luxating patella..
 

My Yorkie Abi is 3, since she was a puppy the vet has said she has lucating patellas. This past week at her checkup he said on a scale of 1-4 (4 being inoperable) that she is a 3. Which in most cases I would do exactly was the vet suggest and do surgery. However, from everything I have read in my research when a dog is at a 3 they are in suvier pain. Abi runs and jumps, she plays rough with our 70 pound lab, she can almost just on the kitchen counter. If she is a 3 how can she be so active, and never cry in pain? or seem to be in any kind of discomfort?

I hate to put her through surgery when she dosnt seem to be in pain.

I would appreciate any thoughts or experiances anyone may have with this.

A dog's instinct teaches them to hide their pain.

If your Vet says it's a 3 then I think it's time for the surgery. In the meantime, she probably shouldn't be running or jumping...it will only take a second to get to a Grade 4.

My maltese just had his 2nd knee done and although the recovery is long and if done correctly - requires alot of rehab - they go on to do just fine! The only problems I have heard of after surgery are from those who didn't follow the post-op directions. Personally, I was too AFRAID not to listen.....first off it was his knees and second off...it cost a fortune...lol!

Good Luck to you and your baby.....

Get a second opinion! If ever you have any concerns about your dogs health or your own go see another unbiased vet or physician. Do not tell them what the previous vet said or that you are coming in because of the patella problem. Tell them you are there for a general checkup and want the dog looked over thoroughly. See if they find it and what they say.

Just a suggestion. Good luck.

IF I were you, I'd seek a second opinion and that would be from an orthopedic surgeon. I wouldn't make a decision on the word of any one dr. Please keep us updated.:)

I looked up a couple of articles. I hope they help you.

Luxating Patellas
Luxating is a fancy word for dislocating. Patella is your dog's "knee", the joint on the front of her hind leg. So a luxating patella is a dislocating knee or trick knee, a knee that keeps slipping out of its socket. This can happen in yorkies with weak ligaments, tendons, and/or muscles. It can also happen in Yorkies whose kneecap groove is too narrow or shallow. The knee usually slips inwardly, toward her body, and locks so that your Yorkie can't bend her leg.
Suspect luxating patella if your Yorkie sometimes lifts one hind leg while she is running, or if she often moves both rear legs at the same time, like a hopping bunny.
Sometimes the knee slips only for a few moments, then slides back into place. Sometimes the knee slips out and stays out, and your Yorkie will hold her leg off the ground and limp, perhaps tucking her thigh into her body. Luxation may occur in one knee, or in both. It is seen in many other toy breeds, and in both sexes, though it seems to be more common in females. No matter how firm the knees seem as puppies, toy dogs are liable to injure their knees.

Is luxation serious?
There are four degrees (grades) of luxation:

I. The knee only slips out when the vet manipulates it.
II. The knee luxates occasionally when your Yorkie is walking or running. She may not seem to mind much, or she may shriek, but it usually slides back by itself as she continues moving. Or you can slip it back manually (ask the vet to show you how).
III. The knee luxates frequently and causes chronic lameness. Even when you put it back manually, it doesn't seem to last long.
IV. The knee luxates, stays that way, and you can't put it back into its socket. This grade is very rare.
How is luxation treated?

•The first treatment should be to crated for a week or two and supervise the activity - no jumping.
•Non-steroidal anti-inflammatories (like Rimadyl). These will hide the symptoms, but do absolutely nothing to strengthen or correct the knee.
•Steroidal anti-inflammatories. These are extremely damaging to the immune system, have awful side effects (short and long term), and should never be used.
•Surgery. Surgery is seldom the answer and should only be done by an orthopedic surgeon. Call the American College of Veterinary Surgeons at (301) 718-6504 and ask for a referral to an orthopedic specialist or college of veterinary medicine in your state. If surgery is your choice, that dog will have problems down the road with arthritis from the surgery. In the opinion of most vets, surgery is over-kill for Grade I or II luxating patella. I would only go with surgery on a Grade IV luxation, or on a Grade I II that did not respond to natural treatment. Surgery costs about five hundred dollars per leg, it is uncomfortable for your Yorkie, and there is a 50% chance that some degree of luxation will return.
Natural ways to treat your Yorkie:

•Feed fresh foods.
•Keep your Yorkie lean. Fat dogs have to carry more weight on their weak leg joint.
•Moderate exercise, walking up slight inclines (gentle hills), will strengthen the muscle groups around the patella.
•Vitamin C is one of the building blocks of strong ligaments and connective tissue.
Glyco-flex and Glucosamine are nutritional products packed with minerals, amino acids, enzymes, and lubricating agents. They build cartilege and cushioning fluid in injured joints, and help heal damaged connective tissue.
What causes luxating patella?

Occasionally it's caused by an injury, but in the absence of such proof, the weak tendons and/or shallow kneecap groove of luxating patella is considered hereditary. Never breed a Yorkie with any degree of luxation (even a "wiggly" knee), whether it has been repaired or not. Fixing the knee doesn't fix the genes that caused the problem.

OFA Certification
The Orthopedic Foundation of America will issue registration numbers to dogs whose patellas have been x-rayed by a vet, forwarded to the OFA, and found to be normal. This condition is so common in Yorkies that we believe it is essential that all breeders start doing these x-rays before breeding. Then you will be able to INSIST on seeing the OFA certificate for each parent before buying a Yorkie puppy. It will be one more way to pick out the responsible breeders from the rest of the pack.

for More Information visit the Orthopedic Foundation of America

http://www.earthsangels.com/html/luxpatel.shtml

The patella is better known as the kneecap, which normally slides up and down in front of the actual knee joint as the leg moves.

