Treatment for Hypertrophic Osteodystrophy in Weimaraners

When Dr. Noa Safra asked us to help her educate owners of Weimaraners afflicted with a disease called Hypertrophic Osteodystrophy (HOD), Clark and I agreed enthusiastically.

I don’t think it’s hyperbole to say she saved Bodhi’s life.

Working with her to create a support network for others facing HOD was the least we could do.

I hope Bodhi’s story gives people necessary information and hope.

Bodhidharma Beasley-Sheer joined our family in New York City on June 26, 2012. Bodhi came from a reputable breeder, from a litter of nine. He descends from one of the show lines; his father had competed in the Westminster Kennel Club Dog Show two years earlier.

Several weeks after we got Bodhi, he came down with a persistent case of diarrhea. We weren’t particularly alarmed, puppies get the runs all the time, but to be on the safe side, we took him to our local veterinarian. She conducted a routine examination but could not find any obvious underlying cause.

The next day he seemed very tired and wasn’t drinking much. Later that afternoon we noticed that Bodhi was not placing his left foot down. He had just walked through some dried-up, prickly holly leaves so we thought maybe he’d irritated his paw pad somehow. He continued to be lethargic for the rest of the day, which concerned us. We decided to call our vet; she told us to monitor him

The following morning he was barely moving, he had peed in his bed, he was shivering, and his body was hot to the touch. We rushed him to a nearby emergency animal hospital where they told us he had a fever of 106 degrees. At first, the vets seemed unsure of what might be ailing Bodhi, but after taking X-rays of his legs, they eventually arrived upon a diagnosis of HOD.

Hypertrophic Osteodystrophy

Hypertrophic Osteodystrophy is a bone disease that afflicts fast-growing, large breed dogs. It usually shows up when the puppies are two-to-four months old. Weimaraners, Irish Setters, Boxers, German Shepherd Dogs, and Great Danes are the dogs most commonly afflicted. Lameness is the primary manifestation of the disease. “Lameness” is a clinical term when used to describe animals. It means “a disturbance in the gait and the ability to move the body about, typically in response to pain, injury, or abnormal anatomy.” Weimaraners and Irish Setters can display a variety of other symptoms. (For more about symptoms, check out the Weimaraner Club of America or my post at the Just Weimaraners site.)

Bodhi was treated with a non-steroidal anti-inflammatory drug (NSAID) called Rimadyl and a pain killer, Tramadol. This is the common treatment for most dogs who get mild, uncomplicated cases of HOD. After two days in the hospital Bodhi was released and seemed largely okay. He was limping a bit, but that cleared up over the course of the next few days. Our initial research online did not indicate that HOD was “different” for Weimaraners and the vets at the hospital did not tell us that HOD was of particular concern for the breed. We were encouraged when we learned that once an afflicted dog’s initial growth spurts ended, they disease went away.

We contacted our breeder and she referred us to the handbook she gave us when we picked up Bodhi. It noted HOD research that had been done a decade earlier. In other words, very out-of-date! We investigated further and soon discovered articles about Dr. Noa Safra’s work at the UC Davis College of Veterinary Medicine. We also contacted the Weimaraner Club of America and spoke to a member of their health committee. She confirmed that Dr. Safra is a recognized expert in HOD.

Doctor Noa Safra

We didn’t need any encouraging. We reached out to Dr. Safra immediately. She provided us with a complete overview of HOD in Weims. She told us how it affects Weimaraners more profoundly than other dogs. She said she had devised a special medical regimen that included Prednisone, not NSAIDs, to treat Weims. And she warned us to keep vigilant for any recurrence of the disease. She said, if left untreated, it could be fatal.

Bodhi did well for about a month and then, out of the blue, he got sick again. This time with diarrhea and a bad cough. We took him to our vet and she prescribed some medicine for the cough and advised us to observe him closely. A few days later the cough worsened and he started limping again. As the day wore on, he lay completely still. Mucus poured out of his eyes and nose. If you touched him, he whimpered in pain.

We took him to the hospital where the emergency room vet diagnosed him with pneumonia and determined that his HOD had indeed flared up again. Again they prescribed NSAIDs and painkillers. This worried us, we knew from our research he needed to be on Prednisone. We shared Dr. Safra’s work about treating HOD-afflicted Weims with immuno-suppresive doses of Pred with this vet, but he said we couldn’t put Bodhi on the medicine because he had pneumonia. He said a dose of Pred that high would make the pneumonia worse.

