RECOGNIZING BONE DISEASES
by Linda Arndt

This is a copy of the guide I offer my puppy buyers as part of my educational packet. I have been asked to share this to other
owners and breeders as support information to be used in conjunction with veterinarian care. Feel free to copy and share
with others if you find it useful. This article is now part of the Great Dane Club of America's Health and Welfare handbook for
owners and has been published in numerous breed magazines.
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Introduction

Raising a large/giant breed that first year can be somewhat difficult. One of the major stumbling blocks are 3 common bone
diseases we often deal with in these breeds. I would like to discuss the facts/myth of these diseases and give you a way to
determine which disease you may be dealing with regarding your puppy. This is not meant to take the place of seeing a
veterinarians care. If you suspect your puppy is not well, use this as support information for you and your vet in diagnosing
the health problem of your puppy. The problem today is the use of multivalent vaccines, particularly on the giant breeds, puts
them at great risk. Their fragile immune systems cannot handle the assault of multivalent vaccines and we lose them to
autoimmune response, which is misdiagnosed as HOD in the early stages. This article will help you and your vet determine
whether or not your dog has true HOD.
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Distinguishing Fact from Fiction

    Fact:        The Orthopedic Foundation for Animals (OFA) states HOD, OCD and Pano are nutritionally causes diseases.

    Fact:        In the textbook Small Animal Clinical Nutrition, 4th edition 2000 has these diseases HOD, OCD and
    Panosteitis (Pano) listed as DOD - Developmental Orthopedic Diseases and nutritionally related, not genetic in origin.

    Fact:        HOD and Septicemia, are NOT the same disease, but share the same symptoms, making it difficult to
    misdiagnose.

    Fact:         All growing puppies, if x-rayed, look as if they have HOD due to fast rate of growth. Therefore, x-rays are not
    that useful in diagnosing HOD.

    Fact:        Vaccine reactions, from combo shots, can produce the same symptoms as HOD and therefore the problem is
    misdiagnosed as HOD when infact it is a Vaccine reaction.

    Fact:        Rabies vaccines given before 6 months of age (particularly in Great Danes)and at the same time as
    combination vaccines, can cause HOD -like symptoms, but not true HOD. These symptoms of fever, swollen joints,
    excruciating pain are often irreversable and result in the need for humane euthansia.

    Fact:        Most research on these diseases have been done in the equine field.

    Fact:        These 3 diseases HOD, OCD, Pano are definitely treatable and do not have to be life threatening. Proper
    diagnosis and change in feeding program is necessary to correct the problem.

    Fact:        Euthanasia does not have to be an option with "true" HOD, OCD and Pano

    Fact:        Septicemia or Septic Arthritis is erroneously labeled as pseudo HOD by breeders/owners. If the dog is septic
    and misdiagnosed as HOD, it can be life threatening. Make sure a blood test and culture is run to correctly diagnose
    Septicemia.
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Definition of the 3 Bone Diseases:

HOD - (Hypertrophic Osteodystrophy)

    Normally Affects the Large/Giant Breeds, Dogs Grow Too Fast. A Problem of More Food Calories (Energy Eaten Than
    Expelled in Activity)

    Nutritionally Caused By:
        - too many calories consumed
        - unbalanced diet disrupted by supplementing
    Age Range for Disease
        - 10 weeks - 6 months  (worst time is 3 months - 6 months)
    Symptoms
        - early stages:
               large knotty joints, toes turning in or out
        - middle stages:
           large knotty joints, toes turning in or out roached toplines, pinched rear end assembly
        - advanced stages:
                     fever (104-106), refusal to eat, jaw tender, swelling of joint areas often hot to the touch
           animals cry in pain, unable to get up, flat feet, bowing of the limbs, lack of mobility, depression
           polyartiritis in all limbs.

Based on the National Bone Survey and my experience in this breed HOD does not happen in puppies past 6 months of age.
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How To Determine Your Puppy has “True” HOD

Again True HOD is a nutritionally caused disease so in order to determine if this is the problem or not, we must go through a
series of questions to draw a conclusion as to what is going on with your puppy.  Most of the time your puppy will be at stage
three (see above) before a veterinarian will be called on for help. Unless your veterinarian has dealt with many large/giant
breeds, they may not be sure how to handle this problem. You can give them a copy of this guideline and it will assist them in
determining the cause for your puppies symptoms (as described in stage three).

