Exam 3: Lecture 27 - Developmental Done Diseases Flashcards by Matthew Irvin

What are the primarily inflammatory bone diseases

panosteitis
hypertrophic osteodystrophy (HOD)

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when do the primarily inflammatory bone diseases appear?

characteristically during growth period of large and giant breed dogs

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what is the definition of canine panosteitis

disease of young dogs causing lameness, bone pain (in long bones), endosteal bone production, and occasional periosteal bone production

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what are some synonyms of canine panosteitis

enostosis, eosinophilic panosteitis, juvenile osteomyelitis and osteomyelitis of young GSDs

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what is the etiology of canine panosteitis

unknown (maybe genetic, viral, or autoimmune??)

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what is the pathophysiology of canine panosteitis

osseous compartment syndrome from protein rich high calorie diets

excessive protein leads to intraosseous edema and secondary increase medullary pressure and ischemia

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T/F: Canine panosteitis is a disease of adipose bone marrow

true!

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what is the usual signalment of canine panosteitis

male large breed dogs (~80%), young dogs under 2 years old, and SOMETIMES seen in older dogs

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what is the usual history of canine panosteitis

shifting leg lameness, pain on deep bone palpation, may be acute lameness on one leg or chronic leg shifting

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what do we usually see on gait analysis with canine panosteitis

single or multiple leg involvement, a varying severity of lameness (usually grade 1 or 2)

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what do we usually see on PE with canine panosteitis

pain on direct palpation of affected bone(s) and generally weight bearing

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T/F: you can diagnose canine panosteitis just by palpation of the long bones

FALSE!! Also need radiographs

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T/F: With canine panosteitis clinical signs may preceed radiographic changes by up to 10 days and the radiograph sings are usually progressive

true!

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What are the radiographic findings of canine panosteitis

widening of the nutrient foramen
intramedullary radiopacity (clouds)
endosteal thickening
perosteal new bone

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What developmental bone disease are these rads showing

canine panosteitis

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what is the medial treatment for canine panosteitis

self limiting disease, NSAIDs, exercise restriction when lame

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T/F: You should surgically correct canine panosteitis

false!! Not indicated

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is prognosis good or poor for canine panosteitis

good!

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What is the definition of hypertrophic osteodystrophy (HOD)

disease causing disruption of metaphyseal trabeculae

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what are some synonyms of HOD

skeletal scurvy, canine scurvy, Moeller-Barlow disease, osteodystrophy types 1 and 2, metaphyseal osteopathy and metaphyseal dysplasia

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What is the etiology of HOD

unknown, maybe caused by diminished levels of vit C, and viral causes are suspected

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why are viral causes suspected for HOD

usually have accompanying history of recent GI/respiratory problems

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what is the pathophysiology of HOD

disturbance of metaphyseal blood supply, no bone formed on calcified cartilarge, and osteoclastic resorption

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what do we see with disturbance of metaphyseal blood supply in HOD

changes in physis and adjacent metaphyseal bone
delayed ossification of physeal hypertrophic zone
widening of physis (increased width of hypertrophied chondrocyte zone)

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T/F: There is no bone formed in calcified cartilage with HOD and instead we see inflammatory infiltration of neutrophils and mononuclear cells

true!!

What is the usual signalment seen with HOD

1. young rapidly growing large breed dogs 2. males more commonly than females 3. clinical signs around 3-4 months old but can be seen as early as 2 months old 4. Weimaraners are at increased risk

what is the usual history we see with HOD

1. acute onset of lameness 2. may be severely affected (puppies may not walk) 3. inappetence and lethargy 4. history of recent diarrhea may precede lameness

what do we usually see on PE with HOD

1. mild to severe lameness of all 4 limbs (may be unable to stand or walk) 2. long bone metastases swollen warm and painful on palpation 3. swelling often present of all 4 limbs 4. swelling in forelimbs may be more obvious

what are some potential differential DDx's when we see a patient with suspected HOD?

septic arthritis, septic physitis, and panosteitis

what are the radiographic findings of HOD

1. irregular radiolucent line metaphyseal side of physis (a "double physis") 2. widening of physis 3. usually evidence in multiple limbs

