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Opinions and Help Needed for my sick puppy

leannkelley1027

Well-Known Member
So I posted a couple of days go about my sick, 50 lb, 4.5 mo DDB puppy. Well, his diarrhea is gone and his poo is all better, but he started limping the same day we got flagyl from the vet because his poo was "full of nasty bacteria". He woke up the following day not limping, but by last night the limping was back and worse. He whimpered for quite some time last night so we took him to the vet as soon as they opened this morning.

They took x-rays after doing a regular exam. The x-rays showed "bumpiness and deterioration along the cartilage" on his back left leg and "lipping" on the bones of the joints in both his back legs. The vet says he has physitis and joint inflammation. He gave him an injection of Convenia (sp?) and Previcox tablets as an anti-inflammatory. We are no longer to give him the flagyl.

The vet said the inflammation and cartilage issues could be from a joint infection or could be osteochondrosis. We are treating it as a joint infection currently. He also said that I need to switch him to a food with less than 27% protein in case it is from him growing too fast. I told him we fed TOTW which is 35% and he says that is too high. I know that is a subject of debate, but I want to hear both sides. Our puppy's breeder feeds TOTW to all of her dogs which is why we are using it (plus our other dog was already on it).

I knew going into getting this dog that there were risks, but I didn't expect this so soon. We have had him 10 days. Our EM passed away a few weeks ago so we are all too familiar with joint issues with this breed and are prepared to do what is necessary to keep our dog healthy, but we do have a 1 year limited health guarantee from our breeder. So far, none of these illnesses are covered as they are not a result of breeding necessarily.

Questions:
1. Did I do the right thing today by getting the antibiotic injection and anti-inflammatory?
2. Should I look into changing his food?
3. The total vet visit was almost $300. We are going to have to have surgery to fix an umbilical hernia and possibly entropion later as well as having him neutered some time around 2 yrs. Should I be prepared to continue with this trend? Is pet insurance something I should look into?
4. Does this diagnosis sound plausible?
5. Any advice for what to do moving forward?

Thanks in advance for your help.
 

ruthcatrin

Well-Known Member
1: only time will tell, it was likely the right decision on the spot
2: which TOTW are you feeding? The big thing is the calcium/phos numbers as those affect bone growth, not the protein.
3: Keep in mind with insurance they frequently won't cover pre-exsisting conditions, if you decide to go with insurance read the coverage carefully! I would certinally start a savings account now to specifically cover coming expenses.
4: in general yes its plausible
5: look into getting him on extra joint supplements and make sure you're taking extra care in his exercise to not be putting strain on his joints. When possible do all exercise on grass instead of pavement. Look into getting him swimming. Try to limit jumping, and fast movements that can result in snap the rear end around.
 

musicdeb

Well-Known Member
The only advice I can offer is to possibly get a second opinion. When in doubt, get a second opinion.

I believe when you get pet insurance, they usually have a 24-month pre-existing clause. Meaning, any condition that has been treated in the past before the policy, they will not cover any treatment for that condition. The insurance companies also pay very little for certain procedures, if at all. There is usually a high deductible and co pays involved.

Do a forum search for pet insurance because there have been a few posts about it.
 

leannkelley1027

Well-Known Member
Thank you ruthcatrin.

We are feeding the bison/venison formula.
Protein: 32% Minimum, Fat: 18% Minimum
Calcium: 2.1%, as-fed; Phosphorus: 1.4%, as-fed
Calories: 3,719 kcal/kg (370 kcal/cup) Calculated Metabolizable Energy

We do not "exercise" him at all so far. He has played with our other dog and I have done some obedience training, but he is very lazy so far. We don't plan to do walks or anything for a while bc it is VERY hot here.

If anyone could link me to peer reviewed, reputable articles about any of the above problems that would be very helpful for when I see the vet again on Monday. I specifically want to know more about the food issue as I thought that TOTW was good for large breed puppies.
 

leannkelley1027

Well-Known Member
Thanks musicdeb. I will look into seeing another vet. The one that we are seeing now is supposed to be the "best" one in our city. If problems persist I may go to a bigger city to see someone.
 

angelbears

Well-Known Member
Did the vet say the Flagyl could have caused the infection? If so, once this clears I wouldn't be too concerned other than what can be used in place of Flagyl.

The lipping sounds like it could be a genetic thing. I'm unclear. Is this because of the infection or in addition to?
 

Boris the Blade

Well-Known Member
Calcium is way too high for a pup under 18mths. Ideally it should be under 1.8 or even 1.6 from my research. There are other TOTW formulas that have a lower calcium ratio maybe look into that?
 

Iymala

Well-Known Member
Did your vet take a fluid sample from the affected joints to test for infection? Or is the vet just prescribing antibiotics to rule that out and see if it works?

Supplements recommend are MSM and Glucosamine. Rest and limited activity is recommended until the issue corrects itself or is surgically corrected. The issue unfortunately, rarely if ever corrects itself.

I would get the xrays to an orthopedic specialist for a second opinion. If it is OCD you need to get to a specialist right away for a diagnosis. It seems shoulder OCD is quite successfully corrected by arthroscopic surgery if done before a year of age, but Knee OCD has a much lower success rate.

