Panosteitis

Key Points

+ Lameness usually lasts 2 to 3 weeks, but not longer than 5 weeks; therefore if your pet’s lameness has been going on for longer than 5 weeks, your pet likely has another condition

+ The lameness may shift from one limb to another

+ This disease is treated with pain medications

+ This disease usually does not recur after 12 to 18 months of age

 

Signalment

  • Young large breed dogs that are 6 to 18 months old
  • Common breeds affected
    • German Shepherds (most common)
    • Great Danes
    • Doberman Pinscher
    • Golden retriever
    • Labrador retriever
    • Basset hounds

 

Synonyms

  • Eosinophilic panosteitis
  • Enostosis
  • Endosteal proliferation of new bone
  • Eopan

 

Clinical Presentation

  • Affects the shaft of long bones
    • Top of the ulna (front limb)
    • Lower part of humerus bone (front limb)
    • Central radius bone (front limb)
    • Central femur bone (thigh bone)
    • Upper end of tibia bone (hind limb)
  • Lameness is frequently of sudden onset
    • May be mild to severe
    • Lameness usually lasts 2 to 3 weeks, but not longer than 5 weeks; therefore if your pet’s lameness has been present longer than 5 weeks, your pet likely has another condition
    • The lameness may have a recurrent pattern
    • The lameness may shift from one limb to another
  • The affected bone is painful to touch
  • Some dogs can show signs of
    • Fever
    • Tonsillitis
    • Elevated white blood cell count

Radiograph


Signs on Radiographs (x-rays)

  • If the disease is early in its course, no abnormalities may not be seen on the radiographs; if the radiographs are repeated in 2 weeks the problem usually can be seen
  • Increased density in the marrow cavity of the affected bone can be seen
  • The wall of the bone becomes thicker due to new bone formation on the inner and outer layer of the bone
  • Two to three months later the bone normalizes, and the bone looks normal on radiographs again
  • In the radiograph take note of the lighter spots in the marrow cavity (denoted by the arrows) which is eopan
  • CT scan:  Panosteitis is a blotchy density within the bone marrow cavity

CT scan

Microscopic Signs

  • There usually is no inflammatory component of panosteitis
  • The main change seen is fibrosis of the marrow (scar tissue develops)
  • With time the fibrous tissue changes into bone, hence the increased density as seen on the radiographs
  • New bone formation on the inner and outer part of the bone can be seen

 

Cause

  • Unknown
  • Potentially an unidentified viral infection

 

Treatment

  • Self-limiting disease that has a spontaneous recovery
  • Repeated bouts of this disease are about one month apart
  • Problem usually does not recur after 12 to 18 months of age
  • Treatment is supportive
  • Anti-inflammatory medications
  • If the pet is systemically ill, then intravenous fluid therapy may be needed for rehydration


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