Kneecap problem

[lilysmum51]

I have a gorgeous 2 year old border terrier with a luxating patella - mobile kneecap.The vet is putting huge pressure on me to have surgery, which is £1500, although the condition is not causing my dog any discomfort. She would need 2 weeks in a crate, followed by 10 weeks rehab. Since she was diagnosed I have reduced her exercise to 2 x30 min walks a day, glucosamine supplements, and hydrotherapy. I have said that I will consider surgery in a few months time,if there is no improvement, but have a huge amount of family commitments in the next few months which would make nursing a poorly dog very difficult. I love her to bits, and hate the idea of causing her any suffering, but also hate the pressure that the vet is putting on me at the moment. Does anyone have any advice or experience? Thanks.

Had a rescue pup who had luxating patella in both knees. She was in no pain but unable to walk much.

So she had the surgery on both knees and know 4 years later is fantastic and even competing in agility.

I am glad we had the op - recovery was ok as she was already crate trained.

We had the surgery at Fitzpatrick Referrals.

Lily have they graded the luxation (between 1 and 4). Higher grades definitely benefit from surgery and lower grades can often improve with rest and anti-inflammatories.

Thanks for the replies.

Lonecat, I think it is Grade 2. Pops in again of its own accord sometimes, but I have to put it back myself sometimes. Only happening once a day at most now, although when it first happened - after a heavy, very energetic dog had bounced on her, it was happening 5 or 6 times a day.

Nutty - did your dog have to stay in the crate for long? Were you able to cuddle her / make a fuss of her, or did you have to pretty much leave her alone? And how was the aftercare and recuperation?

Maybe I am being a bit of a drama queen, but thanks for your advice.

She was crated. But if I was sitting in the sitting room I had her next to me on a lead so she was restricted.

Yes I could cuddle her and fuss her etc she loved that. I think the first week she was a bit quiet due to drugs painkillers etc,

She was used to a crate and I think that made it easier. She had lots of kongs and we did some clicker training etc to keep her amused. She still had to go out for wee breaks etc. It really was not too bad.

We had crates all over the house so she could be in a room where people were.

The building up to exercise was slow but sure with us. We had an easier decision to make though as she could not walk any distance without both of them popping out.

I have had other dogs crated due to other surgery and it has not been too bad.

I remember that she was quite upset the first night she came home _ I think this was day 2 after the op. So I did sleep with her but after that she was subdued for a bit but not in pain.

If you're worried about sticking her in a crate for that long - that's not what crate rest means.

It just means keep them still. My dog had elbow surgery when he was 6 months old, I cordoned off a space about the same size as his crate beside the couch with the coffee table and some chairs so he could be sat with us when we were all in and had him lying next to me on the lead when everyone else was out through the day.

Nutty - thanks for the reassurance. It doesn't sound too bad at all,and I am glad your dog's recovery went well.

Tab - thanks as well. I don't think the vet explained what she meant by crating at all, so I just assumed it meant solitary confinement. She had a crate when she was a puppy, so shouldn't be too put out if it has to come back into use again, if only to stop her chasing the cats.

Have just talked to someone who went through the same thing, never went down the surgical route, and at 7 is still fine and energetic. And another neighbour has recommended getting a 2nd opinion from another vet before I make a decision. Quite sure I didn't get this confused about either of my children.Must be getting soft in my old age.

Things are now going from bad to worse.

After much thought, I took my little dog in today for an x ray, followed by surgery. The vet has just rung to say that although the knee surgery is still necessary, the x ray has shown that the dog has the worst case of hip dysplasia that she has ever seen in a 2 year old, and the only case she has ever even heard about in a border terrier. That means that even after surgery, she will need lifelong medical care and hydrotherapy. My poor little girl. I feel so sorry for her. She may eventually need a hip replacement as well. It makes this knee op look very ordinary.

Oh Lilysmum I am so sorry. I know you are not asking for advice but get an expert decision from a specialist vet and that can help reassure that you are making the right decisions for you and your dog.

There is a lot in her favour though, she is a small dog, you have caught it early, there is a lot they can do for her.

It is hard with dogs as they can not tell you exactly how they are feeling and I guess that is why you are finding the decisions hard to make - I am exactly the same.

My cocker had knee surgery for a luxating patella 2 years ago, the bill was around £1100. He came home after 3 days and believe me he did nothing for 2 weeks and I did not have to crate him. It took about 12 weeks to get him back to 2 30/40 min walks a day, but 9 months later he was back grouse beating on the moor covering 25ish miles in a days shoot. We were lucky in that our vets practice is a vet hospital and the lead vet is a specialist orthopaedic surgeon, even still I did seek a second opinion on the surgery but I am glad I went ahead with it, he will probably suffer from arthritis in that knee later in life but so did both my old labs.

