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Thread: need advice re: surgery to correct Patellar Luxation

  1. #1
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    Default need advice re: surgery to correct Patellar Luxation

    Our 2 year old CKCS, Jack Sprat, has been diagnosed with grade 3 Patellar Luxation in both hind legs. We have seen two different orthopedic specialists, both agree he is not in pain; however, they had two very different treatment suggestions. The first vet said that we should do nothing unless he is in pain as he has seen many small dogs do fine with this condition their whole lives. Just to be sure we exercise him to keep his quad strong the pressure off his knees. The second vet said that we should do the surgery now because the condition will worsen and become painful and the sooner we correct it the better the results. I donít want to put him under the knife unnecessarily, but I donít want to miss the window to keep him comfortable either. Any suggestions??? I should also mention that Jack has SM.
    Mary Ann (Jack Sprat's mom)

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    Good question.

    One thing to consider is that sometimes vets think they are seeing bad patellas when actually it is hind leg weakness due to SM. So you'd really, really want to be sure this is the problem. I know Clare Rusbridge in the past has said that unnecessary surgery should be avoided for dogs with pain from SM (and I know neurologists have seen dogs undergo surgery for misdiagnosed patellas that didn't actually have patellar problems but SM weakness) . If one says he isn't seeing problems or pain right now, and given the limited outlook for SM dogs (sadly, their future is just so unpredictable and I recall with Jack Sprat that you had an early onset case) -- I'd not put any of mine through the very long recovery of a patellar operation (it is many, many weeks of crate confinement) on top of SM.

    The problems with really bad grades tend to be arthritis in middle to old age. I'd think that is a pretty manageable possible issue compared to SM in the immediate term.

    I thought patellas generally show up much earlier and also tend to only go away in dogs that are much younger, as their joints mature -- hadn't heard that this could go away in a two year old? I guess that might also make me question whether this is an SM problem and not patellas at all?
    Karlin
    Cavaliers: Jaspar Lily Tansy Libby Mindy
    In memory: Lucy Leo
    Cavalier SM Information site:www.smcavaliers.com

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    Thanks Karlin. That is excellent advice. I will call the first doctor and ask him if it could be weakness from the SM vs. patellar luxation. They did do x-rays and there are no signs of arthritis at present. I hate the idea of surgery and to confine Jack during recovery would be difficult on all of us. Aside from possibly his legs, his SM has not outwardly progressed!
    Mary Ann (Jack Sprat's mom)

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    I have a dog who I had bilateral lux pat surgery for and he's doing great.. that being said - he doesn't have SM that I know of and he was diagnosed with his lux pats at a year. Is Jack showing any outward physical symptoms (i.e. knee popping out when walking/running?)

    If Jack were mine, I would definitely be asking about the SM question that Karlin stated. How comfortable do you feel leaving it? I got Kosmo done asap because he was having problems running and he was so young.. Faith on the other hand has a slight luxating patella in one of her knees and she doesn't show any outward symptoms so for now we are watching/waiting. I think every scenario is different. I have her on glucosamine/chondroitin to help her knee and other than that, I won't do the surgery unless something changes and she starts to have problems.

    Good luck with whatever you decide
    Sara, mommy to Kosmo ~ 4 year blenheim boy and Faith 3 year b/t girl *rescue*

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    His knees are almost always out. He has a stiff gate and will occasionally fall or stumble. But he seems to run around the yard and bound up and down the stairs just fine. That said he rarely rough houses with other dogs other than Henri (his brother). I'm OK not doing the surgery... just want him to be comfortable.
    Mary Ann (Jack Sprat's mom)

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    I recently also took Bella to an orthopedic surgeon about her knees. She began limping, and her legs looked almost bowed at times. My vet checked them and said she has Lux. Patellas-bilateral- grade 4. So she sent us to the surgeon to evaluate her. He examined her and agreed. He said she had the worse case he'd seen in a while. If surgery was not done, her right femur could begin to curve due to the position of her kneecap. It is out of the socket at all times. So we are doing the surgery, to avoid a more difficult surgery and recovery later on in her life. She is only 18 months old, so she is young and healthy enough to recover well at this point. I dread seeing her in pain and having to be crated for 7 days, but I know it will benefit her later on. I want her to be able to jump and run with her sister! Right now she can't! I wish you luck in making a decision about surgery or no surgery, I know its hard. Especially with the SM factor.
    Mom of Bella-Blenheim female born 12-29-07
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    Hi , Riley, my 2 1/2 B&T male was diagnosed with bi- lux patellas in Jan.09. They firs thought it was his hips but after further testing said it was his knees his right one was a grade 3 and left a grade 2. Riley had stopped running and jumping and had alot of pain so we did the surgery on his right knee. He had a problem with the pin migrating 1 month after the surgery which required another surgery. I took him to P/T and did a LOT of UWT with him. His right knee is doing great.
    We wanted to get that knee strong as his left knee may get worse and he has SEVERE hip dysplasia in his left hip. I am hoping with MANY supplements and alot of exercise we can avoid further surgery. The OS said if his left knee gets worse she will have to do his left knee and a FHO on his left hip at the same time.
    I would say do the knee now as your pup is young enough to recover well. I think it will avoid much trouble down the road. Just my opinion based on my experience. Good luck with whatever route you decide to go.
    Pat & Riley Norther New Jersey

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    Tilly (2.9 yrs) has SM and luxating patallae.
    She had surgery on her right leg at 1 yr (before I had the diagnosis of SM).
    She recovered from the op VERY quickly - she should have been crated - it was just so hard to keep her still - in the end - with the vets agreement we were back to light walks in about one week! Off lead - not for 6 weeks. But she still scampered and played toys around the house.
    I am glad I had the surgery done - however Im not planning to have the other leg operated on now that her SM has progressed.
    That said - if she was diagnosed now with both legs LP - I'd probably go for one repair so that at least she had one good hind leg.
    Its such a tough decision - Tilly's SM badly affects one of her front legs - so its 2 'bad' legs / 2 'good' !

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    Thanks everyone for the advice! It is very help to consider other experiences. I'm leaning towards no surgery at the moment becuase of the SM factor.
    Mary Ann (Jack Sprat's mom)

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    My Ruby has lux patella in her left hind leg and that was diagnosed just a few weeks ago. Her SM was diagnosed just over 2 months ago.
    The LP came on very quickly after she came off the sofa funny and yelped. After that her leg went 4 times in a week and she has been on anti inflamatories and glucosamine and cod liver oil.
    Clare Rusbridge (our neurolgist) advised against surgery and even though it has been correctly diagnosed (its not the SM causeing her problems) we have decided not to put her through the stress and depression that could follow after surgery.
    Her right leg shows no problmes so we have decided to start hydrotherepy and hill walking. He leg hasnt given way in a fortnight and we are really pleased with our desision.
    Like kalin said SM sufferers dont have the longest outlook on life and i certainly wont put Ruby through un necersary surgery!
    Ruby is only a grade 2 and she isnt limping or lame at all

    Karen and Ruby xx

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