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Let’s Talk About HOD

(reprint from 1993 article "Vegetable Soup")
By Linda Arndt

Much of the information in this article was the foundation for my presentation at the Great Dane National in October 1993, but first I need to clear up a reoccurring question regarding H.O.D. as previously discussed in my "Bone Survey Update". The bone survey involves over 5200 cases of veterinarian diagnosed bone diseases in which people had responded to my survey. However, the whole issue of HOD, Hypertrophic Osteodystrophy seems to be most confusing, so at the risk of being redundant, I have decided to represent this discussion in a different manner.

I get phone calls/emails daily from dog owners asking me what my opinion is regarding the cause of HOD (Hypertrophic Osteodystrophy). This is a very confusing disease because there are other problems that mimic the same symptoms as HOD.

First, it is my opinion, based on feed trials, information from the Bone Survey and dealing hundreds of individuals whose dogs were diagnosed or misdiagnoses with HOD, that true HOD is nutritional in origin. It is my experience that HOD is caused by an excessive intake of calories in relation to the amount of energy expended by the animal. It is simply intake versus output. If you keep that in mind, you will then understand why all dog food brands and all protein/fat levels can present a problem. But, we are talking about cases of true H.O.D.

Also, keep in mind when radiographing for diagnosis of H.O.D., there are several other things that cause "H.O.D.-like symptoms" and these appear the same on an xray, regardless of the problem. This is why the diagnosis of true H.O.D. is so confusing by owners and veterinarians, and a diagnosis must be done with consideration of many factors including, amounts of food, exercise, antibiotics and vaccines.

Symptoms: H.O.D. usually effects the large and giant breeds between 12 weeks and 6months of age, but can occur in puppies as young as 8 weeks if a diet is unbalanced. First indications show a swelling in the front joint area or the wrist, which is the growth plate and a slight toeing out. This is often hot and tender to the touch. This is then followed by a very close or pinched rear movement because of an arthritic soreness in the stifle/knee and hock/ankle. As the disease progresses the front pasterns/wrist drop and splayed feet (toes spread or flattened in front and/or back). The topline is often curvy (roached or curved like a greyhound) and the rear legs are tucked under making mobility often strained and making the body look deformed. The rear legs may appear to be very cow-hocked or close behind when moving away from you and a "bowing in" in the front limbs. The only swelling that occurs is in the front carpal/wrist area and that becomes very bony.

In advanced stages, there is a high fever 104-106 degrees, anorexia (refusal to eat) and polyarthritis (aching joints). The animal is in extreme pain and often unable to get up, potty, eat or drink. This disease can seem to come on overnight, although the early stages were there, but often went unnoticed.

This is a list of things that can cause true "H.O.D." or "H.O.D.-like symptoms".

• High protein/high fat = calorie dense foods, consumed in a larger amount than is actually needed by the puppy. These foods tend to be puppy foods or even some maintenance foods. We have found these puppies do best on a high quality, moderate protein food (21-24% max) simply because their tummy feels full, before they over consume too many calories.

• Additions of people food can raise the protein/fat calorie level or imbalance the calcium and phosphorus ratio, particularly protein sources such as meats, eggs, cheeses, and rice. If you want to add things use fruits, nuts, herbs, vegetables, cereal grass powder or tablets or a small amount of canned, fresh and frozen meat. There are things we can add to enhance their diet, to "fill in the holes" without the fear of upping your calorie count that greatly.

• The addition of vitamins/minerals supplements can be a real problem when the vitamins are from a synthetic form and minerals from mined forms instead of coming through a food source. 99% of vitamins on the market are synthetics. It is best to use a high quality super premium food, if using a kibble, and enhance the diet with probiotics/digestive enzymes, dietary enzymes and some fruits and veggies, rather than an vitamin and mineral supplement.

• An allergic reaction to antibiotics, particularly the sulfonamide drugs (Tribrissin, Ditrim, Primor, Bactrim, TMZ and TMP/SDZ) and on occasion an allergic reaction to the antibiotic Keflex (CEFA-tabs, C-tabs, Cephalexin).

• Post-Vaccine Syndrome, a reaction to inoculations. Yes, this will frequently throw them into a H.O.D.-like symptom, which get misdiagnosed as actual nutritional HOD. (The use of Nzymes antioxidants and Vitamin C can help to prevent vaccine reactions because it detoxifies the body. See Puppy Guidelines To order Nzymes call: 877-816-6500 or order online at www.nzymes.com

• Animals that are more tightly line bred often seem to be more sensitive to antibiotics and inoculations. I know you did not want to hear that and I have avoided discussing this in other articles. But the fact is, that we need to start opening up some of these pedigrees in order to get some hybrid vigor back into some of these bloodlines. It is affecting the immune systems, reproduction and longevity ... but that is a topic for another article.

• Septicemia (blood poisoning) or septic-arthritis. This is what you will see listed on the internet as "Pseudo - HOD", it is really Septicemia and mistakenly called HOD.

Septicemia is due to a bacterial infection of blood unsanitary cropping conditions, a puncture wound or from tapping a joint. Tapping a joint should be avoided. It can actually cause more damage in the long run and it is a decision never to be taken lightly. It is a pathway for staph infection and should be avoided at all costs.

Most of the time true H.O.D. cases are due to feeding a high protein/fat and/or calorie dense commercial dog food (puppy foods, stress foods or performance foods 26% - 32% protein) in amounts greater than the animal needs.

Why Do We Insist on Puppy Foods?

Young dogs in the wild get the least amount of food in a pack. They are actually very lean and get less protein/calories because they are left with the scraps and bones of the adults. The dominant adults doing the hunting and females having the new pups to feed, get the best part of the killed prey.

