Panosteitis--at least eight weeks of pure bummer!

Pano. Growing pains. Long bone disease. Shifting lameness. What ever it's called, it just plain sucks. 

It's not known what causes it. (It's thought a virus.)

No prevention, or cure at this time. 

Treatment is pain management with dog-safe nsaids pain medications, and making the dog (usually still a puppy) as comfortable as possible.

To deal with this malady, you've got to be good at enduring a long period of watching pain in the innocent. 

Like I said, panosteitis sucks.  

It's sort of like the childhood diseases of my generation. The measles, mumps, and chicken pox were all nasty illnesses that just had to be endured when I was little. Each one individually, as I remember it, along with all its discomforts and malaise. (Couldn't just get them all over with at once, now. Oh, nooo... I had to be sick TWO Christmases in a row!) Now there's immunizations for them so most children never have to go through those miserable weeks of illness. (That's if parents can be convinced to get their kids immunized now-a-days. But that's a whole other can of worms I'm not going to open at this time.) 

In the case of pano, each long bone of the large, or giant breed dog, is afflicted with the disease, in turn, usually one bone at a time, but can be in more than one at the same time. 

German Shepherd Dogs make up 75% of all cases of panosteoitis treated, but it is not uncommon in the Doberman Pinscher,  Great Dane, The Wolfhounds, Mastiffs, Bernese Mountain Dogs, Great Pyrenees, even the Labrador and Golden Retrievers. 

We went through it with our last White German Shepherd Dog when he was 6 months old, and are now staring down the throat of another round with our female WGSD as she is just reaching her 6 month mark now. 

What is panosteitis?Panosteitis is a bone disease of dogs that is characterized by bone proliferation (growth) and remodeling (destruction). It is often painful and can last as long as 18 months, though more commonly it lasts from 2 to 5 months. It is characterized by lameness that often comes and goes and changes from leg to leg.
Reference taken from  http://www.peteducation.com/article.cfm?c=2+1561&aid=466

The way the remodeling part of the affliction was described to me was that the marrow of an afflicted long bone becomes pressurized by a decrease in internal space within the medullary cavity due to a thickening of the bone's interior walls at both, or either, end. Inflammation of the marrow then sets in, along with an accompanying fever, adding to the problem due to the ensuing swelling.  Since all this is happening within an enclosed space inside the bone, and the pressure has no release, the result is pain, and marrow destruction.

All, or most, of the marrow is destroyed by this internal fever and pressure. A deposit of web-like bone material is then built up inside the emptied medullary cavity. This spongy bone material is then, over time, dissolved and reabsorbed as marrow re-propagates within the cavity. The entire process takes several weeks, although the pain and inflammation usually lasts 2-3 weeks. It can leave the bone straighter than normal, and thicker walls towards the far ends (epiphysises) is not unusual.

Mostly, the process creates tremendous pain in whichever long bone it is affecting at the time. Usually, pano will settle into one long bone at a time, and although it can last for 1-3 weeks before it will show up again in another long bone, it can be in more than one bone at a time. Short bones and flat bones do not seem to be affected by the disease. (Thank heavens!)

The dog may run an elevated temperature, turn his nose up at food, lose muscle mass, or tone due to lack of exercise. Playing, or even walking, just plain hurts! It's no wonder they seem depressed, too, as they lay around on the most comfortable surface they can manage to get up on. Dogs with panosteitis need rest! Just remember, "This too shall pass."

What to expect at a vet visit:

• Your vet may first palpate (gently squeeze) areas of the dog's leg along the long bones to see if there is a pain response. The ulna and the radius are usually the first bones affected, then the humerus, femur, and tibia, take their turns.

• Your vet may radiograph (x-ray) the area. Panosteitis will demonstrate an increased patchy density of the bone cavity with a roughened surface. The lameness may precede the radiographic evidence of the disease by up to 10 days, so second rounds of x-rays to confirm the diagnosis may be required. 

• A prescription of NSAIDS pain reliever, or instructions on how much to give your puppy of over-the-counter NSAIDS pain reliever based upon weight. 

WARNING: Do not guess which medication would be appropriate to give your puppy, or guess at the dosage. The results could be toxic to your puppy. 

One other point worth mentioning, although the studies are not conclusive, is that over-supplementation and, feeding high calcium content dog foods may contribute to the occurrence of panosteitis. Check with your Veterinarian regarding suggested supplements and food appropriate for your dog and its age. 

Shifting lameness. Some will suffer with it, some won't. A few won't get it until around seven years of age, but most will be done with it by the time they're two. Rest assured that they all will outgrow their growing pains, and return to their normal banzai-selves soon enough. 

-woof!

Picture credit to Flying Mo and Friends Webpage.