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 Luxating Patella

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JillC
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PostSubject: Luxating Patella   Sat Dec 31, 2011 5:41 pm

Gonna start on a happy note with a photo of Evie since I haven't been here in forever and I need to start this post with a smile


My girl is 11 months old now & the poor babe STILL can't just be a happy, healthy pup. If you remember she came to us loaded with coccidia, giardia, and worms- now she's up against a whole new battle courtesy of where she came from. In October she started exhibiting lameness in her right hind leg. She would be walking/running normally, then the leg would lock up suddenly and she would lift it. I would massage the leg and could feel a “pop” when it went back in place. Then she would start walking again seemingly fine. We thought maybe she pulled something, so we would give it some time to hopefully heal. It progressively became worse, so we took her to the vet. He didn’t think x-rays were warranted yet and prescribed her a month of anti-inflammatories to see if she improved. She did not get better, she got worse- collapsing in pain and she had begun doing the same with the left hind leg. Sometimes she could hardly walk because both legs would give out on her. It was so sad to see and as you can imagine I was a wreck over it. The vet’s initial thought was hip dysplasia, so we had a complete orthopedic exam and x-rays done of her hips and hind-quarters. The vet’s diagnosis is bilateral luxating patella. Evie has 2 bad knees and he is 100% confident that she was born this way and inherited it from mom and/or dad. The patella is the kneecap and both of Evie’s are dislocating when she walks. We were absolutely devastated at this news. The vet said because she is so young, surgery at this time is not a good idea because she is still growing. He hopes that as her legs lengthen and strengthen, those knee joints may tighten up some. Or they may not and she could continue to get worse requiring surgery on both knees. A prospect we don’t even want to think about considering the expense to us and recovery time for Evie. Right now her condition is classified as Grade 1 and she is being treated medically with NSAIDs and chondroprotective drugs daily. They help a little, but every day she struggles just walking. Very stiff and gimpy Sad It's the saddest thing and it make me so SO mad. I should have researched more about the breeder she came from, but you can bet I'm not letting her off the hook on this. She’s my baby and too young to be going through all of this. This is why i haven't posted- waiting for HAPPY NEWS to be able to share with all of you! I do still come here often and read all of your wonderful posts.

Does anyone have any knowledge or experience with luxating patella? I guess it is VERY common in smaller breeds and becoming more prevalent in larger breeds like huskies, labs, golden retrievers,etc.
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Huskyluv
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PostSubject: Re: Luxating Patella   Sat Dec 31, 2011 9:24 pm

I have plenty of experience with luxating patella but I'll have to reply with more later. Remind me if I forget, please.

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PostSubject: Re: Luxating Patella   Sat Dec 31, 2011 11:36 pm

Okay, I've got a bit more time right now so I'll try to share a little. From what you've posted about her regular luxations, it sounds like she is worse than a grade 1...sounds more like a grade 3 or 4 to me. LP is graded from 1 to 4, 1 being the most mild where the knee stays in place mainly and 4 being the worst where the knee stays out of the socket most of the time.

At least two of the dogs in our family have LP so we've seen first hand how hard it can be. My mother in law has a dog with grade 4 luxating patella (the worst grade) in both knees and she is completely lame since they cannot afford surgery to correct it as surgery costs about $1,500 to $2,000 PER knee.

Our dog, Glory (the long coat Chihuahua), has LP in both her knees as well which we are managing holistically. Our Glory was diagnosed with a grade 2 in one knee and grade 3 in the other when we adopted her. I noticed her difficultly walking as soon as we got her home, so I had her checked immediately. We started her on holistic therapy as soon as we got home from that first vet visit.

Our therapy includes:
-Regular moderate exercise: to keep the muscles tight so that they help hold the knee in place. Also with LP it is a good idea to limit jumping on the sofa, stairs, and heavy impact activity which will put unnecessary stress on the knees.
-Hydrotherapy: again to keep the muscles from atrophy, only hydrotherapy keeps the weight off the knees which is even better than regular walking
-Diet change: we put her on a raw/partial raw diet instead of crappy kibble
-Weight management: keeping a dog with LP on the lean side is important for keeping weight/stress off the knees as much as possible
-Supplements: we have Glory on several supplements for her knees including Glyco-Flex II daily, Nupro Silver with Joint Support daily, Ester C three times a week, and MSM three times a week

With all those changes in place I noticed over time that her knees were luxating less and less frequently. At her next vet visit a year later her knees were regraded and amazingly BOTH her knees had improved a whole grade. So she'd gone from a grade 2 & 3 to a grade 1 & 2. She's been continuing her therapy so I'm hoping to get her back in soon to have her knees regraded since we're coming up on 2 years that we've had her in a few months.

