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Thread: Patella Surgery?

  1. #1
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    Default Patella Surgery?

    I've posted a few times about Bosco's patellas, which are somewhat problematic. He will be 3 in August. Last year, he was limping and crying and my regular vet recommended surgery for both knees. I was very hesitant about proceeding with surgery and consulted with a holistic vet who suggested that I try a combination of herbs and exercise.

    All went well for the past year -- no problems with stairs or any crying episodes. However, I do notice that if I take him on walks further than 1/2 mile he limps. If I keep the walks short, he does fine, but I am starting to worry about whether I am doing the right thing.

    Right now, he goes on walks around the neighborhood, about 3 times a day. He also plays actively with my two Japanese Chin. I would say his quality of life is fine, as long as I limit the length of the walks. However, he is not yet 3 years old, and I'm wondering what to expect over time.

    I've heard of both successful and not-so-successful patella surgeries. The procedure is both expensive and watching over him during recovery would be an issue, but I could probably arrange something (with additional costs).

    For any of you have had the patella surgery done, could you comment on whether you felt it was worth it?

    Thanks for you input.

    Joan

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    Hi Joan: I think he definitely needs to see someone again -- either a regular vet or a specialist.

    Did your regular or holistic vet grade the luxation for each knee? The scale is 1 to 4 with 4 being worst. Usually a 1 is left and sometimes corrects itself, a 2 is considered borderline (some feel they should have it, some not) and at 3 or 4, surgery is definitely needed.

    A grade 2 left uncorrected generally already means the dog will get early-onset arthritis and compromised mobility. Higher grades can mean increasing pain for the dog over its life. Surgery most of the time will fix the issue but sometimes does need to be repeated if it fails. It is not very common that it doesn't work at all.

    I'd really recommend seeing a regular vet -- see another or a specialist, for a third opinion if you prefer. And have them grade the luxation -- any vet can do this by clinical exam -- and go through the implications if the knees are not done.

    Leaving a dog that needs this surgery without it is like leaving someone who needs a knee replacement without one. If the limping has returned in a dog age 3 then you definitely need this checked again as it may have progressed. Half a mile isn't very far, for limping to begin. If the luxation is left untreated it can degenerate to the point where you cannot do a surgery at all (I had one come into rescue whose joints had fused due to severe luxation!).

    You can read more here: http://www.veterinarypartner.com/Content.plx?A=2448

    In particular:

    It is not a good thing to have one’s knee cap out of place; the entire weight-bearing stress of the rear leg is altered which, in time, leads to changes in the hips, long bones, and ultimately arthritis. How severe the changes are depends on how severe the luxation is (i.e., the grade as described above) and how long that degree of luxation has been going on. In time, the legs will actually turn outward with its muscles turning inward, making the dog bow-legged. The luxation is not considered a painful condition but after enough time and conformational change, arthritis sets in, which is indeed painful.
    Karlin
    Cavaliers: Jaspar Leo Lily Tansy Libby (foster) Mindy (foster)
    In memory: Lucy
    Cavalier SM Infosite:www.smcavaliers.com

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    Here's another point of view:

    http://www.cpvh.com/2011/07/27/luxat...ella-knee-cap/

    I'm sure we have lots of people here who've had patellas done on their dogs (or chosen not to) who might give their perspectives!
    Karlin
    Cavaliers: Jaspar Leo Lily Tansy Libby (foster) Mindy (foster)
    In memory: Lucy
    Cavalier SM Infosite:www.smcavaliers.com

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    We've had two cavaliers with obvious patellar luxation. The first was operated on in the mid-1970s. Apart from the compulsory down-time for healing, there were no bad consequences. The second dog had a milder case. He occasionally would pull up lame, and we would massage the knee cap back into place. He did not have surgery and lived a very full life with just his mild case.
    Rod Russell

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    It's tough trying to make the right decision but fact finding is a good place to start. I hope it all works out for Bosco with the least amount of discomfort.
    Joyce - Proudly owned & loved by

    BellaMia (Aug. 30, 2012) My Beautiful Ruby Milo (Jan. 20, 2014) My Handsome Tri
    Sydney (
    April 16, 2000~April 4, 2012) Always and Forever In My Heart

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    Thanks for the comments. Yesterday, he again seemed fine - so I'm guessing his knee popped back in. I'm going to follow up with the holistic vet and then get a consultation with a surgeon. Bosco really had been doing great, but I've noticed changes in the last month and this recent weekend's limping scared me. I will let you know how I make out. He is so young and such a sweet boy that I would not want him to live a life of pain.


    Joan

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    You also want to make sure that the issue is actually luxation. There are other reasons for limping or limb weakness. I'm not sure what the other 'not right' signs are, but they may indicate there's something else going on. I'd try to talk to a vet that knows the breed and its particular heath issues such as CM/SM, hearts, etc. When you return to your holistic vet (or anyone else) I would ask for the grades on each knee; you should have been given this by both vets previously so perhaps it is in your cavalier's records already. They'd be looking for progression and to consider whether the luxation is actually the source of the current issues (most likely yes).
    Karlin
    Cavaliers: Jaspar Leo Lily Tansy Libby (foster) Mindy (foster)
    In memory: Lucy
    Cavalier SM Infosite:www.smcavaliers.com

  8. #8
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    Bentley started having periods of terrible yelping/crying when he was about 10 months old. Vet could immediately feel the knee out of place and directed us to a surgeon. (This all came about in the same 2-week time period in which our daughter was diagnosed with stage 4 cancer so we were really in a state of mind). The surgery was done; we didn't blink an eye at the $850 price tag. The worst part was recovery care, but we got through it and our daughter's death a month later. The other knee was also affected but once the 1st one was fixed he has never had issues with either of them.

  9. #9
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    Both vets said it was luxation of the patellas. One recommended surgery, but I didn't like his dismissive attitude. Went to second vet, who stated that his right knee was particularly bad, and suggested herbs, glucosomine, hill work outs and keeping his weight down. She said she would try that before opting for immediate surgery. Neither gave me a 1-4 grade diagnosis. For the past year I followed the regimin and Bosco had no yelping incidents and was doing fine -- I was super happy that I had not opted for surgery. However, the past month I have seen a few things that have made me pause, and this recent incident of limping after a relatively short walk is disturbing.

    I got smart and searched "patella" on this forum and read practically every post. Maybe post op recovery will not be as bad as I think. I do appreciate everyone's input and will post back with vet results.

  10. #10
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    The post op is more tedious than difficult, really -- I've just had a foster dog go through the same kind of confinement for over 6 weeks following cruciate ligament surgery. She's an older but quite active dog so was not too happy initially but adjusted and I made sure she had Kongs/chews etc to keep her mind busy. Three months later and today she got an A+ from the vet for recovery but still had three months of controlled walks ahead. It's a longer recovery than patellas! She had to have a plate to fuse a joint in her leg, to replace the torn ligament.

    The exercise routine that you describe is often tried in younger dogs to see if the knee will improve. Be sure to get a grade for your own info when you have them checked again. Perhaps just one might need surgery, by the sound of it?
    Karlin
    Cavaliers: Jaspar Leo Lily Tansy Libby (foster) Mindy (foster)
    In memory: Lucy
    Cavalier SM Infosite:www.smcavaliers.com

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