# Patella surgery or not- need opinions



## lfung5 (Jun 30, 2007)

I'm struggling with a decision and would welcome opinions. 

Fred had patella surgery 2.5 years ago on his left leg. He needed surgery because he wasn't putting pressure on that leg.
It was a grade 3-4, which means his knee cap was always out of the socket. From what I am reading, it doesn't cause pain when it's out of the socket all the time. The pain if from the knee cap sliding across the bone.

Fast forward to today. I heard him yipe, then I noticed fred wasn't putting full weight on his right leg. Vet said, he injured it and even though his patella is grade 3-4, 2 weeks crate rest works on 50% of dogs. If it doesn't then it's time for surgery, which I agree with. Although, some people disagree with my vet and are saying 8 weeks crate rest to let it heal completely…..If he doesn't heal after 8 weeks then surgery.

Even if he is putting weight on it after the two- eight week crate rest, he will always have a grade 3-4. It's not going to fix itself. Fred is 9 year old dog who loves his hikes. I am struggling with what to do because some people say, don't do surgery unless the dog can't walk and is in pain. Surgery and recovery is hard on a dog, will causes arthritis, infection can occur or even death.

If I don't do surgery, arthritis will still occur. What about his quality of life? I am going to call my vet to discuss things further. My gut says just do the surgery, he did well the first time….I feel so bad for him 

Also, fred was running and walking fine before the injury, even with a 3-4 luxating patella. This is why my decision is so hard!


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## lfung5 (Jun 30, 2007)

I should add, it's been a couple days since the injury happened and Fred is walking and putting weight on his leg again. He doesn't seem to be in any pain today. He is on anti inflammatories and I am limiting his activity.


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## sandypaws (Aug 8, 2012)

So sorry for you and Fred, Linda. That's quite a decision to have to make. What about physical therapy? Maybe that's something to look into. Look at how well Tyler has done with his ACL tear, all with therapy. I, too, was told that he would definitely develop arthritis in that joint and I am happy to report that he has not. He is now 17 yrs and 4 1/2 mo which is a whole lot older than Fred at 9 yrs. He has been on Cosequin DS for years. I also give him double the maintenance dose. Maybe that's what has helped him. Best of luck with your decision. I know it's a hard one.


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## lfung5 (Jun 30, 2007)

Wow. I would love my guys to live to that age!! Tyler looks so good too. 

I actually doubled the maintenance dose of the Cosequin DS once this happens. I guess I will see what happens after the 2 weeks. If he is not putting full weight on it after 2 weeks of rest, I will do surgery. If he is putting full weight on it, I will continue resting his leg for several more weeks. I was all for sugary but the more I read, I find out it's not the best opinion unless the dog is in pain and can't use it. Tonight fred is walking around fine. To anyone else, they wouldn't notice anything was wrong. I have to actually get down on my hands and knees to see that the pressure isn't evenly spread on both legs.


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## davetgabby (Dec 29, 2007)

tough choices for sure. For a great anti-inflammatory check out my recent post http://www.havaneseforum.com/showthread.php?t=86034&highlight=super+suppliment and it is super for many other things,. Drs Mercola and Becker really recommend it as one of their favorite supplements. Great for older dogs. here's more http://healthypets.mercola.com/site...axanthin-improves-mitochondrial-function.aspx

http://shop.mercola.com/catalog/spirugreen-superfood,92,9,0.htm


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## lfung5 (Jun 30, 2007)

Thanks Dave! I will look at the videos. Fred is walking around fine now. I am not hiking him or letting him run or do stairs for a few weeks. Just with a few days rest, it's not even bothering him. I talked to a great breeder who suggested never doing surgery unless it is life threatening or the dog is in major pain. There are too many risks with surgery. I never even thought of that when Fred had his last surgery. I just listened to the experts! As I do more research on my own, I am finding surgery is not the best option in Fred's case. I'm glad his first surgery went well but he probably didn't need it.


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## sandypaws (Aug 8, 2012)

lfung5 said:


> Thanks Dave! I will look at the videos. Fred is walking around fine now. I am not hiking him or letting him run or do stairs for a few weeks. Just with a few days rest, it's not even bothering him. I talked to a great breeder who suggested never doing surgery unless it is life threatening or the dog is in major pain. There are too many risks with surgery. I never even thought of that when Fred had his last surgery. I just listened to the experts! As I do more research on my own, I am finding surgery is not the best option in Fred's case. I'm glad his first surgery went well but he probably didn't need it.