I hope Evie isn't too far gone already that some therapy wouldn't work for her. Please keep us updated on how it's going for her.

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JillC
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PostSubject: Re: Luxating Patella   Sun Jan 01, 2012 2:10 am

Thanks so much Val for your detailed response. I have been reading and researching since we got the diagnosis and everything you've said is in line with what I've learned. As far as the grading goes, I'm afraid she may be a bit worse off than Grade 1 too, but while her right knee does luxate often, it goes right back in on it's own. I was told not to massage it and let her work it out on her own and she does. It's never out for more than a few seconds. She doesn't draw the leg up anymore-she just freezes now when it luxates, kind of rocks in one spot until it goes back in place and then she's on her way as if nothing happened. She has the mind of a crazy "I wanna do a zoomie husky" which is no good, but so hard to curtail. The problem in her left knee is nowhere near as bad as the right. It does not luxate often at all. I think that one started acting up because she had to overcompensate on it when the right one went out. I have her blocked from everywhere-stairs, living room, no beds because I'm so afraid of her blowing the cruciate ligament too and damaging the knees worse. Like your mom, we cannot afford $4000 in surgeries and honestly I was grateful when the vet said now was not the time to consider that, so I am scouring to find the best things to try to help her and honestly I'm overwhelmed. I have to say it's been a month on the Chondroflex and I have noticed a difference. She was getting Deramaxx everyday too, but it was really taking a toll on her appetite and I worry about long term affects on her liver. Now I'm only giving it to her as needed, every few days or so- some days are worse than others. i do know that the Chondroflex isn't going to be enough, but am just not sure what's safe for her to take with it. I will have to read up on the supplements you mentioned. I imagine Glyco-Flex is similar to what she's taking. I made the mistake of exercising her less before we knew what was wrong because I thought she pulled something and needed to rest and that's when she got worse. Now that I know what I do, we've been doing regular brisk walks around the yard and it's helping. Gotta be careful not to overdo it, but keep her moving for those muscles. She does love to swim in our pond in the summertime! Stinks that it's dead of winter now and I'm not sure if there's anywhere that offers hydrotherapy around here. I don't think I have to worry too much about keeping her lean- she used to be such a pig, but since she hasn't felt well she doesn't want to eat. Her appetite is nearly non-existant. She could be self-regulating too though since she is less active. The vet said her body condition is perfect (other than her knees lol) at about 41 pounds.

It is so wonderful that you've been able to manage Glory's LP holistically and that she has actually improved! I hope when you have her re-graded you get more good news. Gives me some hope at least. This has been scary and it's just the beginning of a long road, I know. I feel for your mom because I know how heartbreaking is. Thank you again Val, and I will keep you posted on how she does.

HAPPY NEW YEAR EVERYONE!
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26nikita
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PostSubject: Re: Luxating Patella   Sun Jan 01, 2012 3:24 am

I'm sorry about Evie's diagnosis. She is a beautiful girl! I hope things get better for her!
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PostSubject: Re: Luxating Patella   Sun Jan 01, 2012 9:41 am

Jill,

I see you listed as in Buffalo, just to let you know that is a place on Vulcan St, Buffalo called Canine Splash that has dog pool(s). I've never been there but a co-worker told me about it, might be a good place for Evie since she likes to swim.

http://caninesplash.com/

http://caninesplash.com/our-pools/
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JillC
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PostSubject: Re: Luxating Patella   Sun Jan 01, 2012 10:57 am

Now that i think about it, I think I saw that place on one of the morning wake up shows Len. Worth looking into and I wondered if she'd be swimming with a bunch of other dogs, but looks like she could have solo pool time. That would be good cuz too many other dogs make her crazy excited meaning jumping, chasing, slipping- BAD for bad knees. Thanks for the links Very Happy

Thank you Mindy, we hope so too.
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PostSubject: Re: Luxating Patella   Sun Jan 01, 2012 12:58 pm

It's encouraging to hear that you've noticed some improvement already.

