# Luxating Patella



## mom2bijou (Oct 19, 2006)

Ok first of all....I'm ticked. I bring the kids to the vet this afternoon b/c first Benny's eye seemed to be bothering him this morning, and Emma needed to have her vaccs done. Ok...so our regular dr was on vacation so we see someone else. When I get there I notice that Benny's eye now seems fine, so figured he must of just gotten something in it. Well she says let me just put some drops in it and then at then end of the appt. I notice I got charged $90 for putting drops in his eyes. WTF! So first annoying thing to happen at the vet. :shocked: 

Moving on....ok so Emma gets her vaccs done and I mention that here and there she will hold her back left leg up, limp around and then she'll be fine. She doesn't seem to be in pain, but she'll limp and then resume to her normal self. Well the dr. looks at her legs and says "oh, she has a grade 3 luxating patella." I flipped out b/c I had her in there for an exam in June b/c of her ear infection and was not told she had this. So all of a sudden she has a grade 3?!?! So then she decides to look at Benny and says oh, Benny has it too, but he's a grade 1. What the heck???? The dr. said it's common in all small dogs. She said she's in no pain and if it persists she can have surgury. I feel terrible for her...and at the same time confused. I totally was NOT expecting this!!!!! :shocked: 

Here are my questions:
-Emma is from a highly reputable breeder....is LP linked to bad breeding?? 
-If it's not linked to breeding, how did she get it? 
-Is my sweet girl gonna be ok??? 

Advice, feedback, hugs???? 

I'm so distraught right now!

UGH! Sorry for the rant....but I just wasn't prepared for this dr. to tell me that my dogs kneecaps are in bad shape...well she didnt' say that, but that's how I felt.


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## Krystal (Feb 3, 2007)

:grouphug: :grouphug: :grouphug: 

Sorry, no advice here, just wanted to give you a hug! I am sorry that you had such a horrible experience at the vet! I hope others can give you some advice!!


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## tamizami (May 1, 2007)

I'm sorry, I know how hard it is to get this news. Hopefully she is not in any pain and you can hold off on surgery. JMM suggested that I go to physical therapy with Shiva and we did and it was a great idea. If you can find a good PT vet in your area, they should be able to do the following:

1. give you a second opinion on the grade and need for surgery (most PT vets are holistic, so they try to avoid surgery at all costs

2. analyze her gait and conformation for you

3. provide accupuncture, PT, supplements (glucosamine), which might be enough to hold off on surgery. at the very least it will strengthen her muscles in preparation for surgery if you decide she needs it.

A board certified surgeon should also be consulted - my experience was that they wanted to avoid surgery unless the dog is clinical (limping) or had signs of pain. Many dogs can live with LP. Watch for bowing legs, though, you may want surgery in that case.

I have heard that this is primarily a genetic issue and that no - it doesn't have to do with bad breeding. It comes up in the breed frequently and unfortunately, and JMM can weigh in on this, I don't think it can be fully diagnosed until they are a little older and the growth plates are almost done. Most certainly jumping on and off furniture will not help and may cause patella and/or ACL injury, so the protocol in our house is no jumping on or off furniture and we discourage jumping up for attention as well.

I hope this helps a little. Jackie (JMM) is a huge help. Jadey, Deb (3maltmom) and I have all gone thru the surgery and have shared experiences here if you do a search on it. I also did a photo collage of Shiva's PT and surgery recovery in the gallery. Feel free to PM me if you have any questions.


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## Lacie's Mom (Oct 11, 2006)

Without xrays, it's almost impossible to determine the grade of a luxating patella.

Luxating patellas are not necessary associated with poor breeding -- some are just caused from jumping and landing wrong as they are very tiny and their legs/knees aren't all that strong.

My Lacie has grade 1 LPs and I try very hard to get her to wait for me to pick her up and put her down. She seldom waits. I also have large doggy beds (padding) where she normally jumps and each year I pray, just before her annual vet visit, that they haven't gotten worse. Lacie is from a very reputable breeder.

Tilly doesn't have a patella problem and she's from a puppymill situation. Go figure.

My vet will not do surgery unless LPs are a grade 3 or worse. There is a chance, however, that the furbabies with the grade 1 or grade 2 LPs will get arthitis. I am giving Lacie joint meds like Cosequin to help prevent as much as I possibly can.

I would suggest that you talk to your normal vet about this. If seriously concerned, please see a specialist abou the LPs.


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## Moxie'smom (Dec 16, 2007)

Oh Tammy! I'm so sorry to hear you're so upset. And the babies are having issues. 

