This is a topic I wish I didn't feel the need to write about, but unfortunately I have a little experience with it. Lacey, my 5 year old Chihuahua / Toy Poodle mix had surgery on her left knee back in 2007 and on March 23, 2001 had surgery on the right one as well.You may wonder, why the time gap between the two? At the time of the first surgery she was showing the classic symptoms including occassional limping when running, holding up of the leg, etc. on the left leg. The surgeon who examined her said that the left knee defintely needed surgery but the right one was only a grade 1 at the time and may or may not need surgery down the road. We opted to do the left one right away and wait to see if the right one ever needed.
As you can guess from the first paragraph the right one had been getting progressively worse recently. She had only had a few noticable issues in the past 3 plus years since the first surgery but in early February the episodes began coming more frequently. On one occassion, I was playing fetch with all three of the dogs when she suddenly stopped and held up her back right leg. Knowing instantly why, I picked her up and gently massaged her knee area waiting for it to pop back into place. I did not feel anything move this time so I put her back down and she walked away gingerly to go lay down. Typically, in the past it only took a few seconds and the knee would move back into place so I knew things were getting worse.
We took her into our vet for an exam. She said the knee was totally out of place and had difficulty moving it back into place. After a few days of thinking and discussing the options with her, we decided to have surgery on Lacey's right knee also. Despite having been through this once before, I was still worried about the decision but after watching Lacey over the next few days before her surgery I know that surgery was the right one. She began limping more often and it looked like sitting and laying down were more difficult than normal and possibly painful for her.
It has been three days since her surgery and she is doing well. She is sleeping in her bed by my feet as I write this. We have a long 12 week road of rest and rehab ahead of us, but I hope that in the long run this will make the rest of her life fun and pain free.
What is a Luxating Patella?
Patella is another name for a knee cap and luxating means to dislocate, so a luxating patella is a knee that dislocates. As painful as it sounds, most dogs do not typically feel any pain associated with this until it gets more severs or if it was the result of some kind of trauma.
What Causes Luxating Patella?
This is primarily a genetic disorder affecting toy breeds including the Chihuahua, Toy Poodle, Boston Terrier, Yorkshire Terrier, Pomeranian, Pekingese and Miniature Pinscher. It can also result from trauma or birth defects.
What are the Symptoms?
The most common symptom of a luxating patella is limping or the dog holding or carrying the leg. This can happen for just a moment or two and the knee will move back into place on its own or it can move out and stay out requiring it to be manually moved back into place. Unfortunately, like in Lacey's case, dog's with a luxating patella generally get worse over time.
What do the Grades Mean? Grade I - At this stage the patella can be manually luxated but will easily move back into position. The dog may or may not occasionally carry the leg.
Grade II - At this stage the knee may move out of place on its own when the dog is walking or running. It typically goes back into place on its own or can be manually moved back into place. The dog may occasionally carry the leg when this happens.
Grade III - At this stage the patella luxates frequently and must be manually put back into place which typically doesn't last long. The dog may frequently carry the leg or shift their weigh to the non-affected limbs. They may have difficulty running, jumping or performing other normal activities.
Grade IV - At this stage the patella is permanently luxated and cannot be manually repositioned. The muscles begin to shorten making it difficult and painful for the dog to fully extend the leg. They transfer the majority of their body weight to their front legs and frequently bunny hop or carry the affected leg.
What Can be Done?
Depending on the dog's age and the grade of luxation, there are several courses of action.
Crating - The vet may recommend crating or otherwise restricting the dog's activities for a couple of weeks to allow the joint to rest and not be strained further.
Diet - Feed a good, quality diet of premium kibble, home-cooked meals or raw food which will improve the dog's overall health.
Weight - Keep your dog lean. Even a few extra pounds especially on a small dog can put unneeded stress on the joints.
Exercise - Moderate exercise, especially walking up slight inclines can help strengthen the muscles around the knee.
Supplements - Glucosamine supplements contain minerals, amino acids, enzymes, and lubricating agents that help build cartilage and cushioning fluid in injured joints and can help heal damaged connective tissue. Vitamin C is a building block and helps to strengthen ligaments and connective tissue.
Homeopathy & Acupuncture - Acupuncture, Homeopathy and the application of therapeutic grade essential oils have been proven effective in helping cases of luxating patella by strengthening the joints and easing pain.
Medication - The vet may prescribe some sort of NSAID (Non-steroidal anti-inflammatory) like Rimydal for any pain or inflammation. These can help with slightly with the inflammation but mostly just mask the symptoms.
Surgery - In severe cases, like Lacey's where the knee cap will not stay in place sugery can be done to correct the issue. The surgery involves grinding away of some of the bone to deepen the grove for the patellar ligament, realigning the ligament and possibly grinding of the kneecap to allow it to fit properly in the groove. If done before arthritis sets in surgery has excellent prognosis in most cases. There is a slight chance that the surgery will need to be re-done later in life. Surgery is typically recommended in cases that are grade 3 or higher. Surgery can be quite expensive. I can tell you from experience that where we went it cost $2600 for one knee.