# Patellar Luxation? - getting a second opinion



## LEUllman (Feb 1, 2010)

First, some background. Beau was 6-months old when we got him. On my way home from dropping him off for the first time at our fabulous groomer, Madeline, I got a call from her: "Did you know your dog has luxating patellas?" Good thing I didn't crash the car. 

Madeline isn't a vet, but she has 35 years of experience with poodles. She's also married to one of the best vets around. All in all, I think she knows whereof she speaks. She told me Beau has lateral luxation (to the outside), which isn't as common as medial. Level 2 in one leg and maybe as high as 3 in the other. Surgery recommended.

Obviously not a happy day.

Well, it's been almost a year since then. I've watched Beau obsessively for any sign of knee issues, but to date I've never seen him skip a step, hold his leg off the ground, or show any sign that his knees are causing him pain. He runs around the back yard, goes up and down the stairs, and stands up on his hind legs to beg - he can balance there for an amazingly long time!

On the other hand (paw?), he does like to stick out one rear leg at a time straight behind him when getting up from a nap; it's part of his just-woke-up-gotta-stretch routine. I ask myself, is this normal, or is he popping his knee?

He's also never been much of a jumper; I've seen some minis bounce up and down like a pogo stick, but I've only seen Beau jump up on the couch a couple of times and up onto our bed exactly once. He sleeps on the bed with us, but until I bought him some stairs, he would just put his front paws on the bed and bark at me until I picked him up. Is his lack of jumping prowess just his personality, or a sign of painful knees?

Finally, he really does not like to go for walks. I've posted about this before, and I'm pretty sure it has to do with anxiety issues, not pain, but what do I know?

I just made an appointment with a very highly regarded holistic vet in our area to get a second opinion, but I'd love to know what you folks think. Wouldn't a dog with trick knees show at least some symptoms? Or are what I consider personality traits actually signs of something more sinister?


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## Cdnjennga (Jul 30, 2009)

Hmm, interesting. I'm glad you're getting a second opinion, best to be sure on something like a luxating patella. Although I always thoght they only needed surgery if it was truly crippling, but who knows, good to go to the vet and find out!

In terms of the signs, Darcy often stretches when he get up but he beds his front legs down and stretches that way. On the jumping onto things, Darcy is fully capable of jumping on most things but has a mental block (which I encourage). So for example he bounds onto the couch, but if he wants up on my bed, he asks up. My bed is quite high, but he has proven in the past that he is physically able, he just doesn't seem to remember that!

So really, I can't say on the symptoms, although nothing sounds too drastic to me. Be sure to update us after the appointment though!


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## CharismaticMillie (Jun 16, 2010)

I don't know anything about luxating patellas, but I do know that Henry stretches out one back leg at at time after he naps too. I wouldn't worry about that!


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## Winnow (Jan 2, 2010)

Dima has this in her right knee after a injures she got as a pup. 

she is graded 2-3 and I am always on the look out for any limp or just anything that tells me she is in pain, but she never does.

She jumps up and down, runs, plays and so nothing yet. I really don't want to put her through surgery until she gets older if its needed since I hear it takes a long time to heal and I am sure a active dog like her would have a hard time with recovery. 

So I just cross my fingers and hope it will never affect her quality of life


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## CelticKitti (Jul 1, 2010)

Kodi has a grade 2 luxating patella in the right knee. He does show symptoms however. The only reason I noticed it is because he plays flyball. Now he has started holding the right leg up while going down the stairs. After a day of to much play time he will be stiff the next morning and hold his leg up for a few moments until he "loosens himself up." I compare it to when I wake up stiff, he does some stretches and just takes a long time to get his butt in gear. 

He will have surgery at one point. There is some thought if surgery is done earlier there will be less arthritis in the knee later in life. I'm looking at doing Kodi's soon because he is symptomatic and he likes playing flyball.


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## Poodle Lover (Mar 24, 2008)

I definitely think it's a great idea to get an opinion from your vet. I am sure your groomer is very knowledgeable, but it would be great to have the diagnosis confirmed or denied. 
What about your breeder, have you contacted her when he was originally diagnosed?


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## Margotsmom (Jun 6, 2010)

I have a Crested mix rescue (the other part thought to be Papillon) who is 6 1/2. She was rescued when she was one after a really crappy 1st year. Anyway, within the last 6-9 months she started limping. The 1st vet did what appeared to be a thorough exam, no diagnosis. One month later a vet I have more confidence in examined her with xrays and diagnosed a grade 4 Luxating Patella. That vet is a holistic vet, and I chose a conservative route. She is taking Phycox (a glucosamine based but combined supplement, available through Amazon). This did not help as much as hoped, so..., I give her that in the morning and DGP (Dog Gone Pain, another joint support formula to reduce inflammation and pain) at night. She does seem to be making improvement now. Second opinions are good.


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## schnauzerpoodle (Apr 21, 2010)

Getting second opinion is good. I hope Beau is okay. I have a friend who gives Dog Gone Pain to her Corgi who has joint problem and she highly recommends it. Please let us know what your holistic vet says.


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## LEUllman (Feb 1, 2010)

Thanks, Everyone. How did any of us survive without great web forums like this one!



> What about your breeder, have you contacted her when he was originally diagnosed?


 Yes, the breeder knows; she was devastated.



> The 1st vet did what appeared to be a thorough exam, no diagnosis.


 I should have mentioned that the first vet I took Beau to -- for the obligatory "get your new puppy examined by a vet within 48 hours" visit -- did a physical exam but did not detect anything, either. I had wanted to use the same holistic vet I'm getting the 2nd opinion from now, but she was booked weeks in advance for new patients, and so I went with a neighbor's recommendation. (And she's _still_ booked in advance - first open appointment is in about two weeks, on Oct. 13.)


