Luxating Patella Issue (updated 7 Weeks Post Surgery)

[ncarter]

ok thanks ness, will see what the specialist says

[ness]

Yep that is what I would be doing. Hope it works out :).

[Double Lab Love]

Ness - me again :)

I seem to be able to finally read posts around this time and then I have to run off from work to get the train home to see my babies :D

I remember that both specialists (we saw two)recommended that post surgery that they should start to put a little weight on the leg after a couple of weeks.... just for toilet breaks etc.. The reason being is that both had seen dogs that had no weight put on the leg for 6-8 weeks and then required more work to get them to weight bear and use the leg... so more rehabilitation I guess... which is the last thing you need after the post surgery care...

I am pleased that Kenz seems better after being sick last Thursday... we had a couple of vomitas days with Tango in the first week due to the meds.... he got a bit spun out by them poor love

You will porbabaly find that things start to look up after about week 3 - so you are nearly there !

[ness]

Yeah see DLL that is what all my "research" has suggested yet I am sure the specialist wouldn't lead me wrong and he wants 6 weeks strict rest now.

Ah well - she is bored as anything at the moment - just back from another drive because it was that time of the night when she was play bowing and generally getting bratty.

Need to go and walk the old girl soon but loathed to leave the feral at home until she is a little less feral.

[ncarter]

i asked my vet for a referral to the place MG suggested. Anyway the vet gets back to me and suggests they can get their own specialist in and can do the surgery for cheaper than they originally quoted and that the specialist would charge a lot more. My vet also said she would be reluctant to do both knees at the same time as the pain would be pretty bad and my dog wouldnt be able to walk at all. From some of the research ive read i thought most toy breeds could cope with having both done at the same time. So im still undecided, i might just get the referral anyway so i can have a good chat with the specialist. Am not totally convinced that the patellas couldnt be managed conservatively with weight loss, alternative therapy and less strenuous exercise.

Edited May 29, 2012 by ncarter

[ness]

Like I said nic - take your time gather all the appropriate information and if you can't commit to the "rehab" for whatever reason then I wouldn't rush to do the surgery. It really comes down to how much of a problem it is for the dog. I have posted questions on one of the US orthodog list and there are dogs who have lived with grade 3 luxations for years and only ended up having surgery much later due to rupturing cruciates rather than the patella causing any problems.

I ended up emailing Kenz's specialist just to double check on the not weight bearing over the weekend and he agreed it was probably just a combination of cold and a lack of activity and nothing to worry about. He did also say that if I was concerned at any stage then he was happy for me to bring her in and he would examine it but since she is still on rest I doubt she has done anything serious so we will wait.

Today sort of marks the half way point of her strict confinement - a week since she had her stitches out so three weeks until she is due back for her next follow up. Not like I am counting or anything .

Edited May 29, 2012 by ness

[ncarter]

so which patella did she have done ness? and was it caused by an injury? seems like it would be a bit rarer to only need one done

[Mason_Gibbs]

Go and see the specialist, get their opinion and then decide :) Tom wasn't at all pushy with us for surgery and actually said he could just X-ray him and then do surgery at a later stage but we knew he was going to ultimately have to have surgery tho so I just did X-rays and surgery on the same day, but elbow dysplasia and luxating patellas at very different, he may say surgery isn't needed etc

Edited May 29, 2012 by Mason_Gibbs

[ness]

Kenz's patella she has had surgery on is her left one. Specialist was asked was it injury related and he said no it was something she was born with. I have heard/read its not commonly caused by injury unless its due to a traumatic injury (which I would know about) and she has certainly never had one. I do worry about her right hind but the specialist gave it a pretty thorough checking over after he missed the left hind (in his defense though her situation deteriorated fairly quickly which is in part why when I returned 2 months later and it had continued to worsen surgery was going to happen sooner rather than later). She had excellent muscle tone though which was supporting everything which is why it was never discovered until she had been resting.

[ness]

Despite being extra good with her confinement she is still having issues . 3 times in the last 4 days she has gone to step on her bed and the leg seems to have buckled underneath her and she has ended up on three legs. Somewhat stressed out . She is just over a month post surgery and done absolutely nothing which should have caused any issue.

.

[Jumabaar]

Despite being extra good with her confinement she is still having issues . 3 times in the last 4 days she has gone to step on her bed and the leg seems to have buckled underneath her and she has ended up on three legs. Somewhat stressed out . She is just over a month post surgery and done absolutely nothing which should have caused any issue.

.

[ness]

Thanks Jumabaar. I ended up emailing the specialist he isn't worried just suggested using pain meds when it happens. I have relaxed a little bit - if he doesn't think its cause for concern yet then I can't stress over it.

Biggest stress at the moment is having decided to take them up to my parents place for the long weekend only to have mum nagging because she thinks Kenz should be walking around and not spending her time in a crate even though that is what the specialist wants . Suffice to say I think we will end up back at home tomorrow. Don't need it. Mum has a point and I have run it through in my head plenty but decided if the specialist is happy with what he is recommending i.e. strict crate rest for 6 weeks then that is what we will do.

