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Old 04-12-2012, 03:38 PM   #1
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Default So Scared! Bella Diagnosed Eith LP Today

Help! Bella taken to vet. Diagnosed with LP. Please dear friends enlighten me and settle my nerves. Jam so worried! Thanks for your support.
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Old 04-12-2012, 03:57 PM   #2
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I'm so sorry, are you talking about Luxating patella? Did he say what grade it was? Joey has grade 1 in one knee, but it hasn't gotten any worse over the years, it just means his bone moves out of joint sometimes, but it will go back in place. It's a very common condition in small breeds.


Taken from: Luxating patella - Wikipedia, the free encyclopedia

Quote:
Grade I - the patella can be manually luxated but is reduced (returns to the normal position) when released;
Grade II - the patella can be manually luxated or it can spontaneously luxate with flexion of the stifle joint. The patella remains luxated until it is manually reduced or when the animal extends the joint and derotates the tibia in the opposite direction of luxation;
Grade III - the patella remains luxated most of the time but can be manually reduced with the stifle joint in extension. Flexion and extension of the stifle results in reluxation of the patella;
Grade IV - the patella is permanently luxated and cannot be manually repositioned. There may be up to 90¼ of rotation of the proximal tibial plateau. The femoral trochlear groove is shallow or absent, and there is displacement of the quadriceps muscle group in the direction of luxation.

Treatment

Grades II, III and IV require surgery to correct, if the animal has difficulty walking. The surgery required is governed by the type of abnormality present, but often involves a sulcoplasty, a deepening of the trochlear sulcus that the patella sits in, a re-alignment of the attachment of the patella tendon on the tibia, and tightening/releasing of the capsule either side of the patella, according to which side the patella is slipping. Some Grade IV conditions may require more involved surgery to realign the femur and/or tibia.

Additional help can be given with the use of pet ramps, stairs, or steps. These can help the animal travel from one place to another, especially up and down, without adding any pain or damage to the patella.



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Old 04-12-2012, 04:17 PM   #3
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Max has had it for 3 years now.
We have not had surgery.
I am sure more people will post who have more experience.
What grade is it?
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Old 04-12-2012, 04:22 PM   #4
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We recently took out a policy for pet Insurance.Well the insurance company did not want to cover Gabby's luxating patella. So I asked my vet if he could look at the policy. This is the email he wrote to the insurance company:



I am disappointed in and confused about your assessment of Gabby's exclusions. First, her patellar luxation is only unilateral, not bilateral. Secondly, it is merely a grade I out of IV. Grade I luxations are ones in which the patella naturally sits in its normal position, and moves out of position only under manual pressure. In my experience, it is relatively common for Yorkshire terriers to have Grade I luxations and not have further problems with their stifles throughout their lives.

My other concern has to do with your statement on osteoarthritis, stating that it would be determined on a case by case basis. Even if you did not cover the stifle joint (and, again, I would ask that you reconsider, or at the very least cover the one that ISN'T luxating), I don't understand why you would not definitively cover other joints. Yorkies are obviously very small, and any impact one stifle would have on, say, the hip joint even of the affected side, would be minimal if any.

I am requesting that you look at this information and reconsider the coverage of this policy for Gabby. I know that the would appreciate it.

Thank you for your time and consideration. Have a good day.
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Old 04-12-2012, 10:28 PM   #5
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How old is Bella? What grade did your vet say? Was the assessment made from just feeling her knee or was an xray done?

There are a lot of varying factors. A dog may have lp, but not be showing, experiencing any problems. My Hot Rod had lp surgery at 1 1/2 years old. He was at a grade 3 and his ligament was off to the side of his leg.

My Maggie May has low grade 2 in both her knees and you would never know it.

Did your vet and you talk about supplements? The 2 that I happen to be familiar with are Cosequin and Dasuquin. I have given these to my cats and dogs per my vet recommendation. I would suggest talking with your vet about these supplements in his/her recommendation of treatment.
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Old 04-12-2012, 11:55 PM   #6
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My Jilly had that bilaterally but only a low grade lux and she was managed conservatively. I was very careful to prevent her jumping as much as I could, provided her doggy steps for couches and beds and helping her down from those myself as much as possible to keep her from jolting down those steps so much. I did not teach her any tricks or anything requiring her to bend that leg unnecessarily so no "sit" or anything for Jilly & no agility. I don't know now - now vets may recommend agility or something but back when I had Jilly, she was prevented from it - plus, she was so sickly & fragile, I wouldn't have had her in that anyway. She never had her patella catch nor did she ever limp in her lifetime from it so I guess we were very lucky and a bit successful in keeping her activities somewhat limited to protect the instability at that tiny portion of the knee joint. I hope your baby can be managed without the need for surgery.
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Old 04-13-2012, 08:35 AM   #7
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My maltese has a grade 1 in one knee and a grade 3 in the other. She has only had a problem one time when she stumbled over a limb in the yard. It was better within a few weeks after some anti-inflammatory meds. They are just going to recheck her when she comes in (yearly exam) to make sure it's still okay. All of mine end up at the vet more often than once a year for some reason or another and I always have them recheck the legs then too.
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Old 04-13-2012, 09:30 AM   #8
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Quote:
Originally Posted by heide210 View Post
We recently took out a policy for pet Insurance.Well the insurance company did not want to cover Gabby's luxating patella. So I asked my vet if he could look at the policy. This is the email he wrote to the insurance company:



