CONTRASTING OSTEODYSTROPHIES ("GROWTH DISTURBANCES"): HELP FOR THE GIANT DOG OWNER

Osteodystrophies can range from the late-onset & self-limiting form referred to as panosteitis (pano) where the dog typically recovers completely without incident, to the most severe (& most commonly seen in young puppies) form referred to as hypertrophic osteodystrophy (H.O.D.), which can have permanent deforming effects & even occassional prove fatal. Epiphysitis is a growth disorder like H.O.D. & pano, and somewhat inbetween as to seriousness, i.e. for all most all young dogs (& horses) recover from this, some will not regain full joint function/complete soundness, and many will end up always having "knobby" joints. (Note; the general category of osteodystrophy covers other issues such as osteochondrosis, OCD, UAP, as well as potential sequella to such as H.O.D. as early closure of the distal ulna & elbow "dysplasia," but a narrow view taken here & the below discusses H.O.D., pano & (epi)physitis.)

H.O.D. is the most severe form in this broad spectrum of bone diseases. It typically strikes young puppies (2-6 mo.), potentially causing lameness & joint deformity. It can end in profound & permanent effects, the need for surgery or even death. To avoid redundancy, follow these two links to learn more about this potentially serious disease: Fred Lanting's HOD page & a surgical/medical perspective of HOD. Pano(steitis) in contrast occurs late (6-12 mo.), is typically self-limiting & unlike the other diseases described here involves the SHAFT of the bone vs. the growth plate.

Epiphysitis (physitis) is defined as structural changes of the growth plates, the "itis" means inflammation. Symptoms are similar to other such inflammatory bone disorders: enlarged growth plates, altered gait and stance (even reluctance to move, lethargy, innappetite, fever and pain). Like panosteitis (pano), this disease strikes typically around/after 6 mo. (in contrast to hypertrophic osteodystrophy (H.O.D.), which often occurs earlier). Like H.O.D., epiphysitis involves the joints of the long bones (in contrast pano involves the shaft of the long bone). H.O.D. usually involves all four legs, first signs often appearing in the forelegs, pano "wanders" from leg to leg, and epiphysitis typically is found in the rear limbs first (but both H.O.D. & epiphysitis can be also seen in both front and rear). Sometimes they are all referred as forms of juvenille (rheumatoid) arthritis.

Etiology for all such growth disturbances is obscure (meaning the cause is in dispute), and they might be best viewed as less disease than syndrome, in that it can be that in one case the inflammation is caused by one thing, another case by something else entirely. Viruses such as distemper have been implicated, as are TBDs (tick borne diseases) and bacteria (sometimes strep/staph is found in a tapped joint). H.O.D. is thought to involve microfractures, perhaps brought on by compression or other factors, which then result in an inflammatory process that causes deformity. Sometimes the reason for the inflammation could be simply immunological (meaning no infection involved, like when there is a vaccine reaction, or other pathological "allergic" immune system response brought on by innate susceptibility). There is accumulating research to suggest "immune genes" are involved. Some cases are thought to be at least triggered simply by too rapid growth, with resulting joint damage (that ends in inflammation) and so high densitiy foods (those rich in calories and calcium) are also implicated. But there is no univeral theory or common thread to cling to but that reducing the inflammation & controlling the deforming process is critical to recovery.

Standard treatment for ALL osteodystrophies of this nature is pallative and supportive: rest, resticted diet, anti-inflammatories (e.g. NSAIDs) and a broad-spectrum antibiotics are typically prescribed. Radiographs (Xrays) and bloodwork (CBC, serum panel, TBD panel) are usually also employed--and are used both diagnostically (to define specific disease) and to monitor the dog's health and progress. Note definitive diagnosis is virtually impossible without radiographs.

Control of the destructive effects of pain & inflammation is critical & if NSAIDs do not rapidly make a difference, steroids may well be necessary. Antibiotics (from chloramphenicol to Primor) are often employed, athough less from these problems being primarily infectious in nature than to cover the potential for secondary infection with a dog in a weakened state and taking powerful anti-inflammatories (from Rimadyl to Prednisone). Restriction in exercise and reduction in diet (both amount fed and caloric intake) are often recommended. Some brands of food/feeding practices seem to be overrepresented where problems occur & most owners review the food choice in question. But it is the case that littermates can nearly simultaneously experience problems with no common environmental factors. And it's now generally thought these diseases are primarily inflammatory in nature, so the key to recovery is to reduce the inflammation, which is responsible for the symptoms seen, from pain to joint swelling. Rapid response & even aggressive treament at the first sign of clinical symptoms has been reported to often reduce the severity of the disease.

Bear in mind that growth "dystrophies" is in some ways an odd term in a breed of dog like the Dane, that, by definition, isn't ever really "normal" by the usual accounting. Giant breeds grow at an "alarming" rate by standard reckoning for canines, and the "normal" Dane puppy has enlarged growth plates & distorted-appearing joints from the perception of most. However there *IS* a point on this sliding scale from well-made Dane puppy to obvious pathology where treatment becomes necesssary, & for most this line would be crossed when the puppy experiences lameness or pain. Some cases are subtle & clincal signs are restricted to orthopedic symptoms which can appear slowly & progressively. Other cases involve sudden & severe symptoms, including general illness. Relapses are not uncommon, so affected puppies should be monitored throughout their adolescence. These are just more reasons to be sure as a Dane owner you truly get expert counsel about your puppy

Below is a set of reliable internet sites that accurately discuss the issues of growth & growth disorders in large & giant dogs:

Chick Newman (Ph.D, DVM) has a very readable article on the general topic of HOW TO FEED--click here as this IMO is a MUST READ Kathryn E. Michel (DVM, MS, DiplACVN, UPENN)) has a talk on development, disease & nutrition I've reproduced here: Nutrition and Developmental Orthopedic Disease Here is another classic by Daniel Richardson (DVM, Diplomate, American College of Veterinary Surgeons): Skeletal Diseases of the Growing Dog: Nutritional Influences and the Role of Diet MORE ARTICLES ON GROWTH ISSUES: Growing Pains: Growth Associated Bone Disorders in the Dog H.O.D.=Fred Lanting page for owners HOD: Recognition & Treatment from DVM group Osteochondrosis & related disorders (includes Pano) HYPERTROPHIC OSTEODYSTROPHY is the most serious of all these conditions & the GDCA is sponsoring a study into H.O.D, click here for more info.

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Best Regards, JP Yousha
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