HistoryA 16-week-old sexually intact male Great Dane was evaluated at the Auburn University Small Animal Veterinary Teaching Hospital because it was nonambulatory and had signs of moderate to severe pain in all limbs. The dog had a history of a rapidly progressive, bilateral hind limb lameness accompanied by lethargy, anorexia, and intermittent fever during the preceding week; in general, the dog had become and remained recumbent. The dog was usually fed a standard ration of commercial dog food, and dietary supplements were not provided.
Clinical and Gross FindingsAt the initial evaluation, the dog was non-weight bearing in all 4 limbs and breathing was labored. Radiography of all 4 limbs was performed, and bilaterally symmetric linear radiolucent zones were evident in the distal radial and ulnar metaphyses. A CBC revealed leukopenia (5.02 X 10 3 cells/ µL; reference range, 6.0 X 10 3 cells/µL to 17.0 X 10 3 cells/ µL) attributed to neutropenia (2,058 cells/µL; reference range, 3,000 to 11,400 cells/µL) with a left shift (904 bands/ µL; reference range, 0 to 300 bands/µL). Results of serum biochemical analyses were indicative of bone and muscle This report was submitted In cooperation with damage, with high activities of alkaline phosphatase (287 U/L; reference range, 3.5 to 95 U/L) and creatine kinase (1,092 U/L; reference range, 92 to 357 U/L) and high concentrations of calcium (19.6 mg/dL; reference range, 9.5 to 11.8 mg/dL) and phosphorus (10.3 mg/dL; reference range, 3.3 to 5.8 mg/dL). Within 12 hours after the initial evaluation, signs of pain in the limbs and respiratory distress intensified; rectal temperature was 40.4°C (104.8°F). The dog developed cardiopulmonary arrest, and resuscitation attempts were unsuccessful.A complete necropsy of the dog revealed bilateral enlargement of the proximal and distal physes and metaphyses of the radii, ulnas, carpal bones, tibias, fibulas, and tarsal bones. Subjacent to the physeal cartilage, the metaphyseal architecture was obscured by 1.0-to 4.0-mmwide bands of pale yellow, friable material admixed with fibrinous strands and bony spicula (Figure 1). These linear zones of fibrinonecrotic debris sometimes impinged on the overlying physes and were often surrounded by locally extensive regions of hemorrhage. A few of the physes were irregular or serpiginous, and thin finger-like extensions of cartilage projected slightly into the respective epiphysis and metaphysis. The radial, ulnar, and tibial metaphyses were surrounded by subperiosteal hemorrhage that slightly elevated the periosteum and extended along the outer bone cortex. These lesions were more severe in the distal physes of the affected bones.Formulate differential diagnoses from the history, clinical findings, and Figure 1-then turn the page → Figure 1-Photograph of a longitudinal section of the distal portion of a tibia obtained during the necropsy of a Great Dane that was evaluated because of progressive, bilateral, non-weight-bearing lameness, lethargy, anorexia, and intermittent fever. Notice that there is ...