Canine Hypertrophic Osteodystrophy

Hypertrophic Osteodystrophy (HOD - Skeletal scurvy, Moller-Barlow's disease, osteodystrophy II, and metaphyseal osteopathy 1) orthopedic bone disease seen in young large and giant breed dogs (including German Shephers, Great dames, Dobermans, retrievers, Alaskan Malamutes, Irish Setters, borzoi boxer, Weimaraner, collie, and greyhound - 5, 6,11), between two and six months old.1, 11 Development of the disease, decrease blood flow to the part of the bone adjacent to the joint (metaphysis), eventually failure of bone formation (ossification). Also, cells and tissue die (Necrosis) and inflammation of cancellous bone (the sponge-like tissue inside bones - 2) Limbs most affected are distal (farthest from the body in terms of direction) radius and ulna, comprised of the two bones from the elbow to the wrist (3) and tibia (larger of two bones in the leg below the knee) 4 The disease is confirmed by x-rays, shown as a thin dark line (radiolucent) at the growth plate (metaphysis) in the end of the ulna, radius or tibia. Also, bone structure of the skull and teeth maybe impaired. 1 Bones of Hypertrophic Osteodystrophy dogs develop microscopic fractures result in inflammation, pain and lameness. 12 Also, a blood test will indicate a higher than normal level of white blood cells (primary infection fighters), further provide evidence of the disease. 18

Symptoms of Moller-Barlow's disease observed: Dogs lameness or inability (reluctance) to walk, occur periodically and depression. 11 The disease frequently affects front and rear legs (bilateral). Also, often a dog will have a fever 104 - 104.2 degrees Fahrenheit (or dehydration 12) and anorexia (refusal to eat). "Over days the metaphyseal regions of the long bones (the area next to the growth plate, but towards the mid bone, not the joint) will be tender to digital pressure, slightly swollen and warm to the touch (using the inside of the wrist)." As a result of HOD, dogs develop shorter bone length and even curvature. 7 Not uncommon for the disease go into remission for a week and then appear in a different limb. 12 Also, the disease may cause unfortunate permanent structural limb deformities or death in some cases. 1 Death link to Hperatrophic Osteodystrophy caused by a secondary infection (if not treated immediately) or pneumonia, mainly because the dog only lies around, unless periodically moved side to side during the day. 17

The exact cause of Hypertrophic Osteodystrophy is unknown, but speculation as to the possible cause is being investigated. Theories as to the cause of HOD include a bacterial infection supported by high fever. Low level of vitamin 'C' may be a result of the disease, not necessarily the cause. Dog owners may inadvertently provide bad nutritional needs for their puppies (has not been confirmed). Advisable feed puppies a diet low in fat and protein to try to encourage moderate steady growth instead of rapid growth may prevent HOD. 1 In 1986, Utrecht University study, connected diets high in calcium and phosphorous with development of Moller-Barlow's disease in young growing Great Danes. 20 "There may be a link to recent vaccination with modified live vaccine, but not specific vaccine has been implicated." 4 "Stress may precipitate the disease, including a rapid dietary change over 1 to 4 days." 14

The disease may be related to a copper deficiency, but no scientific evidence to prove this theory. 17 Hypertrophic Osteodystrophy increased frequency in certain breed lines indicate a genetic component is suspected. 13

The type of treatment Hypertropohic Osteodystrophy, depends upon the severity of the disease, require more or less aggressive care. When HOD is diagnosed late in the development of the disease, dogs require IV fluids for nutritional support. Also, Pharyngostomy tube (feeding tube 8) may be inserted to administer liquid food. 7 Suggestion: "If the jaw is still very sore and your puppy won't eat, then puree it in a food processor and feed it on your finger massaging the throat to get him to swallow it." 19 Anti - inflammation and painkillers such as buffered aspirin; carprofen (Rimadyl) and Hydrocodone (10) are given to treat this painful disease. In some cases, steroids are administered to control pain. 1 Another type of anti-inflammatory medication is Prednisone. "The initial does is 2 mg/kg/day for 7 days. The dose is halved weekly for one month. The last week's dose may need to be extended for a fifth week." 7 Also, comfortable bed is recommended to provide optimal rest. Vitamin 'C' supplement may provide additional treatment but controversial among treatment options. 1 There is information or rumor to discontinue from dietary use, supplementation with vitamins and minerals, since massive Vitamin 'C" may contribute to promote calcification (hard calcium deposits in tissues - 16) link to this disease. 13, 15 In most cases, Solely Non-Steroidal anti-inflammatory drug Rimadyl 9 not proven to treat effectively Hypertrophic Osteodystrophy. 7 Advisable to keep the puppy moving and free from bedsores. 21 Skeletal scurvy may require surgery to restore limbs to normal function. 10

Many dog owners elect to have their dog euthanize rather than watch their puppy suffer from this painful disease, despite a good chance for recovery, long term. 15

References:

1) Hypertrophic Osteodystrophy - Peteducation.com

2.) Bone Disorders Glossary - http://medicalcenter.osu.edu/patientcare/healthcare_services/bone_disorders/bone_disorders_glossary/

3.) Premature Closure Ulna - http://www.shilohgtf.com/Premature%20Closure%20Ulna.htm

4.) Hypertrophic Osteodystrophy - http://en.wikipedia.org/wiki/Hypertrophic_osteodystrophy

5.) Encyclopedia of Canine Veterinary Medical Information - http://www.vetinfo.com/dencyclopedia/dehod.html

6.) Hypertrophic Osteodystrophy - http://www.angelfire.com/az2/iscaz/hypertrophic__osteodystrophy.htm

7.) Hypertropohic Osteodystrophy (HOD) - http://www.angelfire.com/az2/iscaz/hypertrophic__osteodystrophy.htm

8.) Managing PEG Tubes and Feeding Tubes - http://www.maxshouse.com/managing_peg_tubes_and_feeding_t.htm

9.) RIMADYL - http://www.rimadyl.com/display.asp?country=US&lang=EN&drug=RC&species=CN&sec=000

10.) Hypertrophic osteodystrophy (HOD) - http://www.dobermannreview.co.yu/default.php

11.) Hypertrophic Osteodystrophy - http://www.petplace.com/dogs/hypertrophic-osteodystrophy/page1.aspx

12.) Hypertrophic Osteodystrohy - http://www.shilohgtf.com/Hypertrophic%20Osteodystrophy.htm

13.) Canine Hypertrophic Osteodystrophy - http://www.workingdogs.com/doc0046.htm

14.) Hypertrophic Osteodystrophy - http://www.micbrc.org/hod.htm

15.) Hypertrophic Osteodystrophy (HOD) - http://www.irishdogs.ie/Information/vet/Hypertrophic%20Osteodystrophy%20(HOD).htm

16.) Calcification - http://www.wrongdiagnosis.com/c/calcification/intro.htm

17.) HYPERTHROPHIC OSTEODYSTROPHY - http://www.dogstuff.info/hypertrophic_osteodystrophy_swedlow.html

18.) Hypertrophic Osteodystrophy (genannt: HOD) - http://www.zevens.de/knochen2.html

19.) hypertrophic osteodystrophy - http://www.nextdaypets.com/directory/dogs/forum/9425.aspx

20.) 20.) Articles: RISK OF HYPERTROPHIC OSTEODYSTOPHY IN GREAT DANES - http://www.greatdane.co.za/articles%20-%20hypertrophic.htm

21.) HYPERTROPHIC OSTEODYSTROPHY (HOD) - http://www.weim.net/twn/Health/Medical/hypertrophic_osteodystrophy.htm