Luxating patella with ccl partial tear

[Gew]

My two year old Yorkie who has a luxating patella has never been bothered by it. On Thursday she suddenly stopped using her left rear leg, just kept it straight on her side, but putting no weight on it. Took her to the vet who took X-rays etc. she diagnosed a partial tear of the ccl. She prescribed rimady and gabapentin for two weeks. We are to restrict activity completely. If in that time there is no improvement, surgery would be recommended. I did not think of repair of both at the same time, but read it is often done.

Has anyone experienced anything similar? Pro? Cons? The vet did not mention it. If surgery is necessary, she will go to an orthopedic surgeon.

Thanks.

Gew

[pstinard]

Originally Posted by Gew

My two year old Yorkie who has a luxating patella has never been bothered by it. On Thursday she suddenly stopped using her left rear leg, just kept it straight on her side, but putting no weight on it. Took her to the vet who took X-rays etc. she diagnosed a partial tear of the ccl. She prescribed rimady and gabapentin for two weeks. We are to restrict activity completely. If in that time there is no improvement, surgery would be recommended. I did not think of repair of both at the same time, but read it is often done.

Has anyone experienced anything similar? Pro? Cons? The vet did not mention it. If surgery is necessary, she will go to an orthopedic surgeon.

Thanks.

Gew

It depends on the severity of the luxating patella. If it's severe, they would probably want to do both at once to spare future surgery, and to prevent the CCL from tearing again. If it's mild, you might only need to do the CCL repair. I would ask the orthopedic surgeon for their opinion when and if the time comes. Some Yorkietalkers have had both surgeries done, so I'm sure they will share their experiences. Our Bella has only had luxating patella surgery done. Thankfully, she has never torn her CCL.

[Lovetodream88]

Callie had the same thing and we repaired the knee and CCL at the same time. Its better to do it that way. You need to make sure a bored certified surgeon does it though.

[Gew]

The luxating patella is a 2. She showed no pain before yesterday in her legs at all. She is extremely active. Loves to run in the backyard.

I hope she doesn’t need both, but I read that fixing a ccl may negatively impact on a luxating patella. We will use the same board certified surgeon who just did an arthrodesis on our collie who was t-boned by a deer. After 15 weeks in a cast, Jami is walking on leash very well. He is restricted until spring.

I wanted to hear others experience before going to the surgeon.

Thanks so much for responding.

Gew

[yorkiemini]

Haven’t had any experience with this. My previous Yorkie had one lux patetells repaired aight no problems.

Best of luck. Keep us posted!

[ladyjane]

The surgeon I use recommends repairing LP when they are young to reduce the chance of tearing the CCL. Once it is torn, surgery is the only option IMO.
I don't know what you mean about repairing a CCL making an impact on LP...they repair the knee when they repair the ligament.
What I will tell you is that once they tear the ligament in one knee, they are 50% more likely to tear the other.
I have had multiple pups go through surgery for torn cruciates and they did very well after....definitely only would use a boarded surgeon who does arthroscopy and TPLO.

[ladyjane]

I suggest you go to Red Bank this time! I remember the fiasco with Max. (do hope he is ok now)

[Lovetodream88]

Originally Posted by ladyjane

I suggest you go to Red Bank this time! I remember the fiasco with Max. (do hope he is ok now)

Oh yikes I forgot about that. I certainly would not go with who did Max’s surgery.

[Wylie's Mom]

Originally Posted by ladyjane

The surgeon I use recommends repairing LP when they are young to reduce the chance of tearing the CCL. Once it is torn, surgery is the only option IMO.
I don't know what you mean about repairing a CCL making an impact on LP...they repair the knee when they repair the ligament.
What I will tell you is that once they tear the ligament in one knee, they are 50% more likely to tear the other.
I have had multiple pups go through surgery for torn cruciates and they did very well after....definitely only would use a boarded surgeon who does arthroscopy and TPLO.

