Patella Luxation

[ncarter]

I know i should probably post this in health but general will probably get a better response.

My boy is a 5 and a half year old papillon. About 18 months ago my boy mont seemed to slip on wet grass when running in a straight line. His right knee seemed to buckle and he fell over. It was painful for a few weeks and then slowly got better with anti-inflammatories. I took him to the vet and they did an x-ray and said he had degenerative joint disease and might need surgery down the track. Im no expert at reading x-rays but the left knee looked quite normal and the right knee looked like it wasnt aligned perfectly. In the meantime ive been taking him to the vet regularly for zydax injection, and giving him fish oil, chondroiton, glucosomine regularly. He seems to be doing fairly well. His knee doesnt click and ive only noticed him to be sore once after too much running.

I took him back to the vet today to get another course of zydax. I got a new vet. She thinks he has grade 3 PL and needs surgery on both knees too deepen the trochlear groove. I wasnt sure about this because he doesnt seem to be in pain and his patellas dont slip out or click. The vet got pretty pushy and wanted me to book surgery next week. I took my younger bitch in as well and she tested her patellas as well and graded them a 1. What was strange was when she was trying to manipulate monte's patella medially, at first she says 'oh they are actually harder to get out than Stella's'. She then had to use a substantial amount of force to move his patella out of place. So am not entirely sure about this vet. She also tried to sell me the royal canin kibble for teeth cleaning, even though ive had her teeth cleaned and scaled under GA about 4 months ago.

So basically i know his knees arnt 100% and i dont want him to be a cripple when he is 10, but at the same time i dont want to have surgery unless its absolutely necessary.

What do you guys think? get a 2nd opinion from an ortho specialist? Anyone know any good ortho vets in Perth?

Ask my breeder if there is a genetic link?

I have x-rays from the 1st incident if anyone wants to have a look and tell me what they think?

Edited April 26, 2012 by ncarter

[tdierikx]

Definitely get a second opinion from a specialist...

T.

[persephone]

Second opinion, definitely .....and I hope it can be all sorted :)

[smisch]

Deff second opinion. Pm mason_gibbs I think it is I'm pretty sure she was just dealing with an ortho specialist

[Mason_Gibbs]

Nick go and see Neil Gibson or Tom Hill at Rivergum Referral Services. Dr Hill did Gibbs surgery and he is fantastic, saw Dr Gibson for suture removal and he seems good too. Both have a great rep.

[W Sibs]

I agree with what the others have said... get a second opinion.

[dogsaremyworld]

Definately a second opinion. I think sometimes the vets can be more harmful, than good, when they do those patella manipulations.

BUT, in her defence, and to prepare you, the joint doesn't stay out all the time in most patella cases. the problem is that the joint slips out of the joint and in most cases slips back in rather quickly. That means that the xray that your dog had could of looked perfectly normal if the joint was in at the time of the scan. Sometimes, on xray's though they can see that the joint is slightly smaller than it should be.

When he walks, have you ever noticed him 'hopping' on one leg? it may only be for a couple of seconds, or even one beat of a normal gait pattern.

Usually patella's will continually pop in and out throughout the dogs life, to varying degrees, but most dogs handle the pain EXCEPTIONALLY well. Our girl, who hasn't had the surgery, lives pain free, still goes on walks, jumps on the bed, does crazy zoomies, and everything that any of our other dogs would do, BUT her patella does slip in and out, and most of time you cannot see it unless you feel the leg, or are looking at it incredibly closely. Plus you said that your guy had that one time where he slipped on the wet grass - patella's can also be caused by a trauma such as this, and not be a genetic fault, although its very rare, but this is what may of happened.

As for surgery. Depending on the severity of the knees, and how much pain he is in, there are other methods, such as hydrotherapy, that can work wonders for the knee joints. Our girl was going to have surgery, until our ortho suggested a few things that have helped her immensely. So do not rush in, do your research and see if there's any other option for your boy. The surgery has a fairly low success rate, IMO, and all that pain and re-coperation, when not totally necessary is a waste. And if he is a bit 'tubby' - get the weight off! it will be the best thing you ever do for his knees.

