CONFORMATION CORNER 
by Barb Wohlferd

Panosteitis (Pano)

Pano, also known as Wandering Lameness or EosinophilicPanosteitis, and is due to rapid growth. Panocan often be a self-limiting disease and can have spontaneous recovery in time. If left too long without treatment, there can rarely be permanent damage. The age for this condition can be from 6-18 months in large and giant breeds.

Pano or Panosteitis is the least threatening of the developmental orthopedic diseases. Pano is due to excessive growth rate which effects the long bones of the legs and often switches legs from day to day. It often occurs during groth spurts. Often this is caused byfeeding too many calories than is actually needed, or eating a poorly balanced diet. We can stop this condition quicker by slowing the growth rate with an appropriate quality food in measured amounts.

How is panosteitis diagnosed?

Prenatal and Postpartum Eclampsia in Dogs. Also called Puerperal Tetany or Milk Fever.

NOTE: This is NOT properly called Toxemia. Pregnancy Toxemia is a separate condition and is covered at the end of the document.

Eclampsia is a disorder of calcium metabolism. Although the name is the same as a condition in humans, almost everything else is different in dogs. Eclampsia can occur before delivery up to 6 weeks after delivery. But the majority of cases occur AFTER delivery. The causes are not known. But it is believed that over supplementing with calcium during pregnancy can be a cause. Eclampsia is far more common in small breed dogs. But it is not uncommon in golden retrievers. Eclampsia IS AN EMERGENCY situation, and requires veterinary intervention. If you even suspect your bitch might have eclampsia, contact your vet immediately! If you believe that your bitch has eclampsia, give calcium BEFORE heading to the vet. You can use Calsorb, Oral Cal Plus, or Tums dissolved in water and given with a syringe. This could possibly save your bitch's life as you head to the vet's office or emergency clinic. It is possible eclampsia is due to an under active parathyroid gland. Which is the gland that is responsible for regulating the parathyroid hormone. The parathyroid hormone regulates the amount of calcium that is stored in the bones, so it can be withdrawn as needed for use in the blood. In Eclampsia, the body is unable to respond quickly when bitch's milk comes in and the demand for calcium suddenly increases. The lack of calcium results in Tonic–clonic seizure contractions (seizure) of the skeletal muscles, where the muscles in the body contract convulsively.

This disease most often occurs with first litters and in toy breeds. Chihuahuas, miniature pinschers, shih-tzus, miniature poodles, Mexican hairless dogs and Pomeranians are at increased risk for eclampsia, as as toy breeds and bitches with their first litters. However, puppies are often not directly affected by eclampsia because their nutritional needs, including calcium, are being taken care of by their mother.

In addition, the symptoms typically become apparent in the first 40 days after giving birth. And rarely occurs during pregnancy.

Symptoms and Types

Poor maternal behavior or aggressiveness.

Restlessness, nervousness

Disorientation

Panting, whining

Vomiting

Diarrhea

Clumsy walking, stiff gait

Facial itchiness

Muscle tremors, tetany (entire body goes stiff), convulsions

Dog lies down with paws rigidly extended (usually seen 8–12 hours after the first onset of symptoms)

High body temperature, fever (take temperature while bitch is actively nursing)

Rapid, heavy breathing

Dilated pupils which are slow to contract when exposed to light

Lab Findings

Low Serum (Blood) Calcium Levels (hypocalcemia) less than 7mg/dl

High or Low Glucose Levels (hypo or hyperglycemia)

High Potassium levels (Hyperkalemia)

low serum albumin levels

Serum phosphorus levels may also be low

Causes

Calcium supplementation during pregnancy

Inappropriate calcium to phosphorous ratio in the diet while pregnant

Low body weight to litter size ratio

Very Large litter

Poor nutrition during pregnancy

First litter

Excessive milk production (leading to calcium depletion)

Bitches who quit eating for an extended period of time before whelping

Diagnosis

You will need to provide a thorough history of your dog's health leading up to the onset of symptoms. Make sure to provide your veterinarian with the type of pregnancy supplement you have been giving to your dog, and details of the diet you have been feeding her.

