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Old 03-05-2014, 10:18 AM   #1
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Animal Smiley 036 Luxating Patella (bad knees)

Hello All,
We got out first Yorkie a few months ago. She is a wonderful 5.2lb bundle of joy. This little Yorkie has touched our lives in such a positive way with all her little kisses and love. She is about 9 months old now and our vet has diagnosed her as have luxating patella in both back knees with one being worse than the other. Our vet has recommended a type of surgery where they deepen the groove where the kneecap sits.

My concern is with the diagnoses itself. Our Yorkie has no signs of any problems with her knees until the vet does the exam to test for it which seems to cause our Yorkie a lot of pain. And the vet suggest that we do this surgery soon to prevent arthritis from forming. I will definitely get a second opinion before doing anything. But before I let another vet examine our precious puppy, I wanted to see what the normal procedure is for determining problems with knees in Yorkies really is. It is normal for a vet to pop the knee out of joint in order to test for luxating patella? I'm not sure if this is what the vet is doing but some part of the exam is causing pain. And before I let another vet do this, I just want to see what some more experienced Yorkie owners have to say.

Has anyone has this problem before? What did you do?

Thanks
Lisa
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Old 03-05-2014, 10:38 AM   #2
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Originally Posted by Lisasyorkie View Post
Hello All,
We got out first Yorkie a few months ago. She is a wonderful 5.2lb bundle of joy. This little Yorkie has touched our lives in such a positive way with all her little kisses and love. She is about 9 months old now and our vet has diagnosed her as have luxating patella in both back knees with one being worse than the other. Our vet has recommended a type of surgery where they deepen the groove where the kneecap sits.

My concern is with the diagnoses itself. Our Yorkie has no signs of any problems with her knees until the vet does the exam to test for it which seems to cause our Yorkie a lot of pain. And the vet suggest that we do this surgery soon to prevent arthritis from forming. I will definitely get a second opinion before doing anything. But before I let another vet examine our precious puppy, I wanted to see what the normal procedure is for determining problems with knees in Yorkies really is. It is normal for a vet to pop the knee out of joint in order to test for luxating patella? I'm not sure if this is what the vet is doing but some part of the exam is causing pain. And before I let another vet do this, I just want to see what some more experienced Yorkie owners have to say.

Has anyone has this problem before? What did you do?

Thanks
Lisa
Wow, my Bella is going through this very same thing right now. In Bella's case, it is much more extreme, and it's obvious that she is not using her bad leg a lot of the time.

Yes, I'm afraid that the vet does have to feel the kneecap and see how much it moves in and out of the groove. It can seem shocking, and yes, the action of popping the knee in and out of the groove can definitely cause pain and discomfort. In your case, if you're not seeing any other signs of discomfort, like hopping, skipping, or holding one leg off the ground as the dog walks on the other three legs, a second opinion is definitely indicated. Is your vet also the surgeon, and if so, does he or she have lots of experience performing this type of surgery and/or is he or she board certified? If not, get your second opinion from someone who is highly experienced, and preferably board certified. It would be tragic to have surgery done if there is a misdiagnosis, or if the luxating patella is mild enough that it can be treated with anti-inflammatories and rest. Good luck, and keep us posted on what happens!
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Old 03-05-2014, 10:44 AM   #3
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To follow up a little more, Bella was diagnosed with stage 4 luxating patella in one leg--that's the most severe rating, and means that the knee cap is out of place more often than it is in place. If it is stage 4, there is a greater chance of muscle atrophy from the dog not using the affected leg, and arthritis can develop within months. Both muscle atrophy and arthritis can reduce the success rate of the surgery, so if the luxating patella is severe, it's best to have surgery sooner rather than later. Bella was caught early, and does not have those problems yet. Bella will be having surgery in two weeks.
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Old 03-05-2014, 11:11 AM   #4
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Thanks for replying pstinard. I hope everything goes well with Bella's surgery. I wish these little sweeties didn't have these problems. I just hate that they have to go through it even though it may be harder on us as owners than it is on them.

I've been searching youtube for videos of yorkies with luxating patella problems. I want to see what they look like when they walk and run. I found this one posted by a vet. It has good info but the best thing about it is that he says that they have huge success rates with the surgery.