As for telling the breeder, I would get the second opinion first. The way patella's are passed on, the breeder may have no knowledge of the fault within her lines, and even the nicest approach to her, may upset the breeder. After all, being accused of breeding crippled, and essentially faulty stock, would be terrible, and your not even sure what it is yet. If the specialist agrees with the vets diagnosis, by all means, then approach the breeder, but I have a suspicion that your vet may not know what she's talking about, and may be being a bit 'eager'. In the meantime, do not let her manipulate either of your dog's joints again, until you have a clearer picture of what's happening.

[ncarter]

Definately a second opinion. I think sometimes the vets can be more harmful, than good, when they do those patella manipulations.

BUT, in her defence, and to prepare you, the joint doesn't stay out all the time in most patella cases. the problem is that the joint slips out of the joint and in most cases slips back in rather quickly. That means that the xray that your dog had could of looked perfectly normal if the joint was in at the time of the scan. Sometimes, on xray's though they can see that the joint is slightly smaller than it should be.

When he walks, have you ever noticed him 'hopping' on one leg? it may only be for a couple of seconds, or even one beat of a normal gait pattern.

Usually patella's will continually pop in and out throughout the dogs life, to varying degrees, but most dogs handle the pain EXCEPTIONALLY well. Our girl, who hasn't had the surgery, lives pain free, still goes on walks, jumps on the bed, does crazy zoomies, and everything that any of our other dogs would do, BUT her patella does slip in and out, and most of time you cannot see it unless you feel the leg, or are looking at it incredibly closely. Plus you said that your guy had that one time where he slipped on the wet grass - patella's can also be caused by a trauma such as this, and not be a genetic fault, although its very rare, but this is what may of happened.

As for surgery. Depending on the severity of the knees, and how much pain he is in, there are other methods, such as hydrotherapy, that can work wonders for the knee joints. Our girl was going to have surgery, until our ortho suggested a few things that have helped her immensely. So do not rush in, do your research and see if there's any other option for your boy. The surgery has a fairly low success rate, IMO, and all that pain and re-coperation, when not totally necessary is a waste. And if he is a bit 'tubby' - get the weight off! it will be the best thing you ever do for his knees.

Thanks for all the help guys, will definitely get a second opinion. I have noticed once after a lot of hard running, that he hopped for a few strides like it popped out momentarily. Everyday around the house i havent noticed any unusual gait or clicking. He still seems to be doing a lot of stretching and lying with his back legs strecthed out facing behind him without any obvious signs of discomfort or clicking. So i think there is definitely some arthritic symptoms there but not sure the patella's are actually coming out regularly.

[chuckandsteve]

My vet said my biy has a grade 3 and he carries it quite often when he is running, but he also said we didnt need to treat straight away. We decided to wait 6 months due to holidays we had planned and he had no problem with that.

Id get a second opinion some vets are quick to upsell and you need to trust they are giving the right advice

[minxy]

I know you've already said you'll get a second opinion, but I also highly recommend it. It has taken Kyojin 4 months to recover from his patella surgery, with months of confinement, keeping him quiet, no exercise, play dates etc. Now that he's finally all good again, I am so so glad we've had the surgery as he was living pretty much with all of the restrictions above (except the confinement) in the 7 months lead up to the surgery too so that his knees didn't get any worse. (We had to wait so long because of his age, surgeon wanted to wait until he had pretty much stopped growing as there is always the possibility that while they're so young, they could grow out of it).

[ncarter]

anyway i had the lateral imbrication and the deepening of the trochlear grrove, and all went well. The vet says his arthritis isnt that bad. The first 2 weeks recovery was a pain with having the elizabethan collar on all the time but now its not too bad. He is 32 days post op and is fully weight-bearing and can gait almost normally. He can even run and jump on the couch (not that im encouraging this). The vet is wanting me to wait until 12 weeks post-op to do the other knee. But im thinking i could probably get it done at 6-8 post-op as he is only 4kg dog and most of the pressure of movement seems to be absorbed by the front legs. Has anyone heard of a shorter recovery time and/or doing a second op shortly after the first one?

Edited December 9, 2012 by ncarter