Severe Grade 4 LP

[tripsplus6]

My little 12 wk old yorkie has a severe Grade 4 Luxating Patella. I noticed something seemed a bit wrong from when she first started to stand and get around while still in the whelping box.(we have both parents). Her left rear leg seemed to sort of buckle under her a bit when she walked. As she grew this continued and she would often hold it up at her food dish but never gave any indication of discomfort. I asked the vet to check it out when I brought her for her shots at 9 weeks and he felt she had LP and referred us to a board certified orthopedic surgeon vet. We saw him last week and he did exam and xrays. He said her case is very severe, tibia is twisted, no groove for patella, but hips are fine. He said that with a severe case like this, he always sees the other leg also having some degree of LP too, but hers is fine, as are both parents. He said this makes him feel that it is not hereditary but rather is due to her positon in the uterus that caused it to form like this.(litter of 2) He sees no evidence of her being in pain at all. She is tiny at 1lb 12oz but otherwise healthy and runs around and plays. The wobbly back leg is more evident when she walks but not when running, she runs well, doesnt hop. He said that with the severity of the LP, it would be an extremely complicated and expensive surgery ($5000+) with not a good chance of being successful. He felt that we should not do anything as long as she is functional and not in pain. And that if the time came that she has pain from it, then he felt that amputation might be a better alternative than trying to fix it and putting her through such a major procedure with the low chance of success. He will see her again in 6 mos when she is then 9 mos old, unless she shows problems sooner.
Has anyone heard of this happening in utero like this? and being so severe and her so tiny as to make correction not possible? We are in Ohio and wonder if we should get other opinions and where. Also he recommended a grain free diet for high protein, and the low carb would help reduce inflammation. He doesnt feel bone supplements help.

[chachi]

I would definitely get a 2nd opinion before doing anything so drastic as amputation but I can see why the vet would suggest it in a severe case where there is less success with surgery

[ladyjane]

I am flabbergasted. I have never heard of a vet suggesting amputation for LP. Sure she is tiny...she is very young. What I will say is that the cost probably would be between $3,000 and $4500 ... perhaps even $5,000; but I would spend that rather than amputate. If you amputate a leg that could be repaired and then later she suffers some catastrophic injury to another leg, then what? The surgeon I use will not amputate a limb that can be repaired!

While I suppose it is possible that it cannot be repaired, I would want to know that for a fact. I would be looking for a second opinion.

I use a surgeon in Houston who is phenomenal with problem cases like the one you have. If you think you might want his opinion, PM me and I will give you his name. Your vet could probably send her xrays to him and I am sure he would be happy to do a consultation. He has done some very extreme cases for YHR and they have all been very successful.

Are you planning on keeping this puppy?

[Lovetodream88]

I think I would most definitely get a second opinion. So sorry about your pup it sure sounds uncomfortable.

[tripsplus6]

LadyJane thanks for offering vet name, I PM'd you. This puppy has been promised to our adult daughter and her husband all along and they are so in love with her. They llive in town and we have gradually transitioned as she weaned, with visits, sleepovers, and then weekends. Now that baby Nellie is 12 wks and almost 2 lbs, she is pretty much at our daughter's full time. I dont know if they can get pet insurance for this surgery since it is pre-existing. Since the ortho vet doesnt think it is fixable, I told her we are happy to keep her (we love her too of course), but they are attached and in love with her and want her no matter what. I will just start saving up to cover the costs for them whatever procedures need to be done.

[ladyjane]

That's awesome that she is so loved by all of you!!! Please keep us posted on her! Would love to follow her progress. I do hope there is a way to repair her leg. Such a shame you probably cannot get insurance for that. I would encourage her to get it anyway...you never know what can happen in the future.

[ladyjane]

You also could apply for Care Credit. Most places accept it and many offer a certain amount of time with no interest.

CareCredit Healthcare Finance - Payment Plans and Financing for Cosmetic Surgery, Dental, Vision, Hearing, Veterinary & Other Medical Procedures

[DJDB]

I think it is possible for the pup to have a severe case but not be in discomfort. My cat had really bad LP in both legs (with deformed hip sockets). I had one leg operated on because it was causing her pain. By 7 months old she could not stand up and started meowing really loud so I took her to emergency right away. The one leg healed nicely and I never took her in for the other leg because although it was wobbly, she was never in pain and jumped and ran just like any other cat. I definitely would not put her through ANY surgery unless it was necessary.

I would also get a second opinion on the amputation thing. While I don't think it's necessarily the worst thing in the world, because animals seem to do fine with a lost limb, I would make sure it was the BEST solution if the time came for surgery.