First of all, My beloved Mo lived for 13 years with luxating patellas. I never did the surgery, (I had to do spinal surgery) However my vet said that it wasn't necessary. I think that sometimes it can be genetic, however it can also happen by injury. If they run on wood floors their little knees can slip out , perhaps jumping down onto a hard surface. Who knows. Yes our little fluffs are prone to LP, but it's certainly doesn't mean all LP's warrant surgery. This is the big reason I won't let Moxie jump on the bed or on the couch. Since we got him, he has only learned to go up and down the ramps on our beds here in CT and also in NYC. And only can be lifted on to the couch in all places. That being said, a vet certainly should have checked them both for LP, knowing that a Maltese is a breed that is prone to having them. Why they didn;t, who knows ??? I don't know how bad a grade 3 is? Is it causing her pain? 

In any event I hope that Benny's eyes and Emma's knees feel better. And I feel for you with the $90.00 eyedrop application!. A 1/2 hour visit where I was't even charged for the initial consultation (the vet is a friend of mine) cost me $360.00. For a CBC, a lyme test, A titer Lyme test, waste disposal (I love that one) and some other thing. 

(You lucky folks in the mid west..NYC/NJ/LA prices are insane. Which is why I don't bother with the insurance. You get like next to nothing back and very few things are covered. They don't price out for our prices. )

I hope they both feel better. Mox is still very sleepy, but at least he is eating some and drinking some. Still not perky. And last temp was slightly over 101. But hopfully tomorrow we'll get to the bottom of the "nebulous" symptoms.

hugs and kisses to all. Hang in there.
Moxie & Mommy :wub:


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## MalteseJane (Nov 21, 2004)

One more proof that highly reputable breeders are no garanty to get a dog without any health problems. 

The good news is your pups will be ok. Lots of dogs with luxating patellas are doing just fine. Jumping up and down furniture can contribute for the need of having the surgery done. So try to keep them from jumping as much as you can. And if at the end they will need surgery don't worry. They are doing great with it. Alex had surgery on both of his legs (because of jumping and climbing torn cruciate ligament) and when you see him now, you would never think he had surgery.


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## dr.jaimie (Mar 23, 2004)

patellas can be diagnosed at a very young age, toy breeds are at high incidence of LP. some LP can be made from a trauma and wont be present at the initial exam. i dont think that a dog with LP should be bred, but it doesnt mean that 2 normal dogs can't produce a pup with LP. i check the knees at a first pup visit but that isnt to say that every vet does. some dont look unless there is an issue. and u can grade patellas with out an xray:

Medial patellar luxations are graded to assess severity.

Grade I: The kneecap can be moved out of place manually but will fall back into its natural position once the manipulator lets go.

Grade 2: Same thing except that the kneecap does not move back to its normal position when the manipulator lets go. These dogs are likely to progress to arthritis development and should be considered for surgery to prevent conformational damage. There is some controversy over whether grade 2 dogs should have surgery.

Grade 3: The patella is out of place all the time but can be manipulated back into its normal position manually (though it will not stay there).

Grade 4: The patella is not only out of place all the time but cannot even be manipulated back into place by hand. Such a dog has extreme difficulty extending his knees and walks with his knees bent virtually all the time.

It is not a good thing to have one's knee cap out of place; the entire weight-bearing stress of the rear leg is altered which, in time, leads to changes in the hips, long bones, and ultimately arthritis. How severe the changes are depends on how severe the luxation is (i.e., the grade as described above) and how long that degree of luxation has been going on. In time, the legs will actually turn inward, making the dog "knock-kneed." The luxation is not considered a painful condition but after enough time and conformational change, arthritis sets in, which is indeed painful.

Dogs with Grade I luxations do not require surgical repair.

Grade 2 dogs may benefit from surgery and most often the owner is called upon to judge how big a problem the lameness is.

Dogs with Grade 3 or 4 disease definitely should have surgery.

petula has grade 3 on both knees and once she is settled in completely i will fix her knees.

http://www.marvistavet.com/html/medial_luxating_patella.html


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## k/c mom (Oct 9, 2004)

QUOTE (MalteseJane @ Aug 5 2008, 06:59 PM) index.php?act=findpost&pid=616325


> One more proof that highly reputable breeders are no garanty to get a dog without any health problems.
> 
> The good news is your pups will be ok. Lots of dogs with luxating patellas are doing just fine. Jumping up and down furniture can contribute for the need of having the surgery done. So try to keep them from jumping as much as you can. And if at the end they will need surgery don't worry. They are doing great with it. Alex had surgery on both of his legs (because of jumping and climbing torn cruciate ligament) and when you see him now, you would never think he had surgery.[/B]


But with a highly reputable breeder it is likely to receive a puppy that is healthy... free of coccidia, parvo, kennel cough and the other maladies that members have reported when buying from BYBs, pet stores, etc.

