HOD Hypertrophic Osteodystrophy

Rigatoni (Toni for Short) was a Great Dane puppy born at our kennel. He was a beautiful, fun loving puppy ready for a new home when he became sick. At about 11 weeks old he became lethargic and broke with diarrhea. At first we thought the diarrhea was just from a diet change but it did not respond to anti-diarrheals. Being a veterinary technitian, I didn't want to take any chances and brought him to work with me. The doctors I work with took a look at him and we started him on some intravenous fluids and IV metronidazole. Toni got worse. He became neurologic in appearance and could not stand on his own. He was febrile at 105 degrees F and was in a lot of pain. We quickly consulted a neurologist. They felt that Toni could possilbly have Metronidazole toxicity, however, he didn't quite fit the bill. The dose of medications he was on was not excessive and he no longer had diarrhea. My close friend and fellow technitian worked for a specialty clinic that had an orthopedic specialist on staff and offered to take Toni to see him the following day. We had and answer-HOD. We were informed that Toni had Hypertrophic OsteoDystrophy, a condition that in the 12 years I had been working as a vet tech had never heard of. I was told that Toni would have excessive swelling of his joints accompanied be high fever and extreme pain. The only treatment was supportive care. He told me that it would be a difficult road ahead but normally the puppies will get better when the growth plates begin to close at around 5 to 8 months. We decided to continue on as Toni was such a special, good natured pup. Toni responded fairly well to NSAIDs and rest. We were contacted by a family that had purchased Toni's brother "Orbit" and they informed us he was having trouble as well. Although Orbit's cases appeared to be not as severe, he still was struggling. As time went on, Toni had another episode of swelling and pain, this time the NSAID's didn't work. His fever spiked to over 106 and he was extremely lethargic. I consulted with an emergency veterinarian that was the husband of a veterinarian that I work with, he suggested I bring him up for better pain management. Toni was placed on a Morphine/Ketamine/Lidocaine drip and responded well. Within 48 hours he was up again and beginning to eat. His joints were terribly swollen and he walked with severe roaching of his back but he was feeling better. Another orthopedic specialist that sometime performs surgery at our clinic happened to be comming in for another client and agreed to look at Toni and give me his opinion as I was not finding a lot of information about this disease in our text books or other verterinary research media. He told me to hang in there and try steroids. It helped a lot. It was unclear in the information that I found about HOD what the cause is. Some speculate diet, over feeding, over supplementation, deficiency of vitamin C and recommend feeding a low calorie diet and believe that calcuim may be a factor. The most useful information I found was about coat color. This veterinarian and Weimeraner breeder believed that color dilution factors may be a part. Not knowing for sure that genetics may play a role, we decided to not breed the parents together again as they both are Harlequin. We were so careful with our pre-breeding screening and are always careful about out crossing back to black, but we still felt responsible. Committed to helping Toni we continued on. We finally found the right combination of drugs to help him and they worked well for quite some time. His episodes were shorter and we could predict them before they got too bad. A combination of Prednisone, Tramadol and Gabapentin did the trick for a while. We thought were were over the worst, Toni was 7 months old and finally acting like a nomal puppy. He had grown to 76 pounds and his joint swelling and roaching was beginning to improve. That was when the worst happened. Toni started to have another episode. He began with lethargy and inappetance. His temperature began to rise and his joints became hot and painful. I increased his dose of Prednisone. 24 hours later his fever was up to over 107 and he was crying in pain. I began an IV drip overnight but he did not improve much. Although his temperature began to come down, Toni was still in a great deal of pain. The morphine drip and injectable steroids weren't helping. Toni died. We suspect that the extremely high fever damaged his heart and kidneys and he died from multiorgan failure but will never know for sure. He was the most wonderful puppy and didn't deserve to die such a terrible death. Not much is known about this terrible disease but we hope that anyone reading this that has a puppy showing these symptoms will seek experienced help with this disease. We would be happy to share any specific information that we have regarding Toni's case if it can be of help to someone else. If your puppy is diagnosed with HOD, don't give up! Most recover at around 5 to 8 months of age, but it's a long road. Be strong and remember that your puppy has the potential to be a normal dog. Toni's case was extreme but I know that if the knowledge that we have learned can help another, Toni didn't die in vain. Please feel free to contact us via email, even if it is just for support!!!