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My dog has a luxating patella and has been coming in from…

Customer Question
My dog has a...

My dog has a luxating patella and has been coming in from cold limping. Yesterday night came in and has back right leg hiked up and won’t put it down

Veterinarian's Assistant: I'll do all I can to help. Have you looked to see if there is a wound on their foot?

No wound

Veterinarian's Assistant: What is the dog's name and age?

Willow and 5

Veterinarian's Assistant: Is there anything else important you think the Veterinarian should know about Willow?

She has luxating patella and has a metal plate in front leg

Submitted: 4 months ago.Category: Dog Veterinary
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Answered in 2 minutes by:
1/3/2018
Dog Veterinarian: Dr. Kara, Veterinarian replied 4 months ago
Dr. Kara
Dr. Kara, Veterinarian
Category: Dog Veterinary
Satisfied Customers: 18,403
Experience: Over 20 years of experience as a veterinarian.
Verified

Hello, I'm Dr. Kara. I have over 20 years of experience as a veterinarian and I'd like to help. Please give me a moment to review your concerns.

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Customer reply replied 4 months ago
Thank you!
Customer reply replied 4 months ago
It’s also between 0 and 6 degrees
Dog Veterinarian: Dr. Kara, Veterinarian replied 4 months ago

I am sorry to hear that Willow is carrying her right rear leg and refusing to bear weight on it.

Because there is no history of trauma a fracture is unlikely, though possible if she is very fine boned and jumped off a high piece of furniture.

It sounds like she has a previous history of a patellar luxation. It sounds like this has now progressed to the point that she cannot get her kneecap back into place and use her leg normally.

With a patellar luxation the kneecap slides out place rather then staying in the patellar groove. When that occurs the leg cannot bend or flex as it should and the dog becomes lame.

This condition is usually congenital, meaning the puppy is born with the genetics to develop the condition as they grow. It doesn't mean that the pup is affected as soon as they are born however, and in most cases it is a condition that we see develop as the bones, ligaments and tendons that form the knee joint grow and develop or in an older pup that gets arthritic. Not all pups in a litter are necessarily affected.

If your girl has this your veterinarian can examine her, try and reposition her kneecap take, some radiographs and tell you whether surgery is needed now or she could benefit from joint supplements such as glucosamine/chondroitins and omega 3 fatty acids or a supplement called Duralactin as well as pain medication. I do think that Willow is painful because she is carrying her leg.

If you'd like to read more about pateller luxations here is a link to an excellent article written by the American College of Veterinary Surgeons:

https://www.acvs.org/small-animal/patellar-luxations

In mild cases some dogs learn to kick their rear leg and pop the knee cap back into place. Over time however because of the constant wear and rubbing of the knee cap moving in and out of place we see secondary arthritis forming. Whether she needs surgery or not now will depend upon how severely she is affected, and whether we can manipulate her kneecap back into place. In most cases once the knee cap slides out and stays out the dog needs surgery at that point.

If we can manipulate her kneecap back into place, and it stays in pace there are some things we can do for comfort. Long term for any joint pain I recommend using a combination of a glucosamine/chondroitin product (examples are Dasuquin or Cosequin) and an omega 3 fatty acid (like 3V Caps or Derm Caps). I recommend an omega 3 fatty acid dose based upon the EPA portion (eicosapentanoic acid) of the supplement as if we do that the rest of the supplement will be properly balanced. Give her 20mg of EPA per pound of body weight per day. For example a 15 pound dog could take 300mg of EPA per day.
Omega 3's and glucosamine/chondroitins work synergistically and improve cartilage health and joint fluid quality and quantity as well as reducing inflammation. They can take several weeks to see full improvement but some dogs do very well with them alone. They are available over the counter.
Another option is a product called Duralactin. This is an anti-inflammatory product derived from milk proteins and it also has omega 3 fatty acids incorporated into it which can be very helpful. See this link for further information: http://www.duralactin.com/products_canine.htm
If those medications are not enough her veterinarian can prescribe drugs that are more potent. Veterinary drugs we can add include a nonsteroidal like Metacam, Deramaxx, Previcox or Rimadyl. If those aren't enough we can add another drug in the opiod family called Tramadol and/or another drug called Gabapentin.

Because this occurred suddenly another possibility is a complete tear of her anterior cruciate ligament in her knee. This ligament crosses the knee and stabilizes the joint. When the ligament tears there is no stability to the knee joint and the dog suddenly becomes leg carrying lame. It can happen suddenly with the smallest slip, especially one that causes a twisting motion to the knee.

Ideally surgery would be done to give her knee normal stability because without surgery secondary arthritis formation will occur sooner and to a more severe degree then with surgery. It is also more likely that she will rupture the cruciate ligament in her other knee because she will be putting more stress and strain on the other leg.

Your veterinarian will likely examine her, paying close attention to the ability to manipulate the joint and check "drawer" or forward laxity of the knee. We will often sedate our patients if they are very nervous or painful to check the knee and take radiographs of the knee joint to look for a characteristic change in the location of the fat pad in the knee joint.

If surgery is absolutely not in your budget you can try strict rest. Given her age and small size that may be the best plan depending on how painful she is and whether we are able to get her more comfortable with medications and rest. With very strict rest the knee will form scar tissue and gain some stability with time but it won't ever be normal and it will be arthritic. When I say strict rest I mean cage rest, no running, jumping, climbing stairs or playing for at least 6 to 8 weeks. She needs to go outside to eliminate on a leash so she is not overly active.

Surgery or not I also recommend keeping her on the thin side, or weight loss if she is overweight to decrease stress on her knees.

Long term for cruciate injuries I also recommend using a combination of a glucosamine/chondroitin product (examples are Dasuquin or Cosequin) and an omega 3 fatty acid (like 3V Caps or Derm Caps). As with the other conditions we are trying to slow arthritis formation.

If you cannot have her seen for a few days aspirin is the only over the counter pain medication I recommend. Long term it can create gastrointestinal upset, ulcers and interfere with clotting. If your pup is healthy otherwise you can use aspirin but not for more than 2 to 3 days consecutively and should always be given with a meal. If you choose to use it watch for lack of appetite, vomiting, blood in the stools or dark tarry stools and stop immediately if you see those. Do not use aspirin if your dog has liver or kidney disease or a history of a sensitive stomach or clotting problems.

The dose for aspirin is 5mg to 10mg per pound of body weight orally every 12 hours (about one low dose 81mg aspirin for an 8 to 16 pound dog every 12 hours). Always give with a meal. Do not use for more than 2 or 3 days.

Be aware if you choose to use aspirin and it doesn't help your veterinarian will be limited on what they can prescribe as there must be a 5 to 7 day washout period between different nonsteroidals or nonsteroidals and steroids.

You can also try alternating warm and cold packs on her painful knee area for 10 minutes at a time several times a day. Heat reduces painful muscle spasms and cold reduces inflammation.

Best of luck with your pup, please let me know if you have any further questions.

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Dog Veterinarian: Dr. Kara, Veterinarian replied 4 months ago

Hello, I wanted to make sure that you didn't have any further questions for me, and I'd like to know how things turned out for your pup. If you could give me an update that would be great, thank you, ***** *****

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