And the Malt will eventually grow up to look like a Malt. He or she will likely be at or close to standard size and with the features that make a Maltese the breed it is. The Malt's temperament will likely also be that of the standard. 

There are no guarantees in life, especially when we are dealing with a live animal. 

I'm not sure what it is you have against reputable breeders because you always seem to jump to the defense of BYBs.


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## jmm (Nov 23, 2004)

QUOTE (mom2Bijou @ Aug 5 2008, 05:14 PM) index.php?act=findpost&pid=616302


> -Emma is from a highly reputable breeder....is LP linked to bad breeding??
> -If it's not linked to breeding, how did she get it?
> -Is my sweet girl gonna be ok???[/B]



LP can be hereditary or due to an injury, or a combination of the two. Even the best breeders produce dogs with LP...and since very few test their dogs, who really knows...

Many, many dogs have a grade 1 that the vet can luxate on palpation but it does not luxate on its own. It causes the dog no problem and needs no treatment. 

Once the patella starts to luxate on its own, that is when surgery comes into play. The holding leg up, skipping steps, etc. is evidence that Emma's patella is luxating on its own. The more movement in the joint, the more likely arthritis is to build up. Unstable joints are also at increased risk for other injuries such as cruciate ligament injuries. Emma may have had fine knees or grade 1 so it was never mentioned. I would guess she had an injury that worsened/created it. 

I would seek a second opinion with a boarded surgeon and look into physical therapy.


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## mom2bijou (Oct 19, 2006)

Thank you all for your replies. I am relieved to know that Emma is not in pain and will most certainly seek out a second opinion. She's only a year and a 1/2 so anything I can do to prevent it from getting worse if of course the most important. I realize that there are no guarantees in health, but of course just never expected for the doctor to say anything could be wrong w/her. I was taken by surprise completely. 

I was hoping this wasn't linked to bad breeding and you all just confirmed to me it's not. So thank you for that. Emma's breeder was nothing but wonderful to deal with and I have always held her in the highest regards. 

She is the crazier dog out of my two...always running, jumping, etc. At times she can be fearless...so I don't know of a particular injury that happened, but perhaps it's from jumping off the couch before she lets me put her down. The days of her taking the initiative of first one off the couch are now long gone. 

So I will keep you updated on where we go from here. I am thinking I will begin with seeing her regular vet first. 

Thank you again everyone. When I heard this today I came right home and came on SM....afterall there's no better group to turn to. :grouphug:


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## Tina (Aug 6, 2006)

QUOTE (K/C Mom @ Aug 5 2008, 06:12 PM) index.php?act=findpost&pid=616330


> QUOTE (MalteseJane @ Aug 5 2008, 06:59 PM) index.php?act=findpost&pid=616325





> One more proof that highly reputable breeders are no garanty to get a dog without any health problems.
> 
> The good news is your pups will be ok. Lots of dogs with luxating patellas are doing just fine. Jumping up and down furniture can contribute for the need of having the surgery done. So try to keep them from jumping as much as you can. And if at the end they will need surgery don't worry. They are doing great with it. Alex had surgery on both of his legs (because of jumping and climbing torn cruciate ligament) and when you see him now, you would never think he had surgery.[/B]


But with a highly reputable breeder it is likely to receive a puppy that is healthy... free of coccidia, parvo, kennel cough and the other maladies that members have reported when buying from BYBs, pet stores, etc.

And the Malt will eventually grow up to look like a Malt. He or she will likely be at or close to standard size and with the features that make a Maltese the breed it is. The Malt's temperament will likely also be that of the standard. 

There are no guarantees in life, especially when we are dealing with a live animal. 

I'm not sure what it is you have against reputable breeders because you always seem to jump to the defense of BYBs.
[/B][/QUOTE]

:goodpost:


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## miko's mommy (Feb 8, 2005)

I would definitely get a second opinion, though not necessarily from a surgeon. I took Miko to 4 or more vets and they graded his knees from normal to grade 4. Seriously!! We did eventually get both knees fixed but I was shocked at how subjective the grading was. Once we decided to get them fixed, i found a really great surgeon. However, I wouldn't head straight to a surgeon (you have to wonder about their motives). I maybe less trusting than most people, but being a physician myself, I thought it was important to talk to different people about it in order to educate myself. good luck, it really will be fine!


