This report documents a case of marked osteopenia and pathological fractures occurring in a 5-month old Bernese Mountain Dog. The patient presented for investigation of severe generalized bone pain, lameness and difficulty in ambulation. A cursory diet history indicated that the dog was strictly fed a homemade diet consisting of raw meat. Serum biochemistry revealed moderate hyperphosphatemia, (2.31 mmol/L, reference interval 0.8–1.6) and increased serum alkaline phosphatase activity (ALKP) (228 u/l, reference interval 20–150). Serum ionised calcium was within normal limits (1.3 mmol/L, reference internal 1.15-1.33).
The plasma PTH concentration was found to be markedly elevated (633 pg/ml, reference interval 20-65 pg/mL), serum 25-hydroxycholecalciferol concentration was low (56 nmol/L; reference interval 109-423) and parathyroid hormone related peptide (PTHrP) was undetectable. Radiographs revealed diffuse osteopenia and spontaneous fractures of both femurs and ischial bones. Computed tomography (CT) confirmed marked disuse osteopenia with secondary pathological folding fractures in the left and right femurs and ischial bones.
Based on the patient’s clinical presentation and diagnostics investigations the presumptive diagnosis was nutritional secondary hyperparathyroidism (NSHP).
Transition to a balanced growth formula and analgesia were initiated during hospitalization and steady improvement was observed within 4 days. Unfortunately, the patient was euthanized 3 weeks later given permanent skeletal deformities and owners\' lack of compliance. This case report highlights the importance of an appropriate dietary management especially during growth and accounts the relevance of obtaining a thorough dietary history.
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