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Luxating Patella? #63044
07/10/10 08:57 PM
07/10/10 08:57 PM
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Northern CA
MaxaLisa Offline OP

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A friend of mine has a small dog, still a pup, with a luxating patella. Does anyone have experience with this (Lori?)?? We're wondering how much of a chance there is to avoid surgery, or if there is a good way to support this. Also any experiences with the surgery?


MaxaL (aka LisaT)

Jazmine, mini-mix, 10/18/2011
Max-n-Indy
Max, 5/2001-2/2012, RIP my partner, my Regal Boy
Indy, 5/1997-10/2010, RIP my friend, my teacher

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Re: Luxating Patella? [Re: MaxaLisa] #63057
07/10/10 10:20 PM
07/10/10 10:20 PM
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Central Virginia
AvaLaRue Offline
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AvaLaRue  Offline
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Lisa...My shih-tzu, Toby, has bi-lateral luxating patellas. Both of his back legs. He was walking oddly and at the time we thought it was just wonky puppy legs. When he was about 6 months old, we shaved his fur to a summer cut, then we could tell his knees were popping and when we picked him up we could feel his joints popping.

The vet diagnosed him. We were told that it may be an issue in the future that would require surgery. However, at this point, the vet said he would not advise it as Toby was not in any pain. He runs, jumps, plays, etc and doesn't show any signs of pain. The vet told us that we would re-evaluate if he starts showing pain. Either with meds or having the surgery.

He's funny lookin to watch.!! He Just turned 2 years old in January and still doing fine. The only thing we have to be careful with is he doesnt like his rear legs handled much and when I groom him, I have to watch the angle that I move his rear legs.

Not sure if I helped you with your question at all.


~ Leigh ~

Proud mama to
Ava LaRue(GSD) 3/2/10
Chewy (Shih Tzu)
Toby (Shih Tzu)

Volunteer Coordinator, www.southeastgsdrescue.org
Re: Luxating Patella? [Re: MaxaLisa] #63058
07/10/10 10:30 PM
07/10/10 10:30 PM
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JeanKBBMMMAAN Offline
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JeanKBBMMMAAN  Offline
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Yes her Meri, and my Mari(ele) have both had it.

A lot depends on what level it is I think. When I get on my computer I will look for the links I like.

They can work in rehab on the muscles around the knee but my guess is that if it is popping out a lot, that's not going to be enough.

I guess it's fairly common-ish in small dogs. When I was reading up on it two vets said it is one of their favorite surgeries to do because of the high success rate.
So of course Mariele had to have it done twice, right?!? Something he'd never seen before - and he took pictures of my little Mari's leggy all opened up in surgery - she re-grew tissue and it popped the repair out. You could see it...weird. The second time she didn't do that and you'd never know she had it done.

Re: Luxating Patella? [Re: JeanKBBMMMAAN] #63073
07/10/10 11:35 PM
07/10/10 11:35 PM
Joined: Jan 2010
Posts: 19,670
Northern CA
MaxaLisa Offline OP

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MaxaLisa  Offline OP

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Leigh, that is helpful, thank you! Did the vet talk about possible arthritis long term if the surgery wasn't done? If it was done? Do you have her on joint supplements?

Jean, I had forgotten about Mariele, and I missed that she had to have it done twice. Wow! Of course your dogs like to be special wub

My friends pup is probably under 15(?) pounds. The vet did say to wait a bit and see if scar tissue forms before deciding on the surgery.


MaxaL (aka LisaT)

Jazmine, mini-mix, 10/18/2011
Max-n-Indy
Max, 5/2001-2/2012, RIP my partner, my Regal Boy
Indy, 5/1997-10/2010, RIP my friend, my teacher

Health Index
K9 TBD info and Tick List Links
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Re: Luxating Patella? [Re: MaxaLisa] #63128
07/11/10 02:14 AM
07/11/10 02:14 AM
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Posts: 824
SE WI
Lauri & the Gang Offline
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There are 4 Grades of Luxating Patellas:

http://www.cpvh.com/Articles/78.html

First your friend needs to find out the Grade. Not all dogs NEED surgery. Some dogs, even with the higher grades, can manipulate the knee back into position on their own. They may hop along for a bit with the knee out of position but will 'right' it without help. Dogs like this usually don't need surgery unless alot of arthritis develops later in life.

The surgery is very straight forward and simple.