As far as protein, studies have shown it does not contribute to OCD, but you are going to want to keep your pup slim to avoid any extra stress on the joint. You may need to cut back the amount of food you are feeding.

(one thing to consider is the amount fed.... if you are feeding a lower protein, less nutrient dense food, then you have to feed more of it to keep the same body condition. This increase in amount fed leads to the same amount of protein/minerals being feed if not more in most cases than feeding a good quality grain free.)
 

Boris the Blade

Well-Known Member
Ng
Calcium is way too high for a pup under 18mths. Ideally it should be under 1.8 or even 1.6 from my research. There are other TOTW formulas that have a lower calcium ratio maybe look into that?
Of course I couldn't edit in time but I meant to say the calcium levels I. That formula are too high for a growing pup!
 

leannkelley1027

Well-Known Member
Did the vet say the Flagyl could have caused the infection? If so, once this clears I wouldn't be too concerned other than what can be used in place of Flagyl.

The lipping sounds like it could be a genetic thing. I'm unclear. Is this because of the infection or in addition to?

The flagyl was supposed to treat the bacteria overload in his gut. He did not say if it could have caused any secondary infection.

I don't think the lipping is involved with the possible infection.
 

Iymala

Well-Known Member
Osteochondritis Dissecans (OCD)
(Did the puppy have any trauma that could have contributed to this?)

OSTEOCHONDROSIS


Osteochondrosis (OCD) is a focal area of disruption in endochondral ossification. OCD occurs in the physis and/or epiphyseal regions of growth cartilage. This disease can be generalized or systemic and is widespread among young, rapidly growing, warm blooded, domesticated species and in humans. In all species the etiology is considered multifactorial. In the dog, OCD risk factors are associated with age, gender, breed, rapid growth, and nutrient (primarily calcium) excesses.(1,11-14) All large and giant breeds are at increased risk for OCD, with Great Danes, Labrador retrievers, Newfoundlands, and rottweilers having the highest risk.(14) Males have an increased risk of OCD in the proximal humerus, but gender relationships are not found with OCD involving other joints.(14)
Osteochondrosis lesions are routinely found in pigs as young as 25 days of age.(15) These findings would help substantiate that OCD may be caused by a localized, primary effect on the chondrocyte rather than secondary effects of biomechanic force because rapid growth and weight gain are much less of a factor at this age. Regardless of the pathogenesis of OCD, the underlying role of nutrition is still a factor. In the growing puppy, over nutrition can result in a mismatch between body weight and skeletal growth, which can lead to overloading of skeletal structures. Nutrition of the mother may also play a role in the development of OCD in the offspring.(16)
Although generalized nutrient excesses have been blamed for OCD lesions, there is increasing evidence implicating specific nutrients. Excessive calcium intake resulting in a hypercalcitoninism and hypoparathyroidism(2) manifests as retarded bone maturation, inhibition of osteoclastic activity, and slowed cartilage maturation. These effects on bone and cartilage increase the incidence of osteochondral lesions in articular and physeal cartilage.(2) Osteochondrosis of the acetabular rim has been proposed to lead to a shallow acetabulum and subsequent CHD in the dog. Most of the studies evaluating the effect of vitamin C on OCD have used the pig as a research model and agree that vitamin C supplementation has no effect on the incidence of OCD.(8,17)
https://www.msu.edu/~silvar/hips.htm
(the paper goes on to describe what over nutrition is and how to avoid it in giant breeds.)

[SIZE=+1]OCD causes[/SIZE]
[SIZE=+1]Q:[/SIZE]Thank you very much for such a quick reply. We are going to try Glucosamine and Chondroitin and I will let you know what we think. Just one other thing. Do you have any information on the causes of OCD? I've heard of:
Nutrition - TOO MUCH protein, calcium is that so?
Is there a hereditary factor?
Could it be related to trauma, or walking/running on hard ground like concrete?
Thank you once again for your help. --------
[SIZE=+1]A:[/SIZE] Elizabeth-
At the present time the nutritionists who I trust the most believe that excessive protein is a minor factor in the development of OCD. The hereditability of OCD is not fully known but it is thought to be a disorder that is at least partially influenced by heredity and some veterinary researchers believe it is strongly influenced by heredity.
Other than heredity the identified risk factors include living in a multi-dog household, drinking well water instead of city water (which the authors of the study that uncovered this link think relates to the increased opportunity for exercise among rural dogs), excessive caloric intake and excessive calcium in the diet. It is hard to separate excessive calcium intake from excessive caloric intake because they are usually related.
The best way to avoid orthopedic diseases that are influenced by heredity and environmental occurrences in puppies is to keep them thin while they are growing up. Being overweight by even a small amount seems to predispose active puppies to orthopedic diseases such as hip dysplasia, OCD and elbow dysplasia. In big breed puppies keeping them thin enough to see three to five ribs easily is best. The problem is that most people think that is too thin, including the neighbors and other casual observers who feel free to comment on the puppy's appearance. It makes it hard to stick to the plan and help reduce orthopedic illnesses when the neighbors are threatening to call the humane society and turn you in for starving your puppy. But thin is good until they are grown.
Since excessive exercise appears to be the reason behind the multi-dog household and well water problems it is likely that running and playing on concrete is bad for puppies predisposed to this condition, too.
One last thing --- controlling weight is also the single factor most likely to reduce chronic pain associated with degenerative joint diseases, too. It is reported to outperform administration of aspirin but I haven't seen a comparison to the newer medications like carprofen (Rimadyl Rx) and etodolac (Etogesic Rx

Read more: Osteochondritis or OCD

Osteochondritis or OCD - VetInfo
 

leannkelley1027

Well-Known Member
Did your vet take a fluid sample from the affected joints to test for infection? Or is the vet just prescribing antibiotics to rule that out and see if it works?

