Luxating patella / torn ACL
 

Hello. I just picked my baby up from the surgeon's office. He had his second knee operated on. May 1, he had surgery on his right knee for a torn ACL and luxating patella. He will be 9 in October and weighs 8 lbs. He had never had problems with his knees until a couple months before his first surgery when on 2 or 3 occasions, he limped, but was fine the next morning. Then in late April, he jumped down from the couch and limped. It was not better after a couple days, so he went to the vet, who said it was his knee cap. He said he could do the surgery or he could refer us to a surgeon, who was much more experienced. We chose the surgeon, which turned out to be a very good choice, as he also diagnosed a torn ACL. Columbo had surgery to repair both and had a great recovery. After 4 months, he was 110%, but about 10 days ago, he lunged at a dog and was limping again. My first thought was he had re-injured his leg, but no, it was the left leg this time. I knew instantly it was the same thing and he was not better after 2 days. So I went directly to the surgeon this time and yesterday he had surgery on the left leg. Exactly the same thing again. I had read that the other leg will often go out in 6 months, and sure enough it was only 4 months. We were told as a puppy that he had bit of luxating patella, but never a problem until now. I believe the surgeon said he graded him a 3. Hopefully, his recovery will go as well again.

Sorry to hear about your little guy. Hope he heals quickly.

Thank you. He is doing very well tonight. Much better than the day he came home after the first leg. He has hopped out of his bed twice tonight (surprised us as last time he felt poorly for a day or two). I need to keep a good eye on him as he needs to be very careful for the next two weeks until he is cleared for 5 minute walks. We will also start hydro-therapy at 2 weeks. I was so happy with how well all went with the first leg and hope anyone nervous and contemplating this surgery sees his positive outcome.

Today marks one week since surgery. Since Columbo has been through this before, he is pretty good at getting around on 3 legs. Yesterday, he began "toe touching" with his injured leg, and today he is really starting to put weight on it. He still has a pronounced limp, but is definitely making progress. I would say his recovery has been on track with the first leg, maybe even a little better. He just finished 2 of his 3 meds and just has the anti-inflamitory left. He has been pooping regulary since he came home from the hospital, which is amazing since the meds can have an effect on that. The part that amazes me is his positive attitude. He can't wait to go on (short) walks, he's been playing with toys, etc., and he doesn't seem to let his knee problems get in his way. What a trooper! This has been an expensive venture with both knees. But we never hesitated doing it for him, even though we wished it wasn't as costly. And seeing how well he recovered the first time, and hoping the second knee recovers as well, I have never regretted it. I would say he was 110% on the first knee before the 2nd one went out, so hopefully this will be the same. I definitely feel it was the right choice to go to an orthopedic surgeon, rather than have his regular vet do it (no offense to the regular vet - he is wonderful). The surgeon said he has done hundreds of these and that has to play a part in how well things have gone so far.

I'm so glad to read that he's doing so well!

It helps to read this bc my Wylie is having both knees on Oct 1 and I'm scared :(. I feel so bad for making him have surgery. If you have any great tips on how to help him (and us) through it, I'd love to hear them. We're going to put our mattress on the floor for a few months so he won't jump, bc otherwise he would. How soon did you start letting him walk around a bit, after the surgery?

I'm so glad this thread is helping someone else who is going through it! The day or two after surgery, he will be sleeping a lot. The doctor's office said to keep him off the leg except for going potty until after his two week check up. We are supposed to be doing therapy exercises similar to bike riding motion on that leg. HOWEVER... he will have no part of that. Same with the first leg. I talked to the doctor about it when then called after a few days to check on him and they said don't worry about it, just start with 5 minute walks. He started out on 3 legs. On day 5 he started "toe touching" along with 3 legs. Yesterday (day 7) he was bearing weight on it and actually holding himself up on that leg while he peed occasionally. Today, he is even bearing more weight. To repair the ACL, they actually make a new ACL out of something like fishing line. After a couple months, scar tissue forms around it and makes it very strong. It is important not to injure it while healing. No jumping or sudden lunging, etc. Dr said straight forward movements, like walking, is good. It's the side movements that can re-injure. At 2 weeks, he was cleared for longer walks and hydrotherapy (not needed necessary, but we have a hot tub, so good for him at around 80 degrees) At 8 weeks, they took another xray and said it was looking good and he was cleared to gradually work back up to his regular activities. Setbacks are expected, but so far we haven't had any. We intend to limit his jumping as much as possible for the rest of his life. The knees are supposed to work like regular ones, but I'm not made of money, so don't want to ask for problems. Dr said good news is he only has 2 knees. I also want to try to limit those unexpected times like suddenly racing out after a squirrel or the neighbors cat. I pick him up on walks now when we pass an unknown dog instead of just moving over. He sometimes is friendly to newbies, but can also act like a maniac until he gets to know them.