Lauri & The Raw Fed Gang
Tazer HIC CGC Cocker
Winnie CGC - Corgi Mix
Chimanes Spice it Up Piquin (Kaynya) - Chinese Crested
Sasha - GSD mix
Nator von Triton HIC CGC (Mauser) - LC GSD
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Re: Luxating Patella? [Re: Lauri & the Gang] #63155
07/11/10 03:18 AM
07/11/10 03:18 AM
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3K9Mom Offline
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3K9Mom  Offline
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As Jean reports, we did surgery. Mer wasn't in pain as far I could tell. She'd go tripod after zooming around a lot, but it would pop right back in. But my vet and surgeon told me that this could get worse, and Meri is my agility dog. After speaking to Jean about Meri's soul mate Mari, I had the surgery done.

VERY VERY glad I did.

The surgeon said that the patella didn't seem bad when examining it and even with the xrays (he and my holistic vet both graded it a 2, maybe 3). It easily went back in on its own. But when he got IN there and saw it, well, that darn patella was slipping around and causing all sorts of damage to the tibia. In fact, he had to do more work than he expected. Meri was very young (about 20 months when diagnosed), so the fact that there was this much damage served as an eye-opener to my regular vet and my holistic vet who were both rather surprised. They both said that they usually recommend waiting til the symptoms (pain symptoms) get bad. The surgeon didn't just form deeper trochlear grooves as planned, but he had to fixate the patella with pins because the ligament was stretched and the tibular head was worn.

We just can't see what's going on below the surface, and wear of a bone is often subtle and doesn't show up in xrays.

So, Miss Meri has a pin in her knee. But we did TONS of rehab after -- both water treadmill and at home (which we did religiously). So now, she's back to full-time zooming. Surgery was January 19. She was released to full duty -- yes, the vet knows how rough she plays with Celo, and how active she is -- the beginning of April. We got the final FINAL xrays mid June to make sure everything is still healed and holding well. And it's all perfect.

Apparently, small dogs can simply opt to "go tripod" after the surgery and never fully become weight bearing again, even though they're fully healed. (since they're so lightweight and don't 'need' that rear leg to get around). So it's really important with little ones to get them toe-touching, then weight-bearing as soon as feasible. Working with a rehab vet was really important. He got Meri into the treadmill tank 14 days after surgery and gave us specific exercises on a specfic schedule.

Probably, though, the best exercise was simply that she knew "spin" and "twirl" tricks -- which are virtually impossible to do without being fully weight bearing. (We needed to start off with BIG wide twirls and spins, then work into tighter circles as she gained more strength). So if your friend opts for surgery, I would recommend that she trains those tricks now while the dog is willing to learn them.

This was one of the best health decisions I've ever made for my dogs. I was paralyzed at first (and refused to do the surgery during 2009 because it had been such a bad year for my dogs). You know how terrified I've been of surgery I've been in the last year (ok, I admit. I stayed at the clinic for almost two days. blush And the pre-op work-up that my vet internist did was sooooo thorough for such a young healthy dog..... whistling ) . But sometimes, surgery really IS the best option.

No surgery is perfectly safe, of course. No surgery outcome is guaranteed. But my surgeon said that the success rate for this surgery is about 98%. And unlike a TPLO (which I'm also a fan of, having had a dog that had two), the surgeon explained that with a patella repair, the dog is actually restored to 90-100% of actual strength (a TPLO puts the dog back to about 60-70% strength). Good odds for a good outcome with actual restoration of strength. I would only let a board-certified surgeon do this surgery, but yeah, I'd do it again.

Last edited by 3K9Mom; 07/11/10 03:26 AM.
Re: Luxating Patella? [Re: 3K9Mom] #63157
07/11/10 03:27 AM
07/11/10 03:27 AM
Joined: Jan 2010
Posts: 19,670
Northern CA
MaxaLisa Offline OP

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MaxaLisa  Offline OP

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A wealth of information, thank you very very much!

I know that they are carefully looking at all options right now, I'll pass along all the info to help them with their decision.

Thanks again!


MaxaL (aka LisaT)

Jazmine, mini-mix, 10/18/2011
Max-n-Indy
Max, 5/2001-2/2012, RIP my partner, my Regal Boy
Indy, 5/1997-10/2010, RIP my friend, my teacher

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Re: Luxating Patella? [Re: MaxaLisa] #63172
07/11/10 03:38 AM
07/11/10 03:38 AM
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Posts: 19,670
Northern CA
MaxaLisa Offline OP

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MaxaLisa  Offline OP

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While waiting for surgery, or in the case of no surgery, would joint supplements help?


