Linda Arndt ~ Canine Nutritional Consultant

A Guide To Recognizing Bone Diseases

For Your Veterinarian

Understanding the problems and needs of the large/giant breeds can be difficult, and understandably so, if you have not had the experience of dealing with many in your practice. Great Danes in particular are a fragile breed and particularly prone to developmental orthopedic diseases, vaccine and antibiotic reactions as well as immune problems. All to often developmental orthopedic diseases get incorrectly diagnosed.

In light of this information, I offer you this article to assist you in working with the large/giant breeds. First, I understand as a lay person you are hesitant to put much stock in an article brought to you by your client. On the other hand, let me give you some background to assure you my experience is worth considering.

My name is Linda Arndt, I am a professor emeritus of a large mid-west university and owner of Blackwatch Great Dane Kennels and Blackwatch Canine Nutritional Consulting LLC. I have been involved in exhibiting, breeding, and training in conformation and obedience for 36 years. My last 25years of involvement in dogs have been focused on the education of breeders and veterinarians, involving health issues and feeding programs, as it relates to the giant breeds and developmental orthopedic diseases. Over the years I work closely with the Great Dane Club of America to help find solutions to the many problems within our breed.

In 1989 - 1995 I conducted the National Bone Disease Survey in Great Danes, which supplied data from 5200 cases of veterinarian diagnosed DOD - Developmental Orthopedic Diseases. HOD, OCD and Pano where the primary focus of the survey.

I gathered information on age, sex, diets - types and amounts, medications, vaccine protocols. Whereby this is not scientific research, it does give us the most extensive data on DOD problems within our breed. This survey also revealed antibiotic sensitivities in this breed, as well as a large number of vaccine reactions, which led to the current vaccine research being funded by the Great Dane Club of America, under the direction of Dr. Harm HoganEsch and Dr. Larry Glickman, at Purdue University. The results of this 8 year research was published in the JAVMA in 2006.

I mention this information to you because there is evidence, based on the national survey, that vaccine reactions, allergic reactions to certain antibiotics, and septicemia (generally from cropping), are often misdiagnosed as HOD. These conditions can "mimic" the same symptoms as HOD , making it very difficult to diagnose.

With that in mind, I offer this article to you for consideration - a check list of "things to consider" when searching for the answers to a potential developmental orthopedic disease.

It is with the greatest respect that I offer this information. I have worked with many veterinarians and breeders in collective problem solving for the benefit of this breed.
Feel free to contact me at any time that I can be of assistance.

Linda Arndt
Blackwatch Nutritional Consulting LLC
Blackwatch Kennels


This is a copy of the guide I offer my puppy buyers as part of my educational packet. I have been asked to share this to other owners and breeders as support information to be used in conjunction with veterinarian care. Feel free to copy and share with others if you find it useful. This article is now part of the Great Dane Club of America's Health and Welfare handbook since 2001 for owners, and has been published in numerous breed magazines.


Raising a large/giant breed that first year can be somewhat difficult. One of the major stumbling blocks are 3 common bone diseases we often deal with in these breeds. I would like to discuss the facts/myth of these diseases and give you a way to determine which disease you may be dealing with regarding your puppy. This is not meant to take the place of seeing a veterinarians care. If you suspect your puppy is not well, use this as support information for you and your vet in diagnosing the health problem of your puppy. The problem today is the use of multivalent vaccines, particularly on the giant breeds, puts them at great risk. Their fragile immune systems cannot handle the assault of multivalent vaccines and we lose them to autoimmune response, which is misdiagnosed as HOD in the early stages. This article will help you and your vet determine whether or not your dog has true nutritional HOD.

Distinguishing Fact from Fiction

Fact: In the textbook Small Animal Clinical Nutrition, 4th edition 2000 has these diseases HOD, OCD and Panosteitis (Pano) listed as DOD - Developmental Orthopedic Diseases and nutritionally related, not genetic in origin.

Fact: HOD and Septicemia also known as Septic Arthritis, are NOT the same disease, but share the same symptoms, making it difficult to diagnose. Always do a blood test to rule out infection.

Fact: All growing puppies, if x-rayed, look as if they have HOD due to fast rate of growth. Therefore, x-rays are not always all that useful in diagnosing HOD - but a blood culture will to rule out septicemia which mimic's HOD symptoms.

Fact: Vaccine reactions, from combo shots, can produce the same symptoms as HOD and therefore the problem is misdiagnosed as HOD. The Purdue research shows it is the carrier in the vaccine that is a problem. It is important to detoxify the dog when vaccinating. (Vit C and Nzymes info is available in the prevention of this reaction).

