# Questions about Luxating Patella Surgery



## writepudding (Jun 9, 2007)

Hello to everyone at SM,

Before asking this question, I searched the message boards and read a lot of useful information, however I wanted to post because I did have a couple things I was worried about in regards to luxating patella surgery.

My maltese Henry is now a year and a half and needs patella surgery on both knees. After taking him to the vet on Saturday for x-rays, a surgery was schedule for this coming Thursday. I've known he's needed this surgery for about 6 months, but was told I had to wait until his growth plates were in place, I believe. I'm horribly worried and upset because of this, as I'm sure anyone in my position would be. Here are my questions:

1) I was told to bring him in by 8 am in the morning - should he be fed before this, or does he need to go to the vet on an empty stomach

2) The price I was quoted for both knees (including 2 x-rays and post-op visits) was about $3000 to $3800. I live in Los Angeles. Does that seem about normal?

3) The vet also told me that he wants to make sure that he is doing well before he goes home, which would require him to stay overnight for one day I believe. When pets have to stay overnight - is there someone watching them or am I right to assume that they are left in their own cage until the hospital opens again the next morning? And is this safe?

4) How long is the average recovery period. I've heard 6 weeks, I've also heard 12 weeks - I'm not really sure about this.

5) Is the leg put in a bandage or cast?

6) If you were in a situation where your Maltese had to have both legs done, how far did you have to wait in between procedures?

6) Lastly, what are the results that you have all experienced - have they been positive. I know that no surgery, whether it be for a human or an animal is a miracle or 100 percent cure, but I want to hear your experiences to back up (or not back up) what I've read (that the surgery has a very high success rate)

Any other pieces of advise you can offer would be much appreciated. Thanks for your time! Henry says thanks too:


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## mimi2 (Mar 29, 2005)

Hopefully this helps!

1. Empty stomach, I believe 12 hours prior, check with the vet.

2. When Ruby had hers done 2 years ago it was about $1600, so the price seems right for two.

3. Ruby spent the night, the hospital she had her surgery at was an emergency hospital that was open 24/7.

4. I think 6-8 weeks minimum, we had to keep Ruby quiet for a long time!

5. There was no cast or bandage on Ruby's leg.

6. She only had one done, but I would think 6 months...hopefully Dr. Jaimie or JMM will be able to answer this. I would run from a vet that says they'd do both at the same time.

7. Very good results, if she needs to have another one done or any of my other babies, I wouldn't hesitate for a minute.

The hardest part was not having her home for a night and then keeping her quiet, no jumping no running....that was tough!! Is the vet that's doing the surgery an orthoped?

Good luck! Kisses to Henry!! :wub: :wub: LOVE the name!! He's super cute too!!


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## makettle29 (Nov 12, 2005)

QUOTE (writepudding @ Jul 15 2008, 11:13 PM) index.php?act=findpost&pid=605975


> Hello to everyone at SM,
> 
> Before asking this question, I searched the message boards and read a lot of useful information, however I wanted to post because I did have a couple things I was worried about in regards to luxating patella surgery.
> 
> ...


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## tamizami (May 1, 2007)

I live in the LA area and my Shiva had her patella surgery done by ASEC (www.asecvets.com) on Sepulveda. I cannot say enough wonderful things about the facility and the surgeon she had (Raviv Balfour). All the surgeons are board certified. Originally Shiva's surgeon said they don't do both knees at the same time, but he agreed to do it because of her disposition. Shiva was very good about being confined and carried about (she is also crate trained). It cost us about $4500 for both knees, including follow up xrays. ASEC accepts CARE Credit for 3 months with no finance charges/interest. They are an emergency care hospital and someone is there 24X7, including a vet. 

Please PM me if you have any questions. I would never take my dog anywhere else but ASEC after my experience there.


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## jmm (Nov 23, 2004)

1) I was told to bring him in by 8 am in the morning - should he be fed before this, or does he need to go to the vet on an empty stomach

Yes, he needs to be fasted. No food/water after midnight. 

