Just sharing my opinion. I would be more interested in # of cases performed for MPL repair than overall years of surgery experience. Not sure why that opinion bugs you. I think that asking how many surgeries a person has done is relevant for people looking for a surgeon.

How's Bella doing? Is she (and are you)hanging in there until surgery? Don't forget, lots of prayers and well wishes are coming her way - and yours too.

Thanks!!! Bella is doing fine--she is curled up in a little ball under a blanket next to me as I write this. She was walking a little better today. Three weeks to her surgery, and my greatest concern is that she feels well enough to exercise her affected leg so it maintains muscle tone. She was using her leg most of the time today, so that's good. Speaking with the surgeon today was reassuring, and he is willing to speak with me any time I have more questions, so that's reassuring too. Thanks for the prayers!

dog
 

Yeah Bella! Very happy little Bella is getting better. Continued prayers for healing.

Thanks! Bella got up and walked around normally for a while, and now she's back under my left arm. We really appreciate the prayers :)

Prayers for your sweet Bella and you! So glad to see she walked normally today!

Maybe sounds encouraging for a lesser degree of additional pathology or lack of possible CCL or other injury also being involved, doesn't it? I know how stoic dogs are but still........that sounds encouraging.

Phil, I am really late to this thread. First I am wishing you and Bella a very successful surgery!

Just a suggestion, if Bella is not crate trained, then start now to crate her, so that after surgery her crate will be a welcome place to rest and recouperate.

On swimming, if you don't usually swim with her and or she has not experienced the bath tub swimming. Here is what I suggest, buy a non slip mat that will run the whole length of your bathtub, and then try her in the bath tub with you and she in it together.
I would look to see if you have a full dog rehab clinic, that might have the underwater treadmill - I have had good very good results with underwater treadmill work. As has Mike Alaska Yorkie.

Also investigate to see if Class IV or V laser treatments are indicated for her rehab. Again they can do wonders with soft tissue healing.

Also there is a special site (the name escapes me right now) that you can order a specially made ice pack. I have had two made for Magic, one for his lowback sacrum, and one for his elbow. They are worth the $$ as they fit via Velcro to their respective places. Very sturdy construction.. And I keep mine permanently in the freezer.

Also I don't know if you have stairs but stair climbing needs to be strictly curtailed as well.

Best of luck to you and your gal.

Thanks for the tips! Thank goodness Bella is crate trained! She sleeps in her crate at night, and we also keep her in the crate when we are out of the house and she's usually asleep in the crate when we get home, so at least she's comfortable in her crate. That said, she's a very frisky puppy, so I'm not sure how happy she will be in there all the time during her recovery, but we'll try to make it as happy and comfortable an experience as possible.

Bella has not gone swimming before. I was always concerned about her getting too cold or dirty. What temperature do you recommend for bathtub water? The same temperature that I like, warm, but not scalding? My vet clinic is a full-fledged animal hospital, so I think they have physical therapy equipment, but if they don't, then surely the U of I vet clinic does, so I will get a referral if necessary.

Is this the website for the hot and cold packs? If so, it is appropriately named :)

Bella's Hot/Cold Pain Relief Pack- relief for canine arthritis & hip dysplasia!

We do have stairs in the house, and they are carpeted, but of course Bella loves running up and down them. I may have to install a baby gate...

I have had many pups go through knee surgery and to be perfectly honest none of them needed physical therapy afterwards. They usually crate rest for 8 weeks but leash walk during that time with increasing periods of walking. Then, when they get the all clear, they do just fine. At least that has been my experience. I realize that many do it, but I am not so sure it makes a huge difference.

I have used PT for some, but they were extreme cases.

I agree with Gail. Her crate will be her friend during the time her activity is restricted. Toss treats and toys in there and encourage her to go in and toss more treats in as she remains inside. Put an old unwashed t-shirt of yours in there for her to lie on. Close the door and immediately open it back up and let her out but keep her calm so she won't get used to coming out of her crate and frolicking around, which will be contraindicated after surgery. Give her a treat/food-filled kong to play with in the crate with the door closed another time. Repeat. Repeat. Repeat until she's staying in there for a hour, sleeping or accepting that she needs to stay in it and just watching as life goes on around her. Always ask her to remain calm when she emerges to avoid injury after surgery and quietly give her a couple of treats when she comes out calmly.

Dogs have to be crated when they are boarded or at the vet after treatments so a dog who has been crate-trained is a happier and calmer dog when placed in a crate during those times one is necessary.

