| Hypertrophic Osteodystrophy (HOD) Hypertrophic osteodystrophy causes lameness and extreme pain in young growing dogs, usually of a large breed. Great Danes, German shepherds, Doberman, retrievers and Weimaraners are examples of breeds that may be affected by this condition. It appears to occur in Weimaraners as a vaccine reaction and this may also affect mastiffs and great Danes. In this case, it usually occurs a few days after vaccination and may appear to be worse than the "average" case on radiographs. HOD usually shows up as an acute lameness, often seeming to affect all four legs simultaneously. Affected dogs may stand in a "hunched up" stance or refuse to stand up at all. They may have a fever but this is not consistently present. They usually have painful swellings around the lower joints on the legs. Some puppies will die from this disease, some suffer permanent disability but many recover later. The disease is so painful that many owners elect to euthanize the puppy rather than watch it suffer, despite the reasonably good chance for recovery, long term. Affected dogs may be so ill that they refuse to eat. X-rays confirm this diagnosis in most cases. There are very typical X-ray changes, although it can look a little like bone infection from a septic condition. There is some evidence at this point that viral or bacterial infections may underlie some cases of HOD as canine distemper virus has been found in the affected areas in some dogs. There can be high white blood cell counts and the alkaline phosphatase level in the blood stream is often elevated. There is also a theory that this condition may occur with excessive dietary levels of calcium or protein. I am not sure what the current status of this theory is. Treatment usually consists of analgesic medications such as aspirin or carprofen (Rimadyl Rx). Since a viral or bacterial agent may be involved in this problem the use of corticosteroids is questionable. Many people try switching to a diet that is lower in calcium (the puppy foods for large dogs may be a good choice now that they are available. Previously many people switched to adult dog foods which didn't always result in lower total calcium in the diet). Even more potent pain relief medications may be indicated in some puppies. Hydrocodone and aspirin may be a more effective combination than either one alone. Antibiotics are often given for this condition. There is a persistent rumor that vitamin C supplementation is beneficial in dogs with HOD. This appears to be a false rumor and there is some evidence that vitamin C may actually promote abnormal calcification in these puppies. It is not a good idea to supplement vitamin C. Hypertrophic osteodystrophy may resolve spontaneously in as short a time as a week or so. It can be a recurrent, cyclic infection that goes on for a long time, too. If there are severe secondary bone changes, surgical correction of these may be necessary for normal future function of the limbs. There is no reason not to control pain as effectively as possible with this condition. That definitely needs to a primary goal of treatment. Addison's Disease It is the common name for hypoadrenocorticism, or adrenal insufficiency. It is a disease with symptoms that are common to many other ailments, making diagnosis difficult and sometimes a process of elimination. But once Addison’s is correctly diagnosed, a properly treated dog can live a normal, active life. The symptoms of Addison’s disease can be vague. More importantly, they are similar to the symptoms of many different problems. Initially, the dog may be listless, or seem depressed. Many dogs are described as just seeming off, or losing the normal sparkle in their eye. Lack of appetite is a good indicator. Other symptoms include gastro-intestinal problems like vomiting and diarrhea. Pain in the hindquarters, or generalized muscle weakness such as a dog that can’t jump onto the bed or couch as he has done in the past is not uncommon. Shivering or muscle tremors may also be present. The most important thing to remember is that you know your dog better than anyone. If something seems amiss, have it checked out. These symptoms may wax and wane over months or years making diagnosis difficult. If the adrenals continue deteriorating, ultimately the dog will have an acute episode called an Addisonian crisis. Potassium levels elevate and disrupt normal function of the heart. Arrhythmias can result and blood pressure drops to dangerously low levels. BUN and creatinine levels, generally indicators of kidney function, are often elevated. At this point many animals are diagnosed with renal failure, as the kidneys are unable to function properly. Typically animals are given IV solutions for rehydration, which may produce an almost miraculous recovery. This too, is a great indication that failure of the adrenals rather than of the kidneys is creating the symptoms. There are several medications used to treat Addison’s. The first type acts as a mineralocorticoid and replaces the aldosterone – the hormone responsible for maintaining electrolyte levels. It is replaced with either an oral medication called Florinef ™ (fludrocortisone acetate) or the injectable Percorten-V™ (desoxycorticosterone pivalate or DOCP). For dogs that have atypical or secondary Addison’s neither of these medications are used because the production of aldosterone isn’t effected and electrolytes remain in balance In addition to replacing the aldosterone, the cortisol, or glucocorticoids, normally secreted by the adrenals must also be replaced. This is typically done with an oral form of prednisone or hydrocortisone. With atypical and secondary Addison’s the glucocorticoid is the only medication given. |
| Health Issues |
| Health Issues |
| Health Issues |
