Panosteitis

Panosteitis, sometimes shortened to pano among breeders,[1] is an occasionally seen long bone condition in large breed dogs. It manifests with sudden, unexplained pain and lameness that may shift from leg to leg, usually between 5 and 14 months of age, earning the nickname "growing pains. "[2] Signs such as fever, weight loss, anorexia, and lethargy can also be seen. The cause is unknown, but genetics, stress, infection, metabolism, or an autoimmune component may be factors.[3] It has also been suggested that rapid growth and high-protein food are involved in the pathogenesis.[4] Whole blood analysis may show an elevated white blood cell count; this finding lends support to the theory that panosteitis is due to an infection.[5]

For the condition in humans and disambiguation, see Osteitis

Panosteitis is characterized histologically by an increase in activity of osteoblasts and fibroblasts in the periosteum, endosteum and bone marrow, resulting in fibrosis and the formation of connective tissue in the medullary cavity of the affected bone. Pain may be caused by increased pressure in the medullary cavity and the stimulation of pain receptors in the periosteum.[6]

The humerus is most commonly affected.[7] Males are more commonly affected than females.[8]

Diagnosis

Diagnosis is often a diagnosis of exclusion, meaning that other possible causes of lameness have been ruled out, such as hypertrophic osteodystrophy and osteochondrosis dissecans. History, signalment, and clinical signs can help a veterinarian form a presumptive diagnosis. On physical exam, the dog may display signs of pain on palpation of the long bones of the limbs. X-rays may show an increased density in the medullary cavity of the affected bones, often near the nutrient foramen (where the blood vessels enter the bone). This evidence may not be present for up to ten days after lameness begins.[9]

Treatment

Treatment consists of alleviating the pain and inflammation so that the dog is comfortable. This is achieved with the use of analgesics and anti-inflammatory drugs, like carprofen. Steroids may be given in more severe cases to reduce inflammation. It is also recommended to limit physical activity during treatment to prevent exacerbating the condition with high impacts.[10] Lameness usually goes away after days to weeks without additional treatment. Recurrences up to the age of two years may occur.[9] Larger breeds, such as German Shepherd Dogs, Golden Retrievers, Basset Hounds, Dobermanns, Labrador Retrievers, and Rottweilers, are more prone to this problem.[11] There has been one suspected case of panosteitis in a fast-growing six-month-old camel with a shifting leg lameness.[12]

Panosteitis is also referred to as eosinophilic panosteitis, enostosis, endosteal proliferation of new bone, and eopan.

References
  1. Frawley, Ed. "Panosteitis or PANO" (PDF). Leerberg Enterprises. p. 3. Retrieved 2013-06-24.
  2. Ettinger, Stephen J.; Feldman, Edward C. (1995). Textbook of Veterinary Internal Medicine (4th ed.). W.B. Saunders Company. ISBN 0-7216-6795-3.
  3. "Panosteitis". The Merck Veterinary Manual. 2006. Retrieved 2007-01-01.
  4. Schawalder P, Andres HU, Jutzi K, Stoupis C, Bösch C (2002). "Canine panosteitis: an idiopathic bone disease investigated in the light of a new hypothesis concerning pathogenesis. Part 1: Clinical and diagnostic aspects". Schweiz Arch Tierheilkd. 144 (3): 115–30. PMID 11980379.
  5. Brooks, W. (2017, September 15). Panosteitis: Growing Pains in Dogs - Veterinary Partner. Retrieved March 19, 2019 from https://veterinarypartner.vin.com/default.aspx?pid=19239&id=4953019
  6. Demko J, McLaughlin R (2005). "Developmental orthopaedic disease". Vet Clin North Am Small Anim Pract. 35 (5): 1111–35, v. doi:10.1016/j.cvsm.2005.05.002. PMID 16129135.
  7. Baird H, Kerwin S, Henry G, Porterpan B, Johnson M (2005). "What is your diagnosis? Panosteitis". J Am Vet Med Assoc. 226 (6): 871–2. doi:10.2460/javma.2005.226.871. PMID 15786986.
  8. Biery, D.N.; Lenehan, T.M.; Van Sickle, D.C. (1985). "Canine Panosteitis". Textbook of Small Animal Orthopaedics. Retrieved 2006-08-19.
  9. Wehrenberg, Aaron; Elkins, A.D. (Sep 2006). "Juvenile Orthopedics". Veterinary Forum. Veterinary Learning Systems. 23 (9): 22–28.
  10. Johnson, A. (2014).  Small Animal Pathology for Veterinarian Technicians. Hoboken: Wiley Blackwell.
  11. "Panosteitis". Canine Inherited Disorders Database. University of Prince Edward Island. 1998. Retrieved 2007-01-01.
  12. Levine DG, Smith JJ, Richardson DW, et al. (2007). "Suspected panosteitis in a camel". J. Am. Vet. Med. Assoc. 231 (3): 437–41. doi:10.2460/javma.231.3.437. PMID 17669048.
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