I won't bore you all again with the events leading to my decision to defer surgery on my Lowchen's knees, but I would be interested, and reassured, to hear if anyone knows of a dog with grade 3 bilateral medial patella luxation who has NOT been operated on but is (or has) lived a 'normal' life for a good few years. (Obviously the decision not to have the operations having been based on the absence of pain, limping etc).
Advice from friends has varied quite a lot but it has to be said that none of them has first hand experience to back up their views.
If I don't receive any replies, I think my question will be answered !!

Thanks

Joyce

Some small breeds can manage with this condision, but every time the knee slips it does damage to the joint leading to calcum deposit and arthritis in turn causing a lot of pain in future years which may need prolonged treatment with the very drugs you are trying to avoid. On the other hand the dog may develope stong enough muscle to hold the joint stable. Your best plan would be to see an expert in cannine bone problems. Jackie H

Dear Jackie,
Try swimming your dog in a heated hydro pool at least twice a week, it will help immensley.
If your vet refers your dog it should be covered on insurance. Good luck and try to find a pool that
your vet has referred to before.

Hi Sharon, Jackie here and I don't have the problem it's Joyce who does, but I do agree if she can swim her dog it will help develope muscles which will help hold the patella in place, providing the situation is not too bad so that even swimming causes the patella to slip. Jackie H

Hi from across the pond...so grateful to have found this website and to be able to read all the wonderful advice/information here. I have a four year-old Yorshire Terrier...in honor of the U.K.! haha

He was diagnosed with bilateral medial patella luxation at age 1 by a board certified orthopedic specialist who graded his left leg at a III/IV and his right at a II. The specialist advised me not to have surgery. Up until very recently I noticed no change, however a few weeks ago he began holding up his right leg from time to time. His regular vet started him on Cosequin and he is doing better, I haven't seen him hold that leg up since he started on the medicine. I took him to another orthopedic specialist where I live now and he graded both legs II/III and recommended surgery. I am so torn as to what to do. Aflie is a very small and sensitive dog. He also has a collapsable trachea and I fear how well he will fare during surgery. It's so difficult to weigh the risks and benefits. I do fear that he will deteriorate over the years...I also fear the risks of surgery and how well it will work. Please...any information from those who have had good or bad experiences would be great. This is a very difficult decision and any advice/information/resources would be greatly appreciated. Kristen

For what it's worth Kristen, with the trachea problem, I'd leave well alone. Of course it is not the same reading about the dog as it is being able to feel the knees but the weight of a Yorkie is such that he is not likely to have quite the problems of a heaver breed. I've seen several smaller breeds with luxating patella’s which have lived a full life (although I must admit that a few have had to have restrictions on exercise) Heavier breeds tend to have rather more problems.

In the normal course of events the operation is relatively simple, having been performed for so many years. But with the possible complications in your case, were it my dog I would be reluctant. This is your vet, do you trust them? Do you think they are just after your money? These are the questions I would be asking myself. To say categorically that every single vet in the world is just working with the animal's welfare in mind is to be looking through rose coloured glasses so this is something to bear in mind. I trust mine, do you trust yours? Again, different people view things in differing ways and one would push for surgery whilst another would take a rather more cautious approach. You how have two opinions, one for surgery, one against. What is your regular vet's thoughts? You say you have not seen him hold his leg up since starting on Cosequin so it would not appear to me that it is bothering him too much.

Obviously I cannot make the decision for you but this is just a few ideas for you to think about and maybe help you come to a decision.

Regards, John

Hi Kristen - reading your post was like a peep into the future for me ! I have recently decided against surgery for my Lowchen (10 months old now) but I took the decision in the knowledge that he may suffer some problems as he gets older.
You're right, it is a very difficult decision to make simply because no-one knows what the future has in store. The orthopaedic vet I took my dog to was very honest and said, that in the past it was a matter of course to operate on grades 3 and 4, and possibly some grade 2s. However, having looked back over some of the cases, it was apparent that only about 50 - 60% could be rated completely successful. In some dogs the patella started slipping again and needed further surgery and others developed a range of other complications. He emphasised that, because no two dogs react the same, it was very hard to make a sound judgement about which dogs would benefit from surgery and which wouldn't.
Personally I would think that if the Cosequin is helping your yorkie, wait and see if the improvement is sustained. I think it's slightly easier to decide on surgery if its obvious your dog is in pain than it is when he seems his normal happy self.
There is quite a lot of information on patella luxation on the internet - although you will probably find, as I did, that some of the advice is conflicting.
Beat wishes with your decision - your little dog is fortunate to have such a caring owner.
Joyce

Hi Joyce. I groom for a living. Because I specialise in smaller dogs, I trim a number who's patellas click out when I lift their legs to tidy feet/cut nails etc. When I mention it to the owners some say "Yes I know. He does hop sometimes and cries when he jumps onto the sofa, but the Vet says it's not bad enought to operate on!" Others are completely unaware. They just think that their dog does "a cute little bunny jump sometimes" and haven't even mentioned it to the Vet. Now I have no idea of the grades involved because I'm only hearing second hand and the majority of owners have no interest or comprehension of what their Vet says. They only hear "Not bad" and "No operation"!
Sometimes ignorance is bliss, well for the owners anyway if not for the dogs!

