Patellar Luxation - Surgery?
 

Hello,

My 2.5-year-old Yorkie, Blake, jumped off the bed onto the hardwood floor (which she often does) today, then started limping and holding her leg stiffly away from her body. I thought she'd broken her leg, and took her to the animal hospital. It turns out that she has patellar luxation, a congenital problem in Yorkies where the kneecap dislocates.

The emergency vet recommended surgery right away (apparently she has Grade III patellar luxation). I'm going in to get a second opinion from Blake's regular vet tomorrow, but a few friends have told me that their small dogs had the same thing and it didn't require surgery. Have you gone through this with your dog, and if so, did you decide to do the surgery or not?

Thanks!

Many small dogs do well without surgery- some do end up needing surgery and can go on to live very active lives after. I have one yorkie who has LP now and does not require surgery, however, I grew up with a poodle who did require the surgery and she was fine after the surgery.

I would suggest you skip the regular vet and get a second opinion from a board certified orthopedic surgeon- they will be best suited to tell you whether surgery is necessary or not and if they do recommend surgery they will be the best person to do it.

Good Luck!

EDIT: I just noticed you are in NYC, Animal Medical Center at 62nd and York is a great facility and has board certified orthopedic surgeons- all the specialists I use are there.

Hi! I'm sorry that Blake is going through this.

Gilmore had surgery for this the Friday after Thanksgiving. He was a happy healthy 11 month old puppy running and playing before that and never had a problem. He was running and then next thing we know is he was screaming in pain and holding his leg up. He recovered but when it happened again the next day we went to the vet. She put him on anti inflammatory medicine and 10 days of crate rest. On Thanksgiving it happened again 4 times and he was crying and crying. We took him to the hospital and he had surgery the next day. We had no choice as he was in constant pain.

The recovery is intense. He is on 12 weeks of crate rest. We have survived the first two and a half and it has been tough. He is doing great and was able pretty much right away to use the leg. We were amazed.

Please don't hesitate to ask any more questions. I live in Long Island. We are neighbors.

ArmaniMan, thanks for the advice. I used to bring Blake to the Animal Medical Center, but switched to Greenwich Village Animal Hospital when I read the barrage of bad reviews about the AMC on Yelp. I never experienced anything negative there, but didn't want to take any chances. For her emergency care today, I brought her to VERG in Cobble Hill and had a very good experience.

Oh, I'm so sorry to hear that this happened to poor Gilmore. It sounds like his pain was excruciating! Blake didn't show any indications of pain at all--she was just limping and sitting around sadly. The vet did say it's a Grade III (Gilmore's sounds like a Grade IV), so I'm seriously considering the surgery, but since it's only happened once I don't want to just rush out and make her undergo this if she doesn't absolutely have to. On the other hand, I don't love the idea of just waiting around to see if it happens to her again...

I know a lot of people who have dogs with this and they lead happy healthy lives without having the surgery. You should ask about having Blake take a joint supplement. I was nervous after the first time it happened worrying that it would happen again. I don't know what I would have done if it had stopped after the first crate rest ordered by the vet. It's not an easy decision to make. For us I guess it was made easier because we had no choice.

My Lulu was just diagnosed with Grade 3 luxating patella. I got a second opinion as well. For now we are trying 2 weeks of crate rest with Metacam. We are also doing Glucosamine & Omega 3 supplements. Vet said those are good for every dog, especially those with joint problems. We have an appointment this Friday for our 2 week follow up evaluation. I am a nervous wreck. I am pretty sure that we will end up having to do surgery for Lulu. Fortunately, my new vet has a great relationship with a board certified surgeon with whom we have been discussing our situation. So I feel that Lulu will receive the best care. (But that doesn't make me feel any less worried)

I would definitely inquire about the Glucosamine & Omega 3 supplements. Good luck with your decision. I know exactly what you are going through & I know there are many her at YT who can relate as well.

Shelby had this surgery.... I do recommend going to an orthopedic vet.... they have experience and do this surgury often..... we were very pleased with Shelby's recovery.

My Pixie had the surgery in May. She walked off the bed and the next day couldn't stand on her leg. She would keep falling over. I took her to the er and they said LP. I took her back later that night for xrays and they confirmed grade 3 LP and said she needed surgery. Took her to my regular vet and she agreed and referred me to a board certified surgeon who said surgery. Pixie's knee would not stay in the socket at all so I did have the surgery. She did fine but I would only do it as a last resort. My Cali has grade 4 Lp in both knees and is doing fine at 5 1/2 years old with out surgery. I would get a second opinion from a board certified surgeon. Hopefully rest will do the trick.

Thanks so much, everyone! I have appointments with two surgeons on Tuesday. I'm keeping my fingers crossed that we can go without surgery.

