Luxating Patella

[kermat]

Hi everyone!

My beagle boy Judd has been diagnosed with a luxating patella. He had a bit of a fall last year and limped on and off for a little while afterwards, but since then has been running around normally with no problems so we weren't particularly worried. However my husband thinks that he has been favouring the back leg in question recently, so while he was at the vets the other day to get some drops for an ear infection he asked the vet about his leg and was told luxating patella.

I'm not entirely convinced however, this was not our usual vet as because it was only an ear infection (he's had them before) and we knew we just needed some drops we just took him to the vet up the road which is within walking distance, instead of driving to our regular vet. I also haven't noticed Judd limping or being in any discomfort or pain but my husband says he has noticed occasional limping. Judd is 21 months old. This vet said that he will require surgery at a cost of $1200 - $1500 otherwise he will get arthritis as he gets older.

So I will definitely be getting a second opinion from our regular vet - I'm not concerned about the cost so much, we can't really afford it but if Judd needs the surgery we will find a way, but I don't really want to put him through surgery if there is an alternative. I assume he will need to be crated for some time afterwards to recover meaning my husband and I will have to take time off work and I can tell you right now, Judd will hate being crated and confined!! Should I be in a rush to get a second opinion, or is it something that can just wait until the next time we are at our regular vet, given that it doesn't really seem to be affecting him much - he's still as hyper as ever and runs around like crazy!! Also would it be worthwhile to start adding a joint supplement like Sasha's Blend or Joint Guard to his dinner??

And can anyone from Perth recommend a vet who is experienced in this procedure and could do it for a reasonable price??

Thanks in advance for your responses

Edited August 11, 2008 by kermat

[petsearch]

our chihuahua had this problem and you will probably get quite a few responses on here as our vet said it is a very common problem. Our surgery cost about $800 from memory, but it was worth every cent. Prior to the operation our dog had started limping and carrying one of his back legs in the air. We weighed it up a bit more than normal as our chi had a strong heart murmur and was old too, so we were a bit worried about the operation. He only lived another year after the operation, but it was a great year! He recovered really quickly and he could cock his other leg on everything again (which he loved to do), so from our experience I would highly recommend the operation, but the costs do differ quite a bit with vets, so shop around. You can just ring up and ask what the surgery would cost, we found most vets could tell us a figure over the phone because they perform the operation so often.

[puggy_puggy]

I think your best bet would be to find a specalist. The prices that your vet has quoted seem pretty normal for that operation.

[MissMolly]

My cavalier has a luxating patella, and i have seen 3 vets as i wanted what was best for her, hers was caused by an accident and after the first week she had stopped limping, and i havent seen her limp or hold it up for months, so when she went back to the vets for her needles and the vet once again said she needed an operation, i contacted her breeder and filled her in on all the details, and we then took her to the breeders vet (after all she has been seeing the same vet for years and has complete faith in her vet) and he said, that at this stage we should leave it, (as it is becoming more popular to leave the leg alone in smaller breeds of dogs) as it isn't bothering her and she is not limping or favoring the leg at all, of course i have to watch her weight, he said it could become a problem then she will need an operation, one thing he did say is she will have arthritis when she is older, but she would also have arthritis with an operation.

Sorry for the long post..

Mollys mum

[kermat]

Thanks for the responses so far. I was actually wondering if the operation would be worth it given that he doesn't seem to be having much, if any, trouble with the leg and most dogs get arthritis with old age anyway. Will definitely keep more of an eye on his weight though, that is a good point. And I might start searching around for a good joint supplement to add to his food, prevention is better than cure eh!!

[Miss Helena]

My Chi girl was diagnosed with LP about 9 months ago. They got bad quite quickly (clicking in/out and she got slower on walks and a bit limpy). As she was only 18 months old, I went ahead with my vet's suggestion and had both operated on. The surgeon was brilliant (and cute/lovely ) - he was a specialist in orthopedic surgery for dogs. She had the procedure where the little "knob" of bone that the patella ligament attaches to was moved to a more correct central position.