Thanks for your replies.She has had the knee op,which has been successful, and should be able to bring her home tomorrow.

Cath - she has been in a vet teaching hospital,so I know she has had the best care,and we will get the best advice,but the orthopaedics surgeon has already told me that she won't make as good a recovery as most dogs, because of the hip problem. A life of restricted exercise, regular checks,weight watching and pain killers if needed is ahead. Sad, but she is such a little sweetheart that we will do whatever it takes to give her a happy life.

Nutty - thanks also. I am sure she will have a lovely life,as we will do all that is necessary,and as you say, she is very young, and it has been spotted early. Apparently the hip problem might have caused the knee problem, so maybe it is lucky that the x rays have alerted the vets at this stage.

Upwards and onwards. The only way.And thanks for your comments.

My dog is 20 months old, he's had his elbow surgery which although it improved it, he'll never be completely sound in that leg, he has a spinal issue which has caused behavioural issues which painkillers have helped with, but it's still an issue.

So, he gets restricted exercise, I have to keep him pretty lean, he can't be off lead anywhere that there might be dogs and I have to keep him away from visitors (he's a Rottweiler, so although he's never actually bitten I have to be careful) He's currently on two different painkillers, he was on tramadol as well, but it wasn't helping, so he's off it again. He's also muzzled for most walks (unless I drive to the middle of nowhere, which I do a couple of times a week)

It all sounds terribly sad for him...and it is in a way because there are a lot of things he just can't do that you would usually take for granted with a young dog, but, he's happy enough, he doesn't know any different. He enjoys his short walks, I vary them as much as I can to make them interesting, we do lots of training to keep him mentally active, we play scent games in the house.

I'll never be able to do agility with him (I was planning to when I got him) or take him out all day walking...but he does have a good quality of life.

Have they talked to you about hip replacements? Most dogs with hip dysplasia are so much happier after and pain free. It is more difficult in small dogs but I have seen them done in a couple of borders.

Vetnurse - yes, the orthopaedic surgeon did mention hip replacement, but probably in about 5 years time, and then only if the medical treatment, hydrotherapy,etc, fails to keep her happy and active. She said it may not get any worse,as she is a small dog, so it is not as liable to progress as in big dogs, although keeping her weight down is going to be essential.

Hopefully I will have had time to save up a big wad of cash before we get to that stage,as I imagine it is so prohibitively expensive that the insurance won't even touch it.

Good news is that she is back home,and quite comfortable - and eating,which for a border is always a sign that things are getting back to normal.

Small Dog has had her operation,and after 2 weeks, having followed the vet's instructions to the letter, I took her to have her stitches removed. The vet looked at her and was worried, and kept her in for another x ray. The upshot is that the fracture which they created has not healed, so another, much bigger operation is now needed. The original work has to be undone, and then a bone graft taken from the hip is inserted, as well as pins, etc.

The vet took some blood tests to make sure that there was no systemic reason for the failure,and is planning to operate today if the tests are ok. SmallDog will then have an external support on her leg,attached by pins into the bone. That stays on for 3 weeks, and then a 3 month recuperation is needed - if it works.It has more risks of complications,and I suppose Smalldog could end up lame.

I have cried almost non-stop for a day,and now am getting more angry than upset. We were really pressured into the treatment, which I didn't want, and now we have a dog who will possibly never be fully fit again. We have paid £1400 for this treatment already, and the rest of it is not covered by our insurance, which only covers us for £1500 per year. The vet estimates that it will be at least another £1000, even though they won't charge us the full rate for the surgery.

The vet has only seen this once in 14 years - just as she had never seen hip dysplasia in a small dog! She is appalling at ringing when she has said that she will, and I seem to have spent days just hanging around waiting for news. And she has made all that money from the best natured, sweetest dog ever, who is now broken. Sorry, I know there is nothing to be done, but had to let off a head of steam somehow.

Does anyone know roughly how much patella luxation surgery costs at Fitzpatrick referrals please?

Don't know about supervet, but our labradors surgery was around £2k last year at the orthopedic hospital he was referred to in stirling, Scotland. That was including £150 for initial consultation..

With added GA for a couple of xrays before and after, painkillers for a few months, yumove, staples out and follow ups at local vet (he healed well but then development a limp again but thankfully it was temporary) , the final total for insurance was around £3.6k.

Price may vary depending on size of dog. If ours was smaller the local vet would have done the op and much cheaper.

Thank you for the reply he's an 11 month old French bulldog it doesn't seem to hurt him he runs around everywhere but I want it to be sorted as you can hear it pop in and out and my vet hasn't got an orthopaedic surgeon at the moment so not sure where to go for it and the worse thing is that he had 6 weeks free insurance I didn't realise that I had to renew it the same time that he started to limp so trying to get a rough price as they won't pay out for it now