Panosteitis (Growing Pains)

Panosteitis (Pano) is often referred to as Growing Pains and affects the long bones of the dog – Humerus, Ulna, Radius, Femur, Fibula and Tibia. It is generally found to affect medium to larger breeds of dog i.e. Dobermann, GSD, Retrievers, Great Danes etc. during their growing stages -normally between the ages of 5 months to 2 years.

It is a self limiting condition characterised by shifting lameness and can be extremely painful and debilitating with dogs often showing signs of a fever.  It is not known why some dogs suffer with this painful condition,  males are more commonly affected and it is thought that there could be genetic causes although there is nothing proven to date.

Cause

So what causes this painful condition?  Firstly we need to know a little about how bones are formed.

The formation of bone is known as ossification.  Osteoblasts – bone making cells that produce osteoids (these mineralise to form bone) and collagen, start the process in the middle of the cartilage that will eventually become the long bone.  As the osteoblasts lay down bone, the cartilage is gradually replaced outwards towards the ends of the bone known as the epiphyses. The cells of the cartilage divide rapidly in the early stages and are forced to arrange themselves on top of each other to form columnar cartilage rather than outward expansion.  Due to the growing cartilage being forced in this particular direction the growing bones grow lengthways.

As the cortex/outer layer spreads and becomes thicker, chondrocytes (the mature cells in the cartilage) within it stop being supplied nourishment.  Blood vessels sprout through gaps and bring with them a supply of nutrients and new cells that include both osteoblasts and osteoclasts (the cells that break down the cartilage).  They start to remove bone from the centre of the diaphysis to create the marrow cavity which will fill with red bone marrow.

At birth all bone marrow is red, however, as the dog ages, more of it is converted to yellow marrow. Yellow marrow is found in the medullar cavity, the central hollow cavity of long bones.  When a dog is suffering with Panosteitis some of the yellow marrow is replaced by a tough fibrous tissue that ossifies into woven bone – on an x-ray this will show as a white “fuzzy” area.  The woven bone can literally take over the cavity, causing extreme pain.  Shifting lameness may be seen intermittently over a period of months whilst the dog’s bones are growing.

In the meantime, osteoblasts continue to lay down bone in the outer edges.  As the process spreads to the end of the bones, blood vessels sprout at the top and bottom ends of the bones allowing further ossification to take place.  These enable the formation of the epiphyses (the articular ends of the bone).  Between the epiphyses and growing bone shaft a narrow band of original cartilage remains – the epiphyseal plate or growth plate.  This allows the bone to lengthen as the dog continues to grow but once the animal has reached full size growth ceases and the cartilage is replaced by bone, closing the epiphyseal plate.  Once this occurs the bone marrow normalises and dog will no longer suffer from Panosteitis.

Symptoms

A dog suffering with Panosteitis will often show sudden signs of lameness in one leg.  This can suddenly shift to another leg, and this shifting lameness can continue over many months, often disappearing before reappearing some time later.  The dog will show signs of severe pain and discomfort and there is often a fever associated with this condition.  An x-ray can identify this condition.

How may Therapeutic Canine Massage Help?

  • It increases blood circulation therefore nourishing the skeletal cells and speeding up the body’s natural healing process
  • It improves muscle tone and balance therefore reducing physical stress placed on bones and joints, and helps to decrease inflammation
  • Assists with posture awareness and body alignment preventing the dog from developing gait/movement or postural irregularities and Myofascaial issues due to overcompensation
  • Prevents and resolves Trigger Points (hyper irritable bands or ‘knots’ within the muscle where the fascia becomes adhered) and wide radiating Myofascial pain, directly linked to multiple Trigger Points and restricted Fascia (the internal connective tissue that covers every part of the body including muscles, organs, nerves, blood vessels). If left untreated these can lead to additional discomfort and postural issues

Day to Day Care & Management

Panosteitis is self limiting meaning that it will eventually resolve itself.  However it is a painful and debilitating condition and may require pain relief.  Massage is an ideal treatment to help with the pain relief, and due to the shifting lameness seen in dogs with this condition, can also help with muscular stress caused by over compensation.