteitis is common when growth plate trauma has been ruled out. In addition to observing the dog's symptoms and history of no trauma, veterinarians rely on x-rays 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 on x-ray images as 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 Options

Unfortunately, there is no cure for panosteitis — it just has to run its course. If a puppy is in pain, however, it should be carefully controlled.

There is no indication for antibiotics or steroids with this particular condition, so if your veterinarian suggests them, ask why, and don’t accept an explanation that indicates they’re being offered “just in case.” These drugs are overprescribed in veterinary medicine and have significant side effects, especially in puppies.

I have found proteolytic enzymes, curcumin and CDB oil beneficial in helping to naturally control pain and inflammation. I also use homeopathic calcarea carbonica and arnica with good success, as well as Standard Process Canine Musculoskeletal Support.

Prevention Tips

With a large or giant breed puppy, it’s wise to avoid intense play or exercise on hard surfaces during the active growth phase to help prevent panosteitis and trauma that can result in angular limb deformities. And it goes without saying that the goal of any pet parent should be to avoid unnecessary joint stress in a growing puppy altogether.

This is why veterinarians warn pet parents not to engage their dogs in rigorous jumping or other very strenuous exercises until all the growth plates have had time to close and seal. Many proactive veterinarians, including me, also encourage pet parents to provide high-risk puppies with joint support (glycosaminoglycans) or chondroprotective agents (for example, chondroitin) to help reduce damage to growth plates.

I also strongly encourage you to have your growing puppy undergo regular chiropractic care by a licensed animal chiropractor to keep the limbs and joints properly aligned. Consider it sort of an insurance plan in case trauma to a growth plate does occur. Stress from injury is minimized when the body is in proper alignment.

How to Feed Your Puppy to Help Prevent Panosteitis

The diet you offer your pup plays an essential role in preventing panosteitis and other angular limb deformities. The goal in feeding your puppy is to keep him lean, with controlled growth. Contrary to what many people believe, a roly-poly puppy is not a healthy puppy. Optimal growth in a large or giant breed puppy is very different from maximum growth.

Overfeeding an adult dog leads to obesity and serious health conditions like diabetes and heart disease. Overfeeding a puppy during the active, rapid growth period right after weaning leads to skeletal problems. The size a dog ultimately becomes is primarily dictated by genetics; however, the time it takes a dog to reach full adult size can be controlled to a large degree by nutrition. Early spay/neuter also contributes to abnormal growth patterns and joint problems in some breeds.1

Healthy large and giant breed puppies do best on a portion-controlled, nutritionally balanced, species-appropriate, fresh food diet, either a carefully prepared homemade diet or an excellent-quality commercially available diet.

Traditional puppy foods often provide much higher calorie content than large breed puppies require, causing them to gain too much weight too quickly. This is why pet food manufacturers produce formulas specifically for large breed puppies. These are typically diets lower in calorie density (the number of calories per cup or gram of food) than a regular puppy diet. They're also usually lower in calcium on an energy basis. These are two very important factors for avoiding too-rapid growth in big puppies.

Some adult dog foods may also be low calorically, but often have high calcium content on an energy basis, which is not what you want for a growing large or giant breed pup.

Contrary to what many people have been told, protein in excess is not the problem. In fact, a dietary protein deficiency can contribute to skeletal problems. The elements of nutrition that have been scientifically proven to negatively impact skeletal development in puppies are excessive calories, typically from carbohydrates, and high or unbalanced mineral content, specifically calcium and phosphorus.2

Your pup’s body isn’t able to control or limit absorption of dietary calcium and certain other minerals. The higher the calcium and mineral content of the diet, the greater the level of absorption and assimilation into the developing bone structure of the puppy. This can disturb the natural process of bone growth and result in lesions in the skeleton and joints.

High mineral concentrations in the diet can quickly cause bone mineral changes that play into skeletal abnormalities in a growing puppy. Puppies who get too big, too fast and go on to develop orthopedic issues are often eating a high mineral content diet, either free-fed or in too-large individual servings.

If you're going to feed kibble to a large breed puppy (which I don’t recommend), look for a special large breed puppy formula or one that is "Approved for all life stages." This means the food is appropriate for growing puppies or adult dogs.