Here's the link:
I'll keep updating about Annie (our yorkie). And let us know about Bella too.
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Old 03-05-2014, 11:27 AM   #5
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Welcome to YT. I haven't had any experience in LP but I do know that it seems to be a common problem within our breed.

You said your puppy is 9 months old. How did you get your puppy?? If you bought it from a breeder, did you get a health guarantee with your puppy?? If so, does it cover genetic defects, including LP?? Some breeders specifically write LP and Hips out of the health guarantees.
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Old 03-05-2014, 11:49 AM   #6
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Yes Annie is AKC registered and the breeder gave us a genetic warranty that does not exclude hip and joint problems. The warranty is for 1 year but it says that we have to return our pet and another healthy pet would be provided. We are just too attached to do that. But I suppose I should at least let the breeder know.
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Old 03-05-2014, 12:14 PM   #7
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I think it's a long shot....but maybe the breeder would be willing to work with you and help you with the vet bills. I hate it when the only option they give you is to return your pet. They know and they are betting on the fact that you'll get so attached to your puppy that you won't be able to return it and you'll ultimately be the one stuck with the financial responsibility of fixing the pup. I can't tell you how many times I've seen people come on here in similar situations.

If the breeder isn't willing to help pay to get your pup fixed while it's in your care, it makes you wonder what they'd do with the pup if you returned it. Would they put it to sleep...would they just sell it to another unsuspecting customer without paying to fix it...would they give it to a rescue and expect the rescue to fork over the $$??

I know everyone reads the contracts before they sign them, but nobody thinks that their healthy puppy is going to be sick. I guess I could understand seeing the replacement being necessary for a "life threatening" illness....like the dog has encephalitis or something like that....but LP is not. It's just EXPENSIVE to fix and the breeder doesn't want to have to shell out thousands on a puppy.

When I see contracts like that, it makes me wonder how sound their lines are. If they weren't worried about having to pay for problems like LP all of the time, they'd just say the vet bills were covered up to a year.
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Old 03-05-2014, 12:21 PM   #8
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Yes Annie is AKC registered and the breeder gave us a genetic warranty that does not exclude hip and joint problems. The warranty is for 1 year but it says that we have to return our pet and another healthy pet would be provided. We are just too attached to do that. But I suppose I should at least let the breeder know.
Thanks for posting the video--it was very informative! My Bella had a 30 day warranty, and she was perfectly healthy during that time. We've had Bella for one year, and I wouldn't return her, even if I had a one year health warranty, so I'm with you on that. It would be good to let the breeder know--that way, they can try to figure out which parents to keep out of their breeding stock in order to prevent this from happening in the future.
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Old 03-05-2014, 01:46 PM   #9
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We just had a vet visit, a general check up as we are in a new year and I was shocked to have the vet say she had LP in her back left leg. I have never seen any signs (we had a previous issue where she must've stepped on a thorn and my first thought was LP, we took her to the vet at that time to have her checked out and she was good and it was a different paw then the leg the vet is specifying here) She also said with a thoughtful murmur, "hmm..I'd say stage two...yeah. I mean I wouldn't go surgical at this point) and that was that. I was so disappointed and surprised. She showed no discomfort during the exam and I have never seen signs or symptoms at home. The vet (a very nice lady) was so lax about it I just felt like I should get a second opinion. She is just over a year old. What a timely moment to see this post. I will be following it closely.
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Old 03-05-2014, 03:27 PM   #10
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Buster has LP in both his back knees. I first noticed when he would stop walking and extend his leg out in pain. He was diagnosed with grade 3/4 LP. I took him to 2 Vets and an Orthopedic Vet before I decided to get the surgery. The Orthopedic Vet recommended we only do the left leg that was causing him the most problems and do the other leg when it was necessary. That was almost 3 years ago and we have not needed the surgery on the other leg (knock on wood) Even after the surgery sometimes Busters left leg will cause him issues. I recommend getting a second opinion from a board certified Orthopedic Vet. Many cases of LP can be managed. It is important to restrict them from activities that may cause wear and tear on the knees. Avoid letting them jump on/off furniture (impact pressure on knees), running around corners on wood floors (sideways pressure on knees) and keep their weight down. Best wishes.
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Old 03-05-2014, 03:35 PM   #11
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Yes, it is very shocking to see the vet manipulate the patella, but that is how it is evaluated.

