# Diagnosed with Luxating Patella at 8 months...



## Emmayui (May 1, 2012)

Hi everyone on SM!
Elly was diagnosed with luxating patella today  and she's not even one year old yet.

I've always known that LP is a common problem among Malteses, and did everything to prevent, doggy steps, salmon oil, daily walk.

Yesterday during a walk, Elly started to limping. We made urgent appointment and went to the vet today. There was this new doctor we've never seen, and she felt Elly's hind legs and promptly said she indeed has LP.

We didn't do xray, since she wasn't in pain at all, and doctor told us it's obvious.
We got her Dasuquin with msm, and pain med that will not upset her tummy and came home.

I asked about surgery option, and she did not recommend surgery, even though Elly's left leg is grade 3, right leg is grade 2. 
She said numbers are just grouping of symptoms, and she wouldn't want Elly to do surgery until she tears her ligament, since even after surgery dogs with LP are likely to tear their ligament and do redundant surgery.
Also, Elly is only 4 lbs, so her light weight is beneficial for her, and she might not need surgery at all.

Should I get a second opinion from other vet? Or is it possible to see specialist without reference? 
I am probably worrying too much, I only saw Elly limping twice, and either time she didn't show any signs of discomfort at all.


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## Kathleen (Aug 4, 2011)

Poor Elly. The thought of them might needing surgery someday is just awful.
The same thing happened with Max when he was less than a year old (he is now a year and a half). He was diagnosed with a level 3 and a level 2. He had been holding up one leg when he ran. Our vet did not recommend even considering surgery because he was too young and still growing, and because it is not always successful. She said that sometimes people chose surgery hoping to avoid arthritis later, but that he will develop arthritis whether or not he has surgery.
She recommended Dasuquin with MSM, fish oil, and an herbal supplement for inflammation and possible pain. After about two months he was so much better. When we went back, she said he is probably now just a level one in each leg. So we are just taking a wait and see approach, continuing the supplements. He is doing great so far.
You should be able to see a specialist for a second opinion if you want without any kind of referral. 
This is an article you might be interested it by Dr. Karen Becker (a holistic vet) that I found very helpful about luxating patellas and avoiding surgery.
Floating Kneecaps or Luxating Patella in Dogs
I hope that Elly has good success with the supplements. It does take a little while for them to take effect, so don't be discouraged if you don't see immediate results.


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## Ladysmom (Oct 19, 2004)

I would absolutely ask for a referral to an orthopedic vet and not wait. A Grade 3 is pretty serious.

http://spoiledmaltese.com/forum/52-...2645-grading-luxating-patellas-dr-jaimie.html

Did you get a health guarantee with your puppy? You will also want her condition well documented before you speak to her breeder.


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## Emmayui (May 1, 2012)

Thanks so much, Kathleen. It is so relieving to know it's possible to get better with supplements. 
Thanks, Ladysmom, I will ask for specialist recommendation right away.


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## jmm (Nov 23, 2004)

It has been my experience that dogs with properly repaired knees have a much more stable joint and thus decrease the incidence of cruciate injuries. Dogs with unstable joints are much more prone to such injuries.


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## MalteseJane (Nov 21, 2004)

I may be wrong, but if a dog starts limping I think it's time to consider surgery. The patella can go in and out, some dogs manage to get it back in and it's like nothing happened. But sometimes the patella does not go back in on it's own. I would get a second opinion from a good orthopedist.


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## Emmayui (May 1, 2012)

MalteseJane said:


> I may be wrong, but if a dog starts limping I think it's time to consider surgery. The patella can go in and out, some dogs manage to get it back in and it's like nothing happened. But sometimes the patella does not go back in on it's own. I would get a second opinion from a good orthopedist.


Elly was limping for very short time. I guess she dislocated knee yesterday and put it back in the place by stretching. Similar episode happened with her right hind leg few weeks ago. Else than those short moments she's walking and running normal. She is refusing to use doggy stairs to climb up, but going down okay. I was thinking to keep her on Dasuquin for a month and then take her to the orthopedic specialist for a month. (since her alternative therapy insurance coverage won't start for 30 days..)