But what do we do? We take these puppies past 8 weeks of age and feed them "high powered" caloric dense diets so they will grow big and strong, because we have been "told" that puppy foods are needed for reaching their growth potential. There are enough studies done on animals, mice and humans proving an underfed animal actually lives longer than one that is heavy. I am certainly not recommending keeping your puppies underfed. But keeping them well fleshed, but not fat is extremely important. I do NOT recommend a low protein (18-20%) or low fat diet (10% or less) for growth, because fat is needed for energy, organ function and making brain cells.

A high quality, moderate protein/fat and moderate calorie diet in controlled amounts is what works best for the giant breeds.

I am frequently asked, "Which specific brands of commercial dog food cause H.O.D. in growing puppies?" The answer to this question is this, large and giant breeds can develop H.O.D. when fed any brand name and/or type (senior, maintenance, puppy, stress) of commercial dog food, regardless of quality and protein content of the food.

True H.O.D. is caused by consuming too many calories in relation to the amount of expended energy or free exercise.

I know this is confusing, but the higher protein and fat foods are consequently higher in calories. This is no different in people. The more calories you consume, like that extra chocolate donut, the more you need to exercise to make sure that donut does not become a permanent fixture on your hips. It is my experience the higher protein/calorie dense commercial diets (usually over 24%) tend to cause growth pattern problems when fed to growing large and giant breeds. The reason for this is because the puppies will consume more calories per cup of food than if fed a lower protein/lower calorie maintenance type diet where the calories are less per cup.

For the purpose of illustration only, let's pretend for a moment we are using a food from the "Yummy Tummy" dog food company. This company makes several different types of food based on a broad range of protein, fat and caloric content. In this example I will show you how your dog can develop true H.O.D. using any brand or type of dog food.

You can have a calorie intake of 2,175 by feeding 5 1/2 cups a day of a 23% food, or you can have a calorie intake of 2,175 by feeding 4 1/4 cups a day of feeding a 30% food. Both feeds will get you to the same number of calories ingested. Why is it the 30% food is more apt to cause H.O.D? The reason is, we do not monitor closely the amount of caloric intake and cups of foods consumed on a daily basis, in relation to the current weight on the puppy.

The quantity of food to feed a puppy should be guided by the information on the package, however, in many cases, it ends up being too many calories for these animals, so you have to adjust your amounts. I have a guideline in my puppy feed program that gives you a safe range to start.

You will notice there is an approximate recommendation on most bags is based on the premise that you will weigh your dog frequently and feed according to the recommended schedule. From the breeders standpoint, after a certain weight and size, weighing these giant puppies with any frequency is just not realistic.

To complicate matters, owners want to make sure puppy grows to reach his full genetic potential and therefore "think" this means eating lots of good food and, of course, purchasing a giant feed pan. If I dump half of the daily ration in a 5 quart pan (holds 20 cups), a common size pan to be used by great dane owners, the dog and I are both convinced he is going to starve. So what do owners normally do remedy this situation? Dump "more" feed in the pan and dog and owner are both satisfied. Then over a period of time, due to excessive caloric intake, your little Brutus comes down with H.O.D.

The problem with all commercial feeds, particularly the " super premium" foods is they are "designed" to be calorie dense which means, a little goes a long way. But this minuscule amount of kibble in the bottom of a large pan has a psychological impact on the owner - kind of like your new diet program - when you weigh and measure your food and realize 1 oz. of everything is practically nothing. This is the reason puppy foods and higher protein maintenance type foods get us into trouble. Because they are calorie dense and we overfeed 99% of the time when feeding a commercial food.

These animals do better fed a moderate protein food because the portions are more normal in amount, and the dogs fill up before they over consume in calories.
Any animal can come down with H.O.D. even when fed a senior type food if the animal is fed more calories than it can burn off daily/weekly. Likewise, one can feed a puppy food or stress food provided the animals are weighed 3-4 times a week, exercised and fed a restricted diet. It is difficult for the average owner to strike the correct balance in nutritional intake and amount of energy expended, when using these commercial foods. This is why the moderate calorie/protein foods work better for the giant breeds in the management of nutritionally caused bone diseases such as H.O.D. and Pano.

As for OCD, Osteochondritis Dissecans, that is a different story. I am convinced OCD has to do with poor quality and crude form of minerals used in the design of a dog food. These forms are not available to the animal in correct forms so they are usable by the body. Oh yes, in the laboratory tests they are present in the amounts as stated on the bag, but the quality, form and availability by the body are very different. It is interesting that almost all of the OCD cases reported to the survey are animals fed the same three specific commercial brands, none of which used cheated or sequestered minerals.

Also they always list minimum amounts of calcium not maximum, so who knows what they are actually getting. A disruption in the calcium and phosphorus ratio is also at the bottom of many OCD cases and during the developmental stages it is very important to watch using proteins , poultry/meats and grains, or calcium supplements, along with your kibbles.

Animals in the wild eat higher protein foods. But remember, they are whole, fresh raw and natural and the system uses these types of food differently than the processed killed commercial foods with synthetic vitamins and poor quality minerals added back to the diet.

It is also important to keep in mind when we talk about intake versus expended energy there is even more of a problem with puppies burning up calories when they are confined to a crate for 6-10 or more hours a day. It is very important to note that not every brand of moderate protein food is appropriate to feed growing animals. Poor quality generic or grocery store brands are a bad choice for numerous reasons, lack of meat based diets, poor quality foodstuffs used, and no cheated or sequestered minerals, preserved with bad preservatives ie: ethoxiquin, BHA, BHT.

You can find a copy of the Blackwatch Feed Programs at this website.