It cost $1200 for her two legs, but has so been worth it!! She is fine now and can play and go for long walks no worries. Having caught it early too was good, as each time their patella clicks out of place it apparently causes wear and tear, then arthritis occurs. Fix the problem early and this doesn't happen so much.

I had to keep her quiet for 6 weeks afterwards, so took that time off work. Not very convenient, but again it was worth it.

Edited to add: Yes, I have to watch Bonnie's weight too - I've been warned by both that surgeon and my vet that weight is a very important factor with LP. Too bad Bonnie is a gutsy/prone to fat little Chi!!

Edited June 11, 2008 by Miss Helena

[jans]

My Malt girl ruptured hers about 2 months ago and I've decided not to do the surgery. My vet suggested not rushing into anything for at least a month, to see whether she could manage well enough with the leg as it was. Her limp decreased and she is just as mobile as before (she's not an active dog). I asked the question about arthritis and he said that she was going to get it anyway, so to take that out of the equation.

She has other health issues, so unless she becomes immobile, I'm leaving her as is.

Good luck

[kermat]

Thanks everyone. My hubby made me put my hand on Judds knee last night while he moved his leg and I could actually feel it clicking, although Judd really didn't seem bothered by it!! He was still running around like crazy. After doing some research online I've ordered a tub of Joint Guard as a preventative measure so we'll see how that goes, but I am leaning towards not going ahead with surgery. Next time we're at our usual vet for a checkup/vaccination I'll get his opinion, and even maybe a third opinion if necessary - unless Judd gets worse in the meantime.

[Bully]

Thanks for the responses so far. I was actually wondering if the operation would be worth it given that he doesn't seem to be having much, if any, trouble with the leg and most dogs get arthritis with old age anyway. Will definitely keep more of an eye on his weight though, that is a good point. And I might start searching around for a good joint supplement to add to his food, prevention is better than cure eh!!

Sorry to hear about Judd's knee. I'd get him onto a joint supplement such as glucosamine/chondroitin straight away. Sasha's Blend is supposed to be quite good, but I used a human one for Jessie (now at the "Bridge") that I got from my Health Food Store and was cheaper. I think that it was "Wagener's" and you only needed about 1/4 or 1/2 teaspoon from memory. There is a Nutralife one but it is full of sweeteners and you need to give about 6 teaspoons - yuck!!

Here in Adelaide Healthy Life stores have a "Magic Monday". It's free membership and on the first Monday of the month you get 20% off RRP non-food items. I assume that they are Australia wide, and no I don't get commission

[Jed]

I would get another vet. opinion, and also get an opinion from a GOOD animal chiropractor. If he is not limping, or bothered, I wouldn't operate either. And if he is not mature yet, it may well be ok when he matures.

[kermat]

Got our second opinion about Judd's knee on Saturday while at the vet for the boys annual check up. He's booked in for x-rays on Wednesday but the vet thinks he will most likely need surgery. She watched me walk him up and down the waiting room a few times and could clearly see he was favouring his right back leg, then she manipulated it a bit and you could hear his knee clicking!! Poor little guy :rolleyes:

So we'll wait and see what the x-rays show on Wednesday. He's not even 2 years old yet so if the surgery is going to help him then I'll definitely get it, but I also don't want to put him through it unless its absolutely necessary. A lot of people have told me its not really worth it as your dog usually ends up with arthritis later on anyway. I've already got him on Joint Guard powder, and he still runs around the backyard like a maniac so it can't be bothering him TOO much!!

[RuralPug]

I know I'm a bit late on this thread but I thought it was worth adding that "luxating patella" is not so easily compared between individuals. It is actually more of a description of a symptom than a defined condition in some ways.

There is a HUGE range from one extreme of the condition to another - with some the damage is not going to get markedly worse because of the TYPE of wear and tear, with others they can go for years and years wearing it away until the joint is suddenly useless and painful and others have immediate damage that needs fixing fast. Some of the worst cases only limp intermittently and some of the least damaged cannot seem to put any weight on the joint.

You have done EXACTLY the right thing by Judd by getting several opinions (sadly there are some shonkies out there who will always grab the $$$ for surgery of this kind even in those instances where it is not needed.) Get each of those opinions to explain clearly to you what TYPE of damage is in the joint and their opinion of how it will proceed in the medium and long term. If two out of the three opinions agree in the details then to me it would make sense to go with ther advice.

