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  Panosteitis

 

Common names or abbreviations:

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canine panosteitis (07)

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chronic osteomyelitis of young German shepherd dogs (07)

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endosteal proliferation of new bone (08)

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enostosis (03, 07, 08, 10)

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eopan (08)

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eosinophilic panosteitis (03)

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eosinophilic panosteitis of young German shepherd dogs (07)

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growing pains (02, 11)

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hematogenic chronic osteomyelitis (10)

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juvenile osteomyelitis (03)

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long-bone disease (10)

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osteomyelitis of young German shepherd dogs. (03)

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pano (09)

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shifting leg lameness (01)

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wandering lameness (02, 09)

Description or definition:

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Panosteitis (PAN' os-te-I-tis) which means, literally, inflammation of
every part of the bone (pan- + Gr. osteon bone + itis), was first described
in European veterinary literature in 1951 (07).

It is an inflammation inside the long bone of a fast-growing adolescent
large or giant breed dog*, most often the German shepherd (01, 02, 03, 04).

Usually the afflicted is male. However the female sometimes develops this
disease at time of first heat (01, 02, 03). The bone most often affected and,
usually, affected first is the ulna, one of the two long bones in the lower
forelimb (10).

Although the origin of panosteitis is unknown there is thought to be a
genetic component (04) with episodes being triggered by physiological stress
(03, 07). There may also be a viral trigger (04, 07). Growth rate may be a
factor (10) as may be an allergic response, a metabolic phenomenon or a
parasite infestation (07, 11).

Symptoms appear abruptly. For no apparent reason the dog begins to limp. 
Pain may become so severe the dog is reluctant to use the leg at all (12). 
He may also become lethargic and/or feverish, loosing both appetite and 
weight (10).

Palpation of the middle of the affected leg will elicit a pain response from the
dog (01, 03, 04, 05, 10, 12 ). Often the pain and accompanying lameness 
appear to "shift" from one leg to another, usually from a forelimb to a 
hindlimb and then back (02, 03, 07). The "shift" in pain comes about as the
disease resolves in one bone and begins in another (02, 03, 07).

There is no human counterpart for panosteitis (10).

Although the disease is self-limiting (02, 03) and disappears as the dog reaches 
maturity, it is cyclic in nature (04) and may continue to recur for up to a year
and sometimes longer (04). The pain ranges from moderate to excruciating, 
with the worst of it lasting from one to two months (04). The lameness lasts 
from two to three weeks for each affected bone (07, 08, 11). Often there are
painfree interludes between periods of lameness (11). The entire cycle can 
last from 90 to 190 days (02, 07). Time elapsed between cycles varies from 
160 to 180 days (07).

Panosteitis generally occurs in dogs between five and 18 months of age
(07, 08), although episodes of the disease have been reported in German 
Shepherd dogs as young as two months (04) and as old as five years (07).

Bones affected are in the lower foreleg (ulna and radius), upper foreleg (humerus), 
the thigh (femur) and the lower hind leg (tibia). There are no reports that the fibula
(the other long bone in the lower hind leg) is affected (05, 07, 10).

To understand what happens during an episode of panosteitis, consider the
structure and function of the long bone.

Long bones, essentially hollow tubes with fortified and knobby ends, do
more than keep legs (and arms) straight. They provide "hooks" for tendons,
manufacture blood (13) and store calcium and phosphorus (13).

The hollow middle section (staff) of the long bone is filled with
blood-producing marrow and fat cells (adipocytes) (07) which die as bone
cells (osteoblasts) are produced. Panosteitis is called a disease of the fat
tissue in the bone marrow (06), a disease of osteoblasts (10), a disease of
the fatty bone marrow (10) and a disease of the adipose bone marrow (07).

During periods of rapid growth fibrous material develops in the bone
marrow.

For the unlucky dog, it is a case of too much, too soon. There isn't enough 
space inside the bone shaft for everything being produced there.  Congestion 
builds (10). Discomfort evolves into pain. The dog starts to limp.

Then the fibrous material is gradually absorbed into the inner walls of
the bone shaft and new bone is deposited on the outer surface of the bone.  
The congestion abates as does the pain (10).

Panosteitis doesn't occur simultaneously in all the long bones of the affected
dog and this is why this painful condition is said to migrate or wander.

X-rays of the affected bone are likely to show increased density in the congested 
marrow cavity (01, 02, 04 ). Although usable X-rays may be difficult to obtain 
because of the transient nature of the disease, using radiographs can rule out other
diseases (03, 07) such as hypertrophic osteodystrophy (05), elbow or hip dysplasia,
cruciate ligament injury, osteochondritis dissecans (OCD) or osteochondrosis (OC),
both developmental cartilage abnormalities occurring in the joints of growing dogs (03).

