Do all luxating patellas need operation?
 

My eldest daughter Crystal (4 years) has developed this condition now in both hind legs. She first went to stage one in the right rear when she was about 18 months old and never effects her alacrity. However following a recent attempt to wrestle the mailman through the letterbox (a favorite time of the day, not to be missed) she landed awkwardly and I feared the worse as she yelped on landing. I gently stretched the left leg and following a little pop she was her usual self again.

It does sporadically re-occur usually self correcting itself. We visited the vets this week and he confirmed my observation about the recent right hind leg condition. Surgery is about $2500.

Forgetting the money, is surgery necessary (risk etc)? Or being a young dog still, would the curse of arthritis catch her up in later years? - something I now know all about myself.

We have laminate floors throughout and I'm considering providing 'landing carpets' for those leaps off the furniture she lavishes makes with all the skills of a down hill slalommer. Her midget sister (Biewer) is under 5lbs and a year her junior with deliciously stubby little legs. She has her own staircases throughout the bungalow to ascend the heights and tends to gently hop down from the bed or couch with a far more cautious approach. Her patella's are just fine, but she has far sturdier pins and seemingly a lower gravitational centre it seems.

Has anyone been though this dilemma? Do please respond if so, your experience would be so much appreciated ...

LP puts wear and tear on the CCL and can cause CCL tears. Doing LP surgery on an dog not a puppy could cause two surgeries to be necessary because the CCL could still tear even after the knee is fixed. My 10 year old about 6 years about went to the orthopedic surgeon after limping and had a partial CCL tear so we fixed her LP at that time as well. They suspected the CCL would tear in the other leg in the next 18 months. It didn't tear and 2 years ago I got the other Knee done because it seemed to be bothering her and then about a year latter the CCL tore and that meant another surgery. LP surgery is a very tough surgery on the dog it's 8 weeks minimum of crate rest and it's extremely painful. I would not do it unless necessary. I would also never have it done by a regular vet because most of those have to be redone. It should be done by a board certified orthopedic surgeon.

Have a read through this older post: http://www.yorkietalk.com/forums/gen...rice-high.html

I found it very helpful to read everyone else's experience as I recently was going through the same dilemma.

My older dog Thumper (7 years) I was told is grade three LP. My vet is pushing surgery before arthritis kicks in. I am not going to give him the surgery right now for the following reasons:
1. He is in no pain or limping
2. Why put him through the procedure at his age
3. He acts normal

I feel at his age I can manage it when necessary with pain meds.

Now my other dog Bella (2 years old) has grade 1 LP and she is a jumper, there is no stopping her. Should she need surgery in the next five years I would get it because she is much more active and younger.

If your baby is only 4 years old I would consult with an Ortho Specialist and get their opinion it might be worth it.

:) Thank you, your response is very much in line with my thoughts. We thought of seeing a registered orthopaedic surgeon to get x rays and an opinion. Crystal is an athletic little so and so and loves leaping of chairs etc onto hard surfaces, We have placed 'landing mats' in her favorite places now to help her.

:) Thank you, I believe it best to leave it and spare her the pain and stress as long as possible. I have a problem myself after a severe accident 42 years ago and my surgical consultant has advised me at 71 years of age to delay surgery as the side effect may be highly stressful.

:) As I've mentioned above we are seeing a consultant shortly. Crystal is a serial leaper and I know your feelings too!

A New Development
 

Last night Crystal started limping and holding her right rear paw off the ground. The pain is not from the knee and the patella is firmly located. However when I try to part her paw pads she becomes extremely stressed, teeth baring, snarling and air snaps etc. I've bathed the foot in warm salt water several times and she seems bright with a good appetite, but is lying on her little bed all day looking very sad.

I'll take her to the Vets soonest tomorrow, maybe she's picked up a grass seed or a splinter from the garden? I don't think this is knee related but I feel very impotent at the moment. I keep cheering her up with little treats and she still tries to jump up - god bless her, as if nothings wrong.

Any ideas what it might be, can I do any more before the vet to comfort her? She places so much trust in her dad to protect and help her, that currently alone, I feel a real failure ...

In my opinion if she is not using that leg it means it hurts and she should be all the emergency vet for pain meds at least. It could be a torn CCL.

