Can pet parents prevent hypertrophic osteodystrophy (HOD)?

Can pet parents prevent hypertrophic osteodystrophy (HOD)?

Hypertrophic osteodystrophy (HOD) is a confusing disease, partly because it has so many different names. Also known as metaphyseal osteopathy, 

Möller Barlow’s disease, skeletal scurvy, infantile scurvy, osteodystrophy II, and metaphyseal dysplasia. See what I mean?  Very confusing.

HOD is a hugely distressing disease to manage as it can cause a wide range of signs, from mild lameness through to severe pain and ill health. It is  primarily a disease of the large and giant breeds of dogs, with certain breeds such as Great Danes, Saint Bernards, Boxers, Chesapeake Bay Retrievers, Irish Setters, German Shepherd Dogs, and Labrador Retrievers showing a higher prevalence than other breeds.

The disease is a developmental, auto-inflammatory disease that first appears  between 7 weeks and 6 months of age.  It can unfortunately recur until dogs are 20 months old. 

Dr. Hannah Capon, speaking about HOD


HOD leads to abnormalities of bone growth predominantly affecting the lower part of the ulna, radius, and tibia causing significant discomfort. Clinical signs commonly seen are acute pain and swelling, lameness, intermittent pyrexia, and occasional anorexia. The disease classically causes swelling of the shafts of bone due to both thickening of the periosteum and the deposition of new bone. Radiographs are required to confirm the disease. 

The disease primarily affects dogs that are growing rapidly, and the initial signs are typically seen when dogs are between 3 months and 6 months of age. Weimaraners appear to be particularly predisposed to HOD. 

The disease causes a decrease in the blood flow to a part of the bone that is adjacent to the joint which then has a  negative effect on bone formation. It can cause a spectrum of clinical signs, from mildly painful which responds quickly to treatment with pain relief and reduced exercise. Through to severe pain, affecting multiple limbs, inducing systemic signs like fever, depression, weight loss, anorexia, long term damage to growth plates which requires intense support.


Not all cases have the classic HOD signs of swollen, warm, and painful leg bones. Avoidance of weight bearing which may include simply not wishing to even stand. Some cases are really severe causing swollen muzzles, salivation, diarrhea, difficulty breathing and pain. These cases may show radiographic evidence of disease within other unexpected bones such as the jaw, the spine or ribs. 

Diagnosis is based on clinical exam, imaging and survey blood sampling. Once a diagnosis is made a plan to support the dog through the episode that typically lasts a few weeks, can be made.

Treatment tends to rely on pain relief in the form of non-steroidal anti-inflammatories (NSAIDs), however if the signs are very severe these may be replaced with corticosteroids. Alongside these medications supportive therapy may be required such as an intravenous drip and stronger pain relief. Plus recurrences can occur especially when the dogs has tapered off the NSAIDs or steroids, and this can occur until they have stopped growing. 


Unfortunately we are still not sure what causes HOD, so understanding how to prevent it is thus impossible. However, some simple adjustments may prevent your pup getting it. 

Owners of large- or giant-breed puppies should not be tempted to supplement their dog’s diet with any mineral or vitamin supplements, hoping this will speed up their growth rate. Following feeding guidelines for their breed as well as offering a balanced diet is much wiser.  

Ensuring that puppies  do regular low impact exercise is vastly preferable to playing games that culture explosive high impact activities, especially till their growth plates have closed which may be as old as 24 months in giant breeds. 

Many cases of HOD will resolve without medical care, while some cases need medical intervention. However, unfortunately some  cases are very severe, with no end in sight. These cases may require multiple changes to treatment plans, and even consideration of euthanasia on welfare grounds.

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