Panosteitis

Panosteitis is a painful condition that affects the long bones. It appears spontaneously and is auto-limiting (lasts several weeks to several months). It mainly affects young dogs (5 months to 2 years) of medium to large breed, but the illness may also observed in dogs at 2 months to 5 years. German Shepherds are most at risk. Males are more frequently affected than females.

We ignore the cause of panosteitis. We know that it is associated with an excessive bone remodeling following the death of certain cell inside the bone. This cellular death is attributed to vascular congestion, but the primary cause remains unknown.

The clinical signs reported are a sudden limping of varying severity, which typically lasts 1 to 3 weeks and which alternates from one paw to another. The anterior limbs are usually affected first. Occasionally, systemic signs such as anorexia and weakness may be present and may require a hospitalization. Panosteitis should be differentiated from infectious diseases, immune mediated arthropathy and other diseases of bone growth.

The physical examination will reveal pain through the strong palpation of the bones affected. X-rays are the diagnostic test of choice because they allow us to see the characteristic lesions. However, these lesions may not be present in the acute phase of the illness. Furthermore, we may also observe radiographic lesions in other limbs that show no pain when examined.

The goal of treatment is to control the pain in order to permit the normal activities of the animal. To do this, non-steroidal anti-inflammatories may be used (ex. meloxicam, deracoxib, carprofen). Strong analgesics such as opioids, nutritional support or a short term hospital stay may prove necessary in more severe cases. Rest does not speed up the healing process but may reduce the pain. The possible complications are mostly related to the medication rather than the illness, and include gastrointestinal lesions, damage to the liver and kidneys and problems with coagulation (rare with the majority of anti-inflammatories used). Natural products and vitamins have not been proven effective in reducing the symptoms, duration nor the severity of panosteitis. A persistent limp should be reevaluated every 2 to 4 weeks in order to detect any concurrent orthopedic problems.