Supplements recommend are MSM and Glucosamine. Rest and limited activity is recommended until the issue corrects itself or is surgically corrected. The issue unfortunately, rarely if ever corrects itself.

I would get the xrays to an orthopedic specialist for a second opinion. If it is OCD you need to get to a specialist right away for a diagnosis. It seems shoulder OCD is quite successfully corrected by arthroscopic surgery if done before a year of age, but Knee OCD has a much lower success rate.

As far as protein, studies have shown it does not contribute to OCD, but you are going to want to keep your pup slim to avoid any extra stress on the joint. You may need to cut back the amount of food you are feeding.

(one thing to consider is the amount fed.... if you are feeding a lower protein, less nutrient dense food, then you have to feed more of it to keep the same body condition. This increase in amount fed leads to the same amount of protein/minerals being feed if not more in most cases than feeding a good quality grain free.)

No samples were taken as it would take days and around 6-700 dollars to analyze the sample bc it would have to be sent off. The antibiotic was given to rule out infection, yes.

According to the TOTW feeding chart he is getting the lowest end of the amt he should daily.
 

leannkelley1027

Well-Known Member
Calcium is way too high for a pup under 18mths. Ideally it should be under 1.8 or even 1.6 from my research. There are other TOTW formulas that have a lower calcium ratio maybe look into that?

They do have formulas that are lower protein and lower calcium. This flavor was the one he was previously on so we stuck with it. Do you have any reputable articles you can link me to about protein levels and calcium/phosphorous content?
 

Iymala

Well-Known Member
This is rough, especially with her only being home 10 days. I would probably switch to another food. I feed Earthborn Hollistics and am very happy with the results. It is within the acceptable range for a growing puppy nutrient wise. I like the pimitive natural formula, but the others are good as well. Even if it is not food related, which in my research I believe it is as likely to be hereditary, enviromental or minorly food related the act of switching food will give you some peace of mind. You will be able to say you explored all available options.
 

leannkelley1027

Well-Known Member
Osteochondritis Dissecans (OCD)
(Did the puppy have any trauma that could have contributed to this?)


https://www.msu.edu/~silvar/hips.htm
(the paper goes on to describe what over nutrition is and how to avoid it in giant breeds.)



Osteochondritis or OCD - VetInfo

He definitely has not over exercised since we have had him. He is a bum and stays inside most of the day. When he plays it is in grass and for very short times. I may need to cut his weight back a little though. I get worried he will be too thin, but I know that being too heavy is very detrimental.
 

Iymala

Well-Known Member
They do have formulas that are lower protein and lower calcium. This flavor was the one he was previously on so we stuck with it. Do you have any reputable articles you can link me to about protein levels and calcium/phosphorous content?
[h=1]Nutrition and Skeletal Health in Dogs[/h] Relationship of Nutrition to Developmental Skeletal Disease in Young Dogs
Daniel C. Richardson Phillip W. Toll
The role of nutrition in developing healthy joints in dogs is complex. Rate of growth, specific nutrients, food consumption, and feeding methods have all been shown to influence skeletal disease. Large and giant breeds are most susceptible to developmental skeletal disease, presumably because of their accelerated growth rate. Dietary deficiencies are rare in young, growing dogs fed commercial growth foods. Problems associated with dietary excess are far more likely, especially if a high quality growth food is supplemented with minerals, vitamins, and energy. The following review discusses some of the more critical nutrients in developmental skeletal disease.
Energy

The energy needed for any individual depends on breed, age, neuter status, and activity levels. In general, growing puppies require twice as much dietary energy as adults for body maintenance, activity, and growth. The need for good nutrition is greatest right after birth and decreases as the dog grows and matures. Rapid growth in large and giant-breed dogs increases the risk of skeletal disease. Excessive dietary energy may support a growth rate that is too fast for proper skeletal development and results in a higher frequency of skeletal abnormalities in large and giant-breed dogs. Because fat has twice the caloric density of protein or carbohydrate, dietary fat is the primary contributor to excess energy intake.
Excess energy leads to rapid growth. Nutrition energy in excess of a puppy's needs will be stored as body fat. Maintaining appropriate body condition during growth not only avoids excess body fat storage, but also helps control excess growth rate. Limiting intake to maintain a lean body condition will not impede a dog's ultimate genetic potential. It will only reduce food intake, fecal production, obesity, and lessen the risk of skeletal disease.

