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-   Sick & Injured / Emergencies Talk (https://www.yorkietalk.com/forums/sick-injured-emergencies-talk/)
-   -   Luxating Patella - Grade 4 (https://www.yorkietalk.com/forums/sick-injured-emergencies-talk/225747-luxating-patella-grade-4-a.html)

katy-yorkie 04-11-2011 06:36 AM
Luxating Patella - Grade 4
 
Buster is 3 years old, weighs about 5 pounds and has had LP in both legs since I got him as a puppy in February 2008. The vet says he is a Grade 4 but does not recommend surgery until his quality of life is affected. I give him Cosequin daily. He goes down the stairs on three legs, carrying the back left leg. I take him for a walk almost every evening, he could walk forever, but I don't let him walk as far as he thinks he can. He doesn't carry the leg much at all when he's walking. He loves to swim, but here lately, he has been getting out on his own and looking at me, letting me know he is done. I've heard swimming is good for LP and I don't let him swim more than 30-45 minutes at a time. It's usually after he's been in about 30 minutes that he gives me the "look". How will I know when his quality of life is affected? I don't want him to be in pain all of the time. Is the Cosequin enough? Is there something else I can give him that's better?

The three legged hop down the stairs almost brings me to tears.

shodanusmc 04-11-2011 06:43 AM
Have you considered a 2nd Opinion. Not sure if the one you saw is board certified. Like you, I would hate when you get the look that they have had enough. Best of luck with the little one.

kjc 04-11-2011 06:53 AM
Quote:
Originally Posted by shodanusmc (Post 3494966)
Have you considered a 2nd Opinion. Not sure if the one you saw is board certified. Like you, I would hate when you get the look that they have had enough. Best of luck with the little one.
Ditto...

Mom to Hot Rod 04-11-2011 07:17 AM
Hi Jeanie,

First, I am so sorry that Buster is going thru this. Second, I have to apologize as I was supposed to mail you something and I completely forgot...it will be on its way. :(

In Hot Rod's case, he was not wanting to walk on our walks that he so enjoyed. He sit down and not budge at all. I agree about the "look" as Hot Rod would look at me like, "I don't really want walk any further mom but I don't want to go home either." But in our case, he was actually swinging his leg outward as his ligament was on the side. You could see that he was walking lopsided.

I would agree with the others to get a second opinion or if you are confident with your surgeon then go with what your head tells you. I know your heart says wait. The other way to to look at it is that if he should really need the surgery, the quicker he gets it, the quicker he will begin to mend. Best of luck with second opinion and your decision.

Hugs,
Bo

Ladymom 04-11-2011 07:23 AM
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.

katy-yorkie 04-11-2011 07:24 AM
My vet isn't board certified for orthopedics. He has mentioned in the past that he can do the surgery. He does not have the facilities for over night care and from everything I've read, they really should be kept over night when they have the surgery. I need a referral to go to the clinic/hospital that has the best orthopedic vets. I guess it's time to ask for the referral and get the opinion of a board certified orthopedic vet.

katy-yorkie 04-11-2011 07:26 AM
Quote:
Originally Posted by Ladymom (Post 3494989)
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".

Ladymom 04-11-2011 07:27 AM
Quote:
Originally Posted by katy-yorkie (Post 3494991)
My vet isn't board certified for orthopedics. He has mentioned in the past that he can do the surgery. He does not have the facilities for over night care and from everything I've read, they really should be kept over night when they have the surgery. I need a referral to go to the clinic/hospital that has the best orthopedic vets. I guess it's time to ask for the referral and get the opinion of a board certified orthopedic vet.
You absolutely want the surgery to be done by a board certified ortho vet, not your regular vet. How far are you from Texas A&M? They have an excellent vet school there.

katy-yorkie 04-11-2011 07:34 AM
Quote:
Originally Posted by Mom to Hot Rod (Post 3494987)
Hi Jeanie,

First, I am so sorry that Buster is going thru this. Second, I have to apologize as I was supposed to mail you something and I completely forgot...it will be on its way. :(

In Hot Rod's case, he was not wanting to walk on our walks that he so enjoyed. He sit down and not budge at all. I agree about the "look" as Hot Rod would look at me like, "I don't really want walk any further mom but I don't want to go home either." But in our case, he was actually swinging his leg outward as his ligament was on the side. You could see that he was walking lopsided.