If I were you, I would get a second opinion from a board certified ortho vet. In my pup's case, she was diagnosed a little over a year ago as having stage 4 LP in both knees. I could see that she DID have LP, but I dismissed the grade because, like you, I had never seen her hop, limp, or carry either of her legs.

A couple of months later she did start to limp and carry, so I took her to the board certified ortho vet. He examined her and his diagnosis was that she was limping because she tore her CCL. He said that she had grade 2 in both knees, NOT grade IV that was diagnosed by the regular vet. She had surgery a few days later for the CCL tear and they also fixed the LP on that knee at the same time. However -- he never would have done the surgery to correct a grade 2 LP if that had been the only problem, but fixing the LP did make sense because they were going into the knee anyway. He recommended doing nothing on the other knee since it wasn't giving her any problems.

Since you've never noticed any problems, I would be shocked if an ortho vet would recommend surgery. I've seen several here that had a pup with LP for which their regular vet wanted to do surgery, but when they saw the ortho vet they were told it was not needed.

A visit to the ortho vet would let you know exactly what you were dealing with, the grade of the LP, etc. and since you are seeing no problems hearing from an expert that surgery isn't warranted at this time it will give you peace of mind.

Another thing about my regular vet that originally diagnosed my pup with grade 4: A couple of weeks ago I dropped both of my pups off at the vet for grooming and their yearly exam. This time she diagnosed my other pup with grade 4 LP that could not be popped back into place. WTH? I dropped off a dog with two perfectly functioning legs and picked up a dog that was still moving around just fine, full of energy and his usual bouncy self. That boy has never shown any problems, either, and the year before she said that she could just barely nudge one patella and the other was perfect. She was already gone for the day so I couldn't talk to her about it. All I had was a stupid print out with a diagnosis and surgery recommendation that upset me even though I really didn't agree with it.

I brought him home and felt both of his back legs up and down and could not tell ANY difference in the structure, all of the grooves and bumps and shape was exactly the same on both legs. I was going to bring him to the ortho vet but since there were no symptoms I decided to wait a bit. Two days later it was a Saturday when the vet practice takes walk-ins without an appointment so I thought why not take him back in just to talk to a vet and tell them I wanted to discuss what was given to me on that print-out. This time he saw a different vet. I showed him the print-out with the diagnosis and surgery recommendation, and told him I'm no expert but I can't tell any difference between the two knees and have never observed any problems.

Guess what his exam showed? Barely grade 1 in one knee and the other knee was perfect. That vet took him into the back to let vet #3 examine him and did not tell vet #3 the back story just to get an unbiased opinion, and that vet said the same thing. Needless to say I will not be back to vet #1, but if we have to see her I will not trust anything she has to say about LP!

I have a strong feeling that a visit with a specialist would really ease your mind.
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Old 03-05-2014, 04:00 PM   #12
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Originally Posted by OwnedByJezebel View Post
Yes, it is very shocking to see the vet manipulate the patella, but that is how it is evaluated.

If I were you, I would get a second opinion from a board certified ortho vet. In my pup's case, she was diagnosed a little over a year ago as having stage 4 LP in both knees. I could see that she DID have LP, but I dismissed the grade because, like you, I had never seen her hop, limp, or carry either of her legs.

A couple of months later she did start to limp and carry, so I took her to the board certified ortho vet. He examined her and his diagnosis was that she was limping because she tore her CCL. He said that she had grade 2 in both knees, NOT grade IV that was diagnosed by the regular vet. She had surgery a few days later for the CCL tear and they also fixed the LP on that knee at the same time. However -- he never would have done the surgery to correct a grade 2 LP if that had been the only problem, but fixing the LP did make sense because they were going into the knee anyway. He recommended doing nothing on the other knee since it wasn't giving her any problems.

Since you've never noticed any problems, I would be shocked if an ortho vet would recommend surgery. I've seen several here that had a pup with LP for which their regular vet wanted to do surgery, but when they saw the ortho vet they were told it was not needed.

A visit to the ortho vet would let you know exactly what you were dealing with, the grade of the LP, etc. and since you are seeing no problems hearing from an expert that surgery isn't warranted at this time it will give you peace of mind.