Protein

Unlike other species, protein excess has not been demonstrated to negatively affect calcium metabolism or skeletal development in dogs. Protein deficiency, however, has more impact on the developing skeleton. The minimum adequate level of dietary protein depends on digestibility, amino acids, and their availability from protein sources. A growth food should contain > 22% protein (dry matter basis) of high biologic value. The dietary protein requirements of normal dogs decrease with age.
Calcium

The absolute level of calcium in the diet, rather than an imbalance in the calcium/phosphorus ratio, influences skeletal development. Young, giant-breed dogs fed a food containing excess calcium (3.3% dry matter basis) with either normal phosphorus(0.9% dry matter basis) or high phosphorus(3% dry matter basis, to maintain a normal calcium/phosphorus ratio) had significantly increased incidence of developmental bone disease. These puppies apparently were unable to protect themselves against the negative effects of chronic calcium excess. Further, chronic high calcium intake increased the frequency and severity of osteochondrosis.

Often puppies are switched from growth to maintenance-type foods to avoid calcium excess and skeletal disease. However, because some maintenance foods have much lower energy density than growth foods, the puppy must consume more dry matter volume to meet its energy requirement. If the calcium levels are similar (dry matter basis) between the two foods, the puppy will actually consume more calcium when fed the maintenance food.
This point is exemplified in the case of switching a 15-week-old, 15-kg male Rottweiler puppy from a growth food containing, on an as fed basis, 4.0 kcal/g metabolizable energy and 1.35% calcium (1.5% on a dry matter basis) to a maintenance food containing the same amount of calcium but at a lower, 3.2 kcal/g energy density. The puppy would require approximately 1,600 kcal/day. In order to meet this energy need the puppy would consume approximately 400g of the growth food (containing 5.4g of calcium) vs. 500g of the maintenance food (containing approximately 6.7g of calcium).
Feeding treats containing calcium and/or providing calcium supplements further increases daily calcium intake. Two level teaspoons of a typical calcium supplement (calcium carbonate) added to the growth food of the 15-week-old, 15-kg Rottweiler puppy would more than double its daily calcium intake. This calcium intake is well beyond the levels shown to increase the risk for developmental bone disease.
A recent review article best sums up the need for calcium supplements: "Because virtually all dog foods contain more calcium than is needed to meet the requirement, the use of a calcium supplement certainly is unnecessary. Now that the deleterious effects of excess dietary calcium have been delineated, we can say that the feeding of calcium supplements not only is unnecessary, but, in fact, contraindicated!"Because these studies demonstrate the safety and adequacy of 1.1% calcium (dry matter basis) and the Association of American Feed Control Officials (AAFCO) minimum recommendation is 1% (dry matter basis, we recommend that calcium levels for a growth food be within this range for at risk puppies, with no supplementation.

Other Nutrients

L-ascorbic acid (Vitamin C) is necessary for hydroxylation of proline and lysine during biosynthesis of collagen, a major component of ligaments and bones. Food devoid of Vitamin C fed to puppies for 147 to 154 days neither affected growth nor caused skeletal lesions.
There are no known dietary requirements for Vitamin C in the dog.
Even though Vitamin C has been recommended, the relationship between Vitamin C and developmental skeletal disorders in dogs such as osteochondrosis and hip dysplasia is unproven.
Vitamin D metabolites regulate calcium metabolism and therefore skeletal development in dogs. These metabolites aid in the absorption of calcium and phosphorus from the gut, increase bone cell activity, and influence endochondral ossification and calcium excretion. Unlike other omnivores, the dog seems dependent on dietary Vitamin D sources from plants (Vitamin D2) or animals (Vitamin D3). Commercial pet foods contain from two to 10 times the AAFCO recommended amounts of Vitamin D.
Diagnosis of Vitamin D deficiency can be made by measuring circulating levels of Vitamin D metabolites and by measuring growth plate width. Clinical cases of Vitamin D deficiency (rickets) are extremely rare in animals eating commercial foods. Increased growth plate width is not associated with low calcium/high phosphorus foods but is a strong indicator of rickets.
Excess Vitamin D can cause hypercalcemia, hyperphosphatemia, anorexia, polydipsia, polyuria, vomiting, muscle weakness, generalized soft tissue mineralization, and lameness. In growing dogs, supplementation with Vitamin D can markedly disturb normal skeletal development due to increased calcium and phosphorus absorption.

The trace minerals copper and zinc are involved in normal skeletal development. Copper deficiency in dogs has been associated with hair depigmentation, hyperextension of the distal phalanges, and decreased copper levels in the hair, liver, kidney, and heart muscle. However, bone copper concentration was not influenced by dietary treatment and developmental skeletal abnormalities associated with a deficiency of dietary copper were not described.
Similarly, long-term studies of dietary zinc on canine growth and reproduction showed no significant clinical influence on the skeletal development. The role of these two nutrients in the development of skeletal disease in the dog remains unclear at this time.

Two of the most common skeletal diseases of growing dogs are hip dysplasia and osteochondrosis. The balance of this section will review the relationship between these diseases and critical nutrients.

