[katy-yorkie]

Originally Posted by Ladymom

From what you describe, his quality of life has been affected.

Grade 4: The patella is not only out of place all the time but cannot even be manipulated back into place by hand. Such a dog has extreme difficulty extending his knees and walks with his knees bent virtually all the time.

It is not a good thing to have one’s knee cap out of place; the entire weight-bearing stress of the rear leg is altered which, in time, leads to changes in the hips, long bones, and ultimately arthritis. How severe the changes are depend on how severe the luxation is (i.e. the grade as described above) and how long that degree of luxation has been going on. In time, the legs will actually turn outward with its muscles turning inward, making the dog “bow-legged.” The luxation is not considered a painful condition but after enough time and conformational change, arthritis sets in, which is indeed painful.

Medial Luxating Patella

I would ask your vet for a referral to a board certified orthopedic vet.

Then it's time, Buster is "bow-legged".