There are no elevated enzyme levels with panosteitis or any consistent blood work 
abnormalities (03, 07). However, some dogs have been found to have one or the 
other of two blood disorders concurrently with panosteitis. Both Hemophilia A 
and von Willebrand's Disease (vWD) have been linked to panosteitis (10).

There is no proven way to prevent the disease, but methods to manage the
symptoms are available.

Treatment consists of rest and the use of analgesics (03). Sometimes Rimadyl or
Etogesic is prescribed. Although corticosteroids may be used for the most serious 
cases (04, 07), steroids, in general, are not recommended for the growing pup (03).
Intravenous therapy may be required for rehydration (08).

Although vigorous exercise is unwise, moderate exercise is recommended to build 
and maintain muscle mass (09).

Maintaining the pup, nutritionally, is another matter. People stew about what to 
feed the growing pup who either has panosteitis or may be at risk for developing it.

Some say the condition or the risk for developing it is intensified by feeding calorie-
dense diets and over-supplementing with calcium and phosphorus. Therefore, some
recommend changing from puppy food to either an adult formula dog food or a 
large breed puppy slow growth formula. 

Others say giving a growing pup a low-protein, low-calcium adult formula food will
lead the pup to overeat to satisfy his energy requirements and, in so doing, overload 
on calcium.

Therefore, others recommend continuing to feed puppy food, but to give only the 
amount necessary to meet energy requirements and promote growth.  Calcium and 
vitamin supplements should be avoided (10).

It is also suggested that the pup be kept slender (04).

For X-rays and a picture of the canine skeleton as well as technical and detailed 
discussions of panosteitis see the linked references.

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* also has been seen/reported in the Airedale terrier, basset hound,
Doberman pinscher, German short-haired pointer, golden retriever, Great Dane,
Irish setter, Labrador retriever, miniature schnauzer, Samoyed, St. Bernard
and the Scottish terrier. (06, 07) and the Rottweiler and beagle (10).

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References and Links:

01) http://www.vetmed.ufl.edu/sacs/Lewis/Lewis-Diff_Dx_of_Forelimb_Lameness/page8.html  includes lateral view radiograph of dog humerus affected with panosteitis.

02) http://www.barkbytes.com/medical/med0041.htm  note: summarizes Richard's article.

03) http://www.petplace.com/articles/artShow.asp?artID=223   PetPlace.com - Article: Panosteitis.

04) http://www.vetinfo.com/dencyclopedia/depano.html  Encyclopedia of Canine Veterinary Medical Information Panosteitis Mike Richards DVM includes one view of proper diet to feed at-risk pup.

05) http://www.southpaws.com/news/97-2-lameness.html Summer 1997 News > Large Breed Puppies and Lameness   includes: comparison of panosteitis and hypertrophic osteodystrophy.

06) http://www.provet.co.uk/health/diseases/Panosteitis.htm   PROVET HEALTHCARE INFORMATION - Panosteitis  includes picture of X-ray Canine Panosteitis.

07) http://www.ivis.org/special_books/ortho/chapter_49/49mast.asp  detailed discussion of malady from a 17-year-old textbook has pictures of X-rays.

08) http://www.vetsurgerycentral.com/panosteitis.htm  FOCAL POINT & KEY FACTS.

09) http://www.geocities.com/Petsburgh/9139/pano.html DKKennels - Eosinophilic Panosteitis.

10) http://www.gsdhelpline.com/pano.htm detailed article by GSD expert, Fred Lanting.

11) http://www.gvsvet.com/panosteo.htm includes illustration and photograph of affected leg.

12) http://siriusdog.com/pano.htm  Skip first two parts. Article of interest is the third one.

13) http://www.batw.com/netpet/articles/bones.html  Bone and Blood Supply to Bones NetPet presents an Online Gross Anatomy Lecture (c)1995 Bonnie Dalzell, MA ~ outline for lecture given at University of Pennsylvania, School of Veterinary Medicine.

14) "Dorland's Illustrated Medical Dictionary," 25th edition, W.B. Saunders, Philadelphia, London, Toronto, 1974.

 

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Photos, Diagrams, etc. :

http://www.specificbreeds.com/html/skeleton.html  Dog skeleton and its function.

 

 

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Copyright © 1998 - 2009. Shiloh Shepherd Dog™ Club of America.
All rights reserved. Revised: January 2008

The information on this website was written by ISSR breeders and other concerned individuals, however we are are NOT veterinarians. This information is being provided as a general overview, from information we were able to find about each disease through our own research. These summaries are not intended to be relied upon as medical or veterinary advice, nor do we consider ourselves experts in the veterinary field or in any of these conditions. While we do our best to provide the most up to date information, new research is constantly being done on these diseases. We recommend that you do further study and talk to your veterinarian on any topics you see here, as we cannot guarantee that the information posted here is the most current information available.  This site was originally designed and maintained by Debbie Knatz.