Article By Dr. Stan Kunin

Whenever a new dog is introduced into a household, there is always a feeling of excitement, whether the puppy is 8 weeks old or 8 months old. From the start, everything seems wonderful, but as with everything else in life, nothing is guaranteed, especially in regard to health.

This column's topic will cover one of the unexpected problems that can occur in dogs, especially in large and giant dogs, but also occasionally the small/medium sizes as well, juvenile bone disease. This disorder may crop up during a rapid growth phase and is unpredictable. Causes vary depending on which studies you read. No one knows for sure how genetics or diet contributes to these painful "growing pains". It may be a combination of both. What we know for sure, is that any dog going through this disorders absolutely requires special attention, both in diagnosis and treatment, in order for them to live a long and comfortable life.

Juvenile Bone Diseases

There are several types of juvenile bone diseases. There is hip and elbow dysplasia, which is very common. Hip dysplasia is when the growth of the femur doesn’t quite catch up to the growth of the hip socket (acetabulum). This disorder occurs in various stages from mild to severe. Surprisingly, there is no correlation between pain and the severity of the dysplastic joint. Many dogs with severe dysplasia actually do quite well, probably due to their high pain threshold. Symptoms can range from getting up slowly, to "bunny hopping" (when the dog runs with both rear legs moving at the same time instead of applying an alternate gait), to the dog who just stops running and exercising altogether during painful episodes. A proper diagnosis can be made through x-rays. Treatments range from conservative management with anti-inflammatory drugs, to adding dietary supplements, such as Glucosamine, Chondroitin, MSM, and SOD (Super Oxide Dismutase). A drug called Adequan has also been shown to be effective in some cases.

When this disorder prevents the dog from participating in a full range of activities, then surgery can be done. There are different types of surgical corrections available: A total hip replacement is one option. This procedure involves making a new joint from implants to replace the diseased head of the femur and acetabulum. The triple pelvic osteotomy is a procedure that utilizes its own pelvic bones, but the bones are broken down and realigned by plates and screws to help prevent the hip from slipping out of its socket. This option, however, must be done before any degenerative changes are seen. As a last ditch effort to keep the dog from feeling the least amount of pain, and perhaps the procedure with the least out of pocket expense, is a femoral head ostectomy. This procedure entails removing the head of the femur and creating a new false joint to replace it. This would help prevent bone on bone contact. There are advantages and disadvantages, as well as risks, with each of these procedures. A consult with a board certified veterinary surgeon can help you to decide which is of these may be the best course of treatment for your animal.

Elbow dysplasia also occurs in rapidly growing large dogs. This problem occurs when the bones are not developing properly. There are 3 types of elbow dysplasia; Fragmented coronoid process, ununited anconeal process, and osteochondritis dissecans. All of these cause foreleg lameness. If these issues are not detected early, they will lead to painful arthritic joints later in life. These disorders are diagnosed in many cases by x-rays. On occasion, x-rays may not show these lesions so a CT scan or MRI will help. Again, a consult with the surgeon will help you decide what is best for the dog. Surgery is the best course of treatment but even with surgery, some arthritis will develop later in life. Aftercare is just as important as the surgical procedure. Aftercare includes the same protocol as with the hip dysplasia treatment. In some situations, surgery is not an option for owners due to expenses. In these cases, anti-inflammatory drugs plus supplements will help these dogs continue to have a good quality of life, despite having some continued lameness.

Osteochondritis Dissecans (OCD) is another juvenile disease. This is generally caused by a piece of cartilage in the shoulder, elbow, stifles (knees), and ankles (tarsi) not developing properly, which leads to a looseness inside the joint. Sometimes this loose cartilage will actually break off and float around in the joint. They are referred to as "joint mice". Many cases require surgery. With today’s technology the option of arthroscopic surgery is becoming more popular. Arthroscopic surgery can be done for elbow dysplasia as well. Some cases can be managed conservatively with pain management and supplements. Again, this disorder is diagnosed via x-rays.

Panosteitis can occur in the long bones of young dogs. It can cause "shifting leg lameness", where one moment it affects the femur of one back leg, then it will move on to the other femur or to the tibia, humerus, and to the radius/ulna. Survey x-rays will pick up not only panosteitis of the affected leg but also other bones that aren’t as painful and may show no symptoms. Treatment is mainly supportive care with anti-inflammatory drugs, and time. Many of these cases will resolve on their own by the time the dog is 18-24 months of age.

An uncommon juvenile bone disease, Hypertrophic Osteodystrophy (HOD), can cause fever, lethargy, loss of appetite and swollen joints. The cause of this is still being investigated but it’s believed to occur in certain predisposed dogs from a nutritional imbalance. Treatment is supportive care as above, although they may not respond consistently. The duration of this disorder can come and go for a prolong period of time. Patience and supportive care will help many of these dogs get through the crisis.

Weight control and proper nutrition will help all these juvenile bone diseases. Always consult with your veterinarian if your dog, especially ones under a year of age, start to show signs of unexplained lameness. The earlier they are treated, the better quality of life they will have.

About Dr. Stan Kunin

Stan Kunin DVM graduated from UC Davis in 1978 and has had his own practice in Woodland Hills, California since 1986. Dr. Kunin is a special veterinarian who was born 80% deaf, but the weakness in his hearing has helped to give him a 6th sense about animal care and the wellbeing of his patients.

In a regular series of articles for the Jason Debus Heigl Foundation, Dr. Kunin shares his thoughts, opinions and advice on animal matters.