“Jason” was a beautiful, long coated German Shepherd. He was just coming up twelve months of age, and he was still very much a big, boisterous, daft “pup”.
Jason was brought into the clinic with a history of a recently noticed lameness’s in his forelimbs, which seemed to shift from his left, then to the right forelimb. On examination Jason was uncomfortable and particularly painful when examined around his upper forelimbs. Radiographs were advised and Jason was diagnosed with Panosteitis of both his Humerus; his upper forelimb bones.
Panosteitis is a painful inflammation of the outer surface or shaft of one or more long bones of the legs. It may occur in more than one bone at a time, or may move around, causing a “shifting” lameness that goes from one bone or leg to another. The lameness can occur very suddenly and spontaneously without a history of trauma or excessive exercise.
Panosteitis is a condition that affects young, rapidly growing dogs. Although it can occur in any breed of dog, the larger dog breeds, such as German Shepherds, Great Danes, Golden Retrievers, Labrador Retrievers, Rottweilers, Doberman Pinschers, and Basset Hounds, are more prone to this problem. Affected dogs are usually between 5 and 14 months of age, but the first symptoms may occur as early as 2 months of age, or as late as 18 months of age. Males seem to be affected more often than females, although either sex can develop panosteitis. Affected dogs often have recurrent episodes of panosteitis until they reach 2 years of age, at which time the condition will spontaneously resolve.
Panosteitis is a painful condition, and the pain is likely caused by increased pressure within the bone, by stimulation of pain receptors in the periosteum, the outer, soft tissue lining of the bone. The underlying cause of panosteitis is unknown, but genetics, stress, systemic infection, metabolism, or an autoimmune component may be factors. German Shepherds seem to be particularly predisposed, and inappropriate nutrition may also predispose some large breed dogs to this condition.
Typical symptoms are a sudden, unexplained, painful lameness of one or more limbs. The lameness may be mild or severe. The most common bone that is affected is the humerus of the forelimb, but panosteitis may also be found in the radius and ulna; both bones in the lower foreleg, and in the femur; in the upper hindleg, and the tibia; in the lower hindleg. The affected bones will be painful to the touch. Other symptoms such as fever, inappetence, lethargy and weight loss may be noticed.
Panosteitis tends to have a cyclic nature, with periods of worsening symptoms followed by periods of improvement. The condition often shifts from one leg to another. Each episode may last for a few days to a few weeks, and the period between episodes is often about a month but may vary.
Panosteitis will be suspected if the dog shows pain when pressure is applied to the affected bone. The diagnosis is confirmed by radiographs, which usually show a characteristic image and increase in the density of the affected bones. The degree of change may not correlate to the severity of the lameness, and in some cases, radiographic evidence may not be present for up to ten days after the lameness begins; in these cases, repeat X-rays are taken two weeks later to confirm the diagnosis. After the condition has resolved, the bone density returns to normal, and the bone looks normal on radiographs. A blood sample may also be recommended, as your vet will be looking for an increased white cell count. X-rays are important to rule out other more serious causes of lameness.
Panosteitis is a self-limiting disease and should be completely resolved by the time the dog reaches 18-24 months of age. If the radiographs show the typical lesions of panosteitis, then you can rest assured that your dog will eventually outgrow the problem. Each episode of lameness should last no longer than 3 weeks; if, however, the lameness persists without relief for longer than 4-5 weeks, then there may be another bone disorder.
Although this disease is self-limiting, and will spontaneously resolve, during any episodes of lameness the condition is very painful. Treatment is supportive, using pain relieving and anti-inflammatory medications as needed.
During episodes of lameness, any exercise should be restricted. Between episodes, light to moderate exercise should be encouraged, but hard or vigorous exercise is discouraged, as are any long walks.
Some dogs with panosteitis episodes can have a poor appetite; in these cases, it is still important to ensure that they are given a properly balanced nutritious diet.
A dog with panosteitis requires strict, restricted exercise, and will require a reduction to his food allowance whilst resting and recuperating. It is important to keep the young dog at a healthy weight, to avoid extra pressure on his limbs. Ensure that your chosen diet is balanced and contains all the nutrients your puppy needs at the correct level and don’t add extra vitamins or minerals unless your vet has specifically recommended this. The pups’ diet should not be overly high in fat or calories, and specially formulated to promote slow and steady growth.It is advised to feed a high-quality diet that has been specifically formulated for use in large breed puppies or adolescents, and to take care on quantity fed to keep the dog at a lean, healthy body weight. Nutraceutical joint supplements may also be of some benefit.
Young “Jason” was given pain relief and anti-inflammatory treatment and a strict guide for his exercise and a diet specific and appropriate for his Large Dog type and breed. He did have one or two recurring episodes of forelimb lameness until he was around two years of age, then thankfully his symptoms fully resolved.
If you do recognise any of these symptoms in your dog. Please contact your vet for an appropriate appointment and check-up.
Alison Laurie-Chalmers,
Senior Consultant,
Crown Vets.