# Pros and Cons for Grade 4 Bilateral Patella Luxation surgery



## Vitalvc (Jun 3, 2020)

Hi,
My 11 months old mini poodle Luna has been diagnosed with grade 4 bilateral LATERAL (which is less common) patella luxation on both legs. She had it since she was 3 months old. She is not able to jump, walk stairs and do crazy runs with other pups. She has abnormal "crouched" gait with her legs internally rotated. Other than that, I've never seen her in pain, refusing to walk or showing lameness. She is incredibly happy, loving and bubbly little girl. We've been doing water therapy and white laser twice per week to build her muscles.
I consulted with two board certified orthopedic surgeons and both had different opinions in regards to the surgery. One was basically saying we should have done it when she was 3 months old. The longer we wait, the more complex it'll be. The other surgeon is leaning towards waiting longer since Luna is not showing lameness or is in pain. He's also saying let's do on one leg and see if we get results. This sounds to me like experimenting, which I don't like. I'm torn!

Based on what I've researched online, I'm not 100% convinced that surgery risks outweigh the benefits. I read that grade 4 has 36% higher rate of reluxation and another surgery. Complication rates are 17%-50% for grade 4. I could not find any literature or study on long term outcomes and there is limited data available about cases treated non-surgically (e.g., physical therapy, supplements, etc).

Has anybody been in a similar situation? Have you done surgery and had positive or negative long term outcomes? Have you taken the non-surgical approach and how was that journey?

I would greatly appreciate any bits of information, stories, suggestions, thoughts.

Vita


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## twyla (Apr 28, 2010)

I had bilateral Luxating patella surgery done on my girl she was Grade 3 with ruptured ligament in one knee and grade 4 in the other knee. 

I have absolutely no regrets.

Your dog is self limiting because your dog is in pain, as in Luna doesn't run like other dogs, Luna cannot do stairs and Luna cannot do crazy runs.

Sounds like my Beatrice 

My girl Beatrice was young as well, and could not keep up with her sissy with only a 6 month difference in age, I waited with my girl she did exercises, supplements and swim therapy but at 16 months she slipped on a floor and ruptured the ligament in one leg, I had to convince my vet and it was confirmed by an orthopedist that she needed the second knee done at 3 years. 

Since then my girl was diagnosed with Kidney disease at age 4 and cancer at age 5, my Beatrice is 7 now. Even knowing what I know now I would still get her the surgeries. 

The most import thing post surgery is strict rest, that is where the complications rise, and slowly rebuilding those legs exercise otherwise repaired knees get blown out, my mom's yorkie Gizmo had two surgeries on the same leg because of not adhering to strict 8 weeks of crate rest, and then slowly getting back to exercise, the little dog came and stayed with me and healed up just fine.

Your girl is 11 months, and is basically crippled, what will she be in a few years? It that harsh, yea, but a dog needs be able to live their best life.


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## Vitalvc (Jun 3, 2020)

twyla said:


> I had bilateral Luxating patella surgery done on my girl she was Grade 3 with ruptured ligament in one knee and grade 4 in the other knee.
> 
> I have absolutely no regrets.
> 
> ...





twyla said:


> I had bilateral Luxating patella surgery done on my girl she was Grade 3 with ruptured ligament in one knee and grade 4 in the other knee.
> 
> I have absolutely no regrets.
> 
> ...



I really appreciate your sharing your personal experience. I want to give Luna best life possible, even it's a short one. Leaning towards going forward with the surgery.
I'm so sorry to hear about Beatrice's cancer but it looks like you're taking good care of her since she's had it for two years now. My friend's dog had liver cancer and lived decent life for 7 years after the diagnosis. Good diet, good care and lots of love.


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## twyla (Apr 28, 2010)

Vitalvc said:


> I really appreciate your sharing your personal experience. I want to give Luna best life possible, even it's a short one. Leaning towards going forward with the surgery.
> I'm so sorry to hear about Beatrice's cancer but it looks like you're taking good care of her since she's had it for two years now. My friend's dog had liver cancer and lived decent life for 7 years after the diagnosis. Good diet, good care and lots of love.


I wish you luck with Luna, during Beatrice's recovery I used to take her for a sniff and carry, which means I carried her around when I walked my other dogs.
The only regret I have is this was all preventable with good breeding, my girl my be a train wreck health wise but I love her to bits. I


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## Vitalvc (Jun 3, 2020)

Thank you! I'll keep posting updates on our journey. Hopefully it'll be helpful for anybody dealing with this.


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