I would agree with the others to get a second opinion or if you are confident with your surgeon then go with what your head tells you. I know your heart says wait. The other way to to look at it is that if he should really need the surgery, the quicker he gets it, the quicker he will begin to mend. Best of luck with second opinion and your decision.

Hugs,
Bo
Bo, you are too nice! I forgot that you were supposed to send anything!

But I am calling today for the referral for the second opinion from the Board Certified Orthopedic Vet. I think Buster needs something, I think I've waited long enough. If he doesn't, then great, but I want another opinion.

Ladymom 04-11-2011 07:40 AM
Quote:
Originally Posted by Ladymom (Post 3494989)
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.
Quote:
Originally Posted by katy-yorkie (Post 3494993)
Then it's time, Buster is "bow-legged".

It's really past time since arthritic changes have already taken place. The surgery will fix his knees, but nothing can be done about the bowleggedness at this point. Arthritis is not reversible. :(

It's such a shame your vet didn't refer to to an orthopedic vet earlier.

katy-yorkie 04-11-2011 08:24 AM
Quote:
Originally Posted by Ladymom (Post 3495012)
It's really past time since arthritic changes have already taken place. The surgery will fix his knees, but nothing can be done about the bowleggedness at this point. Arthritis is not reversible. :(

It's such a shame your vet didn't refer to to an orthopedic vet earlier.
Yes, it is a shame. His bowleggedness is a sign of arthritis? Really? I did not know that, he sometimes makes fun of Buster being bowlegged. He has told me from the beginning that he could do the surgery, but he isn't board certified and a board certified orthopedic vet needs to do the surgery. Each time that he examines Buster, he has said that he can wait, although I have told him about Buster carrying his leg. I'm not that far from A&M. I have heard that Gulf Coast Veterinary Specialists are excellent. I wasn't aware that A&M would do surgery on LP. I'll call back and ask for a reference for them as well.

107barney 04-11-2011 10:34 AM
Quote:
Originally Posted by katy-yorkie (Post 3494991)
My vet isn't board certified for orthopedics. He has mentioned in the past that he can do the surgery. He does not have the facilities for over night care and from everything I've read, they really should be kept over night when they have the surgery. I need a referral to go to the clinic/hospital that has the best orthopedic vets. I guess it's time to ask for the referral and get the opinion of a board certified orthopedic vet.

There is no way I'd ever let a vet do surgery for LP unless that vet was board certified. I definitely agree with everyone that it is time for a consult.

Also, my dog Daisy was born with two grade 4 LPs. She had to have surgery on one leg at age 2 when she became lame and could no longer walk without crate rest. The other leg, however, has "gone out" a few times over the years and she has been crate rested and medicated. She's almost 11 - no surgery on the other leg has been warranted. The leg that had the surgery 9 years ago is still good and that is because a board certified surgeon did it and he had performed many of these procedures on small dogs.

ALSO - LadyJane sees a surgeon at Gulf Coast for all the fosters and he is wonderful from what she has told me. That surgeon is not only good but I believe he is innovative and has saved legs of some of the fosters when others wanted to amputate!

Good luck!

katy-yorkie 04-11-2011 11:32 AM
Quote:
Originally Posted by 107barney (Post 3495262)
There is no way I'd ever let a vet do surgery for LP unless that vet was board certified. I definitely agree with everyone that it is time for a consult.

Also, my dog Daisy was born with two grade 4 LPs. She had to have surgery on one leg at age 2 when she became lame and could no longer walk without crate rest. The other leg, however, has "gone out" a few times over the years and she has been crate rested and medicated. She's almost 11 - no surgery on the other leg has been warranted. The leg that had the surgery 9 years ago is still good and that is because a board certified surgeon did it and he had performed many of these procedures on small dogs.

