grade 2-3 LP. Surgery price HIGH
 

Turns out Maggie does have LP of a grade between 2-3. She has been fine these past 2 weeks with less walks and very little ball chasing. She still jumps on and off the sofa and goes up and down the stairs. I was keeping her on lower activity in case it was her ACL. Dr says she doesn't think it is acl. Says her knee pops in and out quite easily.

Took her to a vet from the list of board certified in our area. Maybe it is lack of competition around here (south jersey), but the price is way higher than I expected. Is it possible that a place like Jefferson or U of Pennsylvania might be cheaper? The range I was quoted, depending on what is actually done is 3214-3913.

This includes
level 2hospitalization
dr exam
iv catheter
iv fluids
pre-op chem 10
pre-anasthesia
gen anasth first 30
gen anasth, additional 15 mins
OR fee 0-2 hrs
surg asst fee per 15 mins
drugs, cefazolin, hydromorphone, rimadyl, bupiacaine,Cerenia
MPL repair ($1450-1650 for this line item)
MPL implant fee (range 50-250)
e-collar, meds to go home
radiographs 4 views w/ radiologist review, pre and post op ($362)
Game Ready Cold wter compression (She said this is right after)

The total is as i stated 3213-3913 depending on what is actually done and how long it takes. My assumption is that the longer we wait to do it, the worse her knee becomes, and the more it costs.

She said it is ok to walk, even on the beach and on hills, but the ball playing (maggie flies after the ball and often tumbles when she stops to get it) is not a good idea. I don't think Maggie needs surgery yet as her symptoms are not occurring often. If I ever do it, it will be in the winter not the spring/summer.

Is this price in line with board certified surgeons? Why is is so much higher than the $1500 I thought I had read about? We are located about 15-20 miles south of Philadelphia in NJ, on the way to Atlantic City from Philly.

I would wait until she is lame. My dog is going to be 15 in sept and has grade 4s. One was fixed at age two and the other never fixed and she does fine. I recently had a flare and my vet had me do twice a day Adequan shots and Daisy did amazing all for $20.

As for price, I think it's abot $2800-3000 here in the northeast for a repair.

Is that price for both knees or for just one? The $1500 price that is floating around here is for one knee as far as I understand. Seems like many vets want to do one knee than the other after the first has healed. that quoted price seems about right.

I agree with Cathy. I would not do it until she really cannot walk. The recovery is really tough on them, about 8 weeks.

Price sounds about what it costs here.

The first knee Callie had done has to be done at that time about three years ago because of a partial ACL tear. The second knee I had done last July because it's seemed to be bothering her and she loves to run and I figured at 7 there was a lot of life left for a small breed dog so I had it fixed. It is expensive and the recovery time is rough but it is doable and at the end me and my surgeon felt it was best to do. My surgeon also said with any kind of surgery it's better if they are walking in rather then not using the leg I guess because because of the loss of muscle mass a such. He said when the walk in they are normally able to walk out some what. Both times Callie was toe touching the next day when I picked her up which a lot of the time does not happen for awhile.

I'm pretty sure its for one knee. Report says "very low grade and not symptomatic on the right knee, but the left kneecap pops in and out spontaneously" "The left knee can be stabilized with surgery....the best success is when the tibial tuberosity is moved to better align the patella...results in a fracture that is back in place with pins" Recommends high qulaity fish oil to help as a natural anti-inflammatory...If she holds leg up more than once a day or has difficulty jumping onto sofa etc. then surgery is recommended.

We're not doing it now because she isn't doing badly, but that price is a whopper.

While you are limiting her activity, PLEASE stop the jumping on and off the couch, or furniture of any kind. That jumping on and off furniture is a major cause of LP, and most definately an extreme aggrivation to the joints....there can certainly be a genetic issue with shallow joints, and this can be seen on xray as a puppy, but slamming those tiny joints together repeatedly is the worse thing that can be done to normal joints, damaging them with this "repetitive motion injury"! Please, do not let your small dogs of any breed, slam-jam their tiny little bones/joints together by jumping off furniture!
As far as the surgery, I personally would wait until the pup is lame. I would give tissue/joint support with antiinflammatories.....I use GlycoFlexIII in several of my seniors that have arthritis in joints....not the same thing as LP, but I know several neighbors and a couple of my cousin's neighbors that have dogs with spine issues (two are weenie dogs) and they have been able to avoid surgery with support with this medication....some take other meds as well, one is given shots.....but surgery has been held and the dogs are doing well. I can not imagine a Grade 2 requiring surgery!

