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Panosteitis -Pano

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What is Panosteitis, Also known as Pano?

​Panosteitis is sometimes called growing pains."Panosteitis is a painful inflammation of the outer surface or shaft of one or more long bones of the legs. It is sometimes called "growing pains." Panosteitis may occur in more than one bone at a time or may move around from area to area, cause a "shifting" lameness that goes from one bone or leg to another. The lameness tends to occur very suddenly and usually occurs spontaneously, or without a history of trauma or excessive exercise.
Are all dogs affected with this condition? Panosteitis is a condition that affects young, rapidly growing dogs. Although it can occur in any breed of dog, larger breeds, such as German Shepherds (most common) are more prone to this problem. Affected dogs are usually between 5 and 14 months of age, but the first symptoms may occur as early as 2 months of age or as late as 18 months of age. Males seem to be affected more often than females, although either sex can develop panosteitis. Affected dogs often have recurrent episodes of panosteitis until they reach 2 years of age, at which time it will spontaneously resolve.

What is the cause?
Panosteitis is a painful condition, and the pain is likely caused by increased pressure within the bone, and/or by stimulation of pain receptors in the periosteum, or outer, soft tissue lining of the bone. The underlying cause of panosteitis is unknown, but genetics, stress, infection, metabolism, or an autoimmune component may be factors. Since German Shepherds seem to be particularly predisposed to panosteitis, there may be a genetic component to the disease, at least in this breed. It has also been suggested that rapid growth and high-protein, high-calcium diets may predispose some dogs to this condition. More recent studies show that it may be caused more by the energy derived from the puppies diet as opposed to the level of protein or calcium.  Be sure you are feeding a high quality puppy diet.   Feeding your puppy more frequently and smaller meals per day can reduce the symptoms and onset of Pano.  If your dog experiences Pano it is our recommendation that you spread your puppies meals out between 4 smaller meals per day.  DO NOT just add additional feedings, providing more food per day.  Divide the recommended amount to add one additional feeding.  In other words, if your instructions say to feed your puppy 3 cups of food a day, you will now feed your puppy the same 3 cups per day but in 4 meals instead of only 3 meals.

What are the clinical signs?
The typical symptom is a sudden, unexplained, painful lameness of one or more legs. The lameness may be mild or severe. The most common bone that is affected is the humerus (upper arm), but panosteitis may also be found in the radius and ulna (the foreleg), the femur (thigh) and/or the tibia (lower rear leg). The affected bone will be painful to the touch. Other symptoms such as fever, anorexia, lethargy, or weight loss may be noticed.  Panosteitis tends to have a cyclic nature, with periods of worsening symptoms followed by periods of improvement. The pain often shifts from leg to leg. Each episode of lameness may last for a few days to a few weeks, and the period between episodes is often about a month, but may vary.

What is the treatment?

For a Holistic option you can purchase T-Relief for dogs.  It is an alternative to NSD pain relievers for use during bouts Of Pano.  I found the best pricing at Leerburg.com 

Although this disease is self-limiting, and will spontaneously resolve, during episodes of lameness the condition is very painful. At these times, treatment is supportive, using analgesics (pain medications) and/or anti-inflammatory drugs as needed.
"Pain control should always be given to help your pet feel more comfortable; denying your dog pain control is inhumane."Pain control should always be given to help your pet feel more comfortable.  During episodes of lameness, exercise should be restricted. Between episodes, light to moderate exercise should be encouraged, but hard or vigorous exercise is discouraged, as are very long walks.  Some dogs with panosteitis have a poor appetite; in these cases, it is important to ensure that they are given a properly balanced and palatable diet. In some cases, supplements such as nutraceuticals, Omega fatty acids or antioxidants such as Vitamin C may be helpful.  Do not supplement your puppy with Calcium!  You can give your puppy raw beef bones from your local butcher but do not give them more than 1 per week.  The raw beef bones have natural calcium and bone marrow.  Your puppy will love them!

In a recent nutritional seminar I attended it is suggested that Panosteitis can be controlled better by limiting the amount of energy, not protein the dog receives through their diet.  In other words, if you are feeding your puppy the required amount of  Puppy food for their weight you should spread the energy provided by the diet throughout the day.  Example:  If you are feeding your puppy three times per day, split the same amount of food into 4 meals per day.  This will take the energy that is created through the diet and spread it into smaller bursts of energy throughout the day reducing the inflammation of the quick spurts of energy by feeding larger amounts of food in fewer meals throughout the day. 