2) The price I was quoted for both knees (including 2 x-rays and post-op visits) was about $3000 to $3800. I live in Los Angeles. Does that seem about normal?

Sounds comparable to prices in Northern VA. 

3) The vet also told me that he wants to make sure that he is doing well before he goes home, which would require him to stay overnight for one day I believe. When pets have to stay overnight - is there someone watching them or am I right to assume that they are left in their own cage until the hospital opens again the next morning? And is this safe?

Yes, it is normal to keep them overnight. What type of facility are you having it done at? If it is a specialty center with a boarded surgeon, they typically have overnight staff. Many regular vets do not but will leave the pets overnight if they feel comfortable. Primarily it is to keep them confined and quiet. 

4) How long is the average recovery period. I've heard 6 weeks, I've also heard 12 weeks - I'm not really sure about this.

Depends partially on the procedure. Is your dog having a tibial tuberosity transpositioning? Is so then expect a longer recovery period. 

5) Is the leg put in a bandage or cast?

It is the vet's preference. Some like to bandage others do not. 

6) If you were in a situation where your Maltese had to have both legs done, how far did you have to wait in between procedures?

For full recovery. Your surgeon should be able to guide you. Probably at least 12 weeks. 

6) Lastly, what are the results that you have all experienced - have they been positive. I know that no surgery, whether it be for a human or an animal is a miracle or 100 percent cure, but I want to hear your experiences to back up (or not back up) what I've read (that the surgery has a very high success rate)

I had one dog who had the repair with the tibial tuberosity transpositioning. He recovered 100% within a few weeks of surgery. He was walking almost normally within a week. He had intensive physical therapy before and after surgery. My other dog had both knees done. He took about 8 weeks to recover from each and is 100%. Both dogs ran agility after recovery. 

I highly, highly recommend the physical therapy. It speeds recovery.


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## writepudding (Jun 9, 2007)

Tamizami - I pmed you back before reading your post here! I will check out ASEC, it looks like an amazing place. When I first got Henry, I took him to the VCA on the recommendation of an acquaintance, and after a couple visits, I wasn't satisfied with their service, so now I go to Altadena Animal Hospital in the Pasadena area. The vet there is very nice and the staff also cares a lot, when they did Henry's neuter, I was very nervous because he had an undescended testicle that needed to be taken out and they did a really good job, you can't even see where the stitches were at all. I would just about take Henry anywhere in L.A though, if they were good enough and it looks like ASEC is - since I live on the cusp of the Valley and work in Santa Monica (let's not talk about the traffic I endure in the mornings on a daily basis)

JMM - I spoke to the vet's assistant today, and they told me that they don't have a staff there overnight, but they make sure the animals are out of anesthesia, stable and comfortable before they leave for the night. I'm kinda worried about this actually. What if something goes wrong in the middle of the night? She assured me that they make sure they are completely stable before they leave - and my question to that would be, it doesn't make sense to leave him alone, in an unfamiliar place, when I can bring him home, put him in his crate and make him comfortable and also watch him in case anything goes wrong. I can always bring him back the same morning... I don't know, I might be over thinking about it too much. I am not sure if he is having a tibial tuberosity transpositioning. I was told that in these cases, usually the bone groove is not deep enough, so what they do is deepen the groove and put the patella back in place with a pin, I believe.

The more and more I read, the more I am considering physical therapy - however how much does this cost?


Thank you to all of you for your thorough and helpful answers. I cannot imagine how it would feel if I had an actual child (even though Henry is my child) that had to go through an operation.


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## puppymom (Jun 13, 2005)

JMM has done a excellent job of answering your questions. 

I would just add a couple things from my experience with LP surgery. 

My Vet kept Ty for 3 days, he had 24 hour care and they used that time for medical pain control, acupuncture and physical therapy. I missed him terribly but they gave me twice daily phone updates and I was able to see him daily through a one way mirror. They preferred that I not see him in person because it would get him excited. There was someone availalbe 24 hours a day to take phone calls if I was worried. I did not do it but was told I could call anytime day or night for an update. I would never leave a dog that has had surgery in an unattended facility. 

