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Limping and Pano and Elbow Dysplasia

12191 Views 10 Replies 9 Participants Last post by  Baxter Basset
Greetings !
I am looking for some advice on a limping problem. We have a 9 month old Basset called Monty, and we're located in the UK. He has started to limp, and we are strugglinga bit with a diagnosis. Our vet in the UK
thinks he has Dysplasia of the elbow, and the prognosis is not all that brilliant on that. On this web site
and elsewhere, there is the whole "Pano" complex, which has a much more positive outcome. Can anyone help me on how one can realistically distinguish between the two ?? We are currently in the vets about once a week, and it ain't cheap ! Rimadyl has been prescribed and taken. We are inclined to try and keep the medication to a minimum. We are unsure about how much exercise has to do with any of this (probably not a lot). We also think that the genetics side has rather more to do with it. What responsibility does a breeder have in a situation like this ? Any thoughts please ?? Monty has been swallowing lots of dietary supplements, omega tablets etc. He has also been getting shots of cartrophen... which ought to help. Plus occasional injectiosn of more massive pain killers. He is not a very happy dog at the moment, which is very sad, since he is, basically, a very happy dog!
So any thoughts or suggestions very gratefully received.

Andrew
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Greetings !
I am looking for some advice on a limping problem. We have a 9 month old Basset called Monty, and we're located in the UK. He has started to limp, and we are strugglinga bit with a diagnosis. Our vet in the UK
thinks he has Dysplasia of the elbow, and the prognosis is not all that brilliant on that. On this web site
and elsewhere, there is the whole "Pano" complex, which has a much more positive outcome. Can anyone help me on how one can realistically distinguish between the two ?? We are currently in the vets about once a week, and it ain't cheap ! Rimadyl has been prescribed and taken. We are inclined to try and keep the medication to a minimum. We are unsure about how much exercise has to do with any of this (probably not a lot). We also think that the genetics side has rather more to do with it. What responsibility does a breeder have in a situation like this ? Any thoughts please ?? Monty has been swallowing lots of dietary supplements, omega tablets etc. He has also been getting shots of cartrophen... which ought to help. Plus occasional injectiosn of more massive pain killers. He is not a very happy dog at the moment, which is very sad, since he is, basically, a very happy dog!
So any thoughts or suggestions very gratefully received.

Andrew
[/b]
Ernest in on limb three of four of pano.

Has it moved from one limb to the other? That would be a good sign.

Ernest has been really miserable the first few days and then much better. I'm hoping the same thing will be true for Monty.

We're keeping him on omega 3s for life.

lala
Elbow displasia is often used as a term for 1 or more of the following conditions when they effect the elbow,
OCD, UAP, HOD, FCP. However I think most vet refer to those conditions with their specific name rather than the more generic "elbow displasia". When I here elbow dyspasia I think Elbow Incongruity.

From rec.pets.dogs: Basset Hounds Breed-FAQ

Paneosteitis is an elusive ailment occasionally seen in young Bassets.
It is also known as wandering or transient lameness. Attacks are
usually brought on by stress and aggravated by activity, and up to
now, the cause and the cure are unknown. This mysterious disease
causes sudden lameness, but its greatest potential danger may lie in
false diagnosis, resulting in unnecessary surgery...