A lot can happen in three weeks. I would be less worried about muscle tone and more concerned about preventing further injury that would complicate the surgery and make for a more difficult recovery ... but that's just me, the worrywart. Swimming sounds like a great idea.

Recall that my pup not only had LP but a torn CCL, so a more complicated injury than Bella. From the time to injury to the time of the surgeon's consult was 3 days. From the time of the consult to the time of surgery was another 6 days. Within that time there were actually complete days (at one point 2 days in a row even) that she used her leg fully, then the next day she would go back to carrying the leg for a few steps whenever she got up from resting. She even escaped from the exam room during the consult and it was not easy for the surgeon to finally corner her and catch her.

So the point I am trying to make is that with three weeks, expect some very good days and then some days where the symptoms are back, and be grateful for the good days but don't slack on her restrictions just because she seems to be having a good day. They can hide a lot.

I'm praying that the next three weeks for Bella are very calm.

Just want to wish you and your little Bella good luck and a speedy recovery when she gets her surgery!

My husband and I just went through the surgery with our yorkie, Sophie, at the end of September and we are starting to see a difference in her now! She had both knees done and her recovery had some set backs - including her ripping the stitches out of one knee 5 days after surgery, despite wearing her cone! She has so much energy now and she seems so much happier.

I also want to say that we were in the same position with choosing a surgeon and we chose the one that wasn't board certified. Our options were a surgeon that had been certified for a year or a surgeon with 35+ years in the vet field with an interest in orthopedics, just never got certified. He had preformed more of these surgeries than the certified surgeon and we felt a lot more comfortable with him. Everything has turned out fine with Sophie and we don't regret choosing the non-certified surgeon!

(Just want to say, I don't have anything against board certified vets, but I think every situation is different and sometimes the non-certified may be just as good)

Kind of shocking to me that the only board certified vet in Ontario was one with one year of certification.

But, to be clear about board certification.....these vets already have years of experience prior to completion of their board certification requirements. It is always a good idea to inquire about their experience specific to the procedure you are having done.

As you said, each person has to make a choice as to what is best for their pup.

Hi there and Hi to Bella - she is adorable!

I wanted to read this because my oldest, Chanel who is now 12 now may be facing this in her future and it scares me - the last visit she was fine and it was the best visit I've had with her over this -

I worry about her age and recovery so I will be praying for your Bella that everything goes as planned and she is back home quickly on her way back to all FOUR legs hitting the ground :)

All the best to you. It sounds like you know what your doing and I just hope MY vet has many of these surgeries behind him - I have to ask next time or just call him, so this thread really helped me....Thanks!

sending prayers

Edited to add...Chanel is not limping but her walk has changed. She is on medication for inflamation at this time and doing well but she may be a stage 3 and I really am considering talking to her vet now about surgery.....

Villette, in a 12 year old dog, most boarded vets do not recommend surgery on patellar luxations. There are many vets who will do them, but honestly in an older pup I would consider spending the few extra dollars for the opinion of one who is boarded. We have a great one in Houston and he has advised against surgery on the older ones unless they simply cannot use the leg which is usually a torn ccl.

I should clarify the above post....

If a pup is older and has had patellar luxation, there is a higher probability of them tearing the cruciate ligament. If you do surgery to repair the LP the ligament is still in the same shape from being worn down over the years. Then, if the pup tears the ligament, you are looking at another surgery. He advises against surgery on LP for older pups mainly for that reason....

oops I replied in the body of the message

Okay mine came from canineicer.com

Oh, okay. The Canine Icer products look more specialized and are probably more suitable than the Bella product, which comes in only one configuration and has to be adjusted to fit the appropriate body part.

Thanks to everyone for the advice, and keep it coming! It's too many posts to reply to every single one, but there's a solid body of knowledge and experience there, and I (and others going through the same thing) appreciate it!

I didn't do Rehab with my dog who had a MPL repair at age 2. This same dog now age almost 14 has a grade IV MPL in the other leg that wasn't recommended to be repaired. Over the years when she had some lameness, the recommendation still was to see if conservative rest brought her back around. Since she has been diagnosed with liver disease, anti-inflammatory meds were not appropriate so we used rest, warm heat at times, and tramadol for any pain. She recovered each and every time. Just last year, she again was limping and I took her to a surgeon who is board certified for an opinion and he said that the benefits of the surgery at this stage in her life were clearly outweighed by the risks to her given her age and other medical concerns. I didn't have faith that she would pull through but after a good 4-6 weeks of rest she is 100% again. So I think one should proceed cautiously with surgery in an older dog for this problem. I had a discussion wih our dr at the time and he said he would have fixed her leg as a pup, but that others are divergent on that opinion. Her surgery was done by another boarded surgeon who I mentioned does over 4,000 of these a year and he said no. He may have decided differently in recent years as my friend's puppy had surgery with him. She was unable to stop limping. I think my Daisy being light and small has worked to help her with this problem.