My yorkie, Libby, jumped off a table...which she shouldn't have been on in the first place, and ended up with LP, grade 2. My vet said to keep her skinny and give her glucosamine complex and she should be fine. For about the first couple of weeks, she would have bouts of pain and hold up her leg, but then she improved and hasn't had a problem since. I give her Flexicose, which is a liquid glucosamine complex. I hope Blake doesn't have to have surgery.

I wanted to share my experience with Luxating Patellas with you.

My Daisy, a puppy mill dog, was diagnosed with TWO Grade Four luxating patellas when she was just 8 weeks old. She did fine without surgery, until she was just 2 years old and then went lame. We crate rested her for 2 weeks with medication but she still could not walk and she therefore was a candidate for surgery. The other leg never had surgery and although we've had to crate rest her with medication a couple of times over her life, she never became a candidate for surgery because our surgeon would not operate unless the dog was lame. Daisy is now 10 and she runs around like a 2 year old and the knees are good, despite her horrible breeding.

I also wanted to add - Daisy's surgery was performed by a board certified veterinary surgeon who had performed many of these surgeries.

Lastly, I do not use supplementation in this dog - many will use glucosamine with chondroitin (a product called Cosquin) but it has never been recommended by our vets for our dog.

Good luck!

I have pups with varying degrees of LP and none have required surgery. One of my fosters had a problem after jumping off of furniture one day and took anti inflammatories for a week and is now fine!

I use a board certified surgeon and he has not recommended surgery on any of them. My regular vet also does not recommend surgery on these knees unless absolutely necessary. If the knees are not causing discomfort and difficulty walking they both advise leaving them alone.

It is important to keep their weight down and also to prevent a lot of jumping on and off of furniture. Get some steps or a ramp and teach Blake to use them!

Good luck and let us know how things go with the surgeon!

Just wanted to wish you luck with your next appt. Lulu goes friday for her re-evaluation. *keeping fingers crossed*

Update
 

First of all, thanks to everyone who responded. It really helped to hear about others' experiences with their dogs, and what their decisions were!

I met with the board-certified surgeon at Blake's regular vet's office, and he said that he feels surgery should always be the last option. Since this is the first time it's ever happened to Blake, and since she appears to be responding well to the pain medication (straightening her leg, putting weight on it, etc.) he'd like to just keep her rested for a few weeks. He said that even if this were to happen once a year, it wouldn't necessarily indicate surgery--he feels that should only happen in cases where the kneecap just won't stay in place.

Feeling much better, we then brought her to another surgeon (recommended by my brother's girlfriend) just to get another opinion. The second surgeon said basically the same thing.

So I guess I've learned two things from this: (1) don't assume that surgery is immediately necessary when a vet at an emergency care facility recommends it; and (2) don't let the dog jump on and off furniture!

Thanks again, everyone! For those of you who did have the surgery, please post updates on how your little ones are doing!

Just wanted to check and see how Gilmore is doing... my Riley had surgery back in Sept. from a hip fracture and had to be crated/confined for 8 weeks (he was 11 months at the time of his injury). We have a puppy pen that we kept him in and also kept him leashed to the coffee table whenever we were right there with him so that he had a bit of a break from the pen. It's definately challenging when you have a young dog at that age and you have to confine it for weeks on end. He became a huge lap dog during this period and that is still his favorite place to be. We have another Yorkie which made it doubly challenging as Riley wanted to go play so badly, but couldn't :( I could/can always gage how he's feeling by how much he wants to play with Coco. He still takes Metacam periodically as needed and we now refer to him as our "special needs" puppy. This was his second fracture, second surgery and second time he's had to be confined for weeks on end...

Thanks for asking about Gilmore! He seems to feel great and the hard part is keeping him confined. I am forced to keep him in a small crate otherwise he will run back and forth and stand up constantly on his hind legs. Taking him out to potty in the snow was nuts because all he wanted to do was jump in it and even keeping him on a very short leash he still managed to do a little. We are ending week 6 of confinement and have 6 more as they want us to do a total of 12. He is kept on a leash all day unless he is in the crate. He cries and whines a lot unless he is on my lap or right next to me. We are in a routine but I wind up putting my chores and stuff on hold so I can keep him company. It has been tough as I am sure you well know. We are allowed to take 3 ten minute walks a day which he loves and fights because he never wants to come back into the house and I of course don't blame him. He was such a nutty life loving puppy and his world has changed in the last 6 weeks. I am just hoping he will be able to resume life as usual at the end of his confinement. Of course I will be a nervous wreck LOL. Poor Riley! I hope he is doing well. I can't imagine 2 surgeries. I would do whatever it takes for Gilmore as well but when his confinement is over I am going to throw us both a big party!!!!!!

I am glad to hear Gilmore is doing well. I can't believe you have 12 weeks of crate rest!!! We only have 6 & honestly, the surgeon said after 2 we can let her stay in a small level room (like bathroom) IF she isn't too hyper and active....I said, yeah right, she'll have to be crated to not be too active! LOL!