In diagnosing the cause of a Basset's lameness, a radiograph of the
forelimbs may indicate a condition called elbow incongruity. (Elbow
incongruity is a poor fit between the 3 bones which comprise the elbow
joint.) Studies to date indicate that elbow incongruity is normal in
the Basset and is not the cause of the lameness. It is also suspected
that many of the previously mentioned unnecessary (panosteitis)
surgeries have been performed on Basset Pups just because radiographs
that were taken showed elbow incongruity. A study on forelimb lameness
in the Basset is currently underway at the School of Veterinary
Medicine, University of Pennsylvania. As previously mentioned they
have determined that elbow incongruity occurs in the Basset but
suspect that incongruity rarely causes the lameness. During the course
of the study, conservative therapy will be recommended for all cases
in which panosteitis appears to be the cause of the lameness. In cases
with severe growth deformities or elbow pain associated with elbow
incongruity, surgery may be recommended.[/b]
The more likely cause is pano especially considering the dog is male. Males are much more affected by Pano than females. When Toughy went through his bout pano (for LAla don't be so sure on the three of 4 legs Toughy's effected each limb at least twice.) He was diagnosed with an Elbow Incongruity of 6MM. The Vet did not believe this was the cause of the problem because of the breed and tha fact he had see incongruities of twice that amount not effect the breed. A more conservative approach Until a definitive diagnose can be made would seem to be the prudent course of action.
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Age and gender are right for Pano. We have had two young male Bassets that had Pano, one at 10 months and the other around a year. One this spring, one seven years ago. Both started limping suddenly, both on the right front, and we took both to the vet where they were x-rayed. The x- rays were done basically to rule out other problems, but both times the vets stated Basset joints never looked the same from one Basset to the next or "normal" due to the breed being dwarfed down in size. Hopefully your vet is familiar with Bassets and their particular joints.
Both were put on Rimadyl and crate rest, meaning only time out of crate was to potty and eat. Tough on young Bassets to keep them still and contained. We listened to a lot of whining for those two weeks and went through alot of chew toys. We would let them out on the leash in the house and cuddle.
The vets told us Pano was very painful, like an inflammation of the bone and that some dogs would often be lethargic, run fever, etc. Both of ours popped back to their bouncy selves after the two weeks. One had a later occurance about two months later on the other front leg. Followed the same procedure and no more problems.
Good luck and hopefully it's Pano and nothing worse.
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Lala and BubbaLeroy mentioned the shifting lameness that's characteristic of pano. If a dog is chronically lame in the same leg, the suspicion of a structural abnormality involving the affected leg is increased.

Would suggest caution where supplements are concerned. The two nutritional factors that have been consistently associated with canine developmental orthopedic disease are calcium and overnutrition (overfeeding). From a recent issue of Veterinary Surgery
Large breed puppies raised on diets containing high calcium or high calcium and phosphorus concentrations manifest several developmental bone abnormalities[/b]
To disagree with some of the previous posts. Pano can, and does occur in female basset hounds. My experience is that sex has nothing to do with it. Pano does not always move from leg to leg either. In fact, I've only had one case of it that did that. The others were confined to one leg.

According to the research my vet has shared with me over the years, pano is caused by bones growing too quickly. His first question when we have a case, "Is the puppy still on puppy food?" The research he has shared with me suggests that removal from puppy food is a good idea at about four months. We transition our basset hound puppies from puppy food slowly between four and five months. According to what I've read as well as my experience with vets tells me that most vets know very little about our breed's structure, and especially pano. It's taken many years, and many bassets, for our vet to know them well.

If your dog does have pano my experience is that it will subside in about three weeks. That's the experience that we have had over the years as well as many other breeders and ownere here in Southern California. If the condition goes on much longer than that, you may be dealing with something else.

I would certainly get a second opinion on your vet's diagnisis. If necessary, I would get a third before I did anything as drastic as corrective surgery. Perhaps your local chapter of The Basset Hound Club in the UK could suggest a vet that knows more about basset hounds than your current vet. Their web site is http://www.bassethoundclub.co.uk/ if you are interested.
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I agree with Woebegon, the only case of Pano I ever had to deal with affected one leg only.

I always recommend at least a second opinion by a vet familiar with bassets any time there is an issue with legs/hips/elbows in young dogs.
Pano can, and does occur in female basset hounds.[/b]
Of course it does but statisic shows it overwelmingly effect more males than females at about a 4-1 ratio.
From the panosteitis link found below
There is a nearly 4:1 ratio of males to females affected by panosteitis; the clinical signs are more severe and the disease more nearly chronic in males.[/b]


If your dog does have pano my experience is that it will subside in about three weeks. That's the experience that we have had over the years as well as many other breeders and ownere here in Southern California[/b]
FWIW Toughy's bouts of pano lasted approx 1 month or a bit more on each leg. It seemed he went from limping on one leg to the next. It effected every limb twice with the left front 3 times. From the time he was 5 month to 18 months he was limping on on leg or another. Pano effects the idividual dog differently so you don't want to put to much stock in what is "typical" because "a typical" is very common in this diseases progression.
PANOSTEITIS
Whether it is very common for the same bone to be the site of recurrence is not a matter of total agreement, although too many owners report it to be so, to ignore that strong anecdotal evidence. One study of 100 consecutive cases at New York’s Animal Medical Center concluded that “after a bone has passed through all phases of the disease, it is unlikely that it will be affected again”, and reported only one incidence of return to a previously ffected bone. Another study released 5 years later held that “recurrence in the same bone was most frequently found in the radius, followed by the ulna...”, but mentioned a 6-month or more interval between episodes in individual long bones. [/b]



