Luxating Patella -- finding a great surgeon
 

During Jezebel's last yearly exam (just this past February), the vet manipulated her patellas and pointed out that she has LP. That shocked me, since I had never EVER seen her favor one leg over another, limp, lift her leg, or anything like that. When the vet manipulated her patellas, there was an audible pop when the patellas would go right back into the correct position on their own.

Now it is 4 weeks later, and she started lifting her left leg and sometimes doing a little skip, primarily when she gets up after laying down.

I want to start a serious search to find the right surgeon. The vet mentioned that they have an orthopedic surgeon that comes by once per week that handles those sorts of surgeries for the practice. Would you consider a vet with these credentials:

"Dr. XYZ was raised in Wichita Falls, Texas and attended S.H. Rider High School. He earned his B.S. in Veterinary Science at Texas A & M in 1974 and his Doctor of Veterinary Medicine from Texas A & M in 1975. He has a special interest in surgery and is certified in AO-ASIF Fracture Repair / Plating techniques, AO-ASIF Advanced Orthopedics / Corrective Oteotomies (TPLOs), and Slocum Tibial Plateau Leveling Osteotomy (TPLO). Dr XYZ is a member of the American Veterinary Medical Association.

Dr XYZ is currently available for surgical cases every Tuesday and some Friday at ABC Veterinary Clinic.

When Dr. XYZ is not working he is spending time with his three toy poodles Gracie, Lucy, and Scarlet or traveling to see his daughter Jenifer in New York. Dr. XYZ likes to combine travel to exotic places and continuing education several times a year. His extracurricular activities include golf and scuba diving."

I would also consider going to A&M or anywhere in Houston, I'm just starting my search.

Meanwhile, I have started her on supplements. I don't want to jump the gun but I also don't want to wait too long so that we are past the point where it can be fixed.

Thanks in advance.

Does anyone have an opinion on this vet's credentials?

I do. If you're in Houston, I suggest you talk to LadyJane about dr Brian Beale at GCVS. I would not use any surgeon on my dog who was not a diplomat of the American college of veterinary surgeons (ACVS) and it appears the vet in your example is not.

Thank you, that's exactly the type of feedback that I was looking for.

Wouldn't it be advisable to have LP repairs done by someone that is in the ACVS AND is trained/experienced in orthopedics? (If Beale is used by LadyJane, I would assume that he would be well-versed on both counts).

Yeah dr Beale is an ortho. He fixes bones and legs all day long! I pointed out this thread to Linda so she should be around soon!

Oh, I HIGHLY recommend Dr. Beale! There are some other YTers who have also used him. I take all of my orthopedic cases to him...my own pups and my fosters. He has done many surgeries for me over the past 7 years and some were complicated cases that others told me could not be repaired. He is also not "surgery happy" .. we took three pups there recently and he did not recommend surgery for any of them. If he says a knee must be repaired, you can take it to the bank!
YHR website has a couple of articles he has written and given to us to use...one is about LP and the other is about cruciate ligament tears.

Yorkie Haven Rescue - Patellar Luxation Info

Yorkie Haven Rescue - Cranial Cruciate Ligament Tear Info

I don't know how old Jezebel is, but often with the older pups surgery is not needed. Of course they are at a higher risk of tearing a ligament, but it does not mean they will. The younger ones usually should be repaired.

Good luck and keep us posted!

I got an appointment with Dr Beale on Wednesday afternoon. Jezebel is only 3.5 years old and very active, so I really want to get to the bottom of this and fix it if necessary. She's half mountain goat so keeping her from jumping is going to be interesting.

Also, what kind of price range should I expect?

That's so funny....mountain goat.

I am not sure of just LP. The ones I have done were also torn ligaments. I would be afraid to give you an amount. They are not cheap but boarded surgeons never are.

Tell them hi from me...you will probably meet Kate...she is the client services coordinator and really nice. They all are...from the front desk to the back and he is awesome! :)

Oh, you can bet I'll be a name-dropper! I noticed on their website that Dr. Beale has a radio show, I'll have to try and listen sometime.

