Luxating Patellas AND Medial Shoulder Instability
 

Hello all, it has been years since I posted her. My Beanie, the love of my life, my first dog is now almost 12 years old. I cannot believe it! When I first got her, I got so much help here, coping with this little creature. She was, and still is, a total handful, but now I understand her and me dealing with her, more.

I am hoping to get some advice, insight into what I am now struggling with. Beanie has luxating patella, supposedly Grade 4 in the right leg and Grade 3 in the left leg. She also had/has a medial shoulder instability injury on her left right front leg. I was told by my vet that she needed surgery for this, but I opted not to and rehabbed her using aquatic therapy, physical therapy and laser therapy. It took almost 7 months, but she got better and we were back to our walking.

I have had multiple physical problems, including hip replacement last January and comminuted, displaced fracture of my left patella, this January. That happened walking Beanie! I feel, and well smashed my knee up. Couldn't walk for 2 months, which meant she didn't walk much either.

Have started walking again, but she is limping in various degrees. I can't even figure out which leg is making her limp. My vet has told me multiple times that she needs her Grade 4 luxating patella fixed over the years, but I have resisted and, again used non invasive treatments like swimming, etc. She has been fine with all of the above until now.

All her x-rays show minimal arthritis, so that is good. But, well, she is limping. She is also holding up her left leg more, so I know that the medial shoulder instability is rearing it's head again. I went to a wonderful surgeon 2 years ago, who said to keep doing the conservative treatment, swimming, etc., which I did and as I said, she got better. That surgeon has moved to Texas. Noooooooo. LOL.

I did try underwater treadmill last year for the luxating patellas (before I fell), but I don't think it really helped her like the actual swimming did (that was a different therapist). NOW, she is exhibiting problems with the patellas and the shoulder. She is fine in the house, no limping, running around playing, but when we go out to walk, everything manifests.

Sorry for this long post! I am struggling with guilt in that maybe I should have done the patella surgery years ago, but she was fine and we walked for hours. I don't know if I should consider the patella surgery and/or the medial shoulder instability surgery. My inclination is to try the swimming again and maybe acupuncture and chiropractic. I just want to do the right thing and I don't know what that is!!!

Anyway, any advice, help, your own experiences with any of this would be really appreciated and helpful.

Only a boarded ortho surgeon could really advise you; but, that said, I will tell you that is she were mine I would have done the shoulder. That is something that to my knowledge can only be surgically repaired. I had a pup who had it and had surgery.

As for LP I have never had an adult pup have surgery for that. Only for a torn CCL. At this age, her CCL is already worn and you could repair the LP to end up having a torn ligament later on. More money for you and surgery for her..not fun.

Good luck!

BTW, I don't know what vet told you over the years to repair LP. That really is not commonly done on adult dogs....or recommended.

Perhaps this article will be of interest to you.

https://www.vin.com/apputil/content/...5&objTypeID=17

Thanks LadyJane! Very good info. I am going to seek the opinion of an orthopedic surgeon. Unfortunately, the one I saw previously for her shoulder issue is now in Texas. She told me that Beanie didn't need surgery at that time because her shoulder was stabilized and the conservative treatment/management was working. She did say that Beanie might need surgery later on.

I am going to do some research and see if I can find another ortho surgeon.

Thanks again for your help.

The specialist who wrote that article is the one I use for all of my orthopedic pups. He is the best! He is in Texas, too. He does have a place in Maryland but I guess that is not close to you either. If you look on www.acvs.org you can find one in your area.

Please update as you know more!

I can tell you this is good information about the LP surgery because I didn't listen and got LP surgery on my now passed girl as an older adult and then like a year later the CCL tore so another surgery was necessary.

I did the search and it brought up the Mass. Veterinary Referral Hospital in Woburn, MA. The 2 surgeons that popped up were the 2 that I was actually looking at prior to doing the ACVS search. Beanie has spent a lot of time at that hospital due to her hemorrhagic gastroenteritis/IBD and many other things that have happened to her over the last 12 years. They actually know us very well there. I have had mostly, excellent experiences bringing her into emergency there and also seeing other doctors via regular appointments. Plus, they are only 2 miles away from me.