Standard tests will include a chemical blood profile, complete blood count and an electrolyte panel. As soon as the electrolyte panel is ready, the total serum calcium will be verified by a blood test. If the concentration is less than 7 mg/dL, your dog will be diagnosed with eclampsia and will be given calcium supplementation immediately. Low blood sugar and low blood magnesium levels may also be present. These can also be supplemented. Serum potassium is high in 56 percent of cases. An electrocardiogram (ECG) showing the heart's electrical rhythm will often be abnormal.

Treatment

This is a serious and potentially life-threatening condition, but it can be treated quickly and the dog's health stabilized if she is treated as soon as symptoms become apparent. If your dog has a high fever, your veterinarian will try to cool her down with a cool water soak and fan to bring the body temperature down to a normal range. Your veterinarian will treat your dog with intravenous calcium until her levels have increased to a safe level, and until her body alone is able to maintain calcium levels.

Your veterinarian might advise you to take the puppies away to prevent them from nursing, to be hand fed with a commercial milk for 24 hours, or until the mother’s serum calcium is stabilized. If, after the mother stabilizes, you opt to let the puppies continue nursing, you will need to return to your veterinarian to monitor calcium levels in your dog's blood. Depending on whether her body is able to begin producing sufficient amounts of calcium on its own, she may need to remain on calcium supplements for some time.

Prevention:

Feed your bitch a BALANCED diet while pregnant

DO NOT supplement with extra calcium before whelping

After whelping DO supplement with well balanced calcium supplement. It is important that the supplement be balanced between calcium and phosphorus. Rolaids/tums can work well for this.

Tums with 750 - 1000 mg calcium carbonate 2 - 3 times per day while nursing. Wean this off slowly at the time of puppy weaning.

Be careful of using dairy products alone to increase calcium intake. They often do not have the proper ratio of calcium, phosphorus and vitamin D. And can actually make things worse.

Pregnancy Toxemia

There is a separate syndrome called Pregnancy Toxemia that can occur at the end of a pregnancy. Bitches carrying very large litters are especially prone. Especially in bitches who have stopped eating due to the stress of carrying all of those puppies. Bitches with Pregnancy Toxemia present with anorexia and depression. They also often have low or altered blood sugar levels, difficulty breathing, pale gums, signs of shock and diarrhea. Bitches affected should be provided with supplemental nutrition. IV therapy may be required. The condition will resolve after the puppies are delivered. A c-section may be required. Especially if the bitch is in an extremely weakened condition.

Prenatal and Postpartum Eclampsia in Dogs. Also called Puerperal Tetany or Milk Fever.

NOTE: This is NOT properly called Toxemia. Pregnancy Toxemia is a separate condition and is covered at the end of the document.

Eclampsia is a disorder of calcium metabolism. Although the name is the same as a condition in humans, almost everything else is different in dogs. Eclampsia can occur before delivery up to 6 weeks after delivery. But the majority of cases occur AFTER delivery. The causes are not known. But it is believed that over supplementing with calcium during pregnancy can be a cause. Eclampsia is far more common in small breed dogs. But it is not uncommon in golden retrievers. Eclampsia IS AN EMERGENCY situation, and requires veterinary intervention. If you even suspect your bitch might have eclampsia, contact your vet immediately! If you believe that your bitch has eclampsia, give calcium BEFORE heading to the vet. You can use Calsorb, Oral Cal Plus, or Tums dissolved in water and given with a syringe. This could possibly save your bitch's life as you head to the vet's office or emergency clinic. It is possible eclampsia is due to an under active parathyroid gland. Which is the gland that is responsible for regulating the parathyroid hormone. The parathyroid hormone regulates the amount of calcium that is stored in the bones, so it can be withdrawn as needed for use in the blood. In Eclampsia, the body is unable to respond quickly when bitch's milk comes in and the demand for calcium suddenly increases. The lack of calcium results in Tonic–clonic seizure contractions (seizure) of the skeletal muscles, where the muscles in the body contract convulsively.

This disease most often occurs with first litters and in toy breeds. Chihuahuas, miniature pinschers, shih-tzus, miniature poodles, Mexican hairless dogs and Pomeranians are at increased risk for eclampsia, as as toy breeds and bitches with their first litters. However, puppies are often not directly affected by eclampsia because their nutritional needs, including calcium, are being taken care of by their mother.

