Canine panosteitis: an idiopathic bone disease investigated in the light of a new hypothesis concerning pathogenesis. Part 1: Clinical and diagnostic aspects

Abstract

Panosteitis, an idiopathic bone disease of young dogs, was investigated in the light of a new, empirically based hypothesis governing its pathogenesis. Extensive clinical observations suggest a close relationship between the incidence of this disease and the commercialization of various protein-rich, high-calorie dog foods. The theory of an "osseous compartment syndrome" provides a hypothetical pathogenesis, which corroborates this findings. An excessive accumulation of protein causes intraosseous edema due to its osmotic effects. Because bone is a rigid compartment, this leads to an increase in intramedullary pressure and compression of blood vessels. Subsequent osseous ischemia leads to a deficient metabolic state (decreased oxygenation, inadequate influx of nutritive substances, local acidosis, decreased removal of metabolites, disruption of local biochemical processes, etc.), and a vicious circle is created due to the resulting local inflammation. The disease is aggravated by increased metabolism due to excessive physical activity. Within the context of a pilot study, clinical, radiographic, scintigraphic and thermographic examinations and a therapeutic trial with benzopyron were carried out. In addition, more modern investigative tools, including osteomyelography, magnetic resonance tomography and intraosseous pressure measurements were used to provide objective data concerning the pathogenesis of panosteitis. In most cases, clinical remission was seen within days of monotherapy with the proteolytic substance, benzopyron (Cumartrin). This finding appears to corroborate our hypothesis.