On the mend
 

Hello and thanks for the response. She slept (as usual) with me last night and I kept a heat pad I use for fibro myalgia on a low setting throughout the night applied to the sore paw. This morning she's much better, walking normally and even attempting an ear scratch or two. At least she's putting her full weight on the paw in question so I'll keep her close today and see if she's on the mend naturally.

My tiny 9 year old Rin has LP, stage 2 (maybe moving to 3). My vet has never recommended surgery.


His recommendations to me 1. keep her weight down 2. give a glucosamine supplement (he recommended one) and 3. keep jumping to a minimum.


Well her weight is fine, although I do have to scold my husband occasionally for giving her too many treats. We are probably on the third/fourth month of glucosamine, and I tell you, the little diva is acting like a puppy she feels so good. The jumping, ahhhh the jumping. It is so hard to keep a good Yorkie down!! She does have steps for the bed and sofa, which she uses MOST times. All that being said, my beautiful hardwood floors are covered with LANDING PADS :) I'm fond of no slip bath mats!

:thumbup:

I also give glucosamine in her food and as a supplement. I am hoping it helps. I have trouble with the weight as he just will not lose any no matter what I do.

I battled weight issues with two of my pups for years. They are brother and sister which is interesting....I wonder if it is genetic. Anyway....I have done various things. I did home cooking for them for some time and that worked, but I stopped it; and then, when they got back on dog food, they gained again. I then used Hill's Metabolic which worked well to get the weight down. I got comfortable again and stopped that....and sure enough, they gained again on dog food. FINALLY I hit the solution that has worked best. I stopped feeding them kibble...they are on strictly canned food which I weigh so they get the same amount each day. I really do believe it was the kibble that was the issue. I have others on kibble who don't gain like that...but these two pups were eating way less kibble than the others and still gaining. I am NOT changing every again....they are 10 years old now and doing terrific!

My Gizmo, who will soon be 7, has been diagonsed with a LP about 4 weeks ago.At that time the Vet(female) suggested "wait and see if it goes back into place on its own". Two days ago, I decided to take him for a second opinion since he didn't see to be getting better. That Vet(male) tweaked the area of the knee with his hands (turning, squeezing and pulling). He said Gizmo would need a more extensive exam, about $500. I took Gizmo home and now he is in worst shape then when I took him to the second Vet. Before that visit, Gizmo could walk on the leg and run. Now, he walks but lifts the leg at times. He's moping around the house. Not like himself at all. I think he misses our "fetch game, BIG TIME!" I did get pain meds and muscle relaxer for him. Tramadol and Rimadyl. To be given twice a day. Ugh...he hates when I put them in his throat, close his mouth and massage his throat to swallow them. I am going to wait because the second Vet also said, "Rest and no running or jumping. This may heal, work itself out, on it's own." As much as I am tempted to throw the ball for him...I must do what is best for him! I do massage the leg gently and stretch it slowly and gently too.

Did the vet give you an anti inflammatory med for him? Usually that is what is done and crate rest for a couple of weeks. I would not be massaging that leg OR stretching it....leave it alone!

I don't know what the vet meant by tests for $500 to diagnose. Sounds odd to me. They can do xrays but they are not always good for diagnosing and certainly don't cost that much!! If you want a really good opinion, go to a board certified surgeon. If he does not improve, he could have a torn cruciate ligament...and to diagnose that I highly recommend board certified!@!

Hello, Yes the vet gave Rimadyl which is anti-inflammatory. The Vet suggested drawing a blood work up ($170) then following up with taking multiple ex-rays which would require sedation. Then they will be able to do a more in-depth evaluation. Total cost $500. Yes, “ a really good opinion cost a really good price." Not all of us have the means by which to obtain the absolute best available...etc. We all do our best for our pets with the income we have. Thank you for your opinion. I’m am aware that if he doesn’t improve it could be a torn ACL. I’m hoping and praying that he gets better. If not then I will continue to do my best to provide the care that he will need.

I am not exactly sure what you mean by some of your remarks regarding vetting and/or care of your pup.

What I WILL say is that if you go to a board certified surgeon, he/she more than likely will be able to diagnose him for less than $500. The one I use can diagnose a torn CCL without xrays. I was not suggesting you do something that would cost more... actually I was thinking it would be less.

Kind of late for this incident, but if you have limited income, perhaps you might want to consider pet insurance. Sadly, I have seen people have to surrender their pets due to not having enough money to properly care for them. One recently had an adult yorkie with a liver shunt...they surrendered him because they wanted what was best for him. I always hate to see things like that.

