# My dog was just diagnosed with luxating patella



## lisahi (Jun 19, 2011)

My 18 month old toy poodle mix, Coco, was just diagnosed with luxating patella. I started noticing that at times, when she would run, she would yelp, skip a bit with her right hind leg up, then shake it out and "walk it off." She would be fine after that. Turns out it was her kneecap popping out of place.

I can't say I'm surprised. I got Coco for free from a friend whose parents let their pet-store-bought dogs breed. Coco is a product of two probable puppy mill-bred dogs. But now I'm debating what to do.

The vet didn't diagnose her with Stage 1, 2, 3 or 4, but she did recommend surgery. Right now Coco moves just fine when her kneecap is in place. It falls out of place when she plays or runs really hard.

I was told the surgery would be about $3,000 to $3,500 with all attendant costs. That is more than I can afford since my pet insurance doesn't cover congenital conditions (although I may be able to purchase additional hereditary coverage with a higher deductible). I was also approved for Care Credit up to $4,100, which just means I can pay over a certain period of time with no interest.

My question, though, is whether I should do the surgery now or wait. I know I shouldn't have gone online to search the condition, but I'm only human. Some vets seem to say "yes" to surgery, others say "no" unless the condition is Stage 3-4. My worry is that Coco's condition will deteriorate and she'll develop arthritis or lameness. But then I also worry that she'll get the surgery and the condition will still recur.

Any thoughts?

PS: Right now Coco is penned to limit her jumping/running. That's a whole other issue. She's a very active dog. Some online sources say you should still let your dog move around to keep the muscles strong; others say you should limit movement. My personal vet said to limit movement for now.


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## ChaosIsAWeim (Feb 12, 2011)

Why didn't the vet grade it? I wouldn't jump to surgery unless you know the grade. If it is on the higher end then go ahead with the surgery but if not, it is something that can be managed with some muscle building and supplements.


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## lisahi (Jun 19, 2011)

I went ahead and made an appointment next week with a specialist in San Antonio (who would do the surgery, if the surgery is done), to get a more thorough diagnosis. I think the vet here didn't grade it because she referred me to a specialist.

Right now, Coco can't go two days without popping her kneecap. She can still pop it back herself, and then she seems fine, but I'm most concerned about future damage if that continues. She's very active, and I'm not sure how management would work with such an active dog. I was given anti-inflammatory medication today; she's already on a grain-free diet. I will definitely look into supplements.


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## lisahi (Jun 19, 2011)

Hey all... this topic is a little old, but I thought I would update it just in case anybody else's pup had the same problem. Anyway, I saw the specialist in San Antonio for Coco's luxating patella and he diagnosed it as a grade 2. He said that normally he wouldn't advise surgery for a grade 2, but that it was obvious she was in pain and so felt it was best to do the surgery. The other knee was quite stable so he believes that, while she is prone to luxating patella, she probably aggravated it by taking a wrong turn when she was playing. I asked when he could do the surgery and he said, "well, I can do it today." I hadn't planned on spending the night in San Antonio, but my sister lives there so I decided to just do it. The surgery cost me $1,800 for the one knee. The specialist charges a flat fee for the surgery because he's done so many that he basically knows exactly how much it's gonna cost. I used Care Credit and will be paying it over 6 months. I have pet insurance, but luxating patella isn't covered because it's considered "congenital."

The surgery was a success. I came back for her the next morning. I was surprised because they didn't wrap the stapled incision. They told me, "if she licks or picks at it, use a cone." I told them, "she will definitely lick and pick at it, can I just get a cone now?" Sure enough, as soon as I said that, Coco went for the wound.

The surgeon only recommended keeping her penned and inactive for 4 weeks. I asked him 3 times if that meant she could do anything after that--playing, jumping, etc. He said, "yes." This was a shorter time than I had read and can only think it's because Coco is smaller, was only a grade 2, and is only a year and a half old. Coco spent those 4 weeks penned up and had her cone on the entire time. Most of her incision healed nicely, but one area took a bit longer. Hence, she needed to keep the cone on longer. I kept her pretty inactive for the next two weeks after that as well.

At the six week mark I felt a strange cyst-like lump on her knee. At first I freaked out thinking her patella was unstable again. But then I realized that the lump felt like fluid. I called the specialist and a vet tech postulated that it could be a seroma. I went to my local vet the next day and they drained the fluid. It was partially the joint fluid that pooled due to pockets created by moving things around in the knee. The next day, the seroma showed up again. This time, my local vet called the specialist who then called me. Turns out this is very common, but the only way to prevent the seroma from reoccuring was 2 more weeks of inactivity.

So Coco is back in a pen. She developed a few behavioral issues while penned--she started to get more territorial over me, for one. I have another dog, Lucky, who is a puppy. Because she was penned, I either was with Coco in the pen, or outside the pen with Lucky. Coco got used to having me to herself and forgot how to share when the two dogs were together. She was starting to return to normal when I was told to pen her up again. This time around it's tougher to get her to stay inactive, even while penned up. The seroma doesn't cause pain or discomfort. She feels fine so she wants to be running around.

I'll be in Boston for a little over a week starting next week, so Coco will have to stay with the vet. She requires warm packs on her knee 3 times a day. Lucky will be staying with a friend.

I'm hoping after the 2 weeks are done, this adventure will be over. According to my local vet, the knee itself healed very well and is stable. Coco actually began standing on it two days after surgery. Given her age, I'm hoping that's the end of the issues for this knee. And, of course, I'm hoping her other knee never starts acting up.