What are you feeding Evie? I know several people who've put their dogs on raw and seen improvement in the knees, myself included.

I'm on vacation with super unreliable internet on my phone right now so I can't look up the supplements they gave you until I get home on high speed internet. There are many options out there to use. I trust anything my holistic vet recommends so that's why I went with the Glyco-Flex that she highly recommended. She also recommended Missing Link, Wholistic Canine Complete, or Nupro so I opted for Nupro since I liked the ingredients in it better and it's easier for me to get than WCC.

No need to freak out if she overdoes it with exercise, dogs will be dogs. I just wouldn't encourage her and, if you can, you could try to redirect her attention to something less high impact when she goes crazy like sibes often do.

Good luck with it, I hope you continue to see improvement.

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PostSubject: Re: Luxating Patella   Sun Jan 01, 2012 6:04 pm

My Tikaani was diagnosed with Grade 2 medial (knee slides to the inside of leg) LP in his right knee, and had shown his first symptoms when he was 1.5yrs old. We took him to 2 vet practices and 1 orthopedic specialist to get different opinions on treatment and surgery. What I have learned is that you have to keep the knee from popping out as much as possible. The more that knee pops out, the more it grinds down the cartilage and bone, increasing future occurrences. A lot of the times what can cause the knee to pop is the twisting of the leg, like when the dog makes a quick turn or jump (usually from the landing).

The grading is not really based on how often it pops, but more on how easy it is to pop out and how hard it is to pop back in. For example, Tikaani's knee has only had 2-5 occurrences per year, but I can pop the knee in and out of place as easily as opening a DVD case. With some really bad cases, putting the knee back into place is equivalent to pushing a nail through a phone book with your fingers.

The orthopedic specialist had told me to get Tikaani surgery before the knee gets worse and while he was still young (at the time he was about 2yrs old). Doing so would increase his chances of getting nearly full mobility of that leg when recovered. If the knee is too worn down, the surgery would only decrease arthritic pain and the dog would have limited mobility of that leg.

like Val said, exercise is very important in reducing occurrences of popping. The vet had told me that with Tikaani we can still do canicross and hiking with dogpacks, so long as it is in moderation and that runs are broken up with walks or resting breaks.

We've been giving him (all the pups actually) glucosamine supplements such as cosequin and dasuquin, which have really helped reduced occurrences and stiffness in his legs. Some of them even come in flavored varieties to help encourage the dog to eat it.
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PostSubject: Re: Luxating Patella   Mon Jan 02, 2012 12:29 pm

I'm feeding her Taste of the Wild and she's doing well on it. I know raw is best, but am not knowledgeable enough yet to venture into that. The Chondroflex is 500 mg Glucosamine HCI, 300 mg Perna Canaliculus, 200 mg Chondroitan Sulfate, 18 mg EPA, 12 mg DHA, 10 mg Manganese, 20 IU Vitamin E. They are soft chews, only available through my vet, and pretty expensive with only 50 per tub. I'm looking for something comparable or better with a lower cost.

So did Tikaani have the surgery Beth? Sorry if I missed that in your post. Cosequin was the other supplement I've been considering switching to. Evie's knee still pops out often, but it is becoming less frequent and like I said it goes back easily. It's comforting to hear that your boy can still do so many things that huskies love and should be able to do. The thought that she wouldn't be able to enjoy those things broke my heart. Is that Tikaani in your avi? Such an adorable picture!

I've been in contact with the breeder because Evie did come with a 1 year health guarantee against genetic issues and I know she planned on breeding Evie's parents again this spring. Her response wasn't surprising, but disappointing to say the least. She tried saying Evie's 2 bad knees could have been caused by obesity, dog food, stress, or trauma. My vet would argue this is not the case and he is providing a written statement. How I wish I could find the owners of Evie's siblings to see if they've had the same issues we have.
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PostSubject: Re: Luxating Patella   Mon Jan 02, 2012 4:45 pm

That is Tikaani in my avi, love that picture. I didn't go with the surgery because his popping was so infrequent and the cost was more than I can afford (though I am saving up just in case). The reason for taking him to 2 vets and a specialist was to get insight and a 'vote' as to whether or not getting the surgery now was necessary. The specialist said surgery now while both vets said to wait and that he may never need surgery so long as his popping doesn't get much worse.

