Hypertrophic pulmonary osteoarthropathy

From Cow
Antero-posterior radiograph of right metacarpus with evidence of periosteal proliferation in a cow with HPOA[1]

Hypertrophic pulmonary osteoarthropathy (HPOA) is a rare paraneoplastic disease of cattle.

The disease appears to have a relationship with cattle that are affected by chronic respiratory conditions such as tracheobronchitis or chronic bronchopneumia, although vagotomy has resulted in regression of the osteal lesions[2]. The vagus nerve appears to play a key role in the disease since the changes in the distal limbs are often associated with a primary disease in areas of the body such as the lung, liver, diaphragm, and the right side of the large colon, which are supplied by the vagus nerve[3].

This disease involves formation of subperiosteal new bone on the distal diaphyses of long bones or on the axial skeleton or facial bones, with nonedematous swelling of the extremities and occasional swelling and tenderness of joints[4].

Affected cattle often present with vague clinical symptoms such as intermittent anorexia, weight loss and lameness. Affected limb(s) may become swollen and painful and a suspicion of neoplasia leads to investigation via tissue biopsies.

A diagnosis is primarily based on histopathological analysis of tumours and confirmation of


  1. Guyot H et al (2011) A case of hypertrophic osteoarthropathy in a Belgian blue cow. Can Vet J. 2011 Dec;52(12):1308-11
  2. Merrit AM et al (1971) Hypertrophic pulmonary osteopathy in a steer. J Am Vet Med Assoc 159:443–448
  3. Rutherford RB et al (1969) The distribution of extremity blood flow before and after vagectomy in a patient with hypertrophic pulmonary osteoarthropathy. Dis Chest 56:19–23
  4. Martin SW et al (1971) Hypertrophic pulmonary osteoarthropathy in a cow. Can Vet J 12:129–131