Surgery for LP Grade 2?? - YorkieTalk.com Forums

QuickSilver · 10-03-2011, 04:41 PM

I had Thor's hips and joints x-rayed today. The vet said he appears to be at LP grade 2, which is also what another vet said based on touching him while awake.

So hearing grade 2 was not a surprise. What DID surprise me is that this vet said that she recommended sugery to prevent arthritis in the future, particularly since Thor is a high energy doggy.

Have other YTers done surgery at LP 2? My impression was that people generally did not start thinking surgery until grade 3 or 4. Thor doesn't "kick" while he runs, or show any other signs of lameness. Do you think this is proactive? Or overkill?

107barney · 10-03-2011, 05:24 PM

I would never let a regular vet determine if an LP warrants surgery. Generally speaking however, the grading of LPs is not a diagnostic scale -- it is a prognostic scale. So a grade 1 means dog wont need surgery, grade 2 means dog will most likely not need surgery but could, grade 3 means probably will need surgery but maybe not and grade 4 means most probably will need surgery.

I have dogs with LPs. One of my dogs who is 11 has an LP that is a grade 4, the knee cap sits to the medial side of her body where it has been since she was a baby. The dog has never gone lame for longer than a couple of weeks at which time we have crate rested her with meds and she recovers. She's never been on a supplement and xrays show no arthritis. Her hips are a solid as a 2 year old's as well.

So my feeling on this is that no reputable surgeon (diplomat of ACVS) would consider operating on LPs of dogs at that level. At least not for an adult dog who is showing no signs of clinical problems (it may be different for puppies). And just by way of example, I have met two ACVS vets in my time owning yorkies and neither one of them suggested surgery on grades 1s or 2s or said anything about arthritis if surgery was not done.

If you are concerned, I'd see a ACVS vet and get an opinion, ask the vet to burn a copy of the xray to a disk for you. Until then, I'd put the general vet's opinion in the part of my brain labeled "dismiss"

kalina82 · 10-03-2011, 07:50 PM

In my opinion, if he shows no signs of pain or lameness, no matter what the grade be, I would not have surgery done. If I were concerned that the dog was in pain, then I would seek the opinion of a board certified orthopedic surgeon and have them take proper x-rays and evaluate the dog.

A dog can need surgery at any grade if they are in pain. I would not use the number as a part in my decision for surgery.

My yorkie has grade 3-4 LP in both legs. She's had this problem since she was a baby however she has never shown any outward signs of pain or lameness. I had her evaluated twice by the orthopedic surgeons I used to work for. Once at 6 months and then again at 4 years. We came to the decision that since she shows no signs of pain, lameness, or discomfort it is not worth it to put her through the pain of surgery. The benefits of surgery will not out weigh the negatives and in the end she will still end up with arthritis.

The best things to do in my yorkies situation is to keep her at a healthy weight (and even slightly below it if necessary) and to build up the muscles in her rear legs by going for daily walks. A healthy weight will keep stress off of her joints, and good muscle mass will help strengthen her rear legs. Since she has bilateral LPs her rear legs are naturally leaner then her front legs. She over compensates with her front half. If she were a bigger dog this would cause a problem but since she is so small she should be fine the rest of her life by just being proactive and maintaining a healthy lifestyle.

DvlshAngel985 · 10-03-2011, 10:10 PM

I took Kaji to 3 vets when I found out about the LP. One wanted to rush to surgery. I was perplexed because I had yet to any reading on the subject, and Kaji showed no signs of discomfort. 2 years later, he still doesn't. My only responsibilities now are to monitor him and keep his weight down.

Do what the others recommend, and have Thor seen by an orthopedic surgeon.

Ellie May · 10-04-2011, 05:32 AM

I agree with the above.

Ellie has a nasty LP in one leg. Verrrry crunchy on palpation and it makes the cracking noise when she jumps (probably a grade 2ish). But physically it doesn't seem to bother her at all. She never limps or carries her leg. Neither of her vets recommended surgery. Keep her lean is pretty much all they care about and obvious "try" to limit jumping (ha). I think they can get arthritis either way.

If he is in pain, then yes, surgery. If you don't see any signs of pain, I'd ignore it. You can see an ortho which wouldn't be a bad idea, but I really think that's an individual decision in this type of case. It's not something I'd be spending money on.

Why were xrays done? Is he having joints problems? LP isn't something that needs to be xrayed unless you get to the surgical/specialist level.

QuickSilver · 10-04-2011, 06:10 AM

I got them done because Thor was in for dental surgery, and I figured it would be good to have a baseline x-ray just in case. I'm feeling kind of paranoid after the whole "tooth falls out due to severe periodontitis 2 months after a full checkup" thing.

Thanks for the advice. I will have Thor checked by an ortho once we get back to California. This is so complicated!

LDMomma · 10-06-2011, 05:08 AM

I have two dogs with grade 2 LP. My vet recommends holding off on surgery until they show signs of pain/lameness.

10-03-2011, 04:41 PM	#1
QuickSilver Thor's Human Donating Member Join Date: Nov 2008 Location: San Francisco, CA Posts: 5,929 Blog Entries: 31	Surgery for LP Grade 2?? I had Thor's hips and joints x-rayed today. The vet said he appears to be at LP grade 2, which is also what another vet said based on touching him while awake. So hearing grade 2 was not a surprise. What DID surprise me is that this vet said that she recommended sugery to prevent arthritis in the future, particularly since Thor is a high energy doggy. Have other YTers done surgery at LP 2? My impression was that people generally did not start thinking surgery until grade 3 or 4. Thor doesn't "kick" while he runs, or show any other signs of lameness. Do you think this is proactive? Or overkill? __________________ If you love something, set it free. Unless it's an angry tiger.