I am disappointed in and confused about your assessment of Gabby's exclusions. First, her patellar luxation is only unilateral, not bilateral. Secondly, it is merely a grade I out of IV. Grade I luxations are ones in which the patella naturally sits in its normal position, and moves out of position only under manual pressure. In my experience, it is relatively common for Yorkshire terriers to have Grade I luxations and not have further problems with their stifles throughout their lives.

My other concern has to do with your statement on osteoarthritis, stating that it would be determined on a case by case basis. Even if you did not cover the stifle joint (and, again, I would ask that you reconsider, or at the very least cover the one that ISN'T luxating), I don't understand why you would not definitively cover other joints. Yorkies are obviously very small, and any impact one stifle would have on, say, the hip joint even of the affected side, would be minimal if any.

I am requesting that you look at this information and reconsider the coverage of this policy for Gabby. I know that the would appreciate it.

Thank you for your time and consideration. Have a good day.
I'm confused, if the vet is saying it's only grade one, why does he want the insurance company to do anything? They don't do surgery for grade one.
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Old 04-13-2012, 09:57 AM   #9
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Quote:
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I'm confused, if the vet is saying it's only grade one, why does he want the insurance company to do anything? They don't do surgery for grade one.
Because the insurance company his client was thinking of was going to exclude covering both knees for insurance purposes. That would mean in my layperson's understanding that if either knee required over time some medical intervention it would not be covered under the policy.

I too am more concerned over the osteoarthritis determination on a case by case basis. Many dogs over the lifetime as a function of normal ageing may develop this condition. This case by case clause; sounds like to me a perfect out for the insurance company.
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Old 04-13-2012, 10:27 AM   #10
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Quote:
Originally Posted by Nancy1999 View Post
I'm confused, if the vet is saying it's only grade one, why does he want the insurance company to do anything? They don't do surgery for grade one.
Quote:
Originally Posted by Nancy1999 View Post
I'm confused, if the vet is saying it's only grade one, why does he want the insurance company to do anything? They don't do surgery for grade one.
I was in a hurry when I posted for this thread. I was just wanting to share the part explaining the impact of a grade 1 on a yorkie.


Once I took out this policy through Embrace,they offered a health review letting me know what would be covered and what would not.All I needed was to get a yrs worth of medical records and a orthopedic exam for Gabby.So I schedule a examination and found out about her having a grade 1 medial patellar luxation. So I gathered this info and sent it to Embrace.Here's their findings below.

I did not like how they did not want to cover both of her patellas,cause its only one patella that luxates,also in the form Embrace had him fill out he checks the box where it states within normal limits for that breed and age.So, I am thinking if it's normal why not cover her patellas then. I also did not agree with what they had to say about ostoarthritis.

I asked the Vet if he agreed with how I felt and he did and sent this email as addition info for her review



Thank you for giving Embrace the opportunity to conduct a health review of Gabby.
We strive to be upfront and transparent about our coverage. Overall, Gabby has been pretty healthy, but there are a few conditions your policy would not provide coverage for. This medical history review tells you what is and is not covered based on the information we were given.

The following pre-existing chronic conditions shown in Gabby’s vet records are excluded permanently:


Luxating Patellas
Osteoarthritis; this condition is at a greater risk of developing due to the luxating patellas. Future coverage of this condition in other joints will be determined on a case by case basis
Vaccine Reactions

The following curable conditions are excluded until Gabby has been free of them for 12 months:

Dermatological conditions; this condition will have coverage if a new episode of dermatological conditions occurs between the effective date of this policy and 3/13/13 and this episode of dermatological conditions can be shown to be unrelated to the episode of dermatological conditions that occurred in 3/12. To the extent that no new episodes of dermatological conditions occur between the effective date of this policy and 3/13/13, then any and all episodes of dermatological conditions which occur after 3/13/13 will have coverage under this policy for as long as it remains in effect.

Please be aware that this medical history review is based on medical information I currently have in hand. This information consists of your veterinarian’s complete chart notes over the last 12 months and was received by our office directly from your veterinarian’s office as we requested. If additional history or details arrive later showing a condition is pre-existing, the policy will not provide coverage for the condition regardless of what is shown in this medical history review.