Linda, that's why I suggested that you look into physical therapy/rehab for Fred. Tyler never had surgery after he tore his ACL and his outcome with rehab is the same as a dog who has undergone surgery per his vet. For some reason, vets don't seem to recommend PT. Perhaps they see the $$$ instead or don't really know the benefits that rehab can have. I chose rehab myself as I knew about it from my kennel club. Tyler's vet was amazed at what it did for him. Check it out. You must have a facility near you.


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## lfung5 (Jun 30, 2007)

Ok, I will look into it now. Thanks so much!

I want to ask what they do for luxating patella. It might already be what I am doing with our hill hikes. I read things to do for luxating patellas, keep weight down, exercise, supplements.


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## sandypaws (Aug 8, 2012)

lfung5 said:


> Ok, I will look into it now. Thanks so much!
> 
> I want to ask what they do for luxating patella. It might already be what I am doing with our hill hikes. I read things to do for luxating patellas, keep weight down, exercise, supplements.


Sounds like Tyler. His weight is down, he exercises for 45 minutes (3 sessions) on his treadmill each day, as he really doesn't want to go for walks anymore, and takes his supplements. Although the ACL will never mend, the exercise has strengthened the muscle, thus keeping him stable. One sure sign that it is working is the fact that he will lie down flat with all four legs out to the sides (picture a bear rug) on our polished wood floors and be able to get up entirely on his own. It's absolutely amazing!!!


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## lfung5 (Jun 30, 2007)

Wow... He is still quite agile for 17 1/2 years old! He may be the record for longevity!!

Fred also lays with his back legs extended. He looks so cute like a little frog

I am told 2 weeks crate rest from my vet but others have said 8 weeks. I am afraid to go 8 weeks because he strong muscle will deteriorate. If he is ok after 2 weeks, maybe short hill climbs on a leash would be good therapy.

I emailed a therapy place about 30 min from me. I asked them what they do for a luxating patella.


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## SJ1998 (Feb 4, 2013)

I would try the therapy too before the surgery. Some of the therapy places use a variety of treatments including swimming, acupuncture, massage etc. And Tyler is certainly a good advertisement for rehab!


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## lfung5 (Jun 30, 2007)

He sure is!!!


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## sandypaws (Aug 8, 2012)

SJ1998 said:


> I would try the therapy too before the surgery. Some of the therapy places use a variety of treatments including swimming, acupuncture, massage etc. And Tyler is certainly a good advertisement for rehab!


Right on! Tyler had massages, bending and flexing and core strengthening exercises, as well as water therapy. The water therapy is great because they get to exercise their muscles without having to put weight on the injured part. He did that for 3 months, twice a week before transitioning to the land treadmill once a week for another 2 months because winter had arrived and, although I brought a hairdryer, he was still damp. At his age, I didn't want to risk a cold or worse.


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## lfung5 (Jun 30, 2007)

Thanks for all the info! I was giving Fred a bit of freedom but I soon realized I need to be more strict with him. I want to see what he is like after 2 weeks. If he is still holding it up part of the time, I will need to weigh things out. Don't know if more rest will be needed, therapy or even surgery. I am trying to avoid surgery, but his condition can not be fixed. I can straighten the ligaments around his knee but I can't ignore the fact his knee cap is sitting outside of the groove at all times. His groove is too shallow to hold it in place. With years of 2-3 mile hikes a day, I would image his knees would be pretty strong. If this is happening and he is in such good condition, it makes me wonder what is his best option.
4 recommendations for patella issues, supplements, exercise, raw diet and keep him lean. I've been doing all these things for years.


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## lfung5 (Jun 30, 2007)

Fred's not doing much better. I have consultation with a great board certified surgeon next week. All the surgeons at this hospital are board certified and the hospital is accredited. The surgeon has a conservative approach. My main question will be, what would you do if he was your dog? I also have a second consult with a surgeon who is 10 min from me. I'm just not sure I can keep this appt so I made 2 

For now, I am keeping Fred quiet but he will be on the road to recovery soon.


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## davetgabby (Dec 29, 2007)

tough call Linda, I would want to know whether the surgery would fix the problem to a large extent.


