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Old 10-22-2011, 05:55 AM   #1
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Default Luxating Patella- 1st Visit w/ Ortho Surgeon

This is a follow up to the Luxating Patella thread I started here in the Sick/Injured page. I started this new thread in the Health section because it really is a health issue as it is a congenital disorder and he is not sick or injured.

We had our first visit with the orthopedic specialist, Dr. Peacock, yesterday.
First of all, I just loved this ortho surgeon . He has a wonderful bedside manner. He agreed with the grading done my vet (back knees are 3/4 and 2/4). He said we could take a wait and see approach or we could do surgery. He did make it very clear that this wasn't urgent. I liked the fact that he wasn't trying to push the surgery. The doctor did mention that if Mojo went lame, we'd of course have to do the operation. I don't see Mojo doing a lot of limping, but I do see him trying to kind of work out his legs once in a while, so I know it has to bother him somewhat. Honestly, after speaking with the surgeon, I think the best decision is to go with the surgery. I mentioned that we'd need to get through Christmas first (I'm beginning a new job on Monday and won't be able to take a lot of time off right away) and the surgeon suggested waiting until after all the snow melts so there wouldn't be a concern of Mojo slipping on ice and snow.

Again, this doctor wasn't trying to push the surgery, but after hearing all of the information he presented, I feel like the best decision is to go ahead with it. As long as Mojo doesn't have any big problems over the winter, I think we'll wait until the spring. I believe he said Mojo will need to be on restricted activity for about 2 and a half months after the surgery, so I'd like to schedule at least a week off of work. I may even wait until my son is done with school for the year so someone will be home with him. Thankfully Mojo already stays in his x pen when we're not home, but I can't imagine how challenging it will be to keep him from running and jumping for two months! It's horrible to think about such a young dog needing surgery (he'll be one on the 28th), but I want to do what's best for Mojo. The estimate the specialist gave me was $3,600 to $4,500 to do both legs at the same time. I think it was about $2,600 to do one knee by itself.

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Old 10-22-2011, 07:12 AM   #2
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I go to the orthopedic surgeon on Wednesday to see what they think and if it can I would also like to wait until after Christmas because I live with my grandparents so my aunt and uncles come over at different times for the holidays and it would be very very hard to keep her calm because she loves people so much but if he says she is pain and it cant wait I will go ahead and do it. I'm glad you like the orthopedic surgeon thats so very important.
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Old 10-22-2011, 08:02 AM   #3
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I agree, it would be best to have the surgery done at a time when your household is a little calmer. I went to American College of Veterinary Surgeons to find mine, but luckily he is at the 24 hour emergency vet my vet refers to when they're not on call. It's a specialty animal hospital that handles only does emergencies and specialist visits. They have specialists in cardiology, dermatology, diagnostic imaging, emergency/critical care, internal medicine, neurology, oncology, ophthalmology, rehabilitation, surgery, and radiation oncology. I have to say, I was very impressed with the facility. I really hope you have as positive an experience as I did!
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Old 10-23-2011, 08:07 PM   #4
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I am so happy that you have found a surgeon that you can trust! It is such a shame that Mojo is having these issues.
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Old 10-24-2011, 03:42 PM   #5
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I am so happy that you have found a surgeon that you can trust! It is such a shame that Mojo is having these issues.
I know, I feel so bad thinking about what he's going to have to go through recovering from the surgery. To complicate matters, I got a call from my vet this morning. The ortho had faxed him over a copy of our records. Now, when he originally diagnosed the luxating patella, my vet and I did not go into details because Mojo was being seen for an illness. Well, this morning my vet calls to inform me that he routinely performs LP surgery. The price he quoted me was significantly less that the specialist, although of course the specialist is not only a specialist, but is also located in a more urban area where I'd expect prices to be higher (I'm essentially in the sticks). Neither doctor is rushing me to do this surgery. My problem is now I have to decide between the board certified specialist and my general practice vet... I'm not sure what the right choice is.
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Old 10-24-2011, 04:08 PM   #6
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Quote:
Originally Posted by hnybun128 View Post
I know, I feel so bad thinking about what he's going to have to go through recovering from the surgery. To complicate matters, I got a call from my vet this morning. The ortho had faxed him over a copy of our records. Now, when he originally diagnosed the luxating patella, my vet and I did not go into details because Mojo was being seen for an illness. Well, this morning my vet calls to inform me that he routinely performs LP surgery. The price he quoted me was significantly less that the specialist, although of course the specialist is not only a specialist, but is also located in a more urban area where I'd expect prices to be higher (I'm essentially in the sticks). Neither doctor is rushing me to do this surgery. My problem is now I have to decide between the board certified specialist and my general practice vet... I'm not sure what the right choice is.
I would never allow a general practice vet to do LP surgery on any of my pups...or my fosters.
I have issues with vets who do that...but that is of course my opinion.
Sadly, I have seen real messes with people who opted with cheaper fixes...and yes it is possible to have a mess with a boarded surgeon...but I will stick with them.
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Old 10-24-2011, 07:31 PM   #7
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Quote:
Originally Posted by hnybun128 View Post
I know, I feel so bad thinking about what he's going to have to go through recovering from the surgery. To complicate matters, I got a call from my vet this morning. The ortho had faxed him over a copy of our records. Now, when he originally diagnosed the luxating patella, my vet and I did not go into details because Mojo was being seen for an illness. Well, this morning my vet calls to inform me that he routinely performs LP surgery. The price he quoted me was significantly less that the specialist, although of course the specialist is not only a specialist, but is also located in a more urban area where I'd expect prices to be higher (I'm essentially in the sticks). Neither doctor is rushing me to do this surgery. My problem is now I have to decide between the board certified specialist and my general practice vet... I'm not sure what the right choice is.
I would go with specialist.
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Old 10-24-2011, 07:33 PM   #8
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Quote:
Originally Posted by ladyjane View Post
I would never allow a general practice vet to do LP surgery on any of my pups...or my fosters.
I have issues with vets who do that...but that is of course my opinion.
Sadly, I have seen real messes with people who opted with cheaper fixes...and yes it is possible to have a mess with a boarded surgeon...but I will stick with them.
To clarify: I think there is a much less chance of problems with a boarded vet. You have to think: would you allow your medical doctor to operate on your knee?
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Old 10-25-2011, 03:37 AM   #9
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Yeah, I was thinking that, no matter how often my vet claims to have done the surgery, all the specialist does is surgery. Hence being a specialist. Obviously, Mojo needs the best there is.