In addition, the symptoms typically become apparent in the first 40 days after giving birth. And rarely occurs during pregnancy.

Symptoms and Types

Poor maternal behavior or aggressiveness.

Restlessness, nervousness

Disorientation

Panting, whining

Vomiting

Diarrhea

Clumsy walking, stiff gait

Facial itchiness

Muscle tremors, tetany (entire body goes stiff), convulsions

Dog lies down with paws rigidly extended (usually seen 8–12 hours after the first onset of symptoms)

High body temperature, fever (take temperature while bitch is actively nursing)

Rapid, heavy breathing

Dilated pupils which are slow to contract when exposed to light

Lab Findings

Low Serum (Blood) Calcium Levels (hypocalcemia) less than 7mg/dl

High or Low Glucose Levels (hypo or hyperglycemia)

High Potassium levels (Hyperkalemia)

low serum albumin levels

Serum phosphorus levels may also be low

Causes

Calcium supplementation during pregnancy

Inappropriate calcium to phosphorous ratio in the diet while pregnant

Low body weight to litter size ratio

Very Large litter

Poor nutrition during pregnancy

First litter

Excessive milk production (leading to calcium depletion)

Bitches who quit eating for an extended period of time before whelping

Diagnosis

You will need to provide a thorough history of your dog's health leading up to the onset of symptoms. Make sure to provide your veterinarian with the type of pregnancy supplement you have been giving to your dog, and details of the diet you have been feeding her.

Standard tests will include a chemical blood profile, complete blood count and an electrolyte panel. As soon as the electrolyte panel is ready, the total serum calcium will be verified by a blood test. If the concentration is less than 7 mg/dL, your dog will be diagnosed with eclampsia and will be given calcium supplementation immediately. Low blood sugar and low blood magnesium levels may also be present. These can also be supplemented. Serum potassium is high in 56 percent of cases. An electrocardiogram (ECG) showing the heart's electrical rhythm will often be abnormal.

Treatment

This is a serious and potentially life-threatening condition, but it can be treated quickly and the dog's health stabilized if she is treated as soon as symptoms become apparent. If your dog has a high fever, your veterinarian will try to cool her down with a cool water soak and fan to bring the body temperature down to a normal range. Your veterinarian will treat your dog with intravenous calcium until her levels have increased to a safe level, and until her body alone is able to maintain calcium levels.

Your veterinarian might advise you to take the puppies away to prevent them from nursing, to be hand fed with a commercial milk for 24 hours, or until the mother’s serum calcium is stabilized. If, after the mother stabilizes, you opt to let the puppies continue nursing, you will need to return to your veterinarian to monitor calcium levels in your dog's blood. Depending on whether her body is able to begin producing sufficient amounts of calcium on its own, she may need to remain on calcium supplements for some time.

Prevention:

Feed your bitch a BALANCED diet while pregnant

DO NOT supplement with extra calcium before whelping

After whelping DO supplement with well balanced calcium supplement. It is important that the supplement be balanced between calcium and phosphorus. Rolaids/tums can work well for this.

Tums with 750 - 1000 mg calcium carbonate 2 - 3 times per day while nursing. Wean this off slowly at the time of puppy weaning.

Be careful of using dairy products alone to increase calcium intake. They often do not have the proper ratio of calcium, phosphorus and vitamin D. And can actually make things worse.

Pregnancy Toxemia

There is a separate syndrome called Pregnancy Toxemia that can occur at the end of a pregnancy. Bitches carrying very large litters are especially prone. Especially in bitches who have stopped eating due to the stress of carrying all of those puppies. Bitches with Pregnancy Toxemia present with anorexia and depression. They also often have low or altered blood sugar levels, difficulty breathing, pale gums, signs of shock and diarrhea. Bitches affected should be provided with supplemental nutrition. IV therapy may be required. The condition will resolve after the puppies are delivered. A c-section may be required. Especially if the bitch is in an extremely weakened condition.

 How is panosteitis treated?

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