What is this radiograph showing

osteolysis on metaphyseal side of active physis.... AKA the "second growth plate"

what is A

active physis

what is B

osteolysis

What disease are these progressive rads showing

HOD

what is the treatment for HOD in animals that are NOT severely affected

HOD is self limiting so we focus on supportive care like analgesics to control pain

how do we treat severely affected animals with HOD

1. corticosteroids 2. antibiotics 3. vit c 4. IV fluids

What must we rule out prior to using corticosteroids for HOD treatment

MUST RULE OUT bacteremia!!!

what is the prognosis for HOD

most recovery fully in 7-10 days but relapses may occur

when should we consider euth for HOD

if there is severe debilitation or multiple severe relapses

What are retained ulnar cartilaginous cores

cones of growth plate cartilage that project from distal ulnar growth plate into distal metaphysis

what is retained ulnar cartilaginous cores also known as

Retained endochondral cartilage core

what is the usual clinical presentation of retained ulnar cartilaginous core

1. large to giant immature canines 2. growth plate manifestation of osteochrondrosis 3. +/- carpal valgus 4. forelimb deformities may be identical to premature closure of distal ulnar and radial growth plates

How do we definitively diagnose retained ulnar cartilaginous core

radiographs

What is this rad showing

retained ulnar cartilaginous core

What is the treatment for retained ulnar cartilaginous core with no forelimb deformities

no treatment needed

What is the treatment for retained ulnar cartilaginous core with forelimb deformities

1. surgical correction of deformity may be required 2. all patients should be prescribed well balanced diet 3. cores may disappear spontaneously

What is legg-calve-perthes disease

non-inflammatory aseptic necrosis of femoral head in young patient prior to capital femoral physis closure

what is the pathophysiology of Legg-calve-perthes disease

collapse of femoral epiphysis caused by interruption of blood flow (a hypoxic event leads to necrosis and collapse of femoral epiphysis)

what is the etiology of legg-calve-perthes disease

unknown but proposed theories of hereditary factors, hormonal influence, anatomic conformation, intracapsular pressure, and infarction of femoral head

T/F: Synovitis or sustained abnormal limb position may increase intra-articular pressure and collapse fragile veins which inhibits blood flow

true!!!

T/F: vascular supply to the femoral head in young animals comes from the epiphyseal vessels

true!!

T/F: metaphyseal vessels cross the physis to help contribute to femoral head vascularity

false, they do NOT cross physis

T/F: epiphyseal vessels course along femoral neck surface, cross growth plate, penetrate bone, and supplies nourishment to the femoral epiphysis

true!!

What is the usual signalment of legg-calve-perthes disease

1. young small breed dogs 2. peak incidence 6-7 months old but ranges from 3-13 months 3. males and females affected equally 4. occurs bilaterally 10-17% of affected animals

what is the usual history for legg-calve-perthes disease

1. slow onset with weight bearing lameness that worsens over 6 to 8 weeks 2. lameness may progress to NWB 3. may present as acute onset due to sudden collapse of epiphysis 4. other clinical signs such as irritability, reduced appetite, and chewing at skin over hip

what is the PE we usually see with legg-calve-perthes disease

hip joint pain and with advanced disease can have limited range of motion, muscle atrophy, and cepitus

What disease is the radiograph showing

legg-calve-perthes disease

how do we medically manage legg-calve-perthes disease

can in early stages of disease and if it is not painful can use NSAIDs, limited leash walking or NWB exercises like swimming

How do we surgically treat legg-calve-perthes disease

Excision of femoral head and neck (FHO)

what is the post op care for legg-calve-perthes disease

1. limb should be used immediately after sx 2. NSAIDs to reduce pain and encourage early fcn 3. passive flexion-extension exercises 4. physical therapy

when is the prognosis good for legg-calve-perthes disease

after FHO and when there is slight intermittently lameness

when is prognosis poor for legg-calve-perthes disease

NWB prior to surgery, severe preoperative muscle atrophy, incorrect surgical techniques