I am going to go with Karen F. Pastor, DVM, DACVS, she is an orthopedic/soft tissue surgeon and she finished her schooling, internship, etc. in 1996 so she has a lot of experience. Unless my own vet has another recommendation (aside from the woman who moved to Texas), I will schedule an apt. with Dr. Pastor and see what she has to say.

To anyone who is reading this thread: GET PET INSURANCE!! It is totally worth the money and I don't know what I would have done all these years if I didn't have it.

Thank you for your input, I certainly don't want to go through what you had to!!

I was stubborn and hard headed like my mama lol. Callie was who went through all that and she taught me pet insurance is a must. My mom referred to Callie as the dog of gold, she went through so much and that’s what made me so angry and outspoken on bad breeding/ puppy mills because they are the reason she had so many gentian issues. I have 2 out of my four now with LP both my two youngest Ollie’s is not bad at all but he is so active I fear he might tear his CCL one day and then Dixie and hers is horrible but it doesn’t seem to bother her at all and my Vet has seen many live perfectly fine lives without issues so we are hopping for that but do have the pet insurance if it doesn’t happen.

Awesome...sounds like a great plan! That's great that you have a relationship with them and they are so close! Please keep us posted!!

As to your last paragraph AMEN. I spent SO much money on my pups over the years. I finally got smart and the pups I have now are all insured! Best thing I ever did!

That is very heartening to hear that your Dixie has bad LP and is doing fine. Beanie actually has been fine with hers up until now and this all started happening after I fell and broke my knee and we didn't walk for 2 months. All the gains I made on her legs with the years of swimming, PT and laser therapy kind of went out the window. I know that it is really important to keep the dogs moving, especially when they are older, but I really don't have anyone that I trust enough to walk her where I live. A couple of people did walk her, but just around the building and these people are older than me and she really could have just pulled them down. I did the best I could trying to throw her balls around my very tiny apartment to get her SOME exercise, but I was really limited in what I could actually do because I had to stick to a very strict protocol for my knee to heal without surgery.

I am trying to ease us back into walking, doing very short walks as I am still healing. But I can see how much she is laboring and I am pretty sure it is the shoulder that is doing it because she is holding the paw up more and more when we get home. I am going to take her back to my vet next week and get a referral to the ortho surgeon that I decided on. I just want her to be totally honest with me about prognosis of surgery and how that will affect her other legs while she would be recovering.

The bottom line is, I don't have enough information to make any decisions and I really appreciate hearing from people her who have gone through these types of situations.

I have no direct experience with the surgery but have gotten lots of former mill dogs with all kinds of joint issues ... My vet advised to allows absolutely no jumping or stairs for small breeds- we installed ramps everywhere ... and I have put those seniors that are not good candidates for surgery in joint support wraps ( available online for the knees - they help stabilize the knees and ease the pain just like in humans ) - a harness that can help lift the dog over obstacles or get weight off the joints is also nice.

While braces can be a possibility, they also can be problematic in that they are awkward and can cause sores.

With any issue like that, I always recommend having a boarded surgeon take a look. Some seniors can be candidates for surgical repairs for torn ligaments, some not.

Ramps are awesome IF they will use them. LOL these little terriers can often have minds of their own.

I actually have a ramp so she can get on and off my bed, BUT she has recently decided she won't go up the ramp, so I have to pick her up. I don't know if going up the ramp bothers her legs, or if she has just decided that this is something she now won't do. It drives me crazy when I see another woman who lives in my building let her giant Yorkie jump on and off everything. He has a bad knee too. I have never let Beanie jump, except for the times that she managed to do it before I could stop her. This dog is one stubborn animal! I actually tried a hobble brace when she first injured her shoulder a couple of years ago, but it didn't really fit right. That being said, even if it did fit, she wouldn't have tolerated it. She just stood there for 1/2 hour with this terrified look on her face and would not move. There is a company that makes custom braces for dogs and that is something I am going to explore.

I have apt. with ortho surgeon on 6/6 but I may be able to get a much sooner one with the ortho surgeon at the place where she does the aquatic therapy. Beanie's PT person is going to talk to this doctor to see if she will do the PRP (Platelet Rich Plasma) injections to her. This doctor has done that with other dogs with great results.

So, at least I feel like I do have some kind of plan now to get as much information as possible to try and help her. Some days she is actually really good and doesn't limp at all, but other days she limps more. SO frustrating!!