Both of mine have kneecaps that pop in and out. Grade 2 to 3. I would try the fish oil first if she's not having issue much now. Mine don't even hike their legs. Uni only did it once and that's why I found out about it after I took her to the vet to get it checked out.

Also get a second opinion from another surgeon. Some are surgery happy to get your money.

I agree! I am not aware of any necessity of having surgery on a Grade 2, or even a Grade 3....and I do know a breeder with a little girl that has a Grade 4 that is still doing well without surgery. I would get a second opinion for sure....from an ortho. specialist....

We went to a board certified surgeon in Asheville and the cost was $1800. That included the ligament repair. If he were to need an x-ray during recovery, that would be 100 dollars more.
Our regular vet actually wanted a thousand more, and our regular vet is in a rural area, so perhaps that is the difference. good luck. It's a tough decision.
I would definitely get a second opinion about the necessity and also the cost. You might find the first surgeon is just pricey!

Certainly get a second opinion but here in the most expensive city in Canada it is about 2500-2000 with only 2 views of Xrays and one overnight stay.


I really urge you to stop the leaping off couches and unfortunately ball playing is now out of the question - unless you do the fetch and retrieve in water. Swimming is a great activity for their joints. Coupled with good walks.


There are many low impact activities to help your Yorkie enjoy life. Find the toy on non slip surfaces is a great one. When magic was in acute flair - I used to hide the toy around my body and he would get to find the toy! he loves it. You can use an obstacle course in your living room - low height and for each obstacle they get a treat when they complete the task for that obstacle.


Get some very good joint supplements and use them now. Consider seeing a canine physiotherapist and develop a program for your pup.

Wait until she is lame?

Thanks for the input. The challenge now is to find a supplement she will eat. I just ordered 2 pounds of Premium joint care from Drs FosterandSmith and she will only eat it if I catch her in the right mood. She will happily eat Heartgaurd chews, chicken jerky (likes my homemade 100% chicken only the best) and she loves Pedigree mini jumb. Thats about it for treats, not counting roasted/boiled chicken.

I don't intend to get surgery until I see her get worse. The surgeon just put the options on the table, and wanted me to be informed. She didn't give me the feeling she thought I would go for it now.

I wonder if I can get a price over the phone for the same list of procedures etc. at Jefferson or University of Pennsylvania vet schools.

Cap't noonie. Maggie only hiked her leg about 4 times, within one week. The first time seemed like it happened suddenly and she held it up for several minutes, took about 15 to get back to where she seemed normal. The other 3 episodes were about 4 days after the first, one each on Sat, sun, mon and all three were brief. That was about 2 weeks ago. (took that long to get appt due to Easter.) She took Rimadyl during that time and we kept her from roughhousing.

We'll work on a way for her to get up on the bed. It's not as high as many, but still. Right now she jumps onto my Lane cedar chest which is maybe 4 inches lower than the bed. Kind of like this one.
https://s-media-cache-ak0.pinimg.com...62601d79bd.jpg

I wouldn't operate. My surgeon does not recommend for adult dogs...only pups.
I am having a puppy done tomorrow and the price for both knees is $2800 +/- 10% so I don't think your price is that far out of line.

A board certified surgeon is absolutely going to charge more than a general vet.

Yes, you can price check on the phone usually.

Oh, yes, that is very high for one knee!

Adding the other knee should not add that much to the bill. Just for curiosity's sake, I would ask how much it would be if they repaired both knees.

I do believe that if that price is for one knee, they are very high; and, yes, I will bet that U of P will be less. Of course we have to also remember that different parts of the country have different pricing for things. The general cost of living here in Texas is pretty reasonable compared to what I found in NJ.

In my other post, I had suggested GlycoFlex III....perhaps you may want to check that supplement out.