Another thing about my regular vet that originally diagnosed my pup with grade 4: A couple of weeks ago I dropped both of my pups off at the vet for grooming and their yearly exam. This time she diagnosed my other pup with grade 4 LP that could not be popped back into place. WTH? I dropped off a dog with two perfectly functioning legs and picked up a dog that was still moving around just fine, full of energy and his usual bouncy self. That boy has never shown any problems, either, and the year before she said that she could just barely nudge one patella and the other was perfect. She was already gone for the day so I couldn't talk to her about it. All I had was a stupid print out with a diagnosis and surgery recommendation that upset me even though I really didn't agree with it.

I brought him home and felt both of his back legs up and down and could not tell ANY difference in the structure, all of the grooves and bumps and shape was exactly the same on both legs. I was going to bring him to the ortho vet but since there were no symptoms I decided to wait a bit. Two days later it was a Saturday when the vet practice takes walk-ins without an appointment so I thought why not take him back in just to talk to a vet and tell them I wanted to discuss what was given to me on that print-out. This time he saw a different vet. I showed him the print-out with the diagnosis and surgery recommendation, and told him I'm no expert but I can't tell any difference between the two knees and have never observed any problems.

Guess what his exam showed? Barely grade 1 in one knee and the other knee was perfect. That vet took him into the back to let vet #3 examine him and did not tell vet #3 the back story just to get an unbiased opinion, and that vet said the same thing. Needless to say I will not be back to vet #1, but if we have to see her I will not trust anything she has to say about LP!

I have a strong feeling that a visit with a specialist would really ease your mind.
Thanks for all the info. This is what I'm afraid of...that our vet might be totally wrong. We have an appt with another vet. But it's not for 3 weeks. I might have to get her looked at before then just to save my own sanity and not have to wait 3 long weeks. I just hate that the exam causes her pain and question if that's really necessary.
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Old 03-05-2014, 04:13 PM   #13
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Originally Posted by Lilah Charm View Post
We just had a vet visit, a general check up as we are in a new year and I was shocked to have the vet say she had LP in her back left leg. I have never seen any signs (we had a previous issue where she must've stepped on a thorn and my first thought was LP, we took her to the vet at that time to have her checked out and she was good and it was a different paw then the leg the vet is specifying here) She also said with a thoughtful murmur, "hmm..I'd say stage two...yeah. I mean I wouldn't go surgical at this point) and that was that. I was so disappointed and surprised. She showed no discomfort during the exam and I have never seen signs or symptoms at home. The vet (a very nice lady) was so lax about it I just felt like I should get a second opinion. She is just over a year old. What a timely moment to see this post. I will be following it closely.
We were at the vet to get treated for loose stool when we were told Annie needs surgery. It sure is stressful worrying about these little babies.
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Old 03-05-2014, 04:17 PM   #14
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Buster has LP in both his back knees. I first noticed when he would stop walking and extend his leg out in pain. He was diagnosed with grade 3/4 LP. I took him to 2 Vets and an Orthopedic Vet before I decided to get the surgery. The Orthopedic Vet recommended we only do the left leg that was causing him the most problems and do the other leg when it was necessary. That was almost 3 years ago and we have not needed the surgery on the other leg (knock on wood) Even after the surgery sometimes Busters left leg will cause him issues. I recommend getting a second opinion from a board certified Orthopedic Vet. Many cases of LP can be managed. It is important to restrict them from activities that may cause wear and tear on the knees. Avoid letting them jump on/off furniture (impact pressure on knees), running around corners on wood floors (sideways pressure on knees) and keep their weight down. Best wishes.
Thanks. We've been letting Annie dash through the yard at lightening speed. And she will leap off the furniture if we aren't careful. So we'll keep a check on all that now.
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Old 03-05-2014, 05:14 PM   #15
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My little Gizmo is 9 months as well and was diagnosed at around 6 months of grade 1 in one of his back legs. He would occasionally jump off the couch and yelp, I would massage his leg for a couple seconds and off he would go to play. My vet told me to wait to do anything because he could grow out of it as he got older. This was just 3 months ago, and I have seen a vast improvement as he's had no episodes in over a month. I give him extra omegas and a glucosamine supplement once a day and it seems the vet might have been right, as Gizmo is doing amazing. :-) I would definitely get a second opinion, especially if your pup is not even showing any signs of LP.
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