Re the prices, I just wanted to get dh acclimated before the sticker shock.:eek:

Yes, you should listen! He tried to get me to go on that show...as big of a mouth as I have, I could not bring myself to do that. He is great about teaching...you will learn a lot from your appointment. He explains things in great detail and in language that is understandable.

You may not get a great deal dropping my name but they all know me there and they will look out for you and your baby. :) They would anyway...but you know. :) The other thing is that they are good to YHR so it is always nice for them to know that we do refer people to them. That whole place is awesome! I am so thankful to have a place like that so close.

My guess is probably around $3,000 give or take.

Jeanie's Buster had knee surgery there. One was LP and the other a torn CCL. She might know the cost for just LP.
katy yorkie is her user name...going to send her a message...

You know, we might be jumping the gun. Is she having problems with her knee? She may not need surgery!!

She started having trouble with her knee for the first time on Saturday. Every time she gets up, she only uses three legs for the first several steps. Then she will start to use it. If she starts to run, she will start out three legged. If it turns out to be something else entirely different and not LP or no surgery required, that would be great. At least I will know -- one way or another. I feel so bad for her, but looking on the bright side of things I feel grateful that with all of the problems they can have at least we are dealing with something fixable.

Even with LP, they don't always need surgery. Sometimes they will have flare ups and an anti inflammatory will help it. He is the best to ask...if he says she needs it, then she does. I totally trust him.

I thought the exam would not need any follow-up, because she seems to be doing SO much better today, but .....

The surgery is set for next Tuesday. :(

Her acl had ruptured, and the joint is all out of whack. It doesn't stop her from going all the time, though. Oh, the spirit of a terrier! At one point, Dr Beale opened the door of the exam room and she bolted. He chased her a good way, around a couple of corners, before he was able to catch up to the little stinker.

He said it was a fresh injury, because there was no arthritis. so that's good. I can't imagine a three year old dog saddled with arthritis for the rest of her life.

And dh hasn't even asked how much it's going to cost. Love him!

Oh my goodness.....I can just see him chasing her now. hahahhaha He is a great guy. I have seen him get on the floor to pet a small pup and talk to it. He really loves what he does and he is an awesome surgeon. She will be in great hands. Just make sure you keep her from those antics during her recovery!! :D;):p

You will love Dr. Beale and the whole staff. They are all top notch. Buster had a torn ACL on the left leg, it took two surgeries to fix the torn ACL and the LP. The cost for both was $3600.00. When the LP surgery was done on the right leg it was $3000.00. My DH didn't flinch at the cost either, he still says cost doesn't matter. Buster has no arthritis either. He does sometimes still limp. But he doesn't slow down one bit...he would walk for miles if I would let him. However, keeping them "quiet" while they recuperate is another matter. Good luck with the surgery.

Forgot to say, if you drop Buster Geer's name, they will probably start laughing and not stop. :D

I was given an estimate of $3750, = or - 10%, so things haven't changed much. I actually am more worried about the recovery than the surgery. I figure she's in the best of hands while she is there, it's the aftermath that is the difficult part. After surgery, there is only one chance to heal correctly. I started tethering her to me while in bed to prevent her from jumping, and she doesn't mind it at all. I just might do that for the rest of her life. A new wire crate with a memory foam mattress is ready, and I'm considering putting up a note on the front door to ask people (neighbors, etc) not to knock or ring the doorbell. Both of mine jump up instantly and run anytime that doorbell rings. I'm going to put empty cardboard boxes on the sofa and chairs to prevent her from trying to jump up, and she will only be allowed on the furniture if I am there with her and she is tethered to me. I would appreciate any suggestions you have along these lines.

Will do!

Don't worry so much about the long term. Once she is healed up that knee will probably not fall apart. My Daisy had LP surgery at age 2 and the knee is as stable as the day it was fixed. She will be 13 this year. No arthritis and no knee cap out of whack.

Once her leg is healed, she will be just fine! I have had so many of these pups have that surgery.
Tethering her to you is a great idea for her recovery....in time after she is better, you will feel better about letting her be herself. The only thing is that often they will tear the ligament in their other leg once they have had an issue with the one.