Fact: Rabies vaccines given before 6 months of age (particularly in Great Danes)and at the same time as combination vaccines, can cause HOD -like symptoms. These symptoms of fever, swollen joints, excruciating pain are often irreversible and result in the need for humane euthanasia.

Fact: Most research on orthopedic diseases have been done in the equine field not canines.

Fact: These 3 diseases HOD, OCD, Pano are definitely treatable and do not have to be life threatening. Early and proper diagnosis and change in feeding program is necessary to correct the problem.

Fact: Euthanasia does not have to be an option with "true" HOD, OCD and Pano, with vaccine reactions there is little that can be done for them unless it is detected early.

Fact: Septicemia or Septic Arthritis is erroneously labeled as pseudo HOD by breeders/owners. If the dog is septic and misdiagnosed as HOD, it can be life threatening. Make sure a blood test and culture is run to correctly diagnose Septicemia.

How To Determine Your Puppy has "True" HOD

Again true HOD is a nutritionally caused disease so in order to determine if this is the problem or not, we must go through a series of questions to draw a conclusion as to what is going on with your puppy. Most of the time your puppy will be at stage three before a veterinarian will be called on for help. Unless your veterinarian has dealt with many large/giant breeds, they may not be sure how to handle this problem. You can give them a copy of this guideline and it will assist them in determining the cause for your puppies symptoms (as described in stage three). When I receive phone calls from breeders/owners or veterinarians for guidance in this particular disease (HOD) we go through a series of questions and I am more than willing to assist your vet. (

Why Diagnosing HOD Can Be VERY Confusing!!

In diagnosis HOD, it of very confusing because the symptoms I have listed above, are also the same symptoms that your puppy can have with a reaction to vaccines, antibiotics or septicemia. The following things "mimic" the symptoms of HOD.

  1. Vaccine Reactions or Vaccine Mediated Response

  2. Allergic Reactions to Antibiotics:

    Sulfonamide Drugs (Ditrim, TMZ, TMP/SDZ, Bactrim, Primor, Tribrissen, trimethoprim sulfa,septra, cotrim, sulfatrim).
    Cephalexin (Keflex - Cefa-Tabs, ) - it seems to dry out the synovial fluids in the joints!

  3. Septicemia - also known as septic-arthritis. This is a "systemic" infection also known as blood poisoning

These 3 things "Mimic" the same symptoms as HOD which is why so many puppies are misdiagnosed.

Note: After consulting with my own veterinarians, we have decided not to use any sulfonamide antibiotics on Great Danes because of their hypersensitivity and potential life threatening effect on this breed. If a culture determines it is the best suited for the infection only then would it be used on my dogs. We will use Cephalexin, when it is appropriate, but with a watchful eye and stop it immediately, if there are any adverse reaction

Discussion of 3 Bone Diseases HOD, OCD and Pano

HOD - Hypertrophic Osteodystrophy

  • Normally Affects the Large/Giant Breeds (matures 50#+)
  • Dogs Grow Too Fast
  • Uneven growth between muscle, ligaments, tendons and bone/cartilage

Nutritionally Caused By:

    • too many calories consumed vs energy expended
    • unbalanced diet disrupted by supplementing human foods that are not balanced in calcium/phosphorus ratios

    • Poor quality minerals in a diet or lacking in important trace minerals.

Age Range for Disease: 10 weeks - 6 months (worst time is 3 months - 6 months) - although Knuckling Over or Bowed legs are an early indication and this can start at 5 weeks of age if feed too many calories.


    early stages: large knotty joints, toes turning in or out

    middle stages: large knotty joints, toes turning in or out, roached toplines, pinched rear end assembly

    advanced stages: fever (104-106), refusal to eat, jaw tender, swelling of joint areas often hot to the touch animals cry in pain, unable to get up, flat feet, bowing of the limbs, lack of mobility, depression polyartiritis in all limbs.
Based on the National Bone Survey and my experience in this breed HOD does not happen in puppies past 6 months of age.

Course of Action:
    Is the dog having an allergic reaction to one of the drugs listed below in the section on antibiotic reactions, rule that out first ?

    Look At Diet and Amount Being Fed (see Puppy Feed Program and Amount to Feed Chart - are you over feeding? If the dog is being feed a quality diet (see list of better foods) and in appropriate amounts that are listed in the Puppy Feed Program, then you can rule out diet.

    Has the dog had a vaccination within 24 - 48 hours prior to the fever and lethargy?If so then this could be a vaccine reaction. (see info below).

Once you rule out vaccine or allergic reactions to drugs and blood infection, then the problem has to be diet.