Canine Hip Dysplasia (CHD)

Canine hip dysplasia (CHD) is the most frequently encountered orthopedic disease in veterinary medicine. The actual number of cases is estimated to be in the millions.
This extremely common heritable disorder of large and giant-breed dogs can be influenced by nutrition during growth. Early developmental findings of CHD, including joint laxity and coxofemoral anatomical changes, have been documented within 2 weeks of birth. Rapid weight gain in German Shepherd dogs during the first 60 days after birth has been associated with CHD at a later age. The importance of this early influential time period was demonstrated in a study comparing cesarean-section, hand reared puppies to vaginal birth, bitch-fed puppies. Cesarean section and hand rearing markedly reduced growth and the incidence of CHD in these puppies. Vaginally born, bitch-fed puppies that grew "optimally" or somewhat "suboptimally" had a higher incidence of CHD. The period from 3 to 8 months of age is important in the development of CHD, with the first 6 months generally regarded as the most critical.
Frequency and severity of CHD was influenced by weight gain in growing dogs that were offspring of parents with CHD or parents with a high incidence of CHD in their offspring. Dogs with weight gain that exceeded breed standards had a higher frequency and more severe CHD than dogs with weight gain below breed standards.
In one colony of fast growing Labrador Retriever dogs, the triradiate growth plates of the acetabula fused at 5 months as determined by conventional radiography. These growth plates normally close at 6 months in puppies growing at conventional rates. The investigators speculated that early fusion in the acetabulum may result in bone/cartilage disparities in the future and predispose to dysplastic changes.
Limiting food intake in growing Labrador Retriever puppies has been associated with less subluxation of the femoral head and fewer signs of hip dysplasia.
Palpation of the hip is of little to no value in predicting development of hip joints. However, the combination of physical and radiographic examination are important diagnostic methods for evaluating the hips (Orthopedic Foundation for Animals, Columbus, MO; Penn HIP, Malvern, PA). A recent review of nutritional influences on CHD contains more information and a more complete reference list.

Electrolyte Balance and CHD

Control of dietary electrolytes has been proposed as a preventative for CHD. Investigators have associated the dietary anion gap (DAG) with the radiographic changes of subluxation in the coxofemoral joints in several canine breeds. A food with a DAG (Na+ + K+ - Cl-) < 23 mEq/100g of food was fed to large-breed puppies and resulted in less femoral head subluxation, on average, at 6 months of age. The slowed progression of subluxation was also observed in dogs fed a food with a reduced DAG from 35 to 45 weeks of age.
Hip joint laxity was determined using the Norberg hip score computed from radiographs. Significant correlation between radiographic findings (e.g., Norberg hip scores)and progression of CHD, either radiographic or clinical was not proven. The authors propose the balance of anions and cations in the food (specifically sodium, potassium, and chloride) influence the electrolytes and osmolality in joint fluid. The joint fluid of dysplastic dogs has higher osmolality and is increased in volume when compared to that of disease-free hips from dogs of the same breed. The changes in osmolality and fluid volume could be a result rather than a cause of CHD. Changes in synovial fluid osmolality and electrolyte concentrations were not reported. These studies suggest an association between DAG and joint laxity without proving a mechanism of action.
Osteochondrosis (OCD)
Osteochondrosis is a focal disruption in endochondral ossification. OCD is manifested clinically by pain and lameness.
Physical examination results can be confirmed radiographically. Acute inflammatory joint disease begins when the subchondral bone is exposed to synovial fluid. Inflammatory mediators and cartilage fragments are released into the joint and perpetuate the cycle of degenerative joint disease. OCD occurs in the physis and/or epiphysis of growth cartilage, and is a generalized or systemic disease.
When OCD affects the physis, it may cause growth abnormalities in long bones. OCD is wide-spread among young, rapidly growing, warm-blooded, domesticated species and humans. In all species, the etiology is considered multifactorial. In dogs, risk factors for OCD are age, gender, breed, rapid growth and nutrient excesses (primarily calcium).
All large and giant-breed dogs are at increased risk for OCD. Great Dane, Labrador Retriever, Newfoundland, and Rottweiler breeds are at highest risk. Males have an increased risk of OCD in the proximal humerus but gender relationships are not found with OCD involving other joints.
At least two schools of thought exist concerning the pathogenesis of OCD. In the first, cartilage lesions develop secondary to excessive biomechanical stresses. This may be termed an "outside-in" development. Over-nutrition, such as ad libitum feeding, stimulates skeletal growth, cancellous bone remodeling, and weight gain in breeds already having inherent capacity for rapid growth. Rapid growth combined with remodeling results in weakened subchondral regions to support the cartilage surface. If osteopenic and biomechanically weak subchondral spongiosa develops, there is inadequate bony support to the articular cartilage. The increasing body mass exerts excessive biomechanical forces on the cartilage and secondarily disturbs chondrocyte nutrition, metabolism, function, and viability. An outside-in development suggests OCD results when nutritional effects initiate a biomechanical disease.
An "inside-out" pathogenesis has also been proposed. Here, abnormalities of the cartilage canal vessels and chondrocyte necrosis are thought to precede degenerative changes in the articular cartilage matrix. Focal lesions of dead and nectrotic chondrocytes develop, and subsequently, biomechanical stresses disrupt the lesion. Osteochondrosis lesions are routinely found in pigs as young as 25 days of age, when rapid growth and weight gain are much less of a factor. These findings support a localized, primary effect on the chondrocyte rather than secondary effects of biomechanical force.
Regardless of the pathogenesis of OCD, nutrition is still an underlying factor. In growing puppies, overnutrition can result in a mismatch between body weight and skeletal growth, which can overload skeletal structures. Nutrition of the mother may also play a role in the development of OCD in the offspring.
Feeding techniques