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## lfung5 (Jun 30, 2007)

Yes, that's a question I have. He already has arthritis. Is it worth doing surgery if he won't be able to walk due to arthritis anyway…..

Fred is at vet for testing. He was sick this am. He won't eat, throwing up, wanting to go potty more……I am so worried. He had rabies shot a week ago…….


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## davetgabby (Dec 29, 2007)

sorry to hear this, keep us posted.


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## lfung5 (Jun 30, 2007)

Vet said they are testing him for pancreatitis..... Test won't come back for two days. Could have been from the pain med he was taking for the past week. If I can't get him to eat or drink over the weekend he will need to go to the hospital poor Fred!

What is a low fat diet? What should I feed. He is on raw diet now....


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## MarinaGirl (Mar 25, 2012)

Check out DogFoodAdvisor:

Suggested Low Fat Dog Foods

Emmie sends licks and woofs to Fred - hope he feels better soon.


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## MarinaGirl (Mar 25, 2012)

Honest Kitchen Zeal is a 5-star dehydrated raw dog food with only 9% fat and 39% protein.

Primal Canine Rabbit Formula is a 5-star raw frozen dog food with 17% fat and 59% protein.


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## SJ1998 (Feb 4, 2013)

I would give him time to get over the rabies shot before doing any surgery. I hope Fred gets better soon. Have you tried a holistic vet for their opinion?


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## davetgabby (Dec 29, 2007)

lfung5 said:


> Vet said they are testing him for pancreatitis..... Test won't come back for two days. Could have been from the pain med he was taking for the past week. If I can't get him to eat or drink over the weekend he will need to go to the hospital poor Fred!
> 
> What is a low fat diet? What should I feed. He is on raw diet now....


wait to see what turns out before changing diet. and if you do I would talk with Sabine . Here's an article on inappetance http://www.thepossiblecanine.com/inappetance


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## lfung5 (Jun 30, 2007)

SJ1998 said:


> I would give him time to get over the rabies shot before doing any surgery. I hope Fred gets better soon. Have you tried a holistic vet for their opinion?


Good point. If surgery is needed, I wasn't going to do anything until after the holidays.

They might not suggest surgery but I want to have a consult. I did not go to a holistic vet because this condition can only be fixed with surgery. If he had a grade 1 or 2 luxating patella, therapy could work. Fred's problem is he has a grade 3-4. Strengthening the ligaments etc won't help at this point. His knee cap is permanently out of the socket. It won't stay in the socket no matter what because it's been worn flat....


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## lfung5 (Jun 30, 2007)

davetgabby said:


> wait to see what turns out before changing diet. and if you do I would talk with Sabine . Here's an article on inappetance http://www.thepossiblecanine.com/inappetance


Thanks Dave. I will read this tonight.


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## lfung5 (Jun 30, 2007)

Update:
I want to document all this just in case this happens to someone else. Week 2 of resting fred's leg and he is now about 70% better. Vet said he can go for short leash walks now. I am going to rest it for a couple more weeks and the evaluate. Vet explain a lot of small dogs can live with a grade 3 luxating patella. Fred is not in pain. When he doesn't put pressure on it, it's more because he doesn't trust it. He said, if fred is lame 50 % of the time, then you do surgery. Fred injured it, so he may just need a little more time to heal. 
This might be a coincidence but Thursaday fred was having trouble walking. Thursday night I started giving him Chinese herbs from the holistic vet, after that he was walking much better......
After they took him off the drug Deramaxx, no more throwing up or diarrhea. He is on low fat raw diet for a few weeks, then I can start introducing average fat food. This is because they don't suspect the food was the cause of his pancreatitis.


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## davetgabby (Dec 29, 2007)

thanks for that Linda , I hope he continues to improve.


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## krandall (Jun 11, 2009)

Hi Linda, got back last night and just read this this morning. Poor Fred and poor you! I hope he continues to improve!!!


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## lfung5 (Jun 30, 2007)

Welcome back Karen! We missed you

He is improving daily. Just not sure if it will be enough for him to hike like he used to....that's were my decision comes in.


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## krandall (Jun 11, 2009)

lfung5 said:


> Welcome back Karen! We missed you
> 
> He is improving daily. Just not sure if it will be enough for him to hike like he used to....that's were my decision comes in.


Thanks! It was a great trip, but I'm really glad to be home!!!

It's a tough decision with Fred, but I know you'll weigh all the factors and do what's best for him!


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