Change the diet and add the
Blackwatch Supplement Kit #5 for HOD and Pano & OCD people have tremendous success with it.

Read this article for more information: DEALING WITH HOD

      A shot of dexamethsone will help in getting this puppy back on it's feet and you may have to follow up with some Azium tablets. This works better than Prednesone - discuss this with your vet.


OCD - Osteochrondritis Dissecans
    The Separation of Joint Cartilage from Bone
    Cause is Rapid Growth
    Ages 4-12 months of age
    Affects Shoulder, Hocks, Stifles
    Cause Excessive Calcium or Mineral Imbalance
    Nutritionally Caused Disease
    Symptoms - Lameness. Pain present at flexing the joint
    Can happen in more than one joint.
This is defect in the cartilage the overlaying or attaching to the bone does not take place properly and a small piece or flap peels up and acts as an irritant. Sometimes there is fluid build up in the hock area due to loose cartilage.
Suggestions for Prevention:
Course of Action:
If this is diagnosed early enough (7 mo. and under) it may be possible to repair the problems with changes in diet and the use of Adequan shots AND a product which support joint nutritional supplement such Liquid Health Level 5000 . Sometimes surgery to remove the piece of cartilage is the only option. Discuss this with an Orthopedics veterinarian if surgery is a possibility. Most vets will not know about the ability to repair a lesion with joint supplements, Adequan shots and change in diet to a kibble with chelated or sequestered minerals. There is a high success rate of correcting the problem with out surgery if caught under 7 months of age.

The National Bone Survey in this breed had over 5200 cases of veterinarian diagnosed bone diseases reported to the survey. Of those numbers, 517 were OCD cases. Of those cases all were fed the same 3 commercial dog foods and the mineral sources on these foods were crude forms and lacking in trace minerals.

Simply stick to the foods on my list of better foods and you minimize your chances for OCD problems because they use chelated or sequestered minerals, which are higher quality and usable by the system.

Once in a while an animal has been injured, the trauma to that area will cause OCD in a joint especially if the diet is compromised in quality. When it is nutritionally cause is it often in more than one joint. or bilateral.

Panosteitis (Pano)
Pano, is what breeders call this disease. It is the least invasive and least threatening of the three bone diseases discussed in this article.
      Wandering Lameness (Eosinophilic Panosteitis)
      Also Known As Growing Pains in Dogs (and Children) soreness in the long bones
      Rapid Rate of Growth
      Spontaneous Recovery/ Self Limiting Disease
      Achy Arthritis, if it lasts long periods of time their may be muscle wasting
      6 - 14 months (9-12 months being the likely period)

An allergic reaction Chephalexin or the Sulfonamides is often misdiagnosed as Pano in an adult dog. True Pano does not happen in dogs after the growth plates are closed at 18 months, but an allergic relation to antibiotics can happen at any stage of the dogs life.

I do not recommend any pain killer medicines because most compromise the liver function (Deramaxx, Rimydal etc) . They are fragile enough without compromising their liver functions.

We have other pain options today such as using natural anti-inflammatories like Microlactin and Nzymes in conjunction with a good joint supplement. Liquid Health Level 5000 that helps with pain management in a natural way. Also there is info in my article on a product called Recovery SA a new breed of medicine.

Suggestion for Future Prevention:

Feed a moderate (protein/fat/calorie), meat based, high quality diet in moderate amounts to keep growth slow and even and the Blackwatch Puppy Kit#1 or #2 which has joint support supplement in the kit.

Follow the Amount to Feed Chart



Diet - Are you feeding a moderate protein/moderate fat diet? (22%-24% max. protein and 12%-15%fat, 350- 400Kcalories per cup) this is considered moderate in measured amounts in an AM and PM feeding. NO FREE CHOICE FEEDING.

Not all adult brands of dog foods are appropriate to feed a growing giant breed and not all puppy foods are appropriate for giant breed growth...Here is the criteria for large/giant breed growth.Certain brands are notorious for causing orthopedic problems due to poor quality mineral absorption.

NEVER FEED A LOW PROTEIN AND NEVER FEED A HIGH PROTEIN. One is not enough in calories or nutrients the other is too much calories for a growing animal. It is to difficult for the owner to regulate the caloric intake necessary when we are not using moderate foods.
This is a general rule, based on moderate caloric foods and for animals that may be crated during a part of their daily routine or less active during extreme weather conditions.

Are You Supplementing? - if you are supplementing with vitamins, minerals, (calcium) and certain people foods such as rice, cottage cheese, eggs, meat, you might be throwing the calcium and phosphorus balance off of your commercial food, as well as adding to the extra calories.