The nutrient profile of the food and how it is fed control nutritional risk factors for developmental skeletal disease.
There are three basic methods of feeding growing dogs: free-choice (ad libitum), time-limited, or food-limited.
Free-choice feeding:

Free-choice feeding is relatively effortless and may reduce abnormal behavior such as barking at feeding time. Frequent trips to the food bowl help reduce boredom, timid or unthrifty animals have less competition when eating, coprophagy may be decreased, and frequent small meals may result in a more constant blood level of nutrients and hormones. Disadvantages of ad libitum feeding include food wastage, only dry forms of pet food can be fed, and competition or boredom may stimulate overeating. The most serious disadvantage is increased risk of developmental bone disease because of overconsumption in the large and giant breeds. In general, free-choice feeding in contraindicated in "at risk" dogs until they have reached skeletal maturity (about 12 months of age or at least 80 to 90% adult weight.
Time-limited feeding:

Time-limited feeding can be used for most large and giant breeds. Making food available for a set period of time, two to three times per day, may help control intake and help in discipline and housetraining young puppies. The owner interacts with the puppy during this time and is able to observe general condition and behavior. This may lead to earlier detection of health problems. A routine of feeding a puppy then taking it outdoors can enforce housetrainng by taking advantage of the gastrocolic reflex.
Some researchers have proposed that puppies fed on a time-limited basis consumed less food, had slightly reduced growth rates, but achieved similar adult size and lean body mass when compared to puppies eating free-choice. Other studies have shown that feeding 15 minutes twice a day did not result in decreased food intake between ad libitum and time-restricted groups.
Many variables (e.g., breed, temperament, housing, etc.) influence these results and account for the varied findings. If time-restricted feeding is used, 5 to 10 minute feeding periods (3x per day for the first month after weaning, then 2x per day) may be required to decrease food intake in some puppies.
Food-limited feeding:
The method of choice for feeding puppies is limiting food intake to maintain growth rate and body condition. Food-limited feeding requires feeding a measured amount of food based on calculated energy requirement or as recommended by the manufacturer. Energy requirement is most easily calculated by using resting energy requirement (RER) as a base on which to build. RER can be calculated using either of the following two equations:

RER (kcal/day) - 70 (Wtkg)0.75 or RER (kcal/day) = 30 (Wtkg) + 70
As a starting point use 3x RER for the first 4 months of life and 2x RER from 4 months of age to skeletal maturity (about 12 months for most breeds).
Most large and giant-breed dogs will continue to increase bodyweight and muscle mass after 12 months, but the growth rate is reduced and most if not all growth plates are closed. At 12 months they can be fed as adults (1.6x RER).

Once daily caloric requirement has been calculated (kcal/day), divide this number by the energy density of the food (kcal/cup or kcal/can) to determine the number of cups or cans to feed per day. Remember, these calculations and manufacturers' recommendations are only starting points. Clinical evaluation of the growing puppy and adjustment of food offered is crucial.
Rapidly growing, large and giant-breed dogs have a very steep growth curve and their intake requirements can change dramatically over short time periods. These puppies should be weighed, evaluated, and their daily feeding amount adjusted at least once every 2 weeks. Most of the studies that have demonstrated the beneficial effects of limiting food intake of puppies have fed the limited group 25 to 30% less food then their counterparts ate when fed free-choice. Unfortunately, this is not a practical approach to feeding most puppies in a home environment.
Evaluation of feeding methods and body condition scoring Regardless of a food's nutrient profile and how it is fed, the ultimate measurement of appropriate intake is the physical condition of the puppy. The only way to reduce potentially harmful nutritional risk factors that may affect skeletal development is to assess body condition and adjust the amount fed to ensure lean, healthy growth. We recommend that at risk puppies be evaluated at least every 2 weeks.
A body condition score of 1 is characterized as very thin. The ribs are easily palpable with no fat cover. The tailbase has a prominent raised bony structure with no tissues between the skin and the bone. The bony prominences are easily felt with no overlying fat. In animals over 6 months, there is a severe abdominal tuck when viewed from above.
An underweight condition is categorized as a 2 in the scoring system. The ribs are easily palpable with minimal fat cover. The tailbase has a raised bony structure with little tissues between the skin and the bone. The bony prominences are easily felt with minimal overlying fat. In animals over 6 months, there is an abdominal tuck when viewed from the side and a marked hourglass shape when viewed from above.
The ideal body condition of a puppy is represented by a score of 3. The ribs are palpable with a thin layer of fat between the skin and the bone. The bony prominences are easily felt with a significant amount of overlying fat. In animals over 6 months, there is an abdominal tuck when viewed from the side and a well proportional lumbar waist when viewed from above.
A score of 4 is defined as overweight. The ribs are difficult to feel with moderate fat cover. The tailbase has some thickening with moderate amounts of tissue between the skin and the bone. The bony structures can still be felt. The bony prominences are covered by a moderate layer of fat. In animals over 6 month, there is little or no abdominal tuck of the waist when viewed from the side. The back is slightly broadened when viewed from above.
An obese condition is represented as a 5 on the scale. The ribs are very difficult to feel under a thick fat cover. The tailbase appears thickened and is difficult to feel under a prominent layer of fat. The bony prominences are covered by a moderate to thick layer of fat. In animals over 6 months, there is a pendulous ventral bulge and no waist when viewed from the side. The back is markedly broadened when viewed from above.
Conclusion