ALSO - LadyJane sees a surgeon at Gulf Coast for all the fosters and he is wonderful from what she has told me. That surgeon is not only good but I believe he is innovative and has saved legs of some of the fosters when others wanted to amputate!

Good luck!
We have an appointment at Gulf Coast with the surgeon that Lady Jane sees for the fosters. The appointment is Friday morning. This surgeon will not do surgery unless he needs it. Chances are medication will help, I won't know until Friday. So, cross your fingers and paws for Buster!

Ladymom 04-11-2011 12:12 PM
Quote:
Originally Posted by katy-yorkie (Post 3495335)
We have an appointment at Gulf Coast with the surgeon that Lady Jane sees for the fosters. The appointment is Friday morning. This surgeon will not do surgery unless he needs it. Chances are medication will help, I won't know until Friday. So, cross your fingers and paws for Buster!
That's great that Buster has an appointment so soon! Keep us posted!

ladyjane 04-11-2011 03:17 PM
Quote:
Originally Posted by katy-yorkie (Post 3495052)
Yes, it is a shame. His bowleggedness is a sign of arthritis? Really? I did not know that, he sometimes makes fun of Buster being bowlegged. He has told me from the beginning that he could do the surgery, but he isn't board certified and a board certified orthopedic vet needs to do the surgery. Each time that he examines Buster, he has said that he can wait, although I have told him about Buster carrying his leg. I'm not that far from A&M. I have heard that Gulf Coast Veterinary Specialists are excellent. I wasn't aware that A&M would do surgery on LP. I'll call back and ask for a reference for them as well.
It could be that his legs are bowed because he had LP as a puppy. Dr. Beale told me that if a puppy has LP he does suggest surgery because the legs will not grow straight. I have an adult pup who is 5 and he has LP...he does not have any issues and the suggestion for him is to do nothing since the knees are not causing any issues. He has never had problems...and I can feel his knees pop when I pick him up. My Maxwell who passed in 2004 had LP for as long as I had him (he came to me as an adult) and he never had bowed legs. One of my fosters had a problem with one of his knees a while back and he was put on Rimadyl for two weeks and his knee was fine. Yes, he has LP, but surgery is not recommended for him either.

I am certain that you will leave GCVS very pleased and also very knowledgeable about LP. Dr. Beale is very good about teaching. :) I hope all goes well on Friday! :)

ladyjane 04-11-2011 03:21 PM
Quote:
Originally Posted by 107barney (Post 3495262)
There is no way I'd ever let a vet do surgery for LP unless that vet was board certified. I definitely agree with everyone that it is time for a consult.

Also, my dog Daisy was born with two grade 4 LPs. She had to have surgery on one leg at age 2 when she became lame and could no longer walk without crate rest. The other leg, however, has "gone out" a few times over the years and she has been crate rested and medicated. She's almost 11 - no surgery on the other leg has been warranted. The leg that had the surgery 9 years ago is still good and that is because a board certified surgeon did it and he had performed many of these procedures on small dogs.

ALSO - LadyJane sees a surgeon at Gulf Coast for all the fosters and he is wonderful from what she has told me. That surgeon is not only good but I believe he is innovative and has saved legs of some of the fosters when others wanted to amputate!

Good luck!
Dr. Beale is an awesome surgeon! I highly recommend him. My son took his yorkie to him a few years back...surgery was not recommended. He advised an anti-inflammatory and sure enough...Bailey was back to normal in a few weeks! :) I had one of my pups in to see him recently and the same advice was given....he was put on Rimadyl. He said that possibly in the future Teddy will need either an FHO or hip replacement; but that it is not a given and to try the meds first. He is doing great now! :)

Roxxies-mom 04-11-2011 03:24 PM
My little 3lber had it and I said a little prayer for him and popped it right back in to place and he has been fine ever since I popped it back in to place. Playing and running like the dickens anywhere and everywhere. Praise Jesus and God for that one.

katy-yorkie 04-11-2011 07:07 PM
I'm hoping that Buster does not need surgery. Because Buster is hopping around on three legs, I would like to see what a specialist has to say. I hope there are other options other than surgery. Besides all of the obvious reasons, Buster will be hard to keep quiet and penned for any length of time.