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## Snowbody (Jan 3, 2009)

Just a warning. If your vet has diagnosed for LP if you don't have insurance now and are going to get some, they might not cover it because it would be considered a pre-existing condition. They ask for all medical records for your dog when you apply. The records have to be sent from the vet's office. I know that Tyler's knee went out once when he was a year old. Never happened again and he's four. I would see how Elly does and whether it's a usual condition or not and consult with a specialist. As for arthritis - I just had my ACL reconstructed on my knee and my doc says I'll probably have arthritis since I'm having the surgery so don't know about the arthritis card.


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## MalteseJane (Nov 21, 2004)

Susan is right about the insurance. DON'T LET ELLY *JUMP*, up or down. I know it is easier said than done but it's do-able. Start getting her used to take the stairs. If she ever has to have surgery, you don't want her to jump again, you don't want to risk another surgery. Some dogs with luxating patellas never need surgery BUT they don't JUMP. As for arthritis, Alex had surgery on both legs and never developed arthritis. He was on a supplement only for a short time after the surgeries.


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## Emmayui (May 1, 2012)

Elly never jumps...I don't know why this happen so early in her life :-( 
and Elly has Trupanion with zero co-pay, but I'm gonna call them tomorrow and get her additional package that covers acupuncture, hydrotherapy, etc.. I was afraid that Elly will not receive benefit from additional package, since we're getting it post-dianogsis, so I didn't claim today's vet bill. Does anyone else have trupanion?


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## Ladysmom (Oct 19, 2004)

Emmayui said:


> Elly never jumps...I don't know why this happen so early in her life :-(
> and Elly has Trupanion with zero co-pay, but I'm gonna call them tomorrow and get her additional package that covers acupuncture, hydrotherapy, etc.. I was afraid that Elly will not receive benefit from additional package, since we're getting it post-dianogsis, so I didn't claim today's vet bill. Does anyone else have trupanion?


Elly was very likely born with luxating patellas. Did you get a health guarantee from her breeder?

It doesn't matter if you claimed yesterday's vet bill or not. Your insurance company will require copies of all her vet records before they will pay a claim. How long has she been insured? It looks like Trupanion will pay for genetic conditions has long as they were diagnosed after coverage began.

Dog Coverage Details | What Trupanion Dog Insurance Covers


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## Emmayui (May 1, 2012)

Ladysmom said:


> Elly was very likely born with luxating patellas. Did you get a health guarantee from her breeder?
> 
> It doesn't matter if you claimed yesterday's vet bill or not. Your insurance company will require copies of all her vet records before they will pay a claim. How long has she been insured? It looks like Trupanion will pay for genetic conditions has long as they were diagnosed after coverage began.
> 
> Dog Coverage Details | What Trupanion Dog Insurance Covers


Elly's policy has been active for about 4 months now. They covered everything concerning stomach ulcer she got from anti-inflammatory after spay surgery. We got about a grand back from them. My friend, on the other hand, got only 40 buks back for hot spot and baby tooth removal, and they still made stink remark about her benefited 2 times already. I'm pretty sure they will cover Elly's LP but i'm just being cautious now..


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## hoaloha (Jan 27, 2012)

Emma, I'm so sorry and Elly's LP  Like Marj said, at this age and without a history of injury, it is most likely a congenital issue. The breeder should be contacted just so she has a record of it. You are very lucky that she had insurance prior to the symptoms. Get a board certified Orthopedic surgeon to evaluate. Surgery is highly successful although it may not prevent future arthritis. Kandis, mom to Sammie and Penny, went through the surgery with Sammie and now he's doing great. I believe that surgery should be done on persistently symptomatic dogs (regardless of grade) and, of course, grade 4.