I just reread your post and you say Wylie is having surgery on both knees at the same time? That may be more difficult. Columbo is doing well because each time he had a good back leg to use while the other recovered. I questioned the doctor about the second knee going out only 4 months after the first surgery and he said he was healed and strong and in good shape for it. He said the dogs that have a difficult time are the ones that have the second leg go out after only 2 weeks since the first leg is not completely healed yet. Little dogs are pretty good at getting around on 3 legs until they are ready to start putting weight on the new knee. I have seen larger dogs have hip surgery, etc., and not be able to bear weight on the back legs and they use a sling while walking them to help hold them up. I would think that would be harder, though, with a tiny dog since they are so much shorter than us. Also, going to the bathroom will be hard, with pooping being the hardest since they wouldn't have any way to squat on the back legs. If it must be done at the same time, you will get through it, it just will be harder for both of you until Wylie can bear some weight on them.

Thanks for both of these. Yup, he's having both done at the same time...I just figure we may as well get them both done since we already know they both need it. It scares me, but I know so many here have gone through it - like you too. We do have a pool in the backyard - so we can do hydro! That might help him get on track sooner, I hope. I am worried about his poo poos bc he's a 'traveler' when he goes...meaning, he sort of walks around in the poo position when pooping, so I dunno how he's gonna manage at first, but we'll figure it out.

How's your kiddo doing today?

haha! Columbo does that, too.

Glad you have a pool. Swimming will be the best therapy for him when he is cleared to get wet. If you have a life vest, it's good to use one during recovery.

Columbo is still doing good today. Not too interested in his walks today, but still moving about the house a lot.

Glad to hear it went well. I dread the day I have to face that with Maggie.

A neighbor who has a small mixed breed dog just told me that he needs to have his knee done. I think she said he is grade 3, but he looked fine to me on his walk. I guess he has good days and bad days. He is only 1 year old. I think he is poodle and shihtzu mix. She will find a way to for the surgery but she also needs new roof. She is not having an ortho do it because of the cost. I think she said it is like $3000 for the ortho and I forget how much for the non-ortho. Is it really that expensive? We are in Southern NJ.

Columbo's first leg was about $2950 total, but I want to break that down: Visit to regular vet to diagnose & xrays - $250, consult with surgeon & bloodwork - $250, surgery fee (includes followup xrays & consults) $2450.
Columbo's second leg was $2650. This time I went straight to the surgeon, so they did everything. He had a 9am appointment and was told to fast so that if they confirmed it was the same thing, they could take him into surgery that day.
Additional info: the original quote on the first leg for the surgery fee only was $3200. The surgeon hoped to do a newer technique which involved a titanium plate and screws. However, after he got in there, he found the smallest plates they make were too big and did it a different way. He said there are many different ways to do this surgery. Not using the titanium plate knocked $700 off the bill!! (gasp)

I guess I also need to clarify that Columbo really had two surgeries at the same time. He had BOTH his luxating patella and his ACL repaired on both knees. The surgeon said it would have been less expensive had it been just one or the other. However, in Columbo's case, he had no symptoms until the ACL tore. It was probably the LP that caused the ACL to tear, though. The surgeon said he had to fix both, because if he fixed the ACL without fixing the kneecap, it would definitely tear again. I think it would probably knock several hundred (maybe $400?) off what I paid per knee if it was only one or the other. We live in Virginia, so I'm sure prices also vary depending on where you live.

Good luck with recovery! My 12 year old tore his ALC back in January, had surgery, busted his repair requiring a second surgery and a lot of rehab to make up for the setback. He just was released from his surgeon's care.

YIKES! How long from the first surgery was it that he tore the repair? Does he has LP as well or was it just hyper activity that did it?

My dog had a mild LP prior to jumping off the bed onto a wood floor. The injury caused a full ACL tear and a torn meniscus. He had a lateral suture placed to correct the ACL and also had the LP repaired. He was doing fantastic, ahead of scheduled recovery, and then at 7 weeks, he could not weight bear very well. We tried crate rest and medication but at 11 weeks he went back in for a revision surgery. This really set us back, he had a lot of muscle atrophy and a very slow recovery. We took him for PT and really dedicated ourselves to following the home care plan we were given. He just passed 20 weeks after surgery #2 and is about 98% recovered.

I hope Columbo has better luck than Barney and all goes well!