Lisa and Pic 04-12-2011 01:27 AM
Quote:
Originally Posted by katy-yorkie (Post 3495335)
We have an appointment at Gulf Coast with the surgeon that Lady Jane sees for the fosters. The appointment is Friday morning. This surgeon will not do surgery unless he needs it. Chances are medication will help, I won't know until Friday. So, cross your fingers and paws for Buster!
Keeping little Buster in my thoughts and prayers this week. Glad to hear he is going to see an excellent specialist.

yorkieusa 04-14-2011 06:43 PM
Quote:
Originally Posted by katy-yorkie (Post 3495928)
I'm hoping that Buster does not need surgery. Because Buster is hopping around on three legs, I would like to see what a specialist has to say. I hope there are other options other than surgery. Besides all of the obvious reasons, Buster will be hard to keep quiet and penned for any length of time.
I'm just seeing your posts about Buster. I'm so sorry he has LP and I just wanted to send you my best wishes.:)

ladyjane 04-14-2011 06:45 PM
Good luck tomorrow at Buster's appointment. :) I will be there in the morning, but might miss you since Gabby's appointment is at 10AM.

Ladymom 04-15-2011 02:14 PM
Just checking for an update. How did the appointment go?

kjc 04-15-2011 02:29 PM
Checking in for an update... prayers for Buster....

BlueBelle 04-15-2011 02:44 PM
What??
 
This is off topic, but I just was shocked to see LadyJane suspended!!! I can't believe that. She is my hero, how can that be??

shodanusmc 04-15-2011 03:55 PM
Quote:
Originally Posted by BlueBelle (Post 3501649)
This is off topic, but I just was shocked to see LadyJane suspended!!! I can't believe that. She is my hero, how can that be??

Why? I will gladly take her place. Admin, suspend me, and get LJ back on here. She does more than anyone as far as help and support.

shodanusmc 04-15-2011 05:23 PM
Quote:
Originally Posted by shodanusmc (Post 3501691)
Why? I will gladly take her place. Admin, suspend me, and get LJ back on here. She does more than anyone as far as help and support.
\
I bet that POLO thread had something to so with it. I am starting to wonder why most of us even bother with some of these moronic trolls. Maybe it is best to just ignore tham, especially the ones with the intelligence of a maggot.

That's my guess, and I am sticking with it.

ArmaniMan 04-15-2011 05:49 PM
Any update on this pup- I am hoping the appointment went well.

I also have a dog with LP and I am always concerned that it will be time to do the surgery :( But my parents have a dog who did have LP surgery when she was younger and she recovered great and is still a happy active little dog- so if surgery is necessary, it is not the end of the world.

katy-yorkie 04-15-2011 07:25 PM
Buster saw Dr. Beale at GCVS today. Dr. Beale recommended surgery on both legs. He is scheduled for surgery next Friday. Dr. Beale is worried about him tearing his ACLU. He wants to do surgery before any more damage is done.

107barney 04-15-2011 07:36 PM
Quote:
Originally Posted by katy-yorkie (Post 3501908)
Buster saw Dr. Beale at GCVS today. Dr. Beale recommended surgery on both legs. He is scheduled for surgery next Friday. Dr. Beale is worried about him tearing his ACLU. He wants to do surgery before any more damage is done.
So glad Buster saw Dr. Beale. I'm sorry to hear he needs surgery but Dr. Beale knows what he is doing according to LJ so Buster is in great hands! My Daisy had surgery on one grade-4 LP almost years ago and had a great surgeon as well. I will keep you and Buster in our thoughts!

katy-yorkie 04-15-2011 07:41 PM
Buster gets stressed very easy. He stressed from the time we left the house until we got back in the car to come home. He literally gave a big sigh of relief before he finally dozed off for a few minutes. I am so worried about next week. I drop him off on Friday at 7:15AM. He's never been away from us over night.


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