Hypertrophic Osteodystophy (HOD)
Hypertrophic Osteodystrophy is a bone disease that usually affects young, rapidly growing, large breed dogs. The disease has several names including skeletal scurvy, Moeller-Barlow disease, osteodystrophy II, and metaphyseal osteopathy. The disease produces severe lameness and pain and usually affects multiple limbs. The cause of the disease is unknown.
HOD is a disease of young rapidly growing dogs. It usually strikes
puppies between the ages of 3 to 6 months. It is primarily a disease
of large or giant breeds of dogs. As with most of the young, large
breed bone disorders, it affects males more commonly than females.
There does not appear to be an increased incidence in any one
large or giant breed. It does not appear to be genetic.
Dogs that with HOD often show symptoms of mild to moderate painful swelling of the growth plates in the leg bones. It most commonly affects the ends of the radius, ulna, (long bones from the elbow to the wrist) and tibia (long bone from the knee to the hock). The dogs may show lameness and a reluctance to move. They may be lethargic and refuse to eat. A fever may come and go rising as high as 106 degrees. The disease usually affects both legs at the same time. The symptoms may wax and wane and resolve on their own or if the fever is very high for long periods and the bony involvement severe, the dogs may suffer permanent structural damage or even die.
Diagnosis is based on the history, symptoms, physical exam showing
pain and swelling at the growth plates, and with x-rays. The x-rays
will show a thin dark line at the growth plate in the end of the
ulna, radius, or tibia. Bony inflammation and bone remodeling
may also be seen at these sites. Occasionally there may be involvement
and changes in the skull and teeth. Dogs often have a fever and
occasionally a high white blood cell count.
Since this is a very painful condition anti-inflammatories and
painkillers such as buffered aspirin or carprofen (Rimadyl) are
given. In addition the animals are usually given a broad-spectrum
antibiotic. Strict rest on a comfortable warm bed is recommended.
Feeding a nutritious, highly palatable food will help to encourage
some dogs to eat. In severe cases steroids may need to be given
to control the pain but because of the possibility of this being
a bacterial disease their use may be contraindicated due to their
immunosuppressive qualities. Vitamin C is often supplemented though
its benefit may be questionable.
Question and answer
What is hypertrophic osteodystrophy?
Hypertrophic Osteodystrophy (HOD) is an inflammatory bone disease
affecting rapidly growing
puppies of large or giant breeds.
What causes hypertrophic osteodystrophy?
The cause of hypertrophic osteodystrophy is currently unknown.
Diet (over nutrition and over
supplementation), and infections caused by bacterial, fungal or
viral agents have been incriminated
but not proven. Vitamin C deficiency or copper deficiencies have
not been shown to be a factor in causing hypertrophic osteodystrophy.
What are signs of hypertrophic osteodystrophy?
The most common clinical signs associated with hypertrophic
osteodystrophy are lameness (most
typically involving the fore legs), painful and swollen lower
legs, high fever, depression, weight loss, dehydration, and debilitation.
Clinical signs may last several weeks. Respiratory and
gastrointestinal signs may also be present.
How is hypertrophic osteodystrophy diagnosed?
Your veterinarian may have a strong suspicion of hypertrophic osteodystrophy following a thorough physical examination. Radiographs (X-rays) are required to confirm the diagnosis.
How is hypertrophic osteodystrophy treated?
Since there is no specific treatment for hypertrophic osteodystrophy,
therapy is supportive and
varies from no treatment to intensive care in severely affected
puppies. Puppies may recover
regardless of treatment. Activity should be restricted: Running
and jumping may worsen bony injury and result in further inflammation;
confinement to a small well-padded area is often necessary The
dog should be fed a normal commercial puppy ration without any
supplements
Intravenous fluid therapy may be required to treat dehydration
and to keep the puppy well
hydrated until it is able to eat and drink on its own Anti-inflammatory
drugs will be prescribed to treat the pain and fever.
What is the prognosis for animals with hypertrophic osteodystrophy?
Overall, the prognosis is considered good for most puppies with hypertrophic osteodystrophy. Most puppies have one or two episodes and then fully recover. Occasionally, some puppies develop a foreleg growth deformity (bowing or swollen wrist region) after contracting HOD that will eliminate them from the show ring. Some puppies seem to have intractable relapsing episodes of pain and fever. Rarely, some die or are euthanized as a result.
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