Edited June 9, 2012 by ness

[ness]

We are now just over 7 weeks post surgery and the situation is not all as it should be. Kenz had her follow up appointment at 6 weeks and unfortunately the patella didn't stabilise 100% . She had a physio appointment 2 days after her specialist trip and lots of muscle spasms in the surgery leg. She has moderate muscle wastage (if her weight is anything to go by she was 13.7kg on the day of surgery but only 12.7kg at the moment) and we are trying to rebuild muscle and hope that is enough to support the patella and prevent it from popping out.

This last week has been really worrying. She has spent more time on three legs then she has to this point. Most days she ends up 3 legged lame. Sometimes its when we are out doing our 5-10 min walks and other times its just been when she has got up at home and had a stretch. She has been given permission to roam freely at home so long as its within reason and also start with leash walks at whatever distance she is comfortable (not very far).

Specialist has said to see how she gets on over the next 3-4 weeks with increasing the muscle support and if the situation still remains the same after that time she is to go back and see him and we will discuss what we need to do to change things .

I am so stressed by it - for a surgery that was suppose to be relatively straight forward with few complications to have a dog more lame now then she has been pre surgery scares me to bits.

Starting to have regrets about having felt pressured to do the surgery in the first place and thats not a great feeling .

Edited July 1, 2012 by ness

[Mason_Gibbs]

Oh dear not good

[persephone]

what a worry . After all that money & effort and vigilance on your part..

[ness]

My biggest concern at the moment is knowing he had option to do more in there but only went the minimal approach. He has apparently had a chat to the chiro vet who also agreed it should still come good but I didn't like the feeling I got when I walked out of the consult. The specialist just had that enough in what he said to cast a seed of doubt on the success and whether she would come good.

The physio wasn't entirely worried about it and said she felt with the about of muscle wastage some subluxation would still be expected however I still might have thought she wouldn't be having half the issues she is this far down the track. She didn't end up having bone cut and I know the recovery time for just doing soft tissue stuff is supposedly a lot shorter. I was initially told she would only need strict resting for 4 weeks (although he did blow it out to 6 after he saw her at her follow up to have stitches out).

I feel like I have lucked out as I know the failure risk was low but I know I was compliant with all post-op instructions so its just been super bad luck.

I don't know what to do - I may try and get back in touch with the physio tomorrow who wanted to see her again in 3-4 weeks time (so 2-3 weeks time now) and see what she has to say about whats happened in the last few days. I did email her late last week but things have continued on a similar downward path over the weekend so probably should get in touch with her again.

I should also ring the chiro vet and touch base with him but I am not feeling kindly disposed towards him because I really am doubting why I did the surgery to start with and he was the one that said I basically had no choice and it would need doing eventually .

ETA. And yes I guess part of the reason another trip back to the specialist scares me is I don't have many dollars left to do much more to resolve it. Surgery the first time around took a high proportion of savings and available resources .

Edited July 1, 2012 by ness

[Guest RosieFT]

sorry to hear she is not healing as expected. HOw worrying for you. Hopefully she just needs the muscle tone to help hold it in place. Sorry Ness.

[OSoSwift]

So sorry to hear Ness.

To be honest this is what worried me about having Rommi's leg done. The what if's. What if I got a dog who was worse after surgery, or had a complication or what if????

I really hope she comes good with increased muscle tome. Thinking of you.

[Mason_Gibbs]

I was also worried about surgery but in our case there was no choice. We got very very lucky though as we were told he would never be 100% and he is really good now. He has less muscle on his problem side but if u think that from 12 weeks old he hasn't used that shoulder/leg properly I think it will take awhile to build up.

Kenz will prob take awhile too Ness. The loss of muscle is why we were told not to crate and do house confinement instead. I'm a big believer in movement helps to heal everything as it increases blood flow to the area. Obviously you have to be careful in the beginning though and not let them overdue it.

[minxy]

I really feel for you Ness. About the same time after Kyojin's patella surgery I was having the same fears. His leg seemed to be worse if anything and I was miserable thinking that I'd made the wrong choice. All I wanted was for him to have a normal life, to run and play with other dogs again. So I was upset with myself for making him worse. We didn't realise how long the recovery would be. We had been told that they could walk the next day, and would build up to more exercise. My husband works in human orthopedics so we were used to the much shorter recovery times. At one stage our surgeon and another vet (who we saw first about our worries while our surgeon was away) were concerned that they may need to operate again to do some tweaking. They told us to give it a few more weeks, and if we saw no improvement in that time, they'd do the procedure again.

Before we knew it, his knee really started to strengthen and he began to start walking on it. The recovery process was still really long though. We had to keep Kyojin confined and quiet, only allowed to walk around the yard to go to the toilet etc, for a full SIX months. We've only just last month been given the all clear that he's now free to do whatever he wants again. This was after also restricting his exercise for 6 months BEFORE the surgery as well so that things didn't get worse. (Had to wait 6 months to operate because he was still a pup).

I really hope that your situation will be the same, that it may seem like things are worse now, but before you know it, she'll be starting to use her leg again and putting her weight on it. It is such a worrying time though, so I understand your concerns. The recovery process afterwards is pretty miserable, but I really hope that she'll come good. I have my fingers crossed for you guys.