10-03-2011, 05:24 PM	#2
107barney T. Bumpkins & Co. Donating YT Member Join Date: Dec 2008 Location: New England Posts: 9,816	I would never let a regular vet determine if an LP warrants surgery. Generally speaking however, the grading of LPs is not a diagnostic scale -- it is a prognostic scale. So a grade 1 means dog wont need surgery, grade 2 means dog will most likely not need surgery but could, grade 3 means probably will need surgery but maybe not and grade 4 means most probably will need surgery. I have dogs with LPs. One of my dogs who is 11 has an LP that is a grade 4, the knee cap sits to the medial side of her body where it has been since she was a baby. The dog has never gone lame for longer than a couple of weeks at which time we have crate rested her with meds and she recovers. She's never been on a supplement and xrays show no arthritis. Her hips are a solid as a 2 year old's as well. So my feeling on this is that no reputable surgeon (diplomat of ACVS) would consider operating on LPs of dogs at that level. At least not for an adult dog who is showing no signs of clinical problems (it may be different for puppies). And just by way of example, I have met two ACVS vets in my time owning yorkies and neither one of them suggested surgery on grades 1s or 2s or said anything about arthritis if surgery was not done. If you are concerned, I'd see a ACVS vet and get an opinion, ask the vet to burn a copy of the xray to a disk for you. Until then, I'd put the general vet's opinion in the part of my brain labeled "dismiss" __________________ T. Bumpkins & Co. Washable Doggie Pee Pads (Save 10% Enter YTSAVE10 at checkout) Cathy, Teddy, Winston and Baby Clyde...RIP angels Barney and Daisy

10-03-2011, 07:50 PM	#3
kalina82 Phantom Queen Morrigan Donating Member Join Date: May 2006 Location: with my yorkie baby Posts: 10,141 Blog Entries: 1	In my opinion, if he shows no signs of pain or lameness, no matter what the grade be, I would not have surgery done. If I were concerned that the dog was in pain, then I would seek the opinion of a board certified orthopedic surgeon and have them take proper x-rays and evaluate the dog. A dog can need surgery at any grade if they are in pain. I would not use the number as a part in my decision for surgery. My yorkie has grade 3-4 LP in both legs. She's had this problem since she was a baby however she has never shown any outward signs of pain or lameness. I had her evaluated twice by the orthopedic surgeons I used to work for. Once at 6 months and then again at 4 years. We came to the decision that since she shows no signs of pain, lameness, or discomfort it is not worth it to put her through the pain of surgery. The benefits of surgery will not out weigh the negatives and in the end she will still end up with arthritis. The best things to do in my yorkies situation is to keep her at a healthy weight (and even slightly below it if necessary) and to build up the muscles in her rear legs by going for daily walks. A healthy weight will keep stress off of her joints, and good muscle mass will help strengthen her rear legs. Since she has bilateral LPs her rear legs are naturally leaner then her front legs. She over compensates with her front half. If she were a bigger dog this would cause a problem but since she is so small she should be fine the rest of her life by just being proactive and maintaining a healthy lifestyle. __________________ Kellie and Morgan

10-03-2011, 10:10 PM	#4
DvlshAngel985 Donating YT 2000 Club Member Join Date: May 2008 Location: Los Angeles, California, USA Posts: 12,693	I took Kaji to 3 vets when I found out about the LP. One wanted to rush to surgery. I was perplexed because I had yet to any reading on the subject, and Kaji showed no signs of discomfort. 2 years later, he still doesn't. My only responsibilities now are to monitor him and keep his weight down. Do what the others recommend, and have Thor seen by an orthopedic surgeon. __________________ Littlest JakJak We miss you Kaji

10-04-2011, 05:32 AM	#5
Ellie May And Rylee Finnegan Donating Member Join Date: Apr 2007 Location: Metro Detroit, MI Posts: 17,928	I agree with the above. Ellie has a nasty LP in one leg. Verrrry crunchy on palpation and it makes the cracking noise when she jumps (probably a grade 2ish). But physically it doesn't seem to bother her at all. She never limps or carries her leg. Neither of her vets recommended surgery. Keep her lean is pretty much all they care about and obvious "try" to limit jumping (ha). I think they can get arthritis either way. If he is in pain, then yes, surgery. If you don't see any signs of pain, I'd ignore it. You can see an ortho which wouldn't be a bad idea, but I really think that's an individual decision in this type of case. It's not something I'd be spending money on. Why were xrays done? Is he having joints problems? LP isn't something that needs to be xrayed unless you get to the surgical/specialist level. __________________ Crystal, Ellie May (RIP), Rylee Finnegan, and Gracie Boo🐶

10-04-2011, 06:10 AM	#6
QuickSilver Thor's Human Donating Member Join Date: Nov 2008 Location: San Francisco, CA Posts: 5,929 Blog Entries: 31	I got them done because Thor was in for dental surgery, and I figured it would be good to have a baseline x-ray just in case. I'm feeling kind of paranoid after the whole "tooth falls out due to severe periodontitis 2 months after a full checkup" thing. Thanks for the advice. I will have Thor checked by an ortho once we get back to California. This is so complicated! __________________ If you love something, set it free. Unless it's an angry tiger. Last edited by QuickSilver; 10-04-2011 at 06:11 AM.

10-06-2011, 05:08 AM	#7
LDMomma YT Addict Join Date: Dec 2010 Location: FL Posts: 410	I have two dogs with grade 2 LP. My vet recommends holding off on surgery until they show signs of pain/lameness.