My chihuahua has a textbook case of a luxating patella—her stifle slips once or twice each day while running, jumping, etcetera but pops back easily. This is a new problem that just surfaced this week, and it doesn’t seem to cause her any continual discomfort. She’s about one and a half, average weight, very active, and tall for her breed.
I’ve heard she should have gentle exercise (walking up hills?) and restrictions on her active play for a while. Any other advice? Any stories?
This is a very common condition in small dogs. From what you describe, this isn’t bothering your dog. So, we typically do not advise surgery unless it’s bothering her. It may never bother her, or it may, but we can’t predict which Grade 2s will progress to Grade 3 or start to bother her. My feeling is that it isn’t a new problem, but it was less severe earlier (maybe she just had some tendon laxity but no actual displacement was seen). Using chondroprotectants (joint supplements) now can help now to keep cartilage healthy.
Here are some relevant excerpts from the AVCS (American College of Veterinary Surgeons) website http://www.acvs.org/AnimalOwners/HealthConditions/SmallAnimalTopics/MedialPatellarLuxations/
[I]Patellar luxation is one of the most common congenital anomalies in dogs, diagnosed in 7% of puppies. The condition affects primarily small dogs, especially breeds such as Boston terrier, Chihuahua, Pomeranian, miniature poodle and Yorkshire terrier.
The femoral groove into which the knee cap normally rides is commonly shallow (Figure 2a, Figure 2b) or absent in dogs with non–traumatic patellar luxation. Early diagnosis of bilateral disease in the absence of trauma and breed predisposition supports the concept of patellar luxation resulting from a congenital or developmental misalignment of the entire extensor mechanism. Congenital patellar luxation is therefore no longer considered an isolated disease of the knee, but rather a component/consequence of a complex skeletal anomaly affecting the overall alignment of the limb, including:
Abnormal conformation of the hip joint, such as hip dysplasia
Malformation of the femur, with angulation and torsion (Figure 3)
Malformation of the tibia
Deviation of the tibial crest, the bony prominence onto which the patella tendon attaches below the knee
Tightness/atrophy of the quadriceps muscles, acting as a bowstring
A patellar ligament that may be too long
Clinical signs associated with patellar luxation vary greatly with the severity of the disease: this condition may be an incidental finding detected by your veterinarian on a routine physical examination or may cause your pet to carry the affected limb up all the time. Most dogs affected by this disease will suddenly carry the limb up for a few steps, and may be seen shaking or extending the leg prior to regaining its full use. As the disease progresses in duration and severity, this lameness becomes more frequent and eventually becomes continuous. In young puppies with severe medial patellar luxation, the rear legs often present a “bow-legged” appearance that worsens with growth. Large breed dogs with lateral patellar luxation may have a “knocked-in knee” appearance, combining severe lateral patellar luxation and hip dysplasia.
When to Seek Veterinary Advice
You should seek veterinary surgical advice if you have any concern about the gait of your pet or if your primary veterinarian advises you to do so. The severity of patellar luxation has been graded on a scale of 0 to 4, based on orthopedic examination of the knee (Figure 4). Surgical treatment is typically considered in grades 2 and over:
Grade I
Knee cap can be manipulated out of its groove, but returns to its normal position spontaneously
Grade II
Knee cap rides out of its groove occasionally and can be replaced in the groove by manipulation
Grade III
Knee cap rides out of its groove most of the time but can be replaced in the groove via manipulation
Grade IV
Knee cap rides out of its groove all the time and cannot be replaced inside the groove
The diagnosis of patellar luxation is essentially based on palpation of an unstable knee cap (Figure 4) on orthopedic examination. Additional tests are often required to diagnose conditions often associated with patellar luxation and help the surgeon recommend the most appropriate treatment for your pet. These may include:
Palpation of the knee under sedation to assess damage to ligaments
Radiographs of the pelvis, knee and occasionally tibias to evaluate the shape of the bones in the rear leg and rule out hip dysplasia.
What Will Happen if Patellar Luxation is Left Untreated?
Every time the knee cap rides out of its groove, cartilage (the normal lining of bones within joints) is damaged, leading to osteoarthritis and associated pain. The knee cap may ride more and more often out of its normal groove, eventually exposing areas of bone. In puppies, the abnormal alignment of the patella may also aggravate the shallowness of the femoral groove and lead to serous deformation of the leg. In all dogs, the abnormal position of the knee cap destabilizes the knee and predisposes affected dogs to rupture their cranial cruciate ligament, at which point they typically stop using the limb.
What Options are Available for Treating Patellar Luxation?
Patellar luxations that do not cause any clinical sign should be monitored but do not typically warrant surgical correction, especially in small dogs. Surgery is considered in grades 2 and over (see above). Surgical treatment of patellar luxation is more difficult in large breed dogs, especially when combined with cranial cruciate disease, hip dysplasia or angulation of the long bones.
Osteoarthritis is expected to progress on radiographs. However, