During development, any puppy can experience growing pains. Although they are good at hiding their pain, bone growth, tooth renewal and other developmental processes can provide normal levels of discomfort. A condition called panosteitis is often referred to as ‘growing pains’. Although panosteitis does indeed occur during the developmental stages, it is important to distinguish it from normal development. Most common in large and giant dog breeds, this disease can be very painful and even result in lameness of the affected limbs. Fortunately, this disease is self-limiting and usually resolves spontaneously without sequelae.
At AnimalWised, we explain more about panosteitis in dogs, commonly referred to as pano. We look at the symptoms and treatment options of panosteitis, as well as photos of radiographs so you can have a better idea of what may be happening to your dog.
What is panosteitis in dogs?
Panosteitis is a disease that affects the bone marrow of developing dogs. The bone marrow is the tissue present inside most bones, especially longer bones such as the humerus. The bone marrow is responsible for hematopoiesis, i.e. the synthesis and formation of blood cells. In pano, the adipose and hematopoietic tissue of the bone marrow is temporarily replaced by fibrous tissue.
As a developmental disease, panosteitis affects the growing skeleton. It most commonly affects puppies between 2 and 12 months of age. Although it can occur in adult dogs, one study found that 82% of cases occur in dogs under 18 months of age[1]. Although pano in dogs can affect any limb, the forelimbs are four times as likely to be affected than the hindlimbs. More than one limb can be affected at the same time, with 49% of cases affecting more than one limb.
Breeds predisposed to panosteitis
As we have already stated, panosteitis most commonly affects large dog breeds. Although little is known about its exact origins, the fact that panosteitis affects certain dog breeds more than others implies a genetic factor in its development. While large breeds are most commonly affected, it can also affect smaller dog breeds. Panosteitis is most prevalent in the German Shepherd, followed by the Basset Hound.
In addition to those already mentioned, the following are the breeds most predisposed to developing panosteitis:
- Afghan Hound
- Airedale Terrier
- Cocker Spaniel
- Doberman Pinschers
- Golden Retriever
- Labrador Retriever
- Great Dane
- Rottweiler
- Saint Bernard
- Shar Pei
Panosteitis is a disease that typically affects males. In fact, the prevalence of the disease is four times higher in males than in females.
In addition to panosteitis, our related article explains more about the most common diseases affecting German Shepherd dogs.
Symptoms of panosteitis in dogs
The clinical presentation of panosteitis is characterized by the sudden appearance of a limp in one or more of the limbs. The nature of this lameness is intermittent in character as it can appear and disappear for periods. It can also be migratory as it may change location or affect more than one limb at a time. Generally, only a mild to moderate lameness develops, but some can develop a lameness so severe it prevents the dog from walking.
Another characteristic sign of panosteitis in dogs is the presence of pain on deep palpation of the affected bones. In addition to lameness and the presence of pain on palpation, other clinical signs such as fever, loss of appetite and muscle atrophy may be present. However, the frequency of appearance of these other symptoms is much lower.
Learn about a different type of bone disorder that affects canines with our article on bone marrow aplasia in dogs.
Causes of panosteitis in dogs
The etiology of panosteitis in dogs is unclear. Although there is a genetic element, it is not well understood. It has been linked to various factors including the following:
- Excess calcium intake
- Excess protein in diet
- Allergies
- Autoimmune diseases
- Vascular disorders
- Hemophilia
- Metabolic diseases
Although young puppies need plenty of food to develop properly, it is possible panosteitis may be related to overnutrition. Some authors have associated the appearance of panosteitis in puppies with viral infections such as canine distemper. This relationship has not yet been demonstrated with sufficient evidence.
Diagnosis of panosteitis in dogs
The diagnosis of panosteitis in dogs is simple. It is based on two fundamental diagnostic tests:
- Orthopedic examination: when performing a deep palpation of the long bones, a painful reaction is detected in the animal.
- X-rays: the detection of deep pain on palpation of the long bones is usually indicative of panosteitis. Radiographic study is then required to confirm the diagnosis.