From what one of the vets told me, dasuquin is a lower priced version of cosequin. We also purchased a Kuranda bed for in his crate. This was a nice chew proof, cot type bed that suspends the body and helps alleviate join aches and pains.

Totally understand where you are coming from with the breeder, Tikaani's breeder was the same way. They asked for vet proof and said "What do you want me to do about it". I thought I got him from a good breeder, but from day one (had other health issues with him) she has been a total snot.
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PostSubject: Re: Luxating Patella   Mon Jan 02, 2012 6:44 pm

JillC wrote:
I'm feeding her Taste of the Wild and she's doing well on it. I know raw is best, but am not knowledgeable enough yet to venture into that.

Diet can play a big part, even switching to a complete freeze-dried or dehydrated raw if you are not comfortable with raw is a good step that is an option. I don't mean to be pushy about it so please don't take it that way. I just want you to know and consider your options for Evie's sake health-wise and your own sake financially. Wink

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PostSubject: Re: Luxating Patella   Mon Jan 16, 2012 10:39 am

Thanks so much for all of your insight, I appreciate it so much! One more question as I get ready to order alternative supplements- How important is Chondroitin? I was leaning toward the Glyco-Flex II, but it does not have Chondroitin in it whereas the Cosequin DS is only Glucosamine and Chondroitin. I liked the Glyco-Flex b/c it has the Perna and MSM too. Hmmmmm. I don't know which would be best. What she's taking now has 200mg Chondroitin.
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PostSubject: Re: Luxating Patella   Mon Jan 16, 2012 12:29 pm

I would make sure she's getting chondroitin also. I use Glyco-Flex II as well as Nupro Silver with Joint Support. My holistic vet recommended both.

Just as a side note, I'll share a personal observation I've made with my dog who has LP. Since raw feeding was not agreeing with my stomach starting in the latter part of my 1st trimester, I stopped feeding it and put her on kibble with wet. Coincidentally (?) she started luxating MUCH more than she's done since we made the switch. And when I say "much more", we're talking luxating multiple times a day on kibble versus once a month or less on partial raw. And the only thing that's changed is her diet, all supplements have stayed the same. I'm going to get her back on partial raw ASAP and hopefully we'll see noticeable improvement.

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PostSubject: Re: Luxating Patella   Mon Jan 16, 2012 1:46 pm

Awww, poor Evie! And all the other LP doggies! Good thing that you're all doing things to help them and they seem to be getting better.

Beth and Jill, this is off topic but it broke my heart to read the breeder responses to your babies issues. You may want to post what breeders your pups came from if the breeders have not been cooperative. Or perhaps you have on your intro threads. They don't seem to be ethical breeders, even if they were initially seen as "good breeders". I know a lot of people lurk on this forum prior to adopting/buying a puppy and those kinds of breeders should be boycotted.
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PostSubject: Re: Luxating Patella   Mon Jan 16, 2012 3:05 pm

Val, i don't see chondroitin in the Nupro unless I'm looking at the wrong stuff or reading it wrong. Is this it?

http://www.organicpetboutique.com/Nupro_Silver_Daily_Vitamin_Joint_Supplement_p/nups.htm

Amazing if the kibble was making Glory luxate so much more frequently! Scary too! It'll be interesting to see if she improves when you get her back on partial raw. Keep me posted please. I'm doing this stuff step by step and not ruling out anything, including raw.

Sam, I've already encountered one person who also bought a pup from Evie's breeder here on this site and yes, I will be posting more info. We'll see if she follows through with the health guarantee. I mailed her a statement from my vet, as per her request and she received it on friday according to tracking. Now it appears she is ignoring me and the kennel facebook page disappeared the day I first informed her of Evie's condition. The whole thing makes me sick. No concern for her dogs or the pups that leave her and HUGE lesson learned on my part
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PostSubject: Re: Luxating Patella   Mon Jan 16, 2012 5:30 pm

Okay, I KNEW there was Chondroitin in one of the supplements I give Glory. I guess you're right, doesn't look like the Nupro Silver has it from looking at the link you posted, and yes that is the one I use by the way.