Lady Jane, my apologies if I misunderstood your intentions/advice. I have a lot on my plate ..caring for my mother, who will soon be 90 and has advanced dementia, and trying with all my soul to keep her home with her husband of 68 years. My darling dad who is quite healthy for 92 and adores his wife. I guess I’m emotionally strained, so again...I apologize.
As far as surrendering my dog. God willing I will never have to make that decision, I would be and borrow before I’d surrender either one of my boys. I have an appt for Gizmo on Aug 12 at the Humane Society. At that time I will insist they give me a more thorough diagnosis. I will let him rest until then. Continue to give him his meds., pray and shower him with lots of love and kisses.

Oh, no worries. I am sorry for your family issues....it is very hard to watch parents age.

I am with you on the surrendering ...I hope I am never in such a position that I would have to make a decision like that. I was just talking about that last night with a friend of mine.

Hopefully, Gizmo will respond well to the meds and rest. Keep us posted please!

There is not a more exstensive exame to check for LP so that would be a waste. Last time I went to the orthopedic surgeon for a consult it was $100 and he would be able to tell if there was a torn CCL or LP. X-rays really aren't necessary. Have you tried putting the medicine in a treat or cheese or peanut butter?

I see you are in NY and yes here it is very expensive to see a specialist. I went through something similar with an oncologists. It was $200 just for a consultation with no tests done.

Did you go to Blue Pearl or Animal Medical Center. Those are the two hospitals I am aware of for board certified ortho surgeons.

Humane Society is also a great resource I just get nervous when they ask for money up front before even being seen over the phone.

Hello and thank you for that knowledge. I will try to seek out an ortho vet and book an appt for Gizmo. Also, I will give those treats a try because he hates taking med. FYI. before this time, the Humane society has Rimadyl in a chewable form that GIZMO ATE with nooo problem.

Hello, I’ve been to Blue Pearl in the past when I had an emergency with Gizmo. They did a great job but are quite expensive. I’ve also been to the Animal M. C. With other pets and the experience was traumatic to say the least.
The Humane Society has to charge up front because their prices are reasonable and they need the money. If we cancel, especially surgery..they can’t always book another appt immediately since blood works are required in advance. The bad part is that you can’t always get an appt when you need it. My Lucky needs to have his teeth cleaned. I took him to the H.S. last week for his shots and had the vet check his teeth. She said,” OH yes...he is going to need some extractions.” THREE OF HIS FRONT TEETH ARE LOOSE. It didn’t take a genius to make that call! When I went to pay for the blood test for heart-worm(neg.) The woman at the register, who also books appts., told me the next appt won’t be until Sept or Oct. The waiting list is about 700!

Blue Pearl is expensive but they have a great reputation. It wouldn't hurt to go just for an opinion on his leg IF you don't see improvement. I don't think they would charge more than $150 for the exam. Of course there IS a chance he might have to be anesthetized to fully evaluate....they need to manipulate the knee in a certain way and sometimes the pups are resistant. Most times though, they can evaluate for a torn CCL without anesthesia.

That wait for a dental is crazy long...but honestly I doubt there is much harm done in waiting. Doesn't the SPCA also have a place in NY?? I think I heard of one that is low cost and quite good??

More than Likely They will suggested a local anesthetic for ex-rays. They are too costly. I know this well.
The the ASPCA is the org. that refers people to The Humane Society. The wait is long because the price is THE BEST. EX-RAYS, EVAL. CLEANING, AND EXTRACTIONS all together $300!

The boarded surgeon I use hardly ever needs to do rads to diagnose ... I have sadly been to see him more times than I can count...
for fosters and my own pups. I am so lucky to have him!

Definitely a great price on dentals!

You're lucky to have him, and your fur babies are blessed to have you.

Aww thank you. I can tell how much you love Gizmo as well. They really are the best companions!

This is where I go in Houston. The surgeon I use for knee and other ortho issues is Dr. Beale. He is an awesome surgeon and also a wonderful person. The facility is amazing ... many great vets there.

http://channel.nationalgeographic.co...lists-2109373/

Thank you. I love my boys more than words. People love you but animals ADORE YOU! Now THAT IS A PLACE where animals are truly cared for, I can tell! Awesome!