Title: Panosteitis

{{Short description|Bone condition in dogs}}
'''Panosteitis''', sometimes shortened to '''pano''' among breeders,&lt;ref&gt;{{cite web | url=http://leerburg.com/pdf/pano.pdf | title=Panosteitis or PANO | publisher=Leerberg Enterprises | accessdate=2013-06-24 | author=Frawley, Ed | page=3}}&lt;/ref&gt; is an occasionally seen long bone condition in large breed [[dog]]s. Pan (means all or entire) oste (refers to bone) and itis (signifies inflammation). It manifests with sudden, unexplained pain and lameness that may shift from leg to leg, usually between 5 and 14 months of age, earning the nickname &quot;growing pains. &quot;&lt;ref&gt;{{cite book|author1=Ettinger, Stephen J. |author2=Feldman, Edward C. |title=Textbook of Veterinary Internal Medicine|edition=4th|publisher=W.B. Saunders Company|year=1995|isbn=0-7216-6795-3}}&lt;/ref&gt;  Signs such as [[fever]], weight loss, anorexia, and lethargy can also be seen.  The cause is unknown, but genetics, stress, infection, metabolism, or an autoimmune component may be factors.&lt;ref name=Merck&gt;{{cite web | title = Panosteitis | work = The Merck Veterinary Manual | year = 2006 | url = http://www.merckvetmanual.com/mvm/index.jsp?cfile=htm/bc/91506.htm | accessdate = 2007-01-01 | archive-date = 2016-03-04 | archive-url = https://web.archive.org/web/20160304024022/http://www.merckvetmanual.com/mvm/index.jsp?cfile=htm/bc/91506.htm | url-status = dead }}&lt;/ref&gt;  It has also been suggested that rapid growth and high-protein food are involved in the pathogenesis.&lt;ref&gt;{{cite journal |vauthors=Schawalder P, Andres HU, Jutzi K, Stoupis C, Bösch C |title=Canine panosteitis: an idiopathic bone disease investigated in the light of a new hypothesis concerning pathogenesis. Part 1: Clinical and diagnostic aspects|journal=Schweiz Arch Tierheilkd|volume=144 |issue=3 |pages=115–30|year=2002|pmid=11980379}}&lt;/ref&gt; Whole blood analysis may show an elevated white blood cell count; this finding lends support to the theory that panosteitis is due to an infection.&lt;ref&gt;Brooks, W. (2017, September 15). Panosteitis: Growing Pains in Dogs - Veterinary Partner. Retrieved March 19, 2019 from

https://veterinarypartner.vin.com/default.aspx?pid=19239&amp;id=4953019&lt;/ref&gt;

Panosteitis is characterized [[histology|histologically]] by an increase in activity of [[osteoblast]]s and [[fibroblast]]s in the [[periosteum]], [[endosteum]] and [[bone marrow]], resulting in [[fibrosis]] and the formation of [[connective tissue]] in the [[medullary cavity]] of the affected bone.  Pain may be caused by increased pressure in the medullary cavity and the stimulation of [[nociceptor|pain receptor]]s in the periosteum.&lt;ref&gt;{{cite journal |vauthors=Demko J, McLaughlin R |title=Developmental orthopaedic disease |journal=Vet Clin North Am Small Anim Pract |volume=35 |issue=5 |pages=1111–35, v |year=2005 |pmid=16129135 |doi=10.1016/j.cvsm.2005.05.002}}&lt;/ref&gt;

The [[humerus]] is most commonly affected.&lt;ref name=JAVMA&gt;{{cite journal |vauthors=Baird H, Kerwin S, Henry G, Porterpan B, Johnson M |title=What is your diagnosis? Panosteitis |journal=J Am Vet Med Assoc |volume=226 |issue=6 |pages=871–2 |year=2005 |pmid=15786986 |doi=10.2460/javma.2005.226.871|doi-access=free }}&lt;/ref&gt;  Males are more commonly affected than females.&lt;ref name=Lenehan&gt;{{cite web|author1=Biery, D.N.|author2=Lenehan, T.M.|author3=Van Sickle, D.C.|year=1985|title=Canine Panosteitis|work=Textbook of Small Animal Orthopaedics|url=http://www.ivis.org/special_books/ortho/chapter_49/49mast.asp|accessdate=2006-08-19|archive-date=2005-03-07|archive-url=https://web.archive.org/web/20050307045443/http://www.ivis.org/special_books/ortho/chapter_49/49mast.asp|url-status=dead}}&lt;/ref&gt;

== Diagnosis ==

Diagnosis is often a diagnosis of exclusion, meaning that other possible causes of lameness have been ruled out, such as hypertrophic osteodystrophy and osteochondrosis dissecans. History, signalment, and clinical signs can help a veterinarian form a presumptive diagnosis. On physical exam, the dog may display signs of pain on palpation of the long bones of the limbs. [[X-ray]]s may show an increased density in the medullary cavity of the affected bones, often near the [[nutrient foramen]] (where the blood vessels enter the bone).  This evidence may not be present for up to ten days after lameness begins.&lt;ref name=&quot;forum&quot;&gt;{{cite journal | last = Wehrenberg | first = Aaron |author2=Elkins, A.D.  | title = Juvenile Orthopedics | journal = Veterinary Forum | volume = 23 | issue = 9 | pages = 22–28 | publisher = Veterinary Learning Systems | date = Sep 2006 }}&lt;/ref&gt; 

== Treatment ==
Treatment consists of alleviating the pain and inflammation so that the dog is comfortable. This is achieved with the use of analgesics and anti-inflammatory drugs, like carprofen. Steroids may be given in more severe cases to reduce inflammation. It is also recommended to limit physical activity during treatment to prevent exacerbating the condition with high impacts.&lt;ref&gt;Johnson, A. (2014).  Small Animal Pathology for Veterinarian Technicians. Hoboken: Wiley Blackwell.&lt;/ref&gt; Lameness usually goes away after days to weeks without additional treatment.  Recurrences up to the age of two years may occur.&lt;ref name=&quot;forum&quot; /&gt;  Larger breeds, such as [[German Shepherd Dog]]s, [[Golden Retriever]]s, [[Basset Hound]]s, [[Dobermann]]s, [[Labrador Retriever]]s, and [[Rottweiler]]s, are more prone to this problem.&lt;ref name=&quot;cidd&quot;&gt;{{cite web | title = Panosteitis | work = Canine Inherited Disorders Database | publisher = University of Prince Edward Island | year = 1998 | url = http://www.upei.ca/cidd/Diseases/musculoskeletal/panosteitis.htm | accessdate = 2007-01-01 }}&lt;/ref&gt;  There has been one suspected case of panosteitis in a fast-growing six-month-old [[camel]] with a shifting leg lameness.&lt;ref&gt;{{cite journal  |vauthors=Levine DG, Smith JJ, Richardson DW, etal |title=Suspected panosteitis in a camel |journal=J. Am. Vet. Med. Assoc. |volume=231 |issue=3 |pages=437–41 |year=2007 |pmid=17669048 |doi=10.2460/javma.231.3.437|doi-access=free }}&lt;/ref&gt;

Panosteitis is also referred to as eosinophilic panosteitis, enostosis, endosteal proliferation of new bone, and eopan.

==See also==
* [[Osteitis]]

==References==
{{reflist|30em}}

==External  links==
*https://web.archive.org/web/20051203154607/http://www.critterchat.net/pano.htm
*https://web.archive.org/web/20170629224444/http://www.vetsurgerycentral.com/panosteitis.htm

[[Category:Dog musculoskeletal disorders]]