Large and giant-breed dogs are the most susceptible to developmental skeletal disease. Genetics, environment, and nutrition play key roles. Nutritionally, rate of growth, food consumption, specific nutrients, and feeding methods influence our ability to optimize skeletal development and minimize skeletal disease. Maximizing the growth rate in young, growing puppies does not correlate to maximal adult size. It does, however, increase the risk of skeletal disease. The growth phase of 3 to 8 months, and possibly the phases before weaning, are vital to ultimate skeletal integrity. The large and giant breeds may be limited in their ability to cope with excesses of minerals such as calcium.
Overnutrition from overconsumption and oversupplementation increases the frequency of developmental bone disease in large and giant-breed dogs. Energy and calcium are the nutrients of greatest concern. Often, owners feeding highly palatable, energy-dense growth foods switch to maintenance type foods in an attempt to reduce developmental disorders. As shown earlier, this practice may worsen total calcium intake. It is not only important to feed the appropriate food, but to feed the food appropriately.
Nutritional management alone will not completely control developmental bone diseases. Skeletal diseases can be influenced during growth by feeding technique and nutrient profile. Dietary deficiencies are minimal concern in this age of commercial foods specifically prepared for young, growing dogs. The potential for harm is in overnutrition from excess consumption and oversupplementation.

References on website
Nutrition and Joint Health in Dogs
 

ruthcatrin

Well-Known Member
I used to have a couple links and I lost them, if you don't mind digging I know they were posted on here more than once though. I've not had time to do so since my computer went screwy.

The ideal range for calcium is 1.4% to 1.6% with the "good" range between 1.0% and 1.8% and the calcium to phosphorus ratio should be as close to 1.2 to 1.0. I'd do a gradual switch to one of the other formulas of the TOTW that fit that were he mine.
 

ruthcatrin

Well-Known Member
I used to have a couple links and I lost them, if you don't mind digging I know they were posted on here more than once though. I've not had time to do so since my computer went screwy.

The ideal range for calcium is 1.4% to 1.6% with the "good" range between 1.0% and 1.8% and the calcium to phosphorus ratio should be as close to 1.2 to 1.0. I'd do a gradual switch to one of the other formulas of the TOTW that fit that were he mine.


Also keep in mind that most companies only list the MINIMUM for those numbers, not the max, so I usually recommend staying on the lower end when possible.
 

Iymala

Well-Known Member
Optimal feeding of large breed puppies
Jennifer Larsen DVM, MS
Resident, Small Animal Clinical Nutrition
Veterinary Medical Teaching Hospital
School of Veterinary Medicine, University of California, Davis

The feeding of young growing puppies is not as simple as once believed. A number of researchers have been studying the effects of feeding and diet on the growth of puppies, particularly the effects on skeletal development. Although genetics, exercise, trauma, and other aspects of the environment also impact the skeletal development of puppies, the diet is one factor that every owner can control. Several orthopedic diseases of dogs can be precipitated by improper feeding practices during growth. Large breeds of dogs are predisposed to these problems because they have the genetic potential for excessively rapid growth. In rapidly growing, large breed puppies, maximal growth, and therefore increased body weight, can cause stress on the immature developing skeleton. Large breed dogs have decreased bone density compared to smaller breed dogs at this stage (Dammrich, 1991). Additionally, fast bone growth results in structural defects of bones that are in turn unable to accommodate an increased body weight (Dammrich, 1991).

Many nutrients have been studied to determine which components of these diets cause problems. Over 30 years ago a significant amount of data was published that established a connection between improper nutrition and a variety of skeletal abnormalities in Great Danes, including hypertrophic osteodystrophy, osteochondrosis dissecans and 'wobbler' syndrome. The experimental diets varied in protein, energy density, and minerals, and it was unclear which factor or combination thereof contributed to the developmental bone diseases observed in the initial studies (Hedhammar, et. al. 1974). The same group went on to investigate the individual dietary components and demonstrated that dietary protein level had no effect on the development of osteochondrosis (Nap, et. al, 1991). For some reason, dietary protein level continues to be incriminated by some owners, breeders, and veterinarians, despite the lack of supportive evidence.

In contrast to protein, excessive calories and inappropriate amounts of calcium have both been shown to negatively influence optimal skeletal development in puppies. While overnutrition in adult dogs leads to obesity and can lead to serious health problems such as cardiorespiratory disease, we recognize other problems in puppies that result from the same practice of overfeeding. It is necessary to feed the puppy enough to allow for controlled growth, but it is equally important to avoid overfeeding. Many people believe that a round puppy is a happy healthy puppy. However, maximal growth is not optimal growth. Adult size is principally influenced by genetics; however, the time
to reach adult size can and should be controlled by proper nutrition. Excess calories can predispose large breed puppies to developmental bone disease, including hypertrophic osteodystrophy (Dammrich, 1991).

