Often Pano shows up in a foreleg first. Bouts of lameness can come and go, seemingly for months. Some dogs suffer from Pano off and on until they are nearing 2 years of age or even beyond. I believe a case has been documented in a 5 year old dog, but that is unusual. Most cases start near the end of rapid growth, about 5 to 6 months of age, and are cleared up by 12 to 18 months of age.
Males seem to be more affected than females, but both sexes can exhibit signs.
Radiographic signs, those seen on an x-ray, can be elusive when diagnosing Pano. Pano lesions are not always seen on an X-ray even though the dog may be showing clinical signs of lameness and pain. No definitive reason is really known for the cause of Pano. It has been attributed to high protein levels in food, high fat intake, growth spurts, lack of different vitamins or minerals, too much of certain vitamins or minerals, environmental causes, bacterial infections, parasite infections and many other non conclusive reasons. People have reported that high doses of Vitamin C will help to alleviate the onset of Pano, or the symptoms when they occur, and others swear by antibiotic treatments, holistic and natural approaches and even acupuncture and chiropractic treatments.