When I receive phone calls from breeders/owners or veterinarians for guidance in this particular disease (HOD) we go
through a series of questions.

Why Diagnosing HOD Can Be VERY Confusing!!

In diagnosis HOD, it of very confusing because the symptoms I have listed above, are also the same symptoms that your
puppy can have with a reaction to vaccines, antibiotics or septicemia.  The following things "mimic" the symptoms of HOD.

1)    Vaccine Reactions or Vaccine Mediated Response

2)     Allergic Reactions to Antibiotics > Sulfonamide Drugs * (Ditrim, TMZ, TMP/SDZ, Bactrim, Primor,
Tribrissen, trimethoprim sulfa,septra, cotrim, sulfatrim) or  > Cephalexin (Keflex - Cefa-Tabs,)
3)    Septicemia - also known as septic-arthritis. This is a “systemic” infection also known as blood
poisoning

These 3 things “Mimic” the same symptoms as HOD which is why so many puppies are misdiagnosed.  * After consulting with
my own veterinarians, we have decided not to use any sulfonamide antibiotics on Great Danes
because of their hypersensitivity and potential life threatening effect on this breed. We will use Cephalexin, when it is
appropriate, but with a watchful eye and stop it immediately, if there are any adverse reactions.

STEP 1: LET'S TALK ABOUT DIET - IS IT THE ROOT OF THE PROBLEM?

Diet -     Are you feeding a moderate protein/moderate fat diet? (21%-24% max. protein and 12%-18%fat) this is considered
moderate. * Certain brands are notorious for causing orthopedic problems due to poor quality mineral absorption.

If so, this means you are feeding a moderate calorie diet which we know is appropriate for the large breeds to grow slow and
even. Not all adult brands of dog foods are appropriate to feed a growing giant breed, because they will not get adequate
amounts of nutrients on an adult formula.

That is why it is very important to feed only certain brands of moderate adult formulas to puppies.  I can provide you a
complete list of feeds. The two brands I feel work best for young puppies are: Eagle and Precise.

NEVER FEED A LOW PROTEIN AND NEVER FEED A HIGH PROTEIN.

One is not enough in calories or nutrients the other is too much calories for a growing animal. It is to difficult for the owner to
regulate the caloric intake necessary when we are not using moderate foods. Amount to Feed - this is a general guideline for
the giant breeds being fed a moderate food. If your puppy is consuming more then these recommendations, they may be
consuming more calories than they need the results will be “true” HOD.  Remember the most critical time to control growth is
12 weeks - 6 months of age - this window of growth is the most rapid.

Guidelines:        2 months        2-4  cups per day
3 months        3-5  cups per day
4 months        4-6  cups per day
5 months        5-7 cups per day
6 months        6-8  cups per day
7 months        7-9  cups per day
8 months        8-10 cups per day
9 months        9-11 cups per day

This is a general rule, based on moderate caloric foods and for animals that may be crated during a part of their daily routine
or less active during extreme weather conditions.

Are You Supplementing?
If you are supplementing with vitamins, minerals, (calcium) and certain people foods such as rice, cottage
cheese, eggs, meat, you might be throwing the balance off of your commercial food as well as adding to the extra calories.

"NEVER SUPPLEMENT CALCIUM WITH TODAY'S FOODS" - from Small Animal Clinical Nutrition Textbook - 4th edition
2000

This is not to say you should not use real “foods,” but during these delicate growing stages 3-6 months, I recommend we go
easy and use only fruits veggies.

(Copies of my Feed Program for Adults and Puppies are available upon request.)

If you have a puppy that has been diagnosed with HOD, use the above guidelines to determine if the dog is consuming more
food than he needs and/or the diet is being unbalanced by supplementation. If not, then we must look at other factors causing
HOD like symptoms rather than actual HOD. If diet is a problem adjust feeding accordingly.