As for letting a GP operate on my knee, I let my GP deliver my son. Does that count?
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Old 10-25-2011, 05:12 AM   #10
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Quote:
Originally Posted by hnybun128 View Post
Yeah, I was thinking that, no matter how often my vet claims to have done the surgery, all the specialist does is surgery. Hence being a specialist. Obviously, Mojo needs the best there is.

As for letting a GP operate on my knee, I let my GP deliver my son. Does that count?
But would you have let him to a C-section for that delivery?
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Old 10-25-2011, 05:32 AM   #11
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On a serious note: I have seen botch jobs by general vets. I had a foster whose owners had chosen to go a cheaper route for a fractured leg. The vet put an IM pin in that leg and it was just not enough....the pup needed a plate and screws. Yes, it was cheaper...but the leg never healed. When I got this poor pup six months later he needed bone grafting in addition to the plate and screws. Another mess I saw was a FHO surgery and the vet cut the poor pup's sciatic nerve. Then, another one where a regular vet went in to fix LP and ended up closing it up and telling the owner it was the worse knee he had ever seen and to take the pup to a specialist. Often when they get in these things are not as simple as they might appear and I personally think it is better to have a surgeon who has seen it all...who does these surgeries all of the time.

Another consideration: does your vet have a 24 hour facility? I don't allow my pups to stay overnight where there is no one to observe them. If there is a problem after the surgery, what then? An emergency clinic? There goes the savings.

Bottom line is that it is your choice and honestly your pup could be just fine if your vet does the surgery. I am merely telling you how I feel about these things....because you asked.
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Old 10-25-2011, 06:14 AM   #12
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You absolutely should not have anyone but a ACVS boarded surgeon do this surgery. My dog Daisy had this surgery at age 2 -- by a boarded surgeon -- and she is now 11. She jumps on and off the bed, scales up and down the stairs, runs and plays and goes for long walks and there have not been any problems in 9 years. I attribute this to a good surgeon. General vets doing this surgery are looking for the cash cow de jour in my opinion and are not qualified to do the surgery. Sorry if this gets some people fired up but I just had to say it. Best wishes for your baby.
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Old 10-25-2011, 06:30 AM   #13
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A young pup who is already symptomatic, I think surgery sounds like the right thing to do also.

I'd say go with the specialist because there seems to be doubt that the general vet could do an adequate job in your post. Why take the risk if you are already uncomfortable with the idea? There seems to be a lot of vets that do LP surgery now, but how many have they done, are they trained to do it, what method are they using (there is more than one and there is an additional procedure sometimes needed that not everyone does), etc. Boarded vets mess up too, but it's less of a gamble if you have no info about success rates from both boarded and unboarded vets.

I'm not against generals doing ortho surgery if I think they know what they are doing. That is, if I think they just want to add a $2K surgery to their list of services, then I'd run. Some are very good at it though. My dogs would see an unboarded surgeon for these issues, but that is because I'm very comfortable with their abilities. And if it was over their head, they would not do it. But of course with that comes the possibility that the animal gets closed and sent to a specialist. Not the end of the world imo. It's all in what you're comfortable with for your pup. BTW, on the other side of that, I know of two other generals performing ortho surgery that simply should not be. They would not touch my dogs with a zillion foot pole. And this is exactly why I'd say go to the specialist. You could very easily end up with a general doing it that thinks they know what they are doing and they just don't..
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Old 10-25-2011, 04:24 PM   #14
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You've all brought up very good points. Honestly, the general practice vet may do these procedures all the time, but why would I take Mojo to anyone but the best? Also, the quote the vet gave me was so much lower that it actually made me wonder as to the quality of the procedure. Does that make sense? I pretty much knew I was going to use the boarded specialist regardless, but it's so nice to think it through on this board. I do still like my vet, though, because he stressed that it had to be what I was most comfortable with. So even though I think he probably was trying to make a little money, at least he wasn't pressuring me at the sake of my dog's health. In retrospect, I don't think he was really pressuring me at all. I think he was just letting me know he did the procedure. Also, my vet is not 24 hours. I would NEVER leave my Mojo anywhere where he wasn't under constant supervision.

Oh, and no way in heck would I have let my GP do a c-section on me! I was very young (I was a child bride!) and felt comfortable with her. If I were to have a child today, I would research thoroughly to find the best OB I could.
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Old 10-26-2011, 09:43 AM   #15
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Not sure how many board certified surgeons there are near you, but you could always check and see what they charge before making your final decision. There may be some very good surgeons out there that don't charge quite as much, although it will definitely be considerably higher than your general practice vet quoted. You definitely want to stay with an actual surgeon though. Good luck with your decision. I'm sure we are all waiting to see how the surgery goes for your little pup.
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