• Home
• Our Club
  • About the Club
  • Constitution & Bylaws
  • Code of Ethics
  • Officers and Directors
  • Committees
  • Centennial Celebration
  • Membership
  • 25 Year Members
  • Westie Imprint
  • Website
• Find a Westie
  • History of the Westie
  • Westie Traits
  • Westie Profiler
  • Choosing a Breeder
  • Breeder Listings
  • Westie Illustrated
    Standard
  • AKC Breed Standard
  • Grooming
  • Breeding Your Westie
  • Bibliography and
    Reading References
  • Contact Us:
    Team Westie
• Versatile Westies
  • Conformation
  • Junior Showmanship
  • Earthdog
  • Agility
  • Obedience
  • Rally Obedience
  • Tracking
  • Versatile Photo Gallery
  • Flyball
  • Spotlight on
    Performance
  • Title Glossary
• Health
  • Health Committee
  • Breeding Your Westie
  • Spaying and Neutering
  • Health Issues
• Training & Behavior
• Awards
  • Rules for Annual Awards
  • Conformation Awards
  • Registry of Merit
    (ROM/ROMX)
  • Junior Showmanship
    Awards
  • Obedience Awards
  • Agility Awards
  • Versatile Westie Award
  • Most Versatlie
    Westie In Specialty
  • Performance Registry
    of Merits (PROM/PROMX)
  • Title Glossary
• Specialty Shows
  • Specialty Show
  • National Specialty (PDF)
  • Roving National Specialty
  • Centennial Celebration 2009
  • Regional Specialty Shows
  • Specialty Photo Gallery
  • Specialty Results
• Futurity
  • Futurity
• Regional Westie Clubs
  • Regional Westie Clubs
• Westie Rescue
• Judge's Education
  • Mentoring Program
  • Judge's Resources
  • List of Mentors
• The Westie Store
• Member's Only
  • Register Here
  • Members-Log in
• Important Links
  • Westie Foundation
    of America, Inc.
  • WestieMed, Inc.
  • West Highland White
    Terrier Pedigree Research

Craniomandibular Osteopathy (CMO)
Contributed By: Anne Sanders
W.H.W.T.C.A. Health Committee

---

Description: Craniomandibular osteopathy or osteoarthropathy is a noncancerous growth of bone on the lower jaw bone (ramus of the mandible) or over the angle of the mandible and tympanic bulla. In most instances it is bilateral, but this is not always true. The bone is dense and hard and has a rough surface that can usually be detected on palpation by an experienced person. Early in the disease there is an inflammatory component. The disease is painful to the puppy and is usually first recognized when a puppy shows discomfort while chewing or when his mouth is being examined. The bony growth can occasionally occur on other parts of the cranium, and the radius and ulna may also be involved. By casual examination, the jaw may not appear enlarged or abnormal.

Age of Onset: The disease is most often recognized between the ages of 4 and 7 months, but it can occur as early as 3 - 4 weeks and rarely as late as 9 - 10 months. Experienced breeders and veterinarians usually recognize it earlier than 4 months of age by clinical signs or by palpation.

Diagnosis: The disease is most often diagnosed by clinical signs and palpation with definitive confirmation by lateral and/or ventral/dorsal radiographs of the skull, depending on the location of the specific lesion. All board-certified radiologists can diagnose the disease, as can many other experienced veterinarians.

Treatment: The disease can be treated with most anti-inflammatory drugs but since long-term therapy may be required, you should consult your veterinarian about the drug of choice and the specific dosage. See "Common Treatment Regimen" below.

Dogs always or nearly always recover, but the length of treatment may vary from 4 to 10 months. After therapy, remodeling of the jaw occurs and is generally good, and by the time the dog is 2 - 3 years old, it may be impossible to detect that the dog ever had the disease.

Mode of Inheritance: The disease is inherited as a simple autosomal recessive trait. This means that both parents must have at least one gene for CMO (i.e. they are defined carriers). In this disease, the production of an affected puppy provides the only method of identifying carriers.

The disease is known to occur in West Highland White, Scottish, Cairn and Boston Terriers; Doberman Pinschers; Great Danes; Labrador Retrievers; and probably Bulldogs. It is known to occur in the U. S., Canada and most European countries.

Common Treatment Regimen:

CMO is VERY treatable in almost every case, except the MOST severe. The amount of medication and length of treatment varies greatly depending on the severity of the disease. Many puppies with CMO will need to be on some dose of cortisone until they are 10 months old or longer.

The object is to medicate the puppy enough to keep him comfortable with the lowest possible dosage. In order to do this, the owner and veterinarian should keep the following background information in mind.

• The symptoms from CMO run in 10 - 14 day pain/fever cycles. So the puppy may feel better for a while, tempting you to reduce the medication.
• Medication must be removed slowly and you need to be willing to increase the dosage, if pain and/or fever returns.
• Prednisone is the common steroid administered. When using this drug, you must be careful to reduce the dosage in steps.
  1. First dosages are given twice a day.
  2. Next, give the dose only in the MORNING.
  3. Next, reduce the amount given by giving a lower dose and/or by keeping the same dose as the puppy grows.
  4. Then, try giving the dose every other day.
• Medication can be increased any time by going back one or more steps. Then, the reduction steps need to followed again.
• If you give the medication once a day, give it in the morning so that you mimic the dogs' own production of cortisone. It will make weaning the dog off the medication more successful.
  
  Some cases are so mild that they can be treated with baby aspirin or only 1 injection of cortisone. Other may require treatment until 14 months. It all depends on the severity of the case, the location of the inflammation, and the pain sensitivity of the dog. The object is to keep the puppy comfortable and, if the disease is located near the hinge of the jaw, to keep him able to eat. You may need to soften the food or grind the Kibble and make a gruel on painful days.
  
  Sample treatment schedule using Prednisone:
  
  
• First 3 days: 5mg two times a day
• Next 10 days: 5mg once a day (in the morning).
  This dosage can be maintained for quite some time.
• If he is doing well and seems pain free, you can try to give 5mg every other day.
• If after 2 weeks, he is still doing well, try 2.5mg (1/2 tablet) every other day.
• Maintain this dose until you see no more evidence of pain.
  If he develops serious pain again, go back to the previous dosage level.
  
  Prednisone will make him hungry, thirsty, and he will urinate more frequently. These are the major side effects.

Personal Experience:

I have personally treated a half dozen Westies. They have recovered and lived full and healthy lives. I know people are scared of giving cortisone, but I successfully treated one dog until he was 14 months and he is now 11 years old and doing fine.

If you or your veterinarian would like to discuss the disease, its diagnosis or treatment, please feel free to e-mail or call me. If I am not available, I will return you call (collect) as soon as possible.

Anne C. Sanders
Anne@WestiesNW.com
360-629-6434 (PST)

***Disclaimer*** Any information contained on this site relating to various medical, health, and fitness conditions of Westies and their treatment is for informational purposes only and is not meant to be a substitute for the advice provided by your own veterinarian. You should not use the information contained herein for diagnosing a Westie's health - you should always consult your own veterinarian.