[maggiefromnj]

My girl has loose knee in her right leg. I thought she had in her left leg but I’m honestly not sure, it’s at least a little loose, but not too bad. She’s never had surgery for her knees but she did have a hemi laminectomy on her lumbar spine in sept 2016. We went to the beach October 2017 and we noticed one night that she wasn’t going up any steps or curbs. We then realize that she really wasn’t putting her left leg down all the way. We immediately took her to the vet in Myrtle Beach. He had a hard time doing tests on her because she was in so much pain. But he thought it was ccl tear Even though he couldn’t really get it to move (drawer test?) He said with adrenaline and stuff sometimes you can’t do the test properly. We took her home and took her to a local vet who is very experienced (specialize in ortho) and he showed us how Her knee would move and said she had a tear. He said that in 75% of small dogs there uusually is no need for surgery. He said that it would scar over and the scar tissue would stabilize it, though likely to get arthritis. Obviously we had to restrict her for quite a while as far as running and playing.He did say that she has a higher chance of tearing the other side as well. He had me bring her back several times and he checked her knee and measured her thigh muscle. She has done excellent. She is now using it like there was never anything wrong. I realize surgery can sometimes be the better option, but since she had gone through back surgery only a year ago we didn’t want to put her through anything that wasn’t absolutely necessary and of course there is also the cost. I don’t know what the best course is for torn CCL, but I just want to let you know that conservative management can work. I was also happy to have a Doctor who wasn’t just going to recommend the most expensive thing.

[ladyjane]

Originally Posted by maggiefromnj

My girl has loose knee in her right leg. I thought she had in her left leg but I’m honestly not sure, it’s at least a little loose, but not too bad. She’s never had surgery for her knees but she did have a hemi laminectomy on her lumbar spine in sept 2016. We went to the beach October 2017 and we noticed one night that she wasn’t going up any steps or curbs. We then realize that she really wasn’t putting her left leg down all the way. We immediately took her to the vet in Myrtle Beach. He had a hard time doing tests on her because she was in so much pain. But he thought it was ccl tear Even though he couldn’t really get it to move (drawer test?) He said with adrenaline and stuff sometimes you can’t do the test properly. We took her home and took her to a local vet who is very experienced (specialize in ortho) and he showed us how Her knee would move and said she had a tear. He said that in 75% of small dogs there uusually is no need for surgery. He said that it would scar over and the scar tissue would stabilize it, though likely to get arthritis. Obviously we had to restrict her for quite a while as far as running and playing.He did say that she has a higher chance of tearing the other side as well. He had me bring her back several times and he checked her knee and measured her thigh muscle. She has done excellent. She is now using it like there was never anything wrong. I realize surgery can sometimes be the better option, but since she had gone through back surgery only a year ago we didn’t want to put her through anything that wasn’t absolutely necessary and of course there is also the cost. I don’t know what the best course is for torn CCL, but I just want to let you know that conservative management can work. I was also happy to have a Doctor who wasn’t just going to recommend the most expensive thing.

No disrespect but it is not true that in 75% of small dogs surgery is not needed. Yes, they do develop arthritis...matter of fact it is severe arthritis. They also are at high risk of a torn meniscus because of the instability of that knee and that is even more painful and IF the dog was able to use the knee prior, they simply won't then. Muscle atrophy is another complication which of course just adds to that instability. Dogs don't show pain but I can promise you if she has arthritis in that knee, which I am sure she does, she has pain. Perhaps you might want to speak with your vet about some pain management for her comfort. All that said, there are variables to anything....size, age and health .. also monetary concerns are some of them. You "can" do conservative management but again that percentage is simply not accurate. CCL is actually more of a problem for dogs than for humans. Humans with a torn ACL can do conservative treatment unless they are athletes and then surgery must be done.

I am glad that you are happy with your pup's outcome but must respectfully disagree with you.

Some helpful links:

Canine Cruciate Ligament Injury

https://www.acvs.org/small-animal/cr...gament-disease

[Lovetodream88]

