LARGE BREED PUPPIES AND LAMENESS:
Panosteitis or Hypertrophic Osteodystrophy?

Aime G. Berman, V.M.D.

Into your office walks a German Shepherd puppy about 3 months old. He has shifting leg lameness but is otherwise completely normal. You squeeze up and down his long bones and somewhere along the bone he squeals and squirms telling you it hurts. You tell the owners their puppy has Panosteitis and that his problem is self limiting. Baby aspirin is prescribed and the owners are relieved that their puppy is OK.

The owners leave, you see routine appointments the rest of the day, and home you go for dinner and bed. As you lie in bed and think about your inspiring day at the office, you begin to wonder where exactly along the bone did that dog feel pain. It occurs to you that he was particularly painful at the ends of the bones, and that he was younger than expected for Panosteitis. Hypertrophic Osteodystrophy sails through your memory and you begin to question your diagnosis.

PANOSTEITIS	HYPERTROPHIC OSTEODYSTROPHY
Age: • 6-18 months	Age: • 2-8 months (usually 3-4 mos)
Duration: • Recurring bouts up to 18 mos	Duration: • A few days to several weeks
Clinical Signs: • Acute lameness • Intermittent lameness in one or more limbs • Early stages - anorexia, lethargy, pyrexia,weight loss • Pain on palpation of diaphysis of long bones	Clinical Signs: • Acute lameness • Lameness varies from mild limping to severe lameness • If systemically ill - depression, inappetence, pyrexia, neutrophilia, lymphocytopenia, monocytosis • Metaphyseal swelling and pain
Bones affected: • Ulna, humerus, radius, femur, tibia (occasionally ilium and tarsus)	Bones affected: • Ulna, humerus, radius, femur, tibia
Radiographs: • Granular, hazy increase in radiopacity • Begins in nutrient foramen and may extend to entire medullary cavity	Radiographs: • Irregular radiolucent zone in metaphysis separated from the normal growth plate by a dense band • May see soft tissue swelling around metaphysis • Later stage - metaphyseal enlargement with irregular periosteal new bone formation
Cause: • Unknown • Possibly genetic predisposition • Possibly viral	Cause: • Unknown • Possibly hypovitaminosis C • Possibly over nutrition • Possibly virus
Treatment: • Anti-inflammatory analgesics	Treatment: • Anti-inflammatory analgesics • Good nursing care (if complications exist)
Prognosis: • Self-limiting	Prognosis: • Self-limiting unless complications occur