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## SammieMom (Nov 13, 2010)

Many breeders especially a non show breeder will not reinburse a puppy LP. Many write it on the sales contract. At least the first breeder I used did. LP often shows signs in first year. My Sammie skipped / limp about 9 mo, then it became more constant so he had surgery at 2 yrs old for his leg with LP. I could have done it sooner, but I was afraid. So after reg Vets said to wait, I finally took him to an orthopedic surgeon that specializes in* small bones*. 2 general Vets but my current Vet, said just wait. It's a personal choice. But Orgho said his cartilage erodes ea time the kneecap moves. She took X-rays of legs and hips and exam to rule out hip problems as well as LP can be from injury or a deformity from birth involing the hips to knee is what the surgeon told me. The X-ray and exam will tell you whole story. She held a pencil in front of X-ray of leg and I saw a crooked leg too. Somehow that pulls on the knee, (?) and so she trimmed the tibia too while there. And it is just my opinion that I would not do a double surgery on these small dogs. Some vet surgeons will suggest doing both legs at once. My ortho avoids it if possible with 5 lb dogs. We fixed Sammie's knee because the reasons Jackie (JMM) posted in this thread. First week was tough and confinement is not easy (8 weeks) but it's like a memory now and he doesn't skip all the time. The specialist will know what your baby needs. Before we took him to a specialist, I was second guessing everything. My insurance does not cover congenial LP for 1 year undiagnosed. Not sure about LP from injury. Like Marisa said its not the grade but the signs and what is on X-rays/exam that drive whether to operate. 
Good luck. Keep us posted. I have a long thread here on Sammie's surgery last march. 
xxxx


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## SammieMom (Nov 13, 2010)

I see your in a big city, you have no trouble finding a wonderful Orthopedic surgeon. I'm in a small town, so I had to travel a piece to find one. also, wanted to add the ortho took Sammie for a long walk outside as part of her final decision to do surgery, no other gen Vet did that. The exam/xrays took hour and half and cost almost 300.00.


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## MalteseJane (Nov 21, 2004)

One reason why breeders won't cover patellas is because the patella can go wrong due to jumping and ending up the wrong way. The pup can fall down the sofa or bed and injure the patella. And then people blame the breeder for a bad patella.


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## SammieMom (Nov 13, 2010)

That's right Janine, and even when I had a surgeons proof that it was from birth defect.


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## Ladysmom (Oct 19, 2004)

MalteseJane said:


> One reason why breeders won't cover patellas is because the patella can go wrong due to jumping and ending up the wrong way. The pup can fall down the sofa or bed and injure the patella. And then people blame the breeder for a bad patella.


That's why it is very important to have your vet check your puppy's knees when you take him in for his first vet appointment (usually within three days after getting him).


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## SammieMom (Nov 13, 2010)

_*So true Marj! *_I was so clueless as to what a good breeder was, never the less LP or shunt when I got Sammie and Kirby (RIP). I am so glad I found SM for the second time around. Of course I know there are no guarantees with *any* puppy, but helps to cut the risks as much as you can. Even when you take your puppy in early for knee exam, so many Vets say not to worry about LP and wait till something happens, it probably wouldn't even be a red flag to alot of owners. And then you see some with LP and don't have the issues Sammie had. By the time we got to specialist that breeder was long gone I heard.


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## Emmayui (May 1, 2012)

Well, we decided to take Elly to a specialist after a month. Meanwhile, she's learning to swim everyday, and eating chicken feet and trachea treats along with supplements. Elly's vet introduced a swim center for dogs in our area. (HOME - Water4Dogs) it's quite pricey, but we're hoping to take her there once she enjoys swimming in the tub


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## SammieMom (Nov 13, 2010)

Thanks for update. Glad your seeing a spec. does she still limp or skip when she picks up speed on a walk or just running around the house? The more Sammie did the more he skipped. They told me activity would aggrevate Sammie's kind of LP, as it's from too shallow (bone needs deepened) a groove space that kneecap sits in, not a muscle injury/issue. 
Keep us posted.


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