We appealed to a second veterinarian at the hospital with whom we had a closer relationship, Dr. Christina Moore. Dr. Moore called Dr. Safra who advised that we needed to get Bodhi on Pred as soon as possible and that the medicine would clear up the pneumonia, which she said was HOD-related. After some back and forth with the hospital staff, Bodhi was finally weaned off the NSAIDs and given Prednisone. He spent three nights in the hospital. (Note: From time to time I chat with Dr. Moore about dog health. Check out some interviews with her here, here, and here.)

Click here and here to read about Dr. Safra’s work, these links are especially important if you need to share info with your vet.

Recovery

Bodhi’s recovery took some time. He couldn’t walk at all for about a week after being discharged from the hospital. Eventually he got up, but his legs were so weak and painful that moving around was clearly difficult for him. The video below shows Bodhi a few weeks after his last hospitalization. If you look closely you can see his front paws look almost like flippers. You can also see how hard it was for him to walk. That was about as fast as he could go for a long time.

We worked with him over the next few months using physical therapy, and slowly but surely, his legs got stronger.

The biggest problem was every time we tried to lower the dose of the Pred, he’d start to show indications of a flare up (one of the earliest signs with Bodhi was green discharge from his eyes.) But persistence and patience finally paid off. After many, many weeks, he was walking fairly well and we were finally able to take him off the Prednisone.

Below are “before” and “after” pictures of his front legs, which were hit hardest by the disease. On the left, you can see how knobby the joints were, that his wrists had no strength, and that his paws laid almost flat on the ground. You can see on the right that his legs became far less lumpy and that he was largely resting on his toes as he should. His legs ended up being very short for a Weimaraner, but that didn’t slow him down at all!

As I was writing this post, I asked Doctor Safra a question I had avoided years earlier: “Just how sick was Bodhi?”

She responded: “Bodhi was a ‘nine’ on a one-to-ten scale. ‘Ten’ would be pups who by the age of two or three are dead due to complications.”

Ugh. I’m glad I didn’t know that at the time.

Here is a video of Bodhi about a year after he went off Pred.

Advice

To finish, we’ll offer some advice. (I wrote this about HOD, but I think it’s good advice to take when dealing with any of your dog’s health issues.)

1. Do your homework! Make sure you read everything you can about HOD and Weims. Make sure your sources of information are reputable. Consult experts with verifiable credentials and experience with HOD in Weimaraners. Be careful when consulting “Dr. Google!” Dr. Google is not a veterinarian. There’s a lot of misleading and even outright wrong information on the internet concerning HOD. Talk to the experts: Weimaraner breeders, the Weimaraner Club of America, specialists at your regional veterinary teaching hospital, and acknowledged experts like Dr. Safra

2. Make sure your family veterinarian does his or her homework! I don’t want to fault some of the vets we saw for not knowing about Weim-specific diseases, but if you are reading this, you are aware of the problem. Make sure your doctor is too. Advocate for your dog with your vet. If we had not pressed, I don’t think it’s unrealistic to say that Bodhi could’ve died during his second hospitalization.

3. Be patient. This is probably the hardest part. It was truly horrible seeing Bodhi so sick. But we knew that he’d eventually get through it.

4. Stay the course! Be diligent about administering the medicine and keep a close eye on your dog for any changes for the worse. Relapses are common in severe cases of HOD.

5. And finally, shower your Weim with all the love you can. They are the best dogs ever! (I admit I am biased!) Dogs are only with us a short while. Make it the best time you can.

Bodhi Lived a Happy Life

Here’s a picture of a happy and healthy Bodhi five years after HOD, living the good life! Clark and I made sure his years with us were going to be the best ever. He slept with us; he traveled all over the eastern seaboard of the United States with us; he was given every opportunity to be active, engaged, and happy.

He was my constant buddy, my little grey shadow, always by my side.

Bodhi lived for another four years after the picture above was taken. Nine is not a young dog, but, for Weimaraners it’s not very old either. I will always struggle with the notion that he died too soon. For the readers of this article, I want to stress that he did NOT die from anything related to HOD.

For my regular readers, he will live on forever in this article and others he is featured in, for as long as I maintain this site.

For me, he will live forever in my heart.

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