We are on day 9 of recovery today & she is doing so well that I can hardly believe it. The first 5-6 days she was much more laid back & very cautious when out to potty. She pretty much wanted to just lay in our lap & get petted and loved. Then like magic on day 7 she seemed like her old self & it has been difficult ever since to restrain her while on our potty breaks. She found her ball we play with outside & rared up on it...scared me to death! She's tried to run several times even on a very short leash. I am just praying I am doing enough to keep her from hurting her repair.

Lulu is so cute. I am so glad she is doing well. How is her appetite? I think Gilmore has gained weight since his confinement. I so wish we only had to do 6 weeks. I wonder why everyone has a different recovery time from the same surgery.

Lulu has lost about 4 ounces since surgery, which is alot considering how small she is. She went from 3 lbs 6 ounces pre-surgery to 3 lbs 2 ounces. She is eating ok, though. I do have to hand feed her to keep her from running around while I am feeding her. :D I hold her in my lap and put her food in my hand and feed her like that. She goes back to our regular vet tomorrow morning to have her stitches removed. Then we go to the surgeon at 6 weeks out for a check up. I don't envy you with the 12 weeks of crate rest. Even though I plan to make sure Lulu doesn't over do it even past 6 weeks, I can't imagine full, strict crate rest for 12 weeks. :( Poor Gilmore & poor mommy.

I am looking forward to the day where we can have a normal life with Lulu again. I am praying that the surgery works and that Lulu doesn't experience anymore LP episodes in that leg. Her other leg is only a grade 2 LP and she hasn't shown any clinical signs so the surgeon and I are hopeful that that leg won't give her any problems.

Yes- I am too looking forward to having a normal life again with Gilmore. I know how you feel. It seems like forever away though. I feed Gilmore in his crate or on the floor but I keep him on a leash. Even on the leash he still goes to run or jump when he hears any noise or when my other dog barks.

Lulu is so small. Gilmore is a piggy and my back is killing me from carrying him in and out all day. He was 2 pounds when we got him in April. He didn't have any stitches that needed to be taken out- they just dissolved. His hair is finally starting to grow back. Sometimes I have to pick him up if he sees a squirrel because there is no stopping him from going bonkers. I do the best I can to limit his puppy frenzy but it is very tough at times. I think he is happiest when we go upstairs for the night and he gets to cuddle on my bed.

To be honest, once Riley was feeling more like his old self I had to give him a tiny dose of benedryl periodically to calm him down. With Coco around it was just too much of a temptation for him to go frolic and play with her and that's all he wanted to do so he would jump in the pen area and just go bezerk in the crate. We even ended up with an unscheduled trip to the Vet E.R. because his leg swelled up due to him just going nuts when we took Coco out to be groomed on a Saturday.

Trying to keep Riley calm was paramount to his recovery and the vet had given me other sedative-type drugs to help calm him but everything had the opposite effect and benedryl was all he could take; that seemed to just help him settle down and not be so crazy.

The first time Riley fractured his rear leg, he fell off his puppy stairs. The second injury was from falling off or jumping off from our bed and landing wrong (my husband was on the bed with him and we would never let him jump down on his own since he had already been through one fracture but my husband never saw him get down so we think he may have slipped off while chewing on one of his chewies). We now keep him on a leash whenever he is on our bed with us. I thought that his first injury was just the worse thing that could happen to him/us, but I was wrong. The second injury was far worse and much harder on Riley (recovery-wise) and financially it doubled what we paid the first time around at the Vet. Spclst. So if you are bringing your baby up on the bed with you, please, please take precautions! Riley was so pitiful with his second injury and could barely hold himself up to go potty; it was just a very hard injury for him to come back from....

To be honest, once Riley was feeling more like his old self but still had to be confined, I had to give him a tiny dose of benedryl periodically to calm him down. With Coco around it was just too much of a temptation for him to go frolic and play with her and that's all he wanted to do so he would jump in the pen area and just go bezerk in the crate. We even ended up with an unscheduled trip to the Vet E.R. because his leg swelled up due to him just going nuts when we took Coco out to be groomed on a Saturday.

Trying to keep Riley calm was paramount to his recovery and the vet had given me other sedative-type drugs to help calm him but everything had the opposite effect and benedryl was all he could take; that seemed to just help him settle down and not be so crazy.

The first time Riley fractured his rear leg, he fell off his puppy stairs. The second injury was from falling off or jumping off from our bed and landing wrong (my husband was on the bed with him watching TV and Riley was chewing on his chewie and my husband never saw him get down so we think he may have slipped off while chewing on his chewie). We now keep him on a leash whenever he is on our bed with us, so if you are bringing Gilmore up on the bed with you this may be something you might want to consider...