STEP 2:    LET'S TALK ABOUT ALLERGIC REACTIONS TO ANTIBIOTICS

Has your dog been on these Antibiotics?
Sulfonamide Drugs (Ditrim, TMZ, TMP/SDZ, Bactrim, Primor, Tribrissen, trimethoprim sulfa,septra,
cotrim, sulfatrim )Keflex (Cefa-Tabs, Cephalexin)

If so, it is not at all uncommon to have a reaction to these antibiotics that mimic the symptoms of HOD. In some animals this
happens within 24 hours, with others it maybe up to 7-10 days on the therapy before you notice the symptoms of: achy and
swelling joints, fever and loss of appetite. (all the same symptoms as in stage three of “true” HOD  or in older dogs, it is often
misdiagnosed as PANO)

Treatment:
If you determine the “HOD like” symptoms are due to an allergic reaction to antibiotics, generally the animal is treated with
Dexamethsone. Discuss the course of action with your veterinarian. Once you rule out antibiotic reaction we go to step 3.

STEP 3:  LETS TALK ABOUT ADVERSE REACTIONS TO VACCINES

If you determine the “HOD like” symptoms or Pano symptoms are not due to diet, or antibiotics, then we must look at vaccine
reactions.        

Did your puppy have an inoculation within the past 7 days? Normally this response happens within 24-48 hours but can come
on as late as a week or more past the date of inoculations. They symptoms are the same as in stage three of “true” HOD.
Polyarthritis, lethargy, swelling of the joint area, fever and loss of appetite.

Treatment: I have found 3 things helpful in cleansing the fibronectin carrier/preservative which the body recognizes as a
toxin.  (Purdue Vaccine Research - 2000) But keep in mind, nothing is a guarantee and some dogs immune systems are so
compromised that we lose them.

I have found this combination works as a prevention for vaccine reactions in my own animals. This is a combination I have
been using for 16 years.

(A) Biopet Nzymes a metabolic enzyme and major detoxifier (877-816-6500)  website: www.nzymes.com A dietary enzyme
(not digestive enzyme) that provides food for the body so it can make the chemicals necessary to detoxify the body against
free radical damage. These area natural anti-inflammatory and from a food source. I find it useful to prevent vaccine
response, to help heal after a vaccine reaction and fast recovery from anesthesia.

(B) Vitamin C with Bioflavonides - 1000 mg daily to detoxify the body. Human vaccine research shows us vaccines produce
elevated histamine levels and Vitamin C is beneficial in lowing these levels during vaccines.

(C) MSM - Nutritional Sulfur I prefer the Vita Flex brand. (800-937-1104) Dosage is 1/4 tsp. up to 45# and 1/2 tsp. up to 90#
daily increase according to weight. The first week you double dose, then use once a day.
Click here: MSM for Pets by Vita-Flex: Methylsulfonylmethane for small animals. http://www.vita-flex.com/msmpet.htm

Step 4:   LET'S TALK ABOUT SEPTICEMIA (Septic-Arthritis)

When we see the term Pseudo HOD, note - this is an inaccurate term for Septicemia, which gets misdiagnosed as HOD.

If you have ruled out diet, antibiotic reactions and vaccine response we must take a look at the possibility of a systemic
infection. This could be from taping a joint (avoid this at all costs), a puncture wound, from non-sterile ear cropping
conditions, a bite or a wound that is undetected.

Treatment:
Rather than use an antibiotic, that may not be suited for the specific bacteria or use an antibiotic when it is not needed, run a
blood test first to see if there is an elevated blood count, which indicates infection.
I recommend a blood culture as well, to find the best antibiotic to fight the infection. By doing this, you can avoid the
unnecessary use of a very detrimental drug that breeders often push using called Chloremphenical.
This is the year 2001, you have other options, ones that are not as likely to destroy your puppy's new and underdeveloped
immune system.

Chloremphenical suppresses the immune system and is not meant to be used on growing animals/children. Discuss other
options with your veterinarian.

It is my experience, the numbers of "real" Septicemia cases in this breed are not nearly as prevalent as breeders are led to
believe from other breeders. When there is a case of Septicemia, more than likely it is due to unsanitary cropping and
aftercare techniques.

* Note: Of the 5200 cases of bone diseases reported to the NATIONAL BONE SURVEY, only two cases of “HOD-like”
symptoms were the results of veterinarian diagnosed Septicemia.
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THE OTHER BONE DISEASES
The last two disease I will talk about are not as confusing as  HOD. These are rather straight forward and easy to assess.