Radiographs of all four limbs are required as panosteitis can affect several limbs simultaneously. The radiographic image of panosteitis varies depending on the degree of evolution of the disease. In the initial phases, hardly any changes are observed in the bones. As the disease progresses, rounded opaque patches begin to be observed in the medullary cavity. These are pathognomonic of the disease, i.e. a sign that appears exclusively to a certain condition.
In more advanced cases of panosteitis in dogs, it is common to observe changes in the cortex and periosteum of the affected bones. It should be mentioned that the severity of radiological images does not always correlate with clinical severity. In other words, the most affected limb at the radiological level does not have to be the one that produces the most lameness.
Especially when there are other associated pathologies, it may be necessary to perform advanced imaging tests (such as a CT scan or scintigraphy). However, these types of tests are not routinely performed to diagnose panosteitis in dogs.
Treatment of panosteitis in dogs
There is no curative treatment for panosteitis in dogs currently available. Fortunately, panosteitis is a self-limiting disease which heals spontaneously without the need for specific treatment.
While it cannot reduce the length of symptoms, symptom management can reduce discomfort and improve general wellbeing during acute episodes of pain and lameness. The drugs most commonly used for this purpose are non-steroidal anti-inflammatory drugs (NSAIDs). The duration of treatment may vary depending on the course of the disease, although as a rule it should not last more than a few days or a few weeks in severe cases.
It is worth mentioning that affected dogs do not need to rest as much as you may think. Physical activity that is not overly intense or otherwise harmful does not worsen the symptoms of the disease.
Learn more about medications used to mitigate symptoms of pano with our article on carprofen for dogs.
Prevention of panosteitis in dogs
As we have seen, the etiology of panosteitis has not yet been clearly defined. For this reason, we cannot present a definitive method of disease prevention. We can take into account the possible etiologies postulated to date. In doing so, a series of preventive measures can be considered to avoid the appearance of this disease in puppies. These panosteitis prevention methods include the following:
- Avoid hypercalcemia: provide a diet with an adequate calcium/phosphorus ratio for growing dogs. Calcium-based supplements should never be given to puppies, unless specifically prescribed by a veterinary professional. Learn about related symptoms with our guide to calcinosis cutis in dogs.
- Avoid overnutrition: in fast-growing dogs (large and giant breeds) it is especially important to provide a daily food ration with a moderate caloric value and adapted to their individual needs. Offering an excess of food or an excessively caloric diet could predispose to the appearance of this disease.
- Comply with the vaccination schedule: since some researchers associate the appearance of panosteitis with certain viral infections. Learn more with our guide to vaccination schedules in dogs and puppies.
Prognosis of panosteitis in dogs
The prognosis for panosteitis is excellent. As we have seen, it is a self-limiting disease that resolves spontaneously without sequelae (i.e. persistent condition as the result of a certain disease).
It must be taken into account that dogs with panosteitis usually suffer repeated episodes of the disease on a recurring basis up to 2 years of age. During these episodes, it is important to administer the remedies for panosteitis in dogs that we have explained above. These will relieve the pain associated with the disease and ensure the well-being of the animal.
If you notice that your puppy is limping, do not hesitate and go to the veterinary clinic as soon as possible. Although panosteitis is a common disease in puppies of large dog breeds, there are other reasons for lameness which may need immediate treatment. Learn more about these possible causes with our article on why a dog limps on their front leg.
This article is purely informative. AnimalWised does not have the authority to prescribe any veterinary treatment or create a diagnosis. We invite you to take your pet to the veterinarian if they are suffering from any condition or pain.
If you want to read similar articles to Panosteitis in Dogs - Pano Symptoms and Treatment, we recommend you visit our Other health problems category.
1. Böhning, R. H., Jr, Suter, P. F., Hohn, R. B., & Marshall, J. (1970). Clinical and radiologic survey of canine panosteitis. Journal of the American Veterinary Medical Association, 156(7), 870–883.
- Kieves N. R. (2021). Juvenile Disease Processes Affecting the Forelimb in Canines. The Veterinary clinics of North America. Small animal practice, 51(2), 365–382.
https://doi.org/10.1016/j.cvsm.2020.12.004