Yes, that's what I said. Surgeons here won't fix knees until that happens or unless there is a CCL tear (except in the case of a puppy with severe Grade IVs).

Also, in 2002, we paid $1500 for one knee. I paid $2900 for a CCL and MPL repair for my older dog 3 years ago. So for the northeast that price is about the same for a boarded surgeon. A friend paid $3,000 for one knee on a puppy about 4 years ago.

I don't know anything about knee surgury, but yeah vets are expensive in this area.
I paid $700-800 for Lola's spay, including blood work
My cousin paid like $500 for a dental (cleaning and pull a few teeth) then about $1000 for reversal meds, fluids, and an overnight stay at the ER vet when the first vet ODed her dog on pain meds.
My friend paid about $2000 when her boxer ate a dishtowel.

NJ is much more expensive than TX, my best friend's family has lived in both places.

:thumbup::thumbup::thumbup:

Same here at least for the majority of them. Some will still recommend surgery. It really is ridiculous though imo....every one of my personal pups has some degree of LP. If they tear a ligament, they will then have the ligament repaired and knee at the same time. To repair them as adults is not gaining a thing really....they already have wear and tear on the ligament and fixing the knee is not going to prevent a tear that will require surgery. The knee can be repaired at the same time the ligament is. I am not willing to put them through an unnecessary surgery only to have them be faced with another down the road.

Some of these prices sound a bit high. We may be comparing LP surgery to CCL repair surgery. Repairing LP is much less than CCL surgery.

I found the best price to be on pureformulas.com. Not sure how reputable that site is or isn't. I did go to the Vetri-science site to see the labeling for the minis vs the regular. I'm not sure if you can overdose this stuff, but the regular has a much higher amount. I know I can split the larger ones. I might order the mini's just because I can get them for less $ to see if she likes them. She turns her nose up at so many things. If she likes them, then maybe I will ship the other ones back to Dr Fosters and Smith depending on what I paid and what it costs to ship back.

I looked up the fish oil the vet suggested and it comes in a liquid as well as softgel. I wonder if I could sneak the liquid by her in her food....

I think there are occasional circumstances where an adult may need LP surgery with out the ACL tearing. Callie was showing lots of pain with her LP, not wanting to run or play and acting very depressed. When the surgeon was examining her he could tell when he popped her knee out that it was causing her pain. Her whole body was tightening up and tensing up. After her first surgery which was to repair her LP and her ACL we were told her ACL would more then likely tear in the other knee in 18 months. It never did. We knew the knee was bothering her because we could tell so we waited and waited and it became where we were going to the vet for pain meds way to often and the vet suggested going back and having it looked at so we did. He agreed it was bothering her a lot and recommended the surgery. I know he is not money hungry because when Callie jumped off the couch once (she was maybe 2 years old) she was limping and would not put her front leg down and we rushed her to the er vet at 2am where I was not pleased with the service but Callie started walking on it but we requested X-rays and nothing was found so we went home and she was limping again. We went to our vet the next day and the vet looked at the X-rays and saw nothing but when she touched a spot in her shoulder she screamed. This was the first time we were referred to and meet our orthopedic surgeon. He sedated Callie for X-rays and found her shoulder/front leg was over extending when she would jump down/land. He actually recommended the conservative approach rather then looking at surgery and that is what worked. Great guy and I trust him big time. I think it's important that you are the one who knows your dog and if they are hurting.

In my experience, they need to be strictly rested for about 4-6 weeks with a flare. They also need to be good weights and not be overweight. I'm not a believer in supplements but that Adequan is amazing.

If you don't have pet insurance yet..I highly suggest you get it before the surgery..at least you will be reimbursed a good portion of the money you pay out. Its really not terribly expensive per month. I learned that the hard way. I hope Maggie gets better soon. Best of luck! PS…everything is more expensive in NJ! Thats why we have the greatest exodus rate in the country, lol.

Once a dog has a pre-existing condition, you can't get pet insurance for that problem.

It would be pre existing so it would not be covered.

Totally agree! I have 3 with varying degrees of LP and it's never been suggested they needed surgery. Unless your dog is lame they can live with LP.