While any food has the potential to cause problems with skeletal development if overfed or supplemented, maximal growth in puppies is commonly occurs with feeding a highly palatable, high energy density growth diet. These types of diets are often overeaten if fed on a free choice basis, or simply too much is fed on a meal basis. There is currently no perfect formula to guarantee an optimal rate of growth for an individual puppy. It is especially important to avoid overnutrition during periods of the most rapid growth, which will vary with breed and between individuals. Breed and individual differences, environmental factors such as climate, and activity level will all affect the amount of food required. Obviously, palpable body fat is not specific enough to be a guideline for optimal nutrition. Provide an amount of food that will maintain lean body condition throughout growth. This will allow for a slow growth rate, but won’t affect the final adult size. The goal is to keep growing puppies lean at about a body condition score of around 4 on a scale of 1-9 (a score of 1 is emaciated and 9 is grossly obese). You should be able to easily feel the ribs. Study drawings and complete descriptions of the desired body condition. A common body condition scoring system is provided at the following site: Promoting You Dog's Health - Purina®. One very general suggestion is to provide an amount of food that the puppy can eat in 10 minutes three times a day. Using this as a starting point when the puppy is weaned at seven to nine weeks old, it is recommended to continually assess the puppy’s body condition and activity level and adjust the amount of food being offered accordingly.
In addition to excessive energy intake, inappropriate amounts of calcium have also been shown to cause developmental bone disease (Hazewinkel, 1989). Many breeders and dog fanciers advocate calcium supplementation for growing pups. Calcium supplements should never be recommended for dogs eating commercially available diets designed for growth. Excess calcium is potentially very detrimental to the development of a healthy skeleton. Unlike adult animals, puppies appear to have inefficient mechanisms for regulating how much dietary calcium they absorb from the food. This can result in absorption and retention of more calcium, especially when the dietary calcium is high (Hazewinkel et. al., 1991, Tryfonidou, 2002). The excessive calcium may result in skeletal malformation (Hazewinkel et. al. 1985). Excess calcium can also cause deficiencies in other nutrients, especially zinc (Wedekind, et. al. 1998). Feeding a diet with too little calcium is equally problematic. Many home prepared diets for pets are lacking in calcium. In this case, the skeletal system must provide the calcium for the rest of the body, and brittle, malformed bones are the result. Current recommendations for feeding any healthy dog include choosing a nutritionally complete and balanced dog food that has undergone feeding tests. The guidelines for these tests are established by the Association of American Feed Control Officials (AAFCO). When such a diet is fed, vitamin and mineral supplements are unnecessary and potentially harmful.

The common practice of feeding commercially available adult dog foods to puppies can also be detrimental. The broad category of adult canine maintenance foods contains diets with a wide range of nutrient profiles, caloric densities, and mineral contents. Some foods marketed for adult maintenance have passed AAFCO feeding tests for growth, but some have not. Regardless, in some instances, these diets provide more calcium per calorie and/or have more calories per cup than growth diets designed for large breed puppies. A large breed growth diet that has passed AAFCO animal feeding tests should be fed at least until the puppy reaches about 80% of the expected adult weight, and it will not be detrimental to keep a healthy, lean puppy on growth formula until full adult size is achieved. Above all, remember to feed a large breed growth formula in sufficient quantities to maintain a lean body condition, and avoid additional supplements.
References

Dammrich, K. Relationship between nutrition and bone growth in large and giant dogs. J. Nutr. 1991; 121: 114S-121S.
Hazewinkel, H.A.W., Goedegebuure S.A., Poulos, P.W., Wolvekamp, W.Th.C. Influences of chronic calcium excess on the skeletal development of growing Great Danes. J. Am. Anim. Hosp. Assoc. 1985; 21: 377-391.
Hazewinkel, H.A.W. Nutrition in relation to skeletal growth deformities. 1989; J. Sm. Anim. Prac. 30: 525-630.
Hazewinkel, H.A.W., van den Brom, W.E., van ‘t Klooster, A.T., Voorhout, G., van Wees, A. Calcium metabolism in Great Dane dogs fed diets with various calcium and phosphorus levels. J. Nutr. 1991; 121: 99S-106S.
Hedhammar, A., Wu. F., Krook, L., Schriver, H.F., De La Hunta, A., Whalen, J.P., Kallfelz, F., Nunez, E.A., Hintz, H.F., Sheffy, B.E., Ryan, A.D. Overnutrition and skeletal disease: an experimental study in growing Great Dane dogs. Cornell Veterinary Supplement 1974; 64 (2): 5, 11-160.
Lowe J. A., Wiseman J., Cole D.J.A. Zinc source influences zinc retention in hair and hair growth in the dog. J. Nutr. 1994; 124:2575S-2576S.
Nap, R.C., Hazewinkel, H.A.W., Voorhout, G., van den Brom, W.E., Goedegebuure, S.A., van‘t Klooster, A.T. J. Nutr. 1991; 121: 107S-113S.
Tryfonidou, M.A., van den Broek, J., van den Brom, W.E., Hazewinkel, H.A.W. Intestinal calcium absorption in growing dogs is influenced by calcium intake and age but not by growth rate. J. Nutr. 2002; 132: 3363-3368.
Wedekind, K.J., Lowry, S.R. Are organic zinc sources efficacious in puppies? J. Nutr. 1998; 128: 2593S-2595S.
http://www.lgd.org/library/Optimal%20feeding%20of%20large%20breed%20puppies.pdf