If she potties outside, I would take her on a leash. Buster loves to chase birds real or imaginary, he also loves to chase Maggie (his sometimes tormentor). I would take him out on a leash, set him down to potty, then take him back in. He was not at all happy with this but since he wasn't supposed to run that was the only way to do it. Buster had his first surgery two years ago yesterday on Good Friday.

That's what I'm afraid of.

Good advice, I'll be sure to do that.

Yeah, but you cannot let it stop you from letting her be a dog once she is better. Just because it can happen, does not mean it will.
What did he say about the other knee?

Grade 2, so hopefully we can manage it without any problems. I just want to stop the jumping off of my bed (it's pretty high).

When my regular vet checked Chuy in February, she said one of his was very, very slight, and the other was perfect. When Jez jumps, she puts so much into it and sort of "powers" up, but Chuy makes it look totally effortless, he just floats.

The first thing Dr. Beale said to me was "Your regular vet is one of my favorite people!" Turns out their kids go to school together. Small world. I may have stepped on some toes by going straight to the ortho surgeon and not going to my own vet first, but I didn't want to feel pressured into using their "visiting" surgeon that wasn't board certified. My dog, I'm going to do what I think is best. I got a call from the regular vet's office letting me know that Dr. Beale had sent her records over, so all the vets are on the same page.

I remember the day Dr. Beale told me "let him be a dog". Those were the best words I think I've ever heard. Buster had been through four surgeries on his legs by then. Buster was ready to swim, run, chase his real and imaginary birds. Although he still has an occasional limp, I still let him be a dog. Swim season is almost here and he can't wait.

Love it! After 4 surgeries Buster's knees must be bionic.

I went to look at GCVS's facebook page, and they posted the story there of someone that I've met, although I didn't know their dog had been injured. I brought Jezebel to J-Canine for puppy classes (they are awesome with dog training). The trainer in the class, Marine Kopka, has a border collie, Gilley, that she would bring into the class, I think to show off more than anything! Gilley was maybe only 4 months older than the puppies in the class, but she was already very well trained. Since then she broke her leg and Dr. Beale fixed it, and Gilley has gone on to win several agility titles.

I have to keep my thoughts on stories like Buster's and Gilley's, because otherwise I'm starting to feel VERY anxious and I need to snap out of it for her sake.

I could give you a long list of stories of pups Dr. Beale has operated on for me...and for YHR. He does amazing work and when he is out of town I wait until he returns if I have a pup that needs surgery and can wait.

I have a pup who was posted here recently who ended up at the Internal Med side of GCVS and then Soft Tissue Surgery. He ended up with a liver shunt. Anyway....the reason I am bringing him up is because Teddy was a foster of mine in 2007. His back legs were deformed from birth and he was unable to bend them so he walked with them spaying out to the side. The one leg was so bad that his knee was pretty much backwards and his foot was always bleeding from dragging it with the top of it on the ground. He had no toe nails as a result...they were ground down. :( I took him to three vets...my regular vet and two ortho surgeons who said nothing could be done for him...that he was pretty much going to stay that way. Someone told me about Dr. Beale and I figured I would give it one more try. He knew immediately what it was...while others told me it was his bones that were frozen...it was a muscle problem. He operated.....released the muscle in that leg and did something to correct the knee as best as possible and it worked!! Teddy did need PT for some time after but in the end, he was able to bend his knee a bit..and his ankle so that he could put his foot flat on the ground!! To this day, it has remained ok! I have had other complicated cases and there is no one imho who could do what Dr. Beale does. One was a foster who is living a grand life now...her knee was a MESS. He was not sure he would be able to repair it...and would have to make a call on the table. Well, fix it he did...his fix was amazing...he actually reconstructed the knee...and Heidi is fine now!!! :) Only two of many .. and I have had quite a few with TPLO surgeries do so well.

It seems the ortho pups gravitate to me, so I have been a frequent flyer over at GCVS...and I can say that in all of these years, I have never been disappointed. Lately I have had many in the Internal Med side and they are awesome as well!! I feel so fortunate to have this facility so close by.