Knee Cap issues

[Silver Lining]

Well after nearly 2 years of no injuries - we now have one.

After a trip to the vets today due to Maddie yelping and dragging her back leg, he has confirmed she has popped her knee cap. He has given me 2 weeks worth of antibiotics and said if it doesn't help she will need to go in for surgery and have it shaved to make it sit in it's "cradle". Obviously he has said walks on lead only as she runs around at about a million miles an hour, and has said if we have to do surgery it will keep her out for 6 months - so no chance for any work this year as i don't believe the tablets will help tbh as it went with her just stepping out of the car when we got home.

I guess my question is, has this happened to anyone before ? what are the chances of the surgery working and her having a normal working life ? I can't help thinking this could now be a lifetime of "knee cap issues" and a lot of Pet Insurance bashing...

[vicky payne]

Patella luxation is an increasingly common problem in Cockers and Labradors, but has traditionally been a small dog problem. In most cases the patella groove needs deepening, AND the attachment of the patella ligament needs moving as over time the attachment moves and pulls the kneecap out of the groove. Surgical success depends on a) the surgeon's skill, b) how well you follow post op instructions, c) the level of damage already done. A knee with lots of arthritis is not going to do well even after surgery.
Treated early the results are usually excellent.Ensure the other side is assessed as the problem is usually bilateral and some insurance policies won't cover the second op if it happens in a different policy year.

[Alice]

Patella luxation is an increasingly common problem in Cockers and Labradors, but has traditionally been a small dog problem. In most cases the patella groove needs deepening, AND the attachment of the patella ligament needs moving as over time the attachment moves and pulls the kneecap out of the groove. Surgical success depends on a) the surgeon's skill, b) how well you follow post op instructions, c) the level of damage already done. A knee with lots of arthritis is not going to do well even after surgery.
Treated early the results are usually excellent.Ensure the other side is assessed as the problem is usually bilateral and some insurance policies won't cover the second op if it happens in a different policy year.

Would you say there is an inherited/genetic element to this Vicky? I ask in particular as I know the litter brother to this dog. Should their owner be on the lookout for similar?

[Judy]

There have been a few Flatcoats with patella luxation, I do wonder whether its partially genetic in origin.

[Silver Lining]

I must admit when the vet first said about it i immediately thought Fitzpatrick Referrals and the "Supervet" !! I have never owned a pet who has needed this level of surgery ( and possibly have a potential ongoing injury ) and although i like my Vet, he is not a specialist in this area and i wonder if it is worth requesting a referral to ensure the best possible outcome for Maddie. My biggest problem at the moment is trying to keep her calm to stop it from keep popping out, she got excited last night waiting for her dinner and it came out then, it's getting to a point where i will have to keep her in her crate all the time, and for a dog of her nature i know it will be a nightmare for her.

[vicky payne]

Ask for referral (not necessarily to Fitzpatricks!). You need to talk to someone experienced with these ops.

We don't know if there is a simple genetic component, it runs in lines but that could be due to overall hindlimb conformation. Several breeds do test and avoid breeding from affected dogs. It's a simple palpation test.

[Silver Lining]

Hi Vicky. I am going to ask for a referral - i spoke with a lady in my village last night who has 2 Chow Chow's, the puppy of the 2 had problems with her legs and went in to see my vet and ended up having surgery, she got home and Liz ( the owner ) was adamant something wasn't right and eventually he did an X Ray, the bones in her legs had shattered...he eventually admitted that he "probably" put the wrong size staples in which is what had shattered the bones, he did another surgery to fix it but they had to pay for it. It then took another month to get money out of him for what he did wrong and even then he wouldn't give a paper trail for the refund as he said it would be an admission of guilt.

I will be changing my vet based on her experience as i can't risk that happening to Maddie, i need to have confidence in him and that has shaken me.

Thank you for your advice.

[Stacia]

Do look for a specialist orthopaedic vet.

[Saul]

Patellar subluxation in humans is not "genetic" as in a single gene problem, but is multifactorially genetic as in you tend to have the shape of knees your parents have. In humans the depth of the femoral groove and importantly a tendency to genu valgus (knock knee) increase the likelihood as the quads muscle pulls the kneecap laterally rather than along the condylar groove. I know nothing about the condition in dogs but vickys idea that it is hindleg conformation issue that predisposes matches the human medical idea about this condition (in a different species). A test that is a look and feel test would be considered an "opinion" in the human medical world and calling it a test would be slightly over egging it.

[Lizpart]

Hi in my experience and I have 20 years in the veterinary world I would def seek referral advice although I also know of plenty of gp vets that have exceptional orthopaedic skills without having the certificate. To put into perspective this is not a difficult op and lots of vets have the necessary skills to carry this procedure out but specialists would be doing this most days and your general vet wouldn't. Recovery rates vary and this can be down to damage already done and patient compliance in recovery. Physio is also important and extra strain on the opposite leg can cause the same problem. Advice listen to your vet NOT Jo Bloggs down the road and stay away from stick/frisbee/ball retrieving which involves tight turning at speed until recovery is complete. Working ability post op will vary but I know plenty that go onto work well providing the owners are realistic about what they are asking their dogs to do. It won't stick 4 days a week but providing you keep the dog well exercised, fit and not overweight and don't ask it to haul itself out of steep river banks (a lot of damage done here) your dog should continue to work.