Canine Panosteitis

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What is Canine Panosteitis?

Seeing your precious puppy suddenly limping can be a bit of a shock; there can be several reasons this could be happening today; we focus on one disease that can lead to lameness in growing dogs.

Canine Panosteitis, or Pano, is often referred to as “growing pains” for its similar symptoms to the human condition seen in children. Panosteitis refers to the transitory inflammation of the long (leg) bones of dogs. Lameness can occur abruptly, with no previous history of injury or excessive exercise.

Dog with Canine Panosteitis - I Love Veterinary

Panosteitis is a disease of young, rapidly growing dogs. Affected dogs are usually between 5-14 months, but it can be seen in puppies as young as two months or as old as 18 months. Panosteitis is most commonly seen in the front legs of medium and large breed dogs, but any size dog can develop this condition in the front or hind legs.

Pano is painful and can affect one or multiple legs, which may affect mobility. Panosteitis can continue to affect dogs until two years of age when large dog breeds will have finished growing.

What are the Possible Causes?

The exact cause has not been found yet, but the most common theories are:

  • Infection: no bacteria or virus has been isolated in affected dogs, but dogs with panosteitis commonly develop fevers and high white blood cells in blood tests (common signs of infection).
  • Diet: diets high in protein or calcium have been suspected of causing panosteitis, but nothing has been proven.
  • Genetics: some breeds are more likely to be affected than others (see below), suggesting a genetic component.

Ultimately, more investigation needs to be done as no one knows for sure what causes Pano.

Predisposed Breeds to Canine Panosteitis

German Shepherds are most commonly affected, but other medium and large breed dogs can also develop this condition. Panosteitis is also widely seen in Golden Retrievers, Basset hounds, Great Danes, Doberman Pinschers, and Labradors. Cross Breeds can also be affected.

Great Dane puppy, Canine Panosteitis - I Love Veterinary

Clinical Signs and Diagnosis

Clinical Signs

Dogs and puppies with pano will often show signs of lameness and limping, particularly in the front legs. Touching the affected leg will be painful, and dogs may pull away or yelp. Dogs may be reluctant to go for walks, and heavy exercise may worsen symptoms.

Other clinical signs you might see are fever, weight loss, not wanting to eat, and difficulty getting up from rest, and muscles may shrink (atrophy) from reduced use.

Panosteitis can be cyclic where it appears to get better then get worse again. The pain can most commonly last from a few days to a few weeks (up to five weeks) with up to a month between episodes; the pain can shift to other legs in your dog’s body.


An appointment with your dog’s veterinarian should be made if you are concerned about panosteitis. A veterinarian would diagnose panosteitis by taking a thorough history from you and examining your dog thoroughly.

Radiographs (X-rays) can be useful for diagnosis, and affected bones will show cloudiness in the bone marrow. Part of the bone marrow is replaced by woven bone, which appears fluffy on the x-ray image; this will eventually be replaced by normal bone when the dog reaches maturity. Occasionally x-rays need to be repeated to confirm a suspected diagnosis as boney changes may lag up to two weeks behind clinical signs. 

Vet examining dog's x-ray, Canine Panosteitis - I Love Veterianry

X-rays are also useful to rule out other causes of pain in growing dogs, such as developmental conditions (hypertrophic osteodystrophy, osteochondrosis dissecans) or trauma (fractures, ligament damage).

Blood tests may also be performed in affected dogs white blood cell levels are often elevated. 

Risk Factors Associated with Canine Panosteitis

Any medium to large breed dog is at higher risk of developing panosteitis, and German Shepherds are the most at risk of all breeds. Dogs of all sizes can develop panosteitis.

Male dogs are most commonly affected; however, it can be seen in female dogs also.

Other risk factors include rapid weight gain, excessive exercise, and overweight dogs may worsen signs.

Available Treatment Options

Panosteitis is a self-limiting condition, and ultimately it will resolve when your dog stops growing (up to 2 years old). 

Pain management can help relieve symptoms, and your veterinarian can prescribe these. If your pet is in pain, you must visit your veterinarian and have pain relief prescribed; your animal doesn’t need to suffer unnecessarily. Anti-inflammatory drugs (NSAIDs) are most commonly prescribed, but in badly affected dogs, other medications can also be used to keep your pet comfortable.

Antibiotics are rarely indicated unless there is a sign of infection. Steroids can not be given with NSAIDs and are seldom useful in panosteitis.

Giving English Bulldog a pill, Canine Panosteitis - I Love Veterinary

During episodes of pain, strenuous exercise should be limited; short walks are usually ok but check with your vet when in doubt. Between episodes, moderate exercise is encouraged, but avoid hard, strenuous exercise and lengthy running; this applies to all growing dogs but especially those affected by panosteitis.

Ensuring you feed a properly balanced, high-quality puppy food designed for your dog’s size is also an excellent idea to help develop healthy bones. Make sure not to feed too much; overweight puppies put more strain on their growing bones, consult your veterinarian for advice on the best diet to feed your pet.

Regular visits to your veterinarian will help ensure that the treatment is adequate and to ensure that medication doses are correct for your growing pup. 

Are There any Preventative Measures?

There are currently no preventative measures known.

The Prognosis Explained

The prognosis is good for dogs affected by panosteitis; it is self-limiting and shouldn’t affect your pet long-term. Keeping up with light exercise and ensuring your dog is on pain medication when needed, can help to reduce muscle wastage from disuse. 

Living and Management of Canine Panosteitis

Dogs with panosteitis can live normal lives; it is crucial to closely monitor your pet for signs of pain, reduce exercise, and use pain relief recommended by your veterinarian during flare-ups. Your puppy may require more regular vet visits and be closely monitored at home while affected.

Beagle puppies eating, Canine Panosteitis - I Love Veterinary

Ensuring adequate nutrition and exercise is important throughout your pet’s life, especially when they are affected by panosteitis.


Panosteitis is a painful condition in medium and large-breed puppies, which can be frustrating to manage due to its waxing and waning presentation. Still, it can be dealt with appropriate care and lead to a good quality of life in your pet. 

Radiographs and blood tests may be required to diagnose panosteitis and rule out other conditions. It is usually self-resolving, and pain relief is often required until your pet grows out of it. 

If you are ever concerned, it is always best to make an appointment with your veterinarian and get your dog checked over.

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Helen's journey in veterinary medicine is marked by her dedication to small animal practice and a thirst for diverse experiences. She graduated from Massey University in 2016, embarking on her career at a rural clinic in Canterbury, New Zealand, before venturing to the UK in search of new challenges. Helen's love for animals has always been at the core of her passion, and her dream of working with them has become a fulfilling reality.