So some dogs don't need surgery at all, some need it but it can be deferred for varying lengths of time without too much damage and others need it ASAP. Yet you might be surprised at the discomfort levels between individuals in those three situations. It really does need vet diagnosis, which of course you have done and are doing, I guess I'm just trying to hammer the point across to someone reading this who might think that 'cos his auntie's pup with LP never had the surgery and was as right as rain for the rest of it's life, then therefore his own vet was a money hungry con artist for saying that HIS pup needs surgery. Sorry for the rant, it wasn't aimed at you...

[kermat]

Cool, thanks for the info.

The verdict from the vet was that the grade of his luxating patella was around 2.5, with 1 being not so bad and 4 being pretty bad. So he's borderline for needing surgery. Given that we could clearly see on the xrays that he's already got some arthritis developed around his knee, and also that it doesn't seem to bother him that much he still runs around and jumps up and just has the occasional limp - so we decided to pass on the surgery for now and stick to managing his arthritis with fish oil and glucosamine supplements.

Poor little fella, not quite 2 years old yet and already got arthritis........ At least it doesn't slow him down much though!!

[Charles Kuntz]

Hi, Charles Kuntz here. I am a specialist surgeon in Melbourne and I thought I would put my two cents in. Medial patellar luxation is a problem that usually occurs in pure breed small dogs, although large pure breed dogs are affected as well. Mostly, they are congenital, but may be exacerbated by trauma. Medial patellar luxation is best described by the grade of the luxation. THey are graded 1,2,3 and 4. 1 is just loose. 2 is normally in but can be popped out, 3 is normally out but can be popped back in and 4 is always out. There was a study that showed that in dogs with bilateral (both sides) luxations, with only one side repaired, the function was significantly improved in the affected limb with surgery. There was no difference in radiographic signs of arthritis down the road.

The decision is based on the grade of luxation and on the age of the dog (and to some degree, the extent of lameness). Young dogs with grade 2 or above should generally have surgery. Older dogs that have a luxation with no debilitation can probably manage with conservative management. If the surgery is done properly, the success rate is very very high. I strongly recommend that the surgery include repositioning of the tibial crest because that is the primary problem (poor alignment of the tibial crest which drags the patella out of the groove). Revision of the trochlea (groove) is not usually recommended by me because of the extent of damage that it does to the joint cartilage). SOft tissue procedures alone ("tightening" the joint) are destined to fail.

There are great specialists around in Perth. The ones I know are at the vet school. Hope this helps.

Charles

[Miss Helena]

If the surgery is done properly, the success rate is very very high. I strongly recommend that the surgery include repositioning of the tibial crest because that is the primary problem (poor alignment of the tibial crest which drags the patella out of the groove). Revision of the trochlea (groove) is not usually recommended by me because of the extent of damage that it does to the joint cartilage).

Sounds exactly like the surgery my Chi had last year. It went very well and has made a huge difference to her (and she is only 2yo).

[alanglen]

Wow, fantastic to see you on here Charles! Charles is one of our best surgeon's here in Victoria! Very very highly regarded!

[pennyw74]

Interesting topic...my 11 month old Cavalier just had both hers done. She is recovering well.

[poodlefan]

Big Ted had this op in one leg 10 years ago for a Grade 4 luxation. He went on to agility.

He has no symptoms of arthritis in his joint at this point (he is now 11). We won't talk about his neck though.

[Miss Helena]

That's interesting re arthritis PF....I've heard conflicting opinions on whether LP surgery prevents it.

I personally tend to think it would help prevent it....stop the joint clicking out of place and bone rubbing on bone must help preserve joint function in years to come.

[poodlefan]

That's interesting re arthritis PF....I've heard conflicting opinions on whether LP surgery prevents it.

I personally tend to think it would help prevent it....stop the joint clicking out of place and bone rubbing on bone must help preserve joint function in years to come.

My view also. Keeping your dog lean and active and feeding a decent joint supplement don't hurt either.