Chapter 36 Hypertrophic Osteopathy The disease is self-limiting, so treatment consists of controlling pain. Nonsteroidal anti-inflammatory drugs (NSAIDs) (see Table 34-4 on p. 1221) usually are administered during acute episodes of lameness. Exercise restriction is recommended when the animal is lame. Owners should be warned of the likelihood of recurrence, but the long-term prognosis is excellent for complete recovery. Analgesics (see Table 34-4 on p. 1221) should be given to control pain until the animal reaches maturity. Severely debilitated animals that cannot open their mouths enough to eat solid foods require oral fluid nourishment or a feeding tube. Although antibiotics and corticosteroids are often administered during febrile episodes, they will not alter disease progression. Hypertrophic Osteodystrophy This condition should be differentiated from septic arthritis, septic physitis, and panosteitis. Analgesics should be administered to control pain (see Table 34-4 on p. 1221). Occasionally, severely debilitated animals require fluid support. Corticosteroids, antibiotics, and vitamin C have been administered but have not proved effective in shortening the course or severity of the disease. Bacteremia should be ruled out before corticosteroids are administered. Bone Neoplasia Osteosarcoma is the most common primary bone neoplasm in dogs, accounting for approximately 85% of skeletal malignancies; 75% of osteosarcomas originate in the appendicular skeleton (Tables 36-1 and 36-2). The front limbs are affected twice as often as the rear limbs. In dogs less than 15 kg, 60% of tumors originate in the axial skeleton. (Withrow and Vail, 2007). Primary osteosarcoma of extraskeletal tissues is rare but has been reported (mammary, subcutaneous, spleen) (Withrow and Vail, 2007). A genetic cause of osteosarcoma appears likely based on experimental and clinical studies (Withrow and Vail, 2007). Osteosarcoma has been associated with fractures and metallic implants and may also occur within radiation fields following radiation treatment of soft tissue sarcomas. Osteosarcoma is the most common tumor of the axial skeleton. Of 116 axial osteosarcomas evaluated, the most common sites of occurrence were the mandible (27%), maxilla (22%), spine (15%), cranium (14%), ribs (10%), nasal cavity and paranasal sinuses (9%), and pelvis (6%) (Withrow and Vail, 2007). Because osteosarcoma is the most commonly diagnosed bone tumor, it is used as the model for evaluation, diagnosis, treatment, and prognosis of bone tumors in this section. Although the work-up needed to diagnose neoplasia is similar for all bone tumors, treatment and prognosis vary depending on tumor type (see Tables 36-1 and 36-2).
Other Diseases of Bones and Joints
Panosteitis
Medical Treatment
Craniomandibular Osteopathy
Medical Management
Differential Diagnosis
Medical Management
General Considerations and Clinically Relevant Pathophysiology
Other Diseases of Bones and Joints