Let's Talk About OCD:

OCD - (Osteochrondritis Dissecans)

>        The Separation of Joint Cartilage from Bone
>        Cause is Rapid Growth
>        Ages 4-12 months of age
>        Affects Shoulder, Hocks, Stifles
>        Cause Excessive Calcium or Mineral Imbalance  
>        Nutritionally Caused Disease (as proven in Equine research)
>        Symptoms - Lameness. Pain present at flexing the joint can happen in more than one joint.

This is defect in the cartilage the overlaying or attaching to the bone does not take place properly and a small piece or flap
peels up and acts as an irritant.

Suggestions for Prevention:

>        Feed a meat based, moderate protein/calorie, super premium quality food in normal amounts
>        Feed only a food that has chelated or sequestered minerals in it for proper utilization and making
bone and cartilage.
>        Supplement with Vitamin C (1000 mg) daily.
>        MSM - Nutritional Sulfur (800-937-1104)

Course of Action:
If this is diagnosed early enough it may be possible to repair the problems with changes in diet and the use of Adequan or
products which support joint nutritional supplement such as Glyco -Flex Plus or Hip Health. Sometimes surgery to remove the
piece of cartilage is the only option. Discuss this with an Orthopedics veterinarian if surgery is a possibility.  * as a note of
interest, when I ran the National Bone Survey in this breed, 1991 we had over 3,237 cases of veterinarian diagnosed bone
diseases  reported to the survey. Of those numbers, 517 were OCD cases. Of those cases all were fed the same 3
commercial dog foods.

*Note : Once in a while an animal has been injured, the trauma to that area will cause OCD in a joint. When it is nutritionally
cause is it often in more than one joint. Make sure you don’t excuse your feeding program problems and call the problem
“injury” related.

Let's Talk About Panosteitis (Pano):

Pano, is how breeders affectionately refer to this disease.  It is the least invasive and least threatening of the three bone
diseases discussed in this article.

>        Wandering Lameness (Eosinophilic Panosteitis)
>        Also Known As Growing Pains in Dogs (and Children)
>        Rapid Rate of Growth
>        Spontaneous Recovery/ Self Limiting Disease
>        Achy Arthritis, if it lasts long periods of time their may be muscle wasting
>        6 - 14 months (9-12 months being the likely period)

ALERT:
An allergic reaction Chephalexin or the Sulfonamides is often misdiagnoised as Pano in an adult dog. True Pano does not
happen in dogs after the growth plates are closed at 18 months but an allergic relation to antibiotics can happen at any stage
of the dogs life. ALSO, PLEASE TO NOT USE RIMYDAL ON THIS BREED!!!!!

Suggestion for Prevention:
Feeding a moderate, meat based, high quality diet in moderate amounts to keep growth slow and even. Excessive feeding
can actually alter the length of bone and shape of muscle making an animal unsound in their development.

>        Moderate High Quality Food - (Eagle and Precise are my first choices)
>        A Balanced diet that uses chelated/sequestered minerals
>        Nzymes (877-816-6500) a dietary enzyme that is a natural anti-inflammatory.

Course of Action:

>        Is the dog having an allergic reaction to one of the drugs listed?
>        Look At Diet and Amount Being Fed
>        Use MSM- Nutritional Sulfur (800-937-1104) works on the body's metabolism
>        Nzymes - dietary enzyme(877-816-6500) - a natural antiinflammatory
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In Conclusion:

The following 3 diseases are difficult to diagnose at times. It requires looking at a total history of the animal, including feeding,
medications, vaccines, injuries, surgeries etc. I hope this method of discussing these problems makes it a little easier to
understand and helps you find a solution, when and if you have these problems.

Remember two heads are better than one, do not hesitate to call me and discuss the problem. Hopefully we can find the
cause and treatment for the situation along with help from your veterinarian.

Many people ask me what to do when it comes to vaccinating, and how I help prevent any reactions. For vaccine reaction
prevention or for copies of feed programs for puppies and adults, send me an email.

Linda Arndt
GrDaneLady@aol.com
Blackwatch Great Dane Kennels est - 1973
www.daneworld.com/LindaArndt.htm
Click here: Linda Arndt & Blackwatch Great Danes

*This article, my opinion or if you ask for my assistance on health and feeding issues, is not to be used "in lieu of "
veterinarian advise and treatment, and should be discussed with your vet for a comprehensive approach to better health for
your pet.