A luxating patella might be translated into everyday speech as a dislocating kneecap.

The kneecap in question is the cap on the knee of the back legs. Luxation may be caused by injury, but evidence suggest that the condition is genetic or they are born with this condition. The ligaments around the patella may be weak, allowing surplus motion. When the cap dislocates, it will move toward the body, and may lock the leg, making it almost impossible for the dog to walk on. Severity of a luxating patella varies, ranging from an occasional slippage to a permanently dislocated cap. Minor cases may be treated with diet and exercise, but the case must be mild for this to be effective. The only permanent solution to more severe cases luxating patellas is surgical. There is more than one type of surgery available to treat this condition. You should talk with your Vet to determine what is best for your Yorkie.

Making sure that your dog does become overweight is a good way to avoid luxating patellas. The less weight that your Yorkie has to carry, the less strain there is on his kneecaps.

If your dog should be diagnosed with a luxating patella, you should contact the breeder from whom you purchased your puppy. Responsible breeders will want to know this in order to attempt to remove parents from their breeding programs.

http://www.yorkielane.com/Health/patellas.htm

I forgot to leave this link for you from the Orthopedic Foundation for Animals on LP:

http://www.offa.org/patluxinfo.html

Just a quick addition....

My maltese's parents are OFA clear for patellas...........the gene is recessive. Therefore, OFA clearance means nothing. I'm NOT saying it isn't great to have it done, I actually wouldn't buy another with OFA clearance, but it is not a guarantee that your pup will be fine.

The article seems somewhat outdated.....$500 for the surgery.....50% chance of recurring luxation......Rimadyl as an anti-inflammatory....

The second opinion is a great idea! My regular Vet did the original diagnosis and the Orthopaedic Surgeon confirmed it. Of course when your dog hits a Grade 3 it should be apparent in his walking.

I found an excellent article about lp published in the YTNR magazine, "The Yorkie Times" on page 5. The first link is pdf format. If you don't have a pdf reader, I've also given you another link that you can follow.

http://www.yorkierescue.com/YTNR-New...or%20yorkie%22

http://72.14.203.104/search?q=cache:...s&ct=clnk&cd=3

It was a good article....not too much detail...but definitely informative.

I just get a chuckle out of the $1000 per knee......but I know Auburn is in Alabama!

NYC and vicinity prices are more than double that......:mad:

I'll keep her in my prayers.

From what your describing it doesn't sound like a Grade 3 or 4 to me. Why would a Grade 4 be inoperable? I, too, would seek a second opinion. In the meantime I would discourage all jumping and buy stairs for the couch and bed. I would also no longer allow rough play with the larger dog. It's true that dogs hide pain, but with a Grade 3 luxating patella I would think you would see her walking funny at least from time to time.

I have some light weight plastic ones (the 4 step model - 16 " high) from www.doggysteps.com (I bought mine off of Ebay though) and you can also get the 3 step model at Target, Walmart, Walgreens - haven't seen the 4 step at these places, but you can buy a kit to add the step from the www.doggysteps.com - My dogs are all 4 pounds and they work great for me.

ABSOLUTELY! If you are not completely comfortable with your vet's diagnosis, get a second and sometimes even a 3rd opinion! I use 3 vets, myself!

My Bruce just had LPM surgery to correct LP on August 18, and is recovering quite well...This from experience is what I can tell you...

Bruce was and is quite active and never showed signs of pain or cried out when running, jumping or playing with other dogs. The only noticeable sign to me was that he would occassionally stop and lift up his leg suddenly in the middle of a good run or while we were playing, later I The surgery on the other hand pretty much brings this risk down to normal, and the discomfort is not nearly as great as it sounds...

Bruce's experience was not pleasent, but the worst part has been the necessary confinement to heal and rest...I took Bruce in for the surgery in the morning, he had the surgery midday and it took the vet approximately 2 hours. They kept him medicated and under observation for another day and 1 1/2 at the vetrinary hospital. When I picked Bruce up he was obviously very medicated and he barely wanted to walk, and would hardly try to use his leg. For the next three days he slept all day for the most part, and hardly ate or drank, which worried me. Then almost miraculously he was up and trying to use the leg and it became difficult to keep him slowed down.

The surgeon for the first 2 weeks had me keep him crated a lot when I was not directly supervising. He was allowed outside on leash only for bathroom purposes. No jumping of any kind was allowed, and no walks over about 5 minutes. Slowly I increased his walking time by 2 minutes per walk. Then stitches came out and he had the leg checked. He had some restrictions lifted and can now take as long of walks as he wants so long as he is not limping or not using the repaired leg. He can jump down off furniture just not up, and can walk freely throughout the house or yard with supervision to make sure he does not jump up or run...Additionally once a week he has hydro therapy where he walks on an underwater treadmill, and we have proscribed exercises we do in the morning and at night. In 3 weeks assuming he passes his check up he will be allowed to be full speed.

For us the surgery was worth it, for everything including therapy I have paid just over $2250. I advise seeing a specialist and making sure that they are one that takes a wholistic approach to the surgery, meaning they offer therapy services and are willing to spend a lot of time counseling you about what to expect.