What is the prognosis?
Panosteitis is a self-limiting disease, meaning that it will eventually go away. The disease should be completely resolved by the time the dog reaches 18-24 months of age. Each episode of lameness should last no longer than 3 weeks; if your pet's lameness persists without relief for longer than 4-5 weeks, it is likely that the dog is affected with another bone disorder.
If panosteitis is a self-limiting disease, why is it necessary to perform diagnostic procedures such as radiographs? Although panosteitis is not a serious disease, and is a common cause of lameness, other, more serious bone diseases can cause lameness in young dogs. In order to be sure that a sudden onset of lameness is not caused by one of these more serious bone diseases, radio-graphs must be taken. If the radio-graphs show the typical lesions of panosteitis, then you can rest assured that your dog will eventually outgrow the problem.  If your puppy suddenly appears to be limping and no evidence of injury has taken place, please call us so we can help determine if it is Pano.  We see Pano more frequently in male puppies but it is not uncommon to see in females as well.

Are there any preventive measures I can take to prevent panosteitis in my large breed dog?"
For many years, it has been suggested by many breeders, to feed your puppy a lower protein diet to reduce the lameness. More recent studies and through continued nutrition training, it has been discovered that although there are potential links between diets containing excessive levels of dietary protein and/or calcium, it is contradicted to feed large breed puppies with an adult dog food that contains lower levels of protein and calcium.   The reason for this is that adult dog food also has lower calories or energy levels than puppy food. Rapidly growing puppies require higher levels of dietary energy to meet the needs of growth, and will need to eat more of a low-energy food to meet these requirements. Eating more of a low energy diet will result in a higher overall intake of protein and calcium. A better option is to feed an affected dog a high quality diet, we recomend Fromm puppy food (in the pink bag).  These diets have been specifically formulated for use to restrict the quantity fed to keep the dog at a lean, healthy body weight.  In addition, it is important for you to understand that puppies also process calcium differently than adult dogs and cannot eliminate any excess calcium that he may receive through an adult diet like an adult dog can.   If your puppy is affected with Pano and you currently feed your puppy three times a day, increase your feedings to the same amount of food but, spread it to over 4 times per day.  Smaller proportions at each feeding will meet his daily nutritional needs,  reduce the amount of energy the dog receives at each feeding, spreading that energy throughout the day therefore,  reducing the inflammation.   Once your puppy reaches adulthood, and has no further episodes of Pano, generally by 2 years old he can be reduced to feeding once per day.  Dogs should have their intestinal tract completely empty for optimal intestinal health.   Do not allow your puppy to become overweight. Consult your veterinarian for further advice on the most appropriate nutrition for your dog.

This client information sheet is based on material written by: Cheryl Yuill, DVM, MSc, CVH 
               &
Central Coast German Shepherds

Please call us with any questions that you may have about Panosteitis or anything else you may have concerns about.  We are always here to help you and your German Shepherd!

This is for informational purposes only and should never take the place of your consultation and recommendations by your Veterinarian.
  • HOME
  • CONTACT
  • STORE
  • NuVet
  • Puppies
    • Puppies AVAILABLE & Litters
    • FAQ about Getting a Puppy from CCGS
    • Deposit INSTRUCTIONS
    • How we raise our puppies
    • More on Raising our Puppies
    • Why our Breeding Stock come from Europe!
    • GERMAN vs AMERICAN
    • HEALTH WARRANTY
    • TESTIMONIALS
    • Socialization
    • Purchase Warranty
    • Male vs Female Puppy
    • FEEDING / GROOMING
    • Vaccination Schedule
    • Kuranda Beds
    • TRAINING >
      • German Dog Commands
      • More on Puppy Biting - Ouch
      • House Breaking your new puppy
      • Crate Training
      • Stages of Puppy Development
      • Socializing Puppies
      • Spaying and Neutering
      • Veterinary Care
    • LIFE SAVING INFO >
      • More Spaying and Neutering
    • Ears not standing?
    • Recommended Reading
    • Why buy from a reputable breeder?
    • Coat Type & Coat Colors
    • What to look for in a puppy
    • When do we wean the puppies
  • Stud Dogs
    • Working IPO
  • Our FEMALES
  • TRAINING
  • MEMBERS
    • Your PUPPY News
    • Temperament Testing Key
    • BURMA X YURI 11/23/22 >
      • Vaccinations & Vet 11/23/22 Litter
      • Temperament 11/23/22 Litter
    • PAM X YURI Litter 10/2/22 >
      • Pam 10/2/22 Vaccinations & Temperament & VET Exams
    • SARA X YURI 7-29-22 >
      • Temperament & Vaccinations
  • Health Risks
    • LIFE SAVING INFO
    • Hip Dysplasia
    • Panosteitis (PANO)
    • Heart Mur Murs
    • Poisonous to Dogs & Puppies
    • Undescended Testicle(s)
    • Umbilical Hernias
    • FLEA TREATMENTS
    • VACCINATING TOO MUCH
  • Adult Dogs Available
  • Our Ranch In the Making
  • I am a breeder
  • Puppies First Days at Home
  • MICROCHIP REGISTRATIONS
  • Service Dogs