Even though Gabby has some pre-existing conditions, your policy is still going to provide you with great coverage for small things like torn toe nails, all the way up to big things such as cancer and diabetes. If you feel I am incorrect in my assessment, please have your veterinarian send in a letter clarifying the situation and I will be happy to reassess this information at that time.
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Old 04-13-2012, 10:35 AM   #11
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My Vet sent that email on the 3rd and I received a email from Embrace that same day saying that they received the addition information and she will get back with me within 5 business day.Well I called a few times this week and both times they said they r working on it and will get back with me.
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Old 04-13-2012, 10:43 AM   #12
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Quote:
Originally Posted by heide210 View Post
I was in a hurry when I posted for this thread. I was just wanting to share the part explaining the impact of a grade 1 on a yorkie.


Once I took out this policy through Embrace,they offered a health review letting me know what would be covered and what would not.All I needed was to get a yrs worth of medical records and a orthopedic exam for Gabby.So I schedule a examination and found out about her having a grade 1 medial patellar luxation. So I gathered this info and sent it to Embrace.Here's their findings below.

I did not like how they did not want to cover both of her patellas,cause its only one patella that luxates,also in the form Embrace had him fill out he checks the box where it states within normal limits for that breed and age.So, I am thinking if it's normal why not cover her patellas then. I also did not agree with what they had to say about ostoarthritis.

I asked the Vet if he agreed with how I felt and he did and sent this email as addition info for her review



Thank you for giving Embrace the opportunity to conduct a health review of Gabby.
We strive to be upfront and transparent about our coverage. Overall, Gabby has been pretty healthy, but there are a few conditions your policy would not provide coverage for. This medical history review tells you what is and is not covered based on the information we were given.

The following pre-existing chronic conditions shown in Gabby’s vet records are excluded permanently:
Luxating Patellas
Osteoarthritis; this condition is at a greater risk of developing due to the luxating patellas. Future coverage of this condition in other joints will be determined on a case by case basis
Vaccine Reactions

The following curable conditions are excluded until Gabby has been free of them for 12 months:

Dermatological conditions; this condition will have coverage if a new episode of dermatological conditions occurs between the effective date of this policy and 3/13/13 and this episode of dermatological conditions can be shown to be unrelated to the episode of dermatological conditions that occurred in 3/12. To the extent that no new episodes of dermatological conditions occur between the effective date of this policy and 3/13/13, then any and all episodes of dermatological conditions which occur after 3/13/13 will have coverage under this policy for as long as it remains in effect.

Please be aware that this medical history review is based on medical information I currently have in hand. This information consists of your veterinarian’s complete chart notes over the last 12 months and was received by our office directly from your veterinarian’s office as we requested. If additional history or details arrive later showing a condition is pre-existing, the policy will not provide coverage for the condition regardless of what is shown in this medical history review.

Even though Gabby has some pre-existing conditions, your policy is still going to provide you with great coverage for small things like torn toe nails, all the way up to big things such as cancer and diabetes. If you feel I am incorrect in my assessment, please have your veterinarian send in a letter clarifying the situation and I will be happy to reassess this information at that time.
It sounds like they won't cover for preexisting conditions, this is actually very common, however, some people say that some insurance companies will cover them after the first year. I'm not sure how an insurance company could afford to do that. The cost of surgery is around $2000 for one knee, and people would just go buy insurance after their dog was diagnosed.
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Old 04-13-2012, 10:49 AM   #13
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Quote:
Originally Posted by Nancy1999 View Post
It sounds like they won't cover for preexisting conditions, this is actually very common, however, some people say that some insurance companies will cover them after the first year. I'm not sure how an insurance company could afford to do that. The cost of surgery is around $2000 for one knee, and people would just go buy insurance after their dog was diagnosed.

I understand what u r saying.I can see them saying they will not cover her right patella and thats fine cause it is pre exisiting then.I just thought it was unfair not to cover the knee that did not luxate.
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Old 04-13-2012, 11:00 AM   #14
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I understand what u r saying.I can see them saying they will not cover her right patella and thats fine cause it is pre exisiting then.I just thought it was unfair not to cover the knee that did not luxate.
I agree with you, and I've found that many insurance companies spend more on lawyers trying to get out of claims than they actually spend on claims. You might want to find a different insurance company. This thread might interest you: http://www.yorkietalk.com/forums/die...rifaj-dvm.html.
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Old 04-13-2012, 02:49 PM   #15
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Quote:
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I agree with you, and I've found that many insurance companies spend more on lawyers trying to get out of claims than they actually spend on claims. You might want to find a different insurance company. This thread might interest you: http://www.yorkietalk.com/forums/die...rifaj-dvm.html.
I believe that isurance companies are in this business to make money,and pay as little as possible.Thanks for the link. I have been busy,but will read when I have time.
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