What Is Hypertrophic Osteodystrophy (HOD) in Dogs and Puppies?

Puppies are bundles of energy and it's so much fun to watch them romp and play as they grow. But when your pup slows down and stops being their usual playful self, something is clearly wrong. That something could be a bone disease that can cause growing puppies and young dogs a great deal of pain: hypertrophic osteodystrophy, or HOD.

What Is Hypertrophic Osteodystrophy (HOD)?

Some conditions can affect the bones in your dog’s legs and cause limping. In young, largebreed puppies, developmental diseases like hypertrophic osteodystrophy (HOD) can make walking painful.1

Hypertrophic osteodystrophy (HOD), also called metaphyseal osteopathy, is a bone disorder that affects young, growing dogs, usually large or giant breeds. It causes painful swelling and inflammation near the ends of the long bones, where the growth plates are located. These growth plates stay active until the puppy finishes growing, which is why HOD mainly affects growing dogs. The condition most often affects the leg bones but can also involve the jaw, ribs, or other long bones. Puppies with HOD may show lameness, swelling, fever, or loss of appetite and in severe cases, the affected bones can develop deformities.2

Causes of Hypertrophic Osteodystrophy in Dogs and Puppies

Symptoms of HOD are caused by decreased blood flow to the affected portion of the bone, which interferes with proper bone formation.3 No one knows what causes this to happen, although researchers have theorized several possible causes:2

• Genetics
• Canine distemper
• Autoimmune disorders
• Adverse reactions to certain vaccines

Breeds Predisposed to Hypertrophic Osteodystrophy

All large-breed dogs have a higher propensity for developing HOD due to their rapid growth. Weimaraners in particular appear to have a predisposition toward this condition and tend to be more severely affected than other breeds. Pit bulls and Australian cattle dogs, although considered medium-sized breeds, may also be prone to HOD.3

Signs and Symptoms of Hypertrophic Osteodystrophy

One of the most prominent signs of HOD is swelling in the bones that are warm to the touch, but this might not be obvious to pet parents. However, a puppy with HOD might be reluctant to get up and move around normally. Other signs of HOD to look out for include:3

• Fever
• Appetite loss
• Lethargy
• Weakness
• Refusal to walk
• Lameness

In severe cases of HOD, these additional symptoms might be present:3

• Abnormal-sounding respiration
• Eye or nose discharge
• Diarrhea
• Blood in the stool
• Skin bumps or pustules
• Vomiting
• Vaginitis in females

If you notice any of these symptoms or behaviors in your pup, you should have a veterinarian examine them right away.

Diagnosing Hypertrophic Osteodystrophy in Puppies and Dogs

Vets usually suspect HOD based on clinical signs such as swelling and pain in the metaphyses of the long bones, along with systemic symptoms like fever, lethargy, loss of appetite, or depression. Radiographs are then used to confirm the diagnosis, revealing characteristic changes such as metaphyseal lucencies and periosteal bone formation. In some cases, clinical signs may appear before radiographic changes are visible, so follow-up X-rays may be recommended a few days later to confirm the condition and guide treatment.2

Hypertrophic Osteodystrophy Treatment and Costs

In mild to moderate cases of HOD, the prognosis is generally favorable. To keep your puppy comfortable, your vet may provide pain relief with NSAIDs or opioids and focus on supportive care while the condition resolves.2

Costs of prescription NSAIDs for dogs will vary based on brand, dosage and quantity, but the average cost* of carprofen, a generic version of a pet NSAID, is $36 and ranges from $29 to $66.4

Moderate cases in which the puppy experiences more severe lameness or other symptoms may be treated with steroidal medications if they don't respond well to NSAIDs. They may also be treated with antibiotics to head off possible secondary infections due to suppression of the immune system caused by the corticosteroids. Antacids might also be prescribed to help control stomach upset from the medications.3

Deracoxib/Deramaxx is a pain relief medication used to treat inflammation and pain from arthritis or post-surgery in dogs. The average cost* of Deracoxib/Deramaxx is $77 and ranges from $61 to $139. While Firocoxib/Previcox, an anti-inflammatory pain reliever, can help with mobility and has a national average cost* of $119.4

In severe cases of HOD, puppies may need close veterinary monitoring and intensive supportive care. Treatment may include corticosteroids instead of or in addition to NSAIDs and opioid pain medication can be used for severe discomfort. The prognosis for severe cases can be guarded.2

Hypertrophic Osteodystrophy treatment costs

The national average cost* of hypertrophic osteodystrophy treatment in the U.S. is $901.4

You'll find the breakdown for average costs and cost ranges of diagnosing and treating HOD in the table below.4

Recovery From Hypertrophic Osteodystrophy

Most puppies with HOD do well, especially in mild to moderate cases. Severe cases can be more serious and some puppies may develop bone deformities as they grow. Treatment focuses on keeping your puppy comfortable with pain relief and supportive care, including medications like NSAIDs, opioids, or corticosteroids. With proper care, the outlook is generally favorable.2

Preventing Hypertrophic Osteodystrophy in Puppies and Dogs

Without knowing the exact cause, it's difficult to prevent your puppy from developing HOD. But you can take steps to reduce the likelihood of them getting it:3

• Avoid giving large-breed puppies any supplements that will speed up their growth rate and increase their size.
• Feed your pup high-quality food that's formulated for large-breed puppies.
• Avoid having your puppy jump or run long distances or on hard surfaces until after their growth plates have closed.
• Use a puppy growth chart to help track your pup's growth rate so you can tell when they've finished growing.
• Provide soft surfaces for your puppy to lie on.
• Place rugs on hard floors to prevent your puppy from slipping and falling.

As mentioned previously, Weimaraners may be more likely than other breeds to develop HOD. If you have a Weimaraner puppy, talk with your vet about treatment options, including the potential use of corticosteroids, which may be more effective than NSAIDs for this breed.2 Your vet can also advise on ways to manage pain and support your puppy’s recovery.

Financing HOD Treatment With the CareCredit Credit Card

Your dog is your best friend, and you want to make sure they get the very best. That's why the CareCredit credit card is here to help you manage the costs of diagnostics and treatment for conditions like hypertrophic osteodystrophy.** Use our Acceptance Locator to find a veterinarian near you that accepts CareCredit. CareCredit is there for you and your pet every step of the way; continue your wellness journey by downloading the CareCredit Mobile App to manage your account, find a provider on the go and easily access the Well U blog for more great articles, podcasts and videos.

In addition to pet care, you can also use your CareCredit credit card for dentistry, cosmetic, vision, hearing, health systems, dermatology, pharmacy purchases, spa treatments and so much more within the CareCredit network. How will you invest in your health and wellness next?

Author Bio

Jean Marie Bauhaus is a freelance writer and novelist who has been writing pet content since 2013. Her work has appeared on Forbes.com, Hill's Pet, Chewy, AKC.org and more.