"NEVER SUPPLEMENT CALCIUM WITH TODAY'S COMMERCIAL DOG FOODS" - quote from Small Animal Clinical Nutrition Textbook - 4th edition 2000. This is not to say you should not use real "foods," but during these delicate growing stages 3-6 months, I recommend we go easy and use only fruits veggies, canned meats or a little balanced raw diet ( Diets).

See Puppy Feed Program and Puppy Guidelines, and Adult Feed Program at this website.
If you have a puppy that has been diagnosed with HOD, use the above guidelines to determine if the dog is consuming more food than he needs and/or the diet is being unbalanced by supplementation. If not, then we must look at other factors causing HOD like symptoms rather than actual HOD. If diet is a problem adjust feeding accordingly.

Has your dog been on these Antibiotics?

Sulfonamide Drugs - Ditrim, TMZ, TMP/SDZ, Bactrim, Primor, Tribrissen,trimethoprim sulfa,septra, cotrim, sulfatrim OR Cephalexin, Keflex or Cefa-Tabs (all the same antibiotic).
If so, it is not at all uncommon to have a reaction to these antibiotics that mimic the symptoms of HOD. In some animals this happens within 24 hours, with others it maybe up to 7-10 days on the therapy before you notice the symptoms of: achy and swelling joints, fever and loss of appetite.(all the same symptoms as in stage three of "true" HOD or in older dogs, it is often misdiagnosed as PANO)

If you determine the "HOD like" symptoms are due to an allergic reaction to antibiotics, generally the animal is treated with Dexamethsone and antibiotic is changed. Discuss the course of action with your veterinarian. Once you rule out antibiotic reaction we go to step 3.

If you determine the "HOD like" symptoms or Pano symptoms are not due to diet, or antibiotics, then we must look at vaccine reactions. Did your puppy have an inoculation within the past 7 days? Normally this response happens within 24-48 hours but can come on as late as a week or more past the date of inoculations. They symptoms are the same as in stage three of "true" HOD. Polyarthritis, lethargy, swelling of the joint area, fever and loss of appetite.

Treatment: I have found 3 things helpful in cleansing the fibronectin carrier/preservative in the vaccines, which the body recognizes as a toxin. (Purdue Vaccine Research - 2000) But keep in mind, nothing is a guarantee and some dogs immune systems are so compromised that we lose them to autoimmune disease.

The best course of action is prevention by starting your puppies on the Supplement Kit#1 0r #3 and #4 for Adults or use one of the CORE 4 supplement kits to detoxify the body.

Step 4: COULD IT BE SEPTICEMIA (Septic-Arthritis)

When we see the term "Pseudo HOD" all over the internet, note - this is an inaccurate term for Septicemia. This is term is taken from an antiquated article that is published on the internet and has no bearing on the real cause of HOD. What this article is referring to is Septicemia, also known as blood poisoning or septic arthritis, which gets misdiagnosed as HOD.

If you have ruled out diet, antibiotic reactions and vaccine response, we must take a look at the possibility of a systemic infection. This could be from taping a joint (avoid this at all costs), a puncture wound, from non-sterile ear cropping conditions, a bite or a wound that is undetected.

Rather than use an antibiotic, that may not be suited for the specific bacteria or use an antibiotic when it is not needed, run a blood test first to see if there is an elevated blood count, which indicates infection. I recommend a blood culture as well, to find the best antibiotic to fight the infection. You should avoid the unnecessary use of Chloremphenical for septicemia which is a method touted all over the internet. This is a drug not to be used on growing animals or children and we have other options these days.

Chloremphenical suppresses the immune system and is not meant to be used on growing animals/children. Discuss other options with your veterinarian.

It is my experience, the numbers of "real" Septicemia cases in this breed are not nearly as prevalent as breeders are led to believe from other breeders. When there is a case of Septicemia, more than likely it is due to unsanitary cropping and ear aftercare techniques.

Note: Of the 5200 cases of bone diseases reported to the NATIONAL BONE SURVEY, only two cases of "HOD-like" symptoms were the results of veterinarian diagnosed Septicemia.

In Conclusion:

The following 3 diseases are difficult to diagnose at times. It requires looking at a total history of the animal, including feeding, medications, vaccines etc. I hope this method of discussing these problems makes it a little easier to understand and helps you find a solution, when and if you have these problems.

Hopefully we can find the cause and treatment for the situation along with help from your veterinarian and know I am available to assist you.

Linda Arndt
*This article, my opinion or if you ask for my assistance on health and feeding issues, is not to be used "in lieu of " veterinarian advise and treatment, and should be discussed with your vet for a comprehensive approach to better health for your pet.

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