Anyway we didn't do rehab and my friend didn't either. I did do it with my other dog who had a CCL tear and complications and I can tell you that it cost a lot. I think they bounce back a lot on their own like LJ said.

Yes rehab is expensive, and as always consultation with your specialists and vets is advised as to how much and what kind etc.

But I am a true believer in rehab, which is why my new gal has insurance coverage which includes many many forms of rehab.

Once you get to know the exercises and can do them well with your pup, much rehab can be done at home.

Is rehab always necessary? Well I don't know, but I do know that proper rehab can aid in healing times, and overall fitness for the dog.

Cost has never been a deciding factor for me. It was not recommended ... it is optional....and I chose not to. If I had insurance that was paying for it, I still would not do it. I have not found that my pups have any issues...they all get back to normal living in no time once their restrictions are lifted and they do terrific! My pups have all healed well and have not had issues...and I am talking about too many pups to count. I would have to go back and pull all of my files to give you a number, but trust me, I have a lot of experience with knee surgery.

It's just that in a young dog, it's not a good financial expenditure in the absence of some complication. Just my view after spending more on rehab than I did on surgery! I think a puppy with grade IV MPL should be repaired surgically and wish mine was. I would press for it today but then I was ignorant. As for overall fitness, I think that when the dog is starting with the disadvantage of disaster breeding as in the case of grade IV MPL then maybe lifetime attention to that is warranted. Not sure that means rehab.

Prayers to you and dearest Bella >3

Thank you! Bella was worse yesterday evening and this morning (not walking on her bad leg), but she perked up after her bath today and started using her leg more. 19 more days to surgery.

Poor baby...why the lengthy wait for surgery? Is she on anti inflammatories and/or pain meds?

Despite being the owner of the clinic, the surgeon is on rotation at the U of Illinois Veterinary Clinic, and performs surgery at his private practice only two days per week--hence the wait. The surgery will be two weeks from this Friday.

Bella is not on any medications for her LP at this time. She does not seem to be in any pain, not even when she's walking on her affected leg (not even a flinch), but others in this thread have noted that Yorkies can be stoic about expressing discomfort. In some respects, I'd be concerned about medicating her unnecessarily, especially with the pain meds, since they could mask issues when she is feeling extreme pain, or perhaps cause her to use her affected leg more often than she safely should. I haven't heard about anti-inflammatories being prescribed for LP prior to surgery. What is your experience with them? Would it be a mild drug like metacam, or something more hardcore like a steroid?

Yes, mild drugs mostly like rimadyl or metacam as an anti-inflammatory and tramadol for pain.

Here are some words on dogs in pain and just my own opinion but it's based on years of reading about and observing canine pain, dog pack dynamics, canine instincts and behavior, etc., and years and years of working with dogs in foster and my own dogs and hundreds of vet visits with hurting dogs.

I'd give my dog half doses of pain Rx if I were very fearful of it but I'd want any baby in my guardianship not to be in pain when I knew they had it, despite how well he or she is masking the pain. But a limping dog is no doubt feeling pain or the dog would use the leg normally. Pain medicine won't mask their pain to the point they are going to injure themselves unless they are over-medicated. I hate the idea of a dog suffering simply because they won't cry out or whine or talk and tell us how they ache and hurt, which they never can do.

I hurt but still walk on my painful hip and leg when I have to - so do dogs. But I have medication to ease that pain - cannot imagine living in pain with sleep being my only outlet from it. Either pain Rx or anti-inflammatories could keep a little one far more comfortable for the next weeks and relieve the stress of pain and if far better than hurting.

All dogs are stoic to some degree and hide their discomfort to every extent possible instinctively in order to try to stay safe and keep themselves from being shunned/left behind by their pack or attacked by other animals because they are weak. That instinct often requires they needlessly suffer in domestication now that we know they feel pain but are usually masters at hiding all but sudden or shocking type pain. Dogs with traumatic amputations on one leg will still act friendly, wag their tail and even try to play once a little time has passed after the initial trauma. But sentient animals like canines hurt when they have painful medical conditions, injuries or surgery and need human intervention and help when they do.