MaxaL (aka LisaT)

Jazmine, mini-mix, 10/18/2011
Max-n-Indy
Max, 5/2001-2/2012, RIP my partner, my Regal Boy
Indy, 5/1997-10/2010, RIP my friend, my teacher

Health Index
K9 TBD info and Tick List Links
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Re: Luxating Patella? [Re: MaxaLisa] #63184
07/11/10 03:59 AM
07/11/10 03:59 AM
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Posts: 4,618
JeanKBBMMMAAN Offline
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I didn't use them before - not sure if I had a reason or not - but she gets them now. Oh! She was on Nupro joint. Until I figured out that was a great flavor enhancer for poo with my crew. smile

Meri and Mari were again similar with the damage that was found when they were opened up. She had the same multi-step repair.

Like I said that tissue thing is odd - you can tell your friends that!

Re: Luxating Patella? [Re: JeanKBBMMMAAN] #63200
07/11/10 04:24 AM
07/11/10 04:24 AM
Joined: Jan 2010
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Northern CA
MaxaLisa Offline OP

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MaxaLisa  Offline OP

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Originally Posted By: JeanKBBMMMAAN
...... Oh! She was on Nupro joint. Until I figured out that was a great flavor enhancer for poo with my crew. smile


rofl

Thanks again Jean....maybe I can find some info on the supps on a search.

Last edited by MaxaLisa; 07/11/10 04:27 AM.

MaxaL (aka LisaT)

Jazmine, mini-mix, 10/18/2011
Max-n-Indy
Max, 5/2001-2/2012, RIP my partner, my Regal Boy
Indy, 5/1997-10/2010, RIP my friend, my teacher

Health Index
K9 TBD info and Tick List Links
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Re: Luxating Patella? [Re: MaxaLisa] #63330
07/11/10 07:39 PM
07/11/10 07:39 PM
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3K9Mom Offline
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I think that supplements would help SOME because the way that that patella is moving all over the place:

here's a cool picture: http://arthritis.about.com/od/arthritisbyanatomy/ss/causejointpain_2.htm

So I want to support the joint AND prevent inflammation.

But that patella moving around causes wear and tear that will eventually going to break down the synovium.

I have Princess Beagle on supplements now. She switches between Cosamine chewables(which she eats but she doesn't particularly like -- they're too crunchy) and GlycoFlex III (that she thinks are the best treats ever!). I like Cosamine because they've done actual research studies and have proven results. But I like the anti-inflammatory ingredients of GlycoFlex (Vits C, E, Grape Seed Extract, etc). Especially with a little dog, I don't feel really comfortable giving my own supplements. How much vitamin E is enough vs too much? There just isn't as much wiggle room with an 18 lb dog vs my GSDs (or even a medium sized dog like Zamboni). The Glycoflex tells me how much each chew has, so I know what I'm giving.

I use Glycoflex III over Glycoflex II because she already has this knee issue. She's not an adult that I simply want to support (so she never develops arthritis). I'm actively managing this because I know that knee is a weak spot. I learned from Zamboni's TPLO's that if I get in there early and manage it, those weak spots don't have to become problem areas when they're seniors and geriatrics. But we can't simply give moderate doses. We have to be very proactive. So I give the regular dose of Cosamine for two days, then a double dose of Glycoflex the third. She's not quite at a loading dose, but more than a regular dose.

If I were going to manage a dog WITHOUT surgery, I would be inclined to put the dog on a loading dose for probably two months (with rehab). If that worked and the vet didn't have any objections (there's no heart condition that preempts continued use of Glucosamine, which is a salt, or other conditions that contraindicate anti inflammatories like Vit E), I might continue that another month. Then switch down to about 75% of the loading dose and stay there for a while. All of this, of course, with the rehab vet's approval.

Neither Glycoflex nor Cosamine affects poop one way or another... as far as I can tell. smile

Re: Luxating Patella? [Re: 3K9Mom] #63666
07/12/10 08:28 PM
07/12/10 08:28 PM
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Northern CA
MaxaLisa Offline OP

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MaxaLisa  Offline OP

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Thanks a bunch Lori, that's very helpful.

I used to have Indy on both Cosequin and regular Glycoflex, and it worked very well. I had to take her off the glyco for other health reasons special to her though. I like the combination of the purity of the Cosequin, and the combination and more natural forms in the Glycoflex products.

All that info will come in very handy, I really appreciate it!


MaxaL (aka LisaT)

Jazmine, mini-mix, 10/18/2011
Max-n-Indy
Max, 5/2001-2/2012, RIP my partner, my Regal Boy
Indy, 5/1997-10/2010, RIP my friend, my teacher

Health Index
K9 TBD info and Tick List Links
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