According to the research my vet has shared with me over the years, pano is caused by bones growing too quickly. His first question when we have a case, "Is the puppy still on puppy food?" [/b]
Canine panosteitis: an idiopathic bone disease investigated in the light of a new hypothesis concerning pathogenesis. Part 1: Clinical and diagnostic aspects
Panosteitis, an idiopathic bone disease of young dogs, was investigated in the light of a new, empirically based hypothesis governing its pathogenesis. Extensive clinical observations suggest a close relationship between the incidence of this disease and the commercialization of various protein-rich, high-calorie dog foods. The theory of an "osseous compartment syndrome" provides a hypothetical pathogenesis, which corroborates this findings. An excessive accumulation of protein causes intraosseous edema due to its osmotic effects. Because bone is a rigid compartment, this leads to an increase in intramedullary pressure and compression of blood vessels. Subsequent osseous ischemia leads to a deficient metabolic state (decreased oxygenation, inadequate influx of nutritive substances, local acidosis, decreased removal of metabolites, disruption of local biochemical processes, etc.), and a vicious circle is created due to the resulting local inflammation. The disease is aggravated by increased metabolism due to excessive physical activity. Within the context of a pilot study, clinical, radiographic, scintigraphic and thermographic examinations and a therapeutic trial with benzopyron were carried out. In addition, more modern investigative tools, including osteomyelography, magnetic resonance tomography and intraosseous pressure measurements were used to provide objective data concerning the pathogenesis of panosteitis. In most cases, clinical remission was seen within days of monotherapy with the proteolytic substance, benzopyron (Cumartrin). This finding appears to corroborate our hypothesis.[/b]
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Of course it does but statisic shows it overwelmingly effect more males than females at about a 4-1 ratio.
From the panosteitis link found below
FWIW Toughy's bouts of pano lasted approx 1 month or a bit more on each leg. It seemed he went from limping on one leg to the next. It effected every limb twice with the left front 3 times. From the time he was 5 month to 18 months he was limping on on leg or another. Pano effects the idividual dog differently so you don't want to put to much stock in what is "typical" because "a typical" is very common in this diseases progression.
PANOSTEITIS
Canine panosteitis: an idiopathic bone disease investigated in the light of a new hypothesis concerning pathogenesis. Part 1: Clinical and diagnostic aspects
[/b]
So, as I said, female bassets can get panosteitis. Personally I haven't seen a 4:1 ratio and neither have some of my friends who have been breeding for many years. I trust their experience over some limited study. It may be true that more males get it, but not at that ratio. This may be partly due to the fact that most basset hound males seem to be larger and heavier than the females. BTW - My ratio to date has been almost 1:1, but that's an a very limited number of bassets.

Approximately one month fits my about three weeks time frame. Of course, if it moves from leg to leg the time would be extended. Again I'm speaking from not just my own experience. I qualified my statement that this is the experience of "many other breeders and ownere here in Southern California." For those who don't know, Southern California has the largest concentration of basset hound breeders in the country.

"...but mentioned a 6-month or more interval between episodes in individual long bones..." that sounds about right for the one case that I have had as well.

Yes, the puppy food we use is protein-rich. That's why my vet wants our dogs off of it at four months.
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Ruby had pano and it was pretty bad. She was crated and was told no exercise and was on a medication (can't recall the name now; think it began with the letter "E"; don't quote me tho).

Sending healing drool!

Janice
Thank you all for your help. I had never heard of pano and thought it was just from too much exercise. I am printing out all the information you provided and will read it all tonight.

I agree that it is extremely difficult to keep a young Basset quiet. As for his food, I gave him Nutro brand lamb and rice for Large Breed Puppies. The woman at the feed store said that the food for large breeds slows down the growth process so that the bones don't grow too fast. I kept him on that till he was one and now he's eating the Nutro venison and brown rice formula for adults. The x-rays showed nothing because the vet compared both legs and sholders and they were the same. He didn't want to give Baxter any pain medication because if he didn't feel pain he would not be careful. I've been trying to keep him from running around outside, and have succeeded MOST of the time. I try to keep him busy with bones and playing with him in my lap, which he loves.

Again, thank you so much for all that information.
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