Thanks for these suggestions and views, they're much appreciated. From what I understand of Buddy's grade 3 condition, the patellas (or is it patellae ?!) are 'clicked out' all the time, although they can be clicked back in manually. I think the grade 4s are worse in that they can't be put back into place by hand as easily. I have now decided to take him to see an ortho surgeon - appointment next week I hope - just to get an expert opinion. Unfortunately the breeder did not have insurance on Buddy when we got him and now we know he has this condition it can't be covered by any insurance we might take out.
If he has to have surgery we'll need a second mortgage - we've discovered that this particular ortho vet charges up to £1100 .....per leg !!!
I think the hydrotherapy is definitely worth considering though.

Joyce

Joyce, sorry to hear you are not insured it is a poor deal that your breeder did not encourage you to do so. Your boys knees are bad because they are unstable all the time. Where do you live, the fees being quoted seem very high, my vet happens to be an orthopidic specialist and I'm sure he would not charge that much. It may be worth your looking outside your area to find a more reasonable surgeon. Have you got the x-ray plates from the original vets if they are any good you should not have to pay for that again. Jackie H

Jackie, I live in North East Wales and the referral practice my vet uses is in Cheshire. Of course I don't have to have the surgery done there (if it's needed) but all the advice I've had is that it's best that an orthopaedic specialist does it. My own vet says he would do it for approx £350 per leg.
Re the insurance situation - even if we'd applied for insurance as soon as we had him from the breeder, we still wouldn't have been covered for this as the condition was diagnosed before the two week 'acceptance' period was up. Everything would only have been OK if the breeder had already had him insured.
I don't think more x-rays will be needed, fortunately. The ones taken by our vet are good, apparently he's a referral radiographer. So a bit of money saved there then !!

Regards
Joyce

Hi there,

Somehow managed to miss this thread. I was one of those daft folk who did not notice my little dog(now deceased, unrelated) had this condition, thought the 'bunny hops ' were sweet. At the risk of telling 'horror stories', she was out playing ball with our lab one day and said leg somehow ended up in a hole in the ground whilst she was running, there was an ear splitting scream and the knee had come out all together it was awful, resulting in an emergancy major operation and then another 6 wks later the cost went into thousands, and due to leaving it so late she never recovered competely and went from a fun loving ball mad dog, into an 'enforced rest' misery, who could only play ball for short intevals and no more long walks. We also had to stop her from playing out with the lab, as the risk was to great (he being a bit clumsy).

I am glad you have decided to take your dog to the orthepedic. I hope I have not alarmed you this was not the intention, just wanted to share the experience, and wish I had known about this condition before hand - If my Vicky (dog concerned) had the operation sooner it may have been more successful.

Good luck with your dog,
I will watch this with interest, it is a very interesting condition
Lynda

Sorry Joyce must have missed your posting yesterday. You are on the otherside of the country so I'm not able to help with referal suggestions. Best plan is to see the specialist and see what they say, hopefully you may get away without an op, lets hope so. Is the breeder willing to help, don't supose so, bet they are glad you did not return the pup. If you do have to go ahead you may be able to arrange to pay in instalments I know some vets will help like this, be sure to let them know you are not insured. I don't know but have the feeling that the cost may go up if you are insured, sorry vets, just a feeling. Jackie H

It cost me just short of £700 to have my poodles leg done for luxating Patella. I am insured but I don't think the price would have been higher as my vets know that I pay up front first!

Thanks a lot for these further responses.
No, Jackie, the breeder has not offered to help with any vet fees. In fact she has not really helped with any aspect, she said at first that she felt bad about it all but she hasn't bothered to ring since to enquire about Buddy. It's odd that, within the Lowchen circle, she seems very well respected. (!) Your suggestion about instalments is a good idea, we'll definitely bear it in mind.

I was also interested to hear about Lynda and Bec's dogs having had similar surgery. Any further details or tips particularly regarding the rehab period would be really welcome.

The appointment with the ortho vet is next Wednesday at 11.30 a.m. so I will let you all know how it goes.
Your support and interest have really helped so far - it makes such a difference being able to 'talk' things through.
Thanks again
Joyce

Hi Joyce, I don't know how old your dog is. My Poodle, Tala, is still a pup. She was only 5 months old when she had her first op and had the pin removed (not sure why they put in a pin!) about 2 weeks ago. She bounced back very well and very quickly from both ops. The only problem I had was she hated having a plaster on (only 2 day temporary one) and got quite stressed but once it was removed was running around like a loon! Other than that (and a bit of clipper rash where they clipped her coat) she has recovered very well.

Had the problem but with a larger dog and some time ago, I found, because I had other dogs, that a cage was needed to insure rest and sensible behaviour. The rest period was about 12 weeks but it was worth it as I would not want to risk having to have even more surgery because the repair had broken away. there are several different things that may be done to repair this problem from deepening the grove that the ligament runs in to moving the tibial crest which is a spur of bone that has one end of the ligament attached and sometimes the ligament is shortened. It is possible that two or more things will be done to correct this problem. It is if the tibial crest is moved that great care must be taken during the recovery as if it brakes away you can be left with a fragmented bone which is difficult to repair. When you see the surgeon ask questions until you are clear what is going to happen and you will feel more able to cope with the recovery. Wishing you all the best. Jackie H