So here's the thing, about a year ago I switched from using Glyco-Flex II to using Pet Naturals of Vermont Hip + Joint. I compared the two and the ingredients were pretty much the same as far as the important stuff (and honestly I preferred the contents of the Pet Naturals supplement more than that of Glyco-Flex because I'd rather have Chondroitin and Vit C over Perna Mussel any day) and the Pet Naturals one was cheaper so I decided to try that instead. After the switch she'd been doing just as well on the Pet Naturals as she had on Glyco-Flex so I just kept buying it.

In case you want to take a look:
http://www.petnaturals.com/vitamins_supplements/hip-joint-support-dogs.php

http://www.petnaturals.com/vitamins_supplements/hip-joint-support-softchew-ML-dogs.php

I personally buy the soft chews for small dogs since I use it for Glory who is a Chihuahua, but I posted links to the equivalents for husky size dogs.

I will try to remember to keep this updated on how Glory does once I get her back on partial raw. She's scheduled to have her knees regraded in less than two weeks but I have a feeling it's not going to be good news since I can see her luxating every single day right now.

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PostSubject: Re: Luxating Patella   Mon Jan 16, 2012 5:48 pm

If she doesn't hold up to the health guarantee, and I assume you have a signed contract, you should report it to the Better Business Bureau. Businesses can get into all kinds of trouble if they disregard complaints made against them through the BBB. Good luck, and I hope you find something that works for Evie.

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PostSubject: Re: Luxating Patella   Mon Jan 16, 2012 6:52 pm

Thanks Val, those look like a good choice. These are the same just in tablet form, correct? EVie's not picky and will eat anything.

http://www.luckyvitamin.com/p-4189-pet-naturals-of-vermont-hip-joint-extra-strength-for-dogs-120-chewable-tablets

I'm so sorry to hear about Glory Sad We were just talking about how well she was doing and that you hoped she actually improved. Maybe she's just overdone it or something and will get back on track.

Thanks for the reminder about the BBB Meredith! I have filed complaints with them before online and was surprised at how easy it is.

*edit* Missed your first link to the tablets Val so disregard my question. The ones I found are just extra strength
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PostSubject: Re: Luxating Patella   Mon Jan 16, 2012 8:38 pm

I know, it's very discouraging to see her like this. Even if I put her back on raw now it wouldn't be enough time to make a difference in her knees since she's being regraded next week. Sad I will still update after she's been on partial raw again...hopefully it will make a difference.

How's Evie been doing so far? Any improvement? You might prefer to start with the extra strength tablets for Evie if her knees are bad enough. I just use regular strength but if things don't improve with her food change I might consider switching to the extra strength chews instead. Please keep us updated on Evie's progress too!

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PostSubject: Re: Luxating Patella   Wed Feb 01, 2012 4:54 pm

Okay, an update now that Glory's been re-graded. As I suspected, she has gotten worse. She's dropped a grade in each of her knees and is now a grade 2 in her left knee and a grade 3 in her right knee. Basically she's back to where she was when we adopted her 2 years ago so all the progress she'd made before is gone.

My holistic vet wants her Glucosamine and Chondroitin supplements increased to a higher dosage, something equivalent to Glyco-Flex III. So now I have some shopping to do and comparisons to make to get her on something stronger. I am holding off on reintroducing her raw food because she is now on allergy and skin supplements for her other issues so I want to see if the allergy/skin supplements make a difference before putting her back on raw.

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PostSubject: Re: Luxating Patella   Wed Feb 01, 2012 9:57 pm

Oh Val, I'm so sorry to hear Glory has gotten worse. Did your vet think that the food change could be the culprit? Hopefully her skin problems clear up soon, poor girl Sad Has her attitude/behavior changed at all? Just curious because even at her worst, Evie's maintained a happy disposition. I know that when those knees luxate it's painful, but most of the time I would never know it by how she acts- other than that gimpy walk until it goes back in place. Keep us posted on what you decide as far as supplements and how Glory does on them. I feel like I'm constantly researching too.

