In severe cases, and if the Maalox® doesn't work, you will need to limit the exercise that the puppy gets and try the following:

Use a dog crate to limit exercise and only let the puppy out for bathroom breaks and for very, very limited exercise.

Then, try this plan given me by a good friend and top breeder of fine German Shepherds for many, many years. It works really well for puppies with more severe downed pasterns that do not respond to the Maalox® routine alone.

Put the German Shepherd puppy back on the 21% diet, and add the following each meal: add one Maalox® tablet (2 times per day), add 800 units of vitamin e, 1000 mg vitamin c and 1 Selenium/Magnesium tablet.

Make sure that you are under veterinary care as well and don't give up. Treatment may take some time before your puppy gets back to normal. I would encourage you to keep the puppy on the vitamin-Maalox routine listed above for a few weeks even after the puppy's pasterns gets back to normal.

It is also a good idea not to put your puppy back on a high protein diet even though you might want to increase it just a bit, especially if your treatment is being done on a young puppy.

Your veterinarian may encourage you to euthanize the puppy. Please don't, at least not until you give the treatment above a try. Who knows what kind of results you will get?

I do know personally that I have used the treatments above in puppies of my own and they have worked well and the pups went back up in their downed pasterns in just a short time.