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## Feralpudel (Jun 28, 2010)

I can see going to a holistic vet to discuss treatment options, but have you considered seeing an orthopedic specialist for diagnosis and evaluation? 

Madeline gave Dexter his first trim. She is a fabulous groomer, but as you know, also knows a huge amount about poodles. (She is a toy breeder, former handler, and now judge of poodles.) Didn't you love her gorgeous white toys? (Sorry--getting OT here!) 

Best wishes for good news for Beau.


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## Rockporters (Jan 14, 2010)

Definitely get a second opinion. He's young, it could be a long time before you see signs. Not all dogs have severe pain. Or maybe they're like us, different tolerance levels?

My almost 16 year old TP's legs are shot. He's stiff in the winter but does okay in warm weather. So far no pain meds or management needed really. It's really amazing, they look incredibly painful! I can't remember when he was diagnosed. It was either 2002 or 2005... His leg would pop out here and there for years before that.

Since he's not visibly in pain, and he's willing to walk and climb stairs, I let him. I figure it's good to keep the muscles strong while we can. He scales the stairs with me every time I head upstairs. I keep telling him he doesn't always have to follow me to the bathroom LOL, but he insists. He does stairs up and down outside to go to the bathroom. In the winter if he's slow on the outdoor steps I help him, but leave him alone if doing okay.


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## LEUllman (Feb 1, 2010)

Feralpudel said:


> I can see going to a holistic vet to discuss treatment options, but have you considered seeing an orthopedic specialist for diagnosis and evaluation?


 Once I can identify who is the go-to veterinary orthopedist in our area, I will likely make an appointment there, too. Maybe I'm too cynical, but I suspect that any surgeon is going to recommend surgery. That's what they do, after all.


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## neVar (Dec 25, 2009)

i find opposit- i find the specialists are less likely to recommend surgery. where the general vets tend to see Slight things and go OMG OMG the specialist goes "OK lets be smart- this isn't much so go try THIS and THIS and if it gets worse to THIS point then we talk surgery"


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## Karma'sACat (Jun 1, 2010)

neVar said:


> i find opposit- i find the specialists are less likely to recommend surgery. where the general vets tend to see Slight things and go OMG OMG the specialist goes "OK lets be smart- this isn't much so go try THIS and THIS and if it gets worse to THIS point then we talk surgery"


I agree. Dix saw a specialist after my regular vet (who thought she needed surgery but wasn't comfortable doing it) and she said surgery was not the best option. Some PT exercises and a joint supplment were her treatment plan and it worked great. When it reared its ugly head again, she suggested retirement from service work, pt and more supplement before surgery again and it worked well


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## grab (Jun 1, 2010)

Yep, I've found surgeons to be pretty conservative in treatment also.

My Yorkie does have luxating patellas. He's 9 now and, aside from a rare time when he may have a skip in his step for a brief second, he's never limped. He can clear gates that are over twice his height easily and is very athletic. We do keep him on the trim side.


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## Feralpudel (Jun 28, 2010)

I just noticed in the VIP newsletter that the PCA Foundation is funding a genetic study on LCP and luxating patellas in toys and minis. They currently need DNA samples from *affected* dogs. Rockporters and Celtickitty, you can triple the sample size of affected PL dogs if you can participate! 

From the newsletter:

A preliminary announcement about participation in such a
study was made at PCA in April and as a result Dr. Alison Starr
has received 27 samples from unaffected Poodles (12 Toys and
15 Minis) and from affected Poodles there are only 4
LCP dogs (2 Toys and 2 Minis) and I PL Poodle (Mini). Dr.
Starr says samples from affected Toys and Mins are really
needed and she asked that we focus our efforts on getting more
samples from affected Toys and Minis.
If you know an owner who has an affect dog,
please encourage him/her to participate. We
need their help. As is always the case, we have to
have samples from affected Poodles to be able to
begin to get answers.
To participate in this study the owner needs to
supply the following for each dog: a blood sample;
pedigree; documentation of LCP diagnosis in
affecteds –or- OFA certification in normals.
Forms and shipping instructions are available
by contacting Dr. Alison Starr at (864) 656-0191 or
at ([email protected]).


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## LEUllman (Feb 1, 2010)

Hi Everyone. Just got back from seeing the holistic vet (who was wonderful), and thought I'd give you a update.

First, she didn't find that Beau's patellas are just randomly jumping out of position on their own; if he does have luxation, it's mild. He's a bit bowlegged, and his kneecaps might be a little loose laterally (toward the outside), but it's nothing really serious. Because Beau is asymptomatic -- he has never limped or shown any sign of knee problems -- she definitely does not think surgery is called for at this time. As she put it, "Once you do the surgery, the only direction you can go is down." She also said she would not "waste my money on xrays" at this visit. Instead, she gave me a referral to an orthopedist, who apparently would want to do his own very detailed xrays, anyway, with Beau under sedation. Hopefully that next step will never be necessary.

Beau has gained some weight since he was neutered three months ago, and now weighs 21 lbs. He's not technically "overweight," but is at the top of his range and could probably use to lose a pound or two. (Him and me both!) I guess we're going to have to find ways to increase his activity level, which is complicated by his aversion to going for walks. Dr. also gave us a bottle of Ligaplex II capsules, a dietary supplement said to be good for joints.

All in all, I am very glad I got a second opinion and now can breath a big sigh of relief.


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## Locket (Jun 21, 2009)

Yay for the good news!! Keeping those unnecessary pounds off is really important for dogs with joint issues. Matrix has 3rd degree hip dysplasia in both hips and keeping him lean has really saved his hips from degenerating quickly.


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