Originally Posted by maggiefromnj

My girl has loose knee in her right leg. I thought she had in her left leg but I’m honestly not sure, it’s at least a little loose, but not too bad. She’s never had surgery for her knees but she did have a hemi laminectomy on her lumbar spine in sept 2016. We went to the beach October 2017 and we noticed one night that she wasn’t going up any steps or curbs. We then realize that she really wasn’t putting her left leg down all the way. We immediately took her to the vet in Myrtle Beach. He had a hard time doing tests on her because she was in so much pain. But he thought it was ccl tear Even though he couldn’t really get it to move (drawer test?) He said with adrenaline and stuff sometimes you can’t do the test properly. We took her home and took her to a local vet who is very experienced (specialize in ortho) and he showed us how Her knee would move and said she had a tear. He said that in 75% of small dogs there uusually is no need for surgery. He said that it would scar over and the scar tissue would stabilize it, though likely to get arthritis. Obviously we had to restrict her for quite a while as far as running and playing.He did say that she has a higher chance of tearing the other side as well. He had me bring her back several times and he checked her knee and measured her thigh muscle. She has done excellent. She is now using it like there was never anything wrong. I realize surgery can sometimes be the better option, but since she had gone through back surgery only a year ago we didn’t want to put her through anything that wasn’t absolutely necessary and of course there is also the cost. I don’t know what the best course is for torn CCL, but I just want to let you know that conservative management can work. I was also happy to have a Doctor who wasn’t just going to recommend the most expensive thing.

I disagree with your vet. In most cases where you do not do the surgery your dog will end up with debilitating arthritis. I would always recommend surgery for a torn CCL unless there is a significant health issue.

[maggiefromnj]

I'm not going to argue with you guys. I know you have more experience than me and I'm glad you try to educate the rest of us and now the OP can make an informed decision. For us, another surgery so soon was just not something we wanted for many reasons ($, surgery risks, personal reasons) ,including that there could be yet ANOTHER unavoidable one in her future for the other knee. I'm hopeful that she doesn't develop arthritis and that if she does that it can be managed. She will be turning 8 in April and today was out joyfully running. Our vet is very experienced and I expected him to suggest surgery.

Here in NJ, vet surgery is VERY expensive. We took her to U of P for her back surgery and spent THOUSANDS! So much that I don't even tell my friends what it really cost because they would think I was nuts. But, in that case we were watching her become more paralyzed by the hour.....

[ladyjane]

Originally Posted by maggiefromnj

I'm not going to argue with you guys. I know you have more experience than me and I'm glad you try to educate the rest of us and now the OP can make an informed decision. For us, another surgery so soon was just not something we wanted for many reasons ($, surgery risks, personal reasons) ,including that there could be yet ANOTHER unavoidable one in her future for the other knee. I'm hopeful that she doesn't develop arthritis and that if she does that it can be managed. She will be turning 8 in April and today was out joyfully running. Our vet is very experienced and I expected him to suggest surgery.

Here in NJ, vet surgery is VERY expensive. We took her to U of P for her back surgery and spent THOUSANDS! So much that I don't even tell my friends what it really cost because they would think I was nuts. But, in that case we were watching her become more paralyzed by the hour.....

It isn't any cheaper here in Texas and I used to live in NJ so I know about your costs as well. A torn CCL here is $4,500. I had a pup at Texas A&M in 2004 for two herniated discs and it was just under $4,000 so it has been expensive for a very long time.

I wasn't trying to argue or dispute your decision...I was merely responding to that percentage that is not accurate. As I said, there are MANY factors to consider. I am glad things are going well for your girl.

[Lovetodream88]

Originally Posted by maggiefromnj

I'm not going to argue with you guys. I know you have more experience than me and I'm glad you try to educate the rest of us and now the OP can make an informed decision. For us, another surgery so soon was just not something we wanted for many reasons ($, surgery risks, personal reasons) ,including that there could be yet ANOTHER unavoidable one in her future for the other knee. I'm hopeful that she doesn't develop arthritis and that if she does that it can be managed. She will be turning 8 in April and today was out joyfully running. Our vet is very experienced and I expected him to suggest surgery.

Here in NJ, vet surgery is VERY expensive. We took her to U of P for her back surgery and spent THOUSANDS! So much that I don't even tell my friends what it really cost because they would think I was nuts. But, in that case we were watching her become more paralyzed by the hour.....

Callie had LP and CCL surgery on one knee and it was $3500. Years later we did LP surgery on the other knee at $2500 then a year latter her CCL tore and it was surgery for $2000. Very expensive but I found away to pay for them because I knew it was best. At almost 11 she already has some arthritis I can not imagine how terrible it would have been if I didn’t fix the CCLs. I sure everyone gets lucky now and then but I would not play with that kinda luck with my babies. The research shows its much better to surgically fix it. In Maryland it is very expensive for vet care.