I would ABSOLUTELY do physical therapy. We went a few times a week for the first couple weeks and they taught me what to do after that, both with massage and exercise. 

Your price is very normal. I paid $2,200 for one leg and I do not live in an area known for "high cost of living".


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## tamizami (May 1, 2007)

The cost for physical therapy is not cheap. In LA I think I only found 2 centers with certified staff (Santa Monica & Pasadena) and the only one with a vet on staff is California Animal Rehab. As I said in my PM, they are amazing and gave Shiva the best care. Dr. Waldman does at least a 2 hour physical exam of the dog for the initial consult and then will make recommendations on surgery, physical therapy, accupuncture and diet. We started with physical therapy 2 or 3 weeks BEFORE Shiva's surgery, then started up again 2 weeks after surgery (her surgeon wanted us to wait at least 2 weeks).

Both CARE & ASEC accept Care Credit (http://www.carecredit.com/) - which helps spread the cost over a few months.


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## writepudding (Jun 9, 2007)

Thank you again for the information. I was looking to get pet insurance to cover this cost, however I had read that insurance does not cover congenital diseases. I will definitely sign up for Care Credit, as it looks like my vet accepts it!


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## jmm (Nov 23, 2004)

If you are not having a board certified surgeon do this surgery, I would get a consult with one before you go ahead. It is important to address bowed legs with adjusting the tibia if this needs to be done. Most regular vets do not offer such specialized procedures. You are getting awesome advice from Tami. I'd look into her recommendations. 

I do not think it is a good idea to bring your pet home the same day as a major orthopedic surgery. If you are not comfortable with your vet's recommendations, you can transfer your pet to an emergency clinic for overnight care.


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## Nikki's Mom (Feb 13, 2008)

I know nothing about Patella surgery, but my Bichon had emergency back surgery for a ruptured disk, and was unable to walk afterward. I had someone at the clinic train me in basic physical therapy and I worked with her every day for two weeks until she was able to get up by herself and start walking again. It wasn't easy, but it was a good bonding experience. I would have preferred to have a professional physical therapist for her, but I couldn't afford it. They were gracious enough to give me some instruction. It didn't replace professional help, but my furbaby recovered fully from the surgery.


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## tamizami (May 1, 2007)

QUOTE (Nikki's Mom @ Jul 16 2008, 02:06 PM) index.php?act=findpost&pid=606299


> I know nothing about Patella surgery, but my Bichon had emergency back surgery for a ruptured disk, and was unable to walk afterward. I had someone at the clinic train me in basic physical therapy and I worked with her every day for two weeks until she was able to get up by herself and start walking again. It wasn't easy, but it was a good bonding experience. I would have preferred to have a professional physical therapist for her, but I couldn't afford it. They were gracious enough to give me some instruction. It didn't replace professional help, but my furbaby recovered fully from the surgery.[/B]


Suzan - you bring up a really good point about the physical therapy. At CARE, I worked with Shiva and the therapist. They taught me what to do at home as well. Many people drop off their dog and then pick up later, but they are missing an excellent bonding experience for you and your dog.


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## writepudding (Jun 9, 2007)

QUOTE (JMM @ Jul 16 2008, 03:55 PM) index.php?act=findpost&pid=606290


> If you are not having a board certified surgeon do this surgery, I would get a consult with one before you go ahead. It is important to address bowed legs with adjusting the tibia if this needs to be done. Most regular vets do not offer such specialized procedures. You are getting awesome advice from Tami. I'd look into her recommendations.
> 
> I do not think it is a good idea to bring your pet home the same day as a major orthopedic surgery. If you are not comfortable with your vet's recommendations, you can transfer your pet to an emergency clinic for overnight care.[/B]



The surgeon is board certified and has worked in animal hospitals all over Los Angeles County, but I will definitely keep what you said in mind. I am just getting more and more nervous and anxious as the day passes because it's one step closer to surgery tomorrow.


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