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## annadee (Aug 22, 2012)

Oh goodness, sounds so complicated! I hope everything will be okay in the end. I'm interested in a small dog in the future, and luxating patellas is one of the health concerns I am worried about.


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## lisahi (Jun 19, 2011)

annadee said:


> Oh goodness, sounds so complicated! I hope everything will be okay in the end. I'm interested in a small dog in the future, and luxating patellas is one of the health concerns I am worried about.


Truthfully, I didn't even know it was a big thing with small dogs until Coco was diagnosed. I grew up with small dogs, but none had this issue. Coco was an "oops" birth that I took in. Her parents belonged to the parents of one of my work colleagues. I think Coco's father was a puppy store (puppy mill) dog--a toy poodle. Her mother is a maltipoo. There might be other surprises lurking in her genes.


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## CoverTune (Mar 11, 2007)

I find it odd that you were advised to keep her movement limited for such a long period of time. I worked at a clinic that did LOTS of LP surgeries and clients were told to keep their pets quiet for two weeks, by three weeks the dog should be at least toe-touching or attempting to use the leg, and by four weeks they should be using the leg more than not.. if they weren't using the leg by four weeks, then often physical therapy and/or hydrotherapy were recommended, though very few dogs got to that point. I went through it with one of my dogs and he was a touch slow to get back to using the leg, but we pretty much made the four week mark.

Did they advise any exercises for you to do with her at home after the surgery? Passive ROM is what is usually prescribed and can help a lot in preventing muscle atrophy and seromas.


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## lisahi (Jun 19, 2011)

CoverTune said:


> I find it odd that you were advised to keep her movement limited for such a long period of time. I worked at a clinic that did LOTS of LP surgeries and clients were told to keep their pets quiet for two weeks, by three weeks the dog should be at least toe-touching or attempting to use the leg, and by four weeks they should be using the leg more than not.. if they weren't using the leg by four weeks, then often physical therapy and/or hydrotherapy were recommended, though very few dogs got to that point. I went through it with one of my dogs and he was a touch slow to get back to using the leg, but we pretty much made the four week mark.
> 
> Did they advise any exercises for you to do with her at home after the surgery? Passive ROM is what is usually prescribed and can help a lot in preventing muscle atrophy and seromas.


The exact instructions were to keep her penned for 4 weeks, but Coco was walking on her leg 2 days after surgery. She was sitting, standing, moving around well after about a week. She can walk around the pen--it's not that small. The real restrictions were no running, jumping, playing with other dogs. So I would take her out on a leash for potty breaks, which she would stretch out because she didn't want to go back in the pen. So I would be out with her, walking around, for 15-45 minutes, depending on her mood. Walking at her speed, but still walking around. After about a week and a half, she thought she was better, so she would even try to run on the leash. The specialist said, when examining her, that she looked like a dog that would get up and want to walk and run and jump after surgery. Sure enough...

One of the biggest issues was that her incision site didn't heal as fast as expected, so we couldn't remove the staples until 3 weeks after surgery. Even after they were removed, there was one area of the incision that wasn't as healed as well as the rest. So I had to be careful so as to not break open the wound. It's this problem area on the wound under which the pocket formed causing the seroma. When the wound was still a bit open, the fluid drained (light pinkish) and she was on antibiotics, but the wound is closed now. The pocket under the skin, however, is still there. Hence, the fluid build up. The fluid built up the more Coco was active after she was un-penned. I think the skin just didn't have a chance to adhere and close the pocket.

The specialist did recommend passive ROM exercises, which I did. But the exercises he recommended, she was already doing on her own (sit/stand; stretching leg; bending leg; etc). As of now, the knee has healed well, she's walking without a limp and without favoring the one leg. She can run and jump as if nothing was ever wrong.

My local vet actually wanted me to keep her penned up for the full 6 weeks. I followed the advise of the specialist instead (4 weeks penned). I didn't take her to daycare or take her on extra long walks for 2 weeks after that, but she was unpenned after 4 weeks. Turns out that she needs to be penned up for another 2 weeks anyway according to the specialist so that the skin has a chance to adhere at the seroma site and close the pocket. Today she's going to the vet to stay for a week while I have to go to Boston for work, so they'll be keeping an eye on it and applying warm packs as well.


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## georgiapeach (Mar 17, 2012)

I have a 4.5 year old rescued small miniature poodle with luxating patellas (grade 3.5 in one knee and a 4 in the other knee). His knees are never in place. You can put them back in place, and they'll immediately pop back out. Believe it or not, he's not lame, and I don't restrict his activity. I have always fed him Cosequin DS plus MSM daily (the directions say every other day, once loaded in their system, but I give it every day, due to the severity of Potsie's situation). I also give him a fish oil capsule daily, as well as a quality grain free kibble. 

My vet is very happy (and completely surprised) that he's not lame, and said to keep doing what I'm doing, since it works (she's not the holistic type, so this treatment isn't one she's advised before). She told me (and I TOTALLY agree), that it's critical to keep the dog on the slender side, to reduce the stress on the joints. I weigh Potsie frequently, and I make sure that he doesn't deviate more than 1/2 pound from the weight that the vet wants him to be (remember, he's small - only 12.5 lb.). My vet told me she has another client with only a grade 2 who's very lame, and nearly ready for surgery. She actually told me that she was going to share my treatment plan with that client, which made me feel good! 

It takes awhile for the Cosequin DS plus MSM and the fish oil to become therapeutic (a month or so), so if you try it, don't expect immediate results. I can see why your vet wants to restrict some movement if your dog's already lame, but I would think controlled, short walks would be helpful. But I'm not a vet...


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