I'm happy to say Evie is doing pretty well. I rarely give her the Deramaxx now because I've seen a marked improvement and don't think she needs it all the time. On occasion she does overdo it(like yesterday when my brother showed up with his choc. lab) so I will give her 1 dose and she's better again within 24 hours. I have The PetNaturals Hip & Joint Extra Strength and will start those as soon as she finishes the last few of the supplements she was on. I'm anxious to see how she does on them as they are stronger and much cheaper. She is walking and getting up from laying down easier and has not collapsed in a long time. Praying she continues this upswing.

In other news, the breeder has reimbursed Evie's purchase price after receiving the statement from my vet. Little consolation, but it's something at least. I was disgusted to discover that Evie's mother is actually due today with a new litter of pups. She was paired with a different male, but it's anyones guess which of her parents Evie inherited this from. So the cycle continues Evil or Very Mad
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PostSubject: Re: Luxating Patella   Thu Feb 02, 2012 10:23 am

Has Evie's breeder had her mother checked at the vet for luxating patella? Glory's mom, Faith, comes from a great breeder and excellent bloodlines but her father is a totally different story so I am positive Glory's LP is from her father's side. Faith's knees have been checked every year since we got her in 2009 and hers are perfect, no LP at all.

That is such good news to hear that Evie seems to be doing better. I'm sure on the stronger stuff that will only continue...at least I hope that is the case.

I didn't even mention the correlation between the increased luxations and stopping the raw feeding when I talked to the vet. I mentioned both as separate items but didn't bother to make mention of how they seemed to happen around the same time. We had all 3 dogs at the vet and Glory had so much going on it slipped my mind at the time. I have several months supply of her usual Pet Naturals supplement but will probably get the next stronger dosage (Extra Strength possibly? I haven't looked into it yet) when I place my next order. I would think she'll probably be back on raw before then but we'll see which happens first and I will keep updating.

Glory's behavior has not changed at all throughout. Of course she had grade 2 and 3 LP when we adopted her so I couldn't say how she was in her prior years to compare. She certainly doesn't show if she's in pain although I'm sure she is, I too have to see her walking funny to know when she's luxated. Her skin problems only make matters worse because when she uses her back legs to scratch, it often CAUSES her knees to luxate. No She's a mess...but we'll keep trying to improve all her conditions.

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Huskyluv
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PostSubject: Re: Luxating Patella   Thu Mar 08, 2012 4:58 pm

I wanted to update real quick on Glory's progress since we changed her food and nothing else. What a total and complete difference! Since changing her food back to partial raw she's completely stopped luxating as far as I've seen for the last 4 weeks!

I ordered some extra Glucosamine, Chondroitin, and MSM pills (they're smallish human pills that I'll just slip in her food bowl) to add to her current regimen which hasn't changed for the past 2 yrs. I will be starting her on those extra pills today but I haven't seen her luxate in over a month just from her diet change so I don't really expect to see a noticeable change with the new pills added to her daily diet.

I am just so happy that a simple food change got her back on track and so quickly too. Not supplements or exercise, just diet change. Very Happy

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Tiff&Kya
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PostSubject: Re: Luxating Patella   Thu Mar 08, 2012 5:10 pm

Huskyluv wrote:
I wanted to update real quick on Glory's progress since we changed her food and nothing else. What a total and complete difference! Since changing her food back to partial raw she's completely stopped luxating as far as I've seen for the last 4 weeks!

I ordered some extra Glucosamine, Chondroitin, and MSM pills (they're smallish human pills that I'll just slip in her food bowl) to add to her current regimen which hasn't changed for the past 2 yrs. I will be starting her on those extra pills today but I haven't seen her luxate in over a month just from her diet change so I don't really expect to see a noticeable change with the new pills added to her daily diet.

I am just so happy that a simple food change got her back on track and so quickly too. Not supplements or exercise, just diet change. Very Happy

These are your chis you are talking about?

My male pom has a LP and he looks so pitiful. I have no idea what to do to help him. The partial raw has helped her?
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