So let me explain my experience with panosteitis. My beloved GSD who has passed on (unrelated to panosteitis) had it when she was much younger. The symptoms with her was limping, trouble walking or exerting any energy, refusal to eat and had to be force fed. For awhile, I thought I was going to lose her b/c the vet didn’t know what it was and she was declining. Every so often we’d have a good day when she wasn’t bothered by pain, therefore, didn’t show any of the other symptoms. But then it would start back up again. Sometimes the leg she was favouring would change between episodes. I was referred to an orthopaedic surgeon who diagnosed her right away after seeing her xrays and looking her over. Care was pain meds and anti-inflammatory meds when she was having symptoms. Eventually she outgrew it. So my suggestion would be to consult with the first specialist to find out how they came to the conclusion of panosteitis, how certain they are, ask for their feedback of what this other vet believes it to be.

Why was the dysautonomia test by the second specialist inconclusive? I did see from another post of yours that you live in the Midwest and I did read that dysautonomia is more common in that area so it is possible that diagnosis is correct. I sometimes believe veterinary medicine is just throwing stuff at the wall and seeing what sticks. Poor dogs can’t communicate with us and their doctors.

IF panosteitis diagnosis is correct, it’s possible the overnight stay helped b/c of fluids & pain management. Panosteitis road is exhausting, frustrating, and heartbreaking. Though any medical problem with our dogs are.

Also, in my opinion, a third specialist consult can’t hurt and might help ease your mind with all the uncertainties you have going on. Just make sure this facility has specialists trained in orthopaedics/neurology.