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## luvmyfurbaby (Feb 11, 2007)

Last vet visit I asked the vet to check Mia's knees because I always hear them make noise. She did and to my suprise she told me Mia had LP3 on both knees???????? :bysmilie: She has never limped, never jumps down from the sofa or bed and you all have seen her at play. The vet told me unless she is in pain or limps to leave it. I asked her to check Cody who does jump off of everything and he has 1 knee with LP1. She did tell me about glucosamine and pool therapy. She also told me a few months back that Mia might get arthritis since her hip joint was shallow. :smcry: Tammy I hope Emma doesn't need surgery.


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## anouk (Nov 3, 2006)

A couple of months ago during a routine visit I asked the vet about the hops that Lizzie does occasionally when she runs and she told me that maybe she had luxating patella.
I went to see one of the best orthopedic surgeon in Italy and after the x-rays he told me that she has grade two on both knees. Yahoo.
He reccomended me to perform surgery. Went back to my vet who didn't agree very much and had a second opinion from another specialist.
This vet asked me why on earth would I put Lizzie under such an hard surgery on both legs since she doesn't limp or is in pain at all.
I'm a little bit confused but for now I'm not fixing her.
She's no more allowed to jump, the stairs are mom lift and I'm giving her a supplement.
If one day thing are worse I'll consider the surgery immediately. 
I mean, in my bad english, that I looked both at the benefits and the risks (in this case not really risks but a very large rehab period confined in a crate for two months at least and the pain she will suffer twice) and in my opinion the first are not worth it. For now.
But then again I have a third app. scheduled next month with a third vet and maybe I'll change idea.


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## domino_angel (Apr 17, 2008)

Chloe is a little mexican jumping bean! It drives me crazy because I fear she will wear out her knees or injure herself. We have been training her to sit or down for attention, we won't pick her up when she jumps. Its getting a little better. She isn't much for jumping on or off furniture, Thank goodness! 

I hope your second, third and (possibly) fourth opinions go well, and that she doesn't need surgery. rayer:


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## Luna'sMom (Oct 7, 2007)

This makes me worry because Luna has started lifting her leg occasionally after playing or jumping around or vigorous activity - i.e. limping around with her leg held up in the air  makes me worried because my parents dog has really bad LP and had to have surgery earlier this year. I think a vet visit is in order - but I may hold off until her vaccination due date :blink: 

What kind of supplements would be good?


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## Luna'sMom (Oct 7, 2007)

Ooops pressed post too soon... 

I hope that Emma is fine - imo definitely a good idea to get on top of treatment after seeing a dog suffering from the instability/pain of damaged cruciate ligament caused by bad LP - I like the sound of less invasive treatments to start with though - Americans are so lucky to have such a wide variety of pet care services avaliable to them :thumbsup:


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## The A Team (Dec 1, 2005)

Geez, Tammy, I'm sorry to hear Emma has LP, but it doesn't sound bad though. Our vet told me that Archie's LP is a "2" in one knee and a "3" in the other - with "4" being the worst!! :w00t: YIKES!

I know the boy will need an operation down the road some time, he's not athletic at all and doesn't jump up anywhere (usually). But I love him and figure...he is what he is and all I can do is take care of him. Abbey, on the other hand, is a regular jumping bean!!!!! (one vet had told me she has it too - but I'm not so sure I believe that)


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## luvmyfurbaby (Feb 11, 2007)

QUOTE (Luna'sMom @ Aug 6 2008, 04:54 AM) index.php?act=findpost&pid=616480


> What kind of supplements would be good?[/B]



I was told to give her glucosamine for her knees. This is what I'm giving all three. http://www.entirelypets.com/jointmaxrs.html The pill is big but I break it into 1/2 and give each one half. They eat it like a treat.


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## casa verde maltese (Apr 7, 2007)

:grouphug: :grouphug: :grouphug: :grouphug: :grouphug: :grouphug: :grouphug:


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## tamizami (May 1, 2007)

Cosequin is very good - in powder capsules so easy to administer for small dogs. They have been tested and are approved at Consumer Labs.


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## godiva goddess (Nov 19, 2007)

hi Tam,
I know we have emailed about this but I just found this post and I wanted to say HI and also give you a BIG BIG HUG!!! I hope your precious B & E are well...just wanted to let you know I was thinking of you and wishing you the best!!! Please keep us posted. Miss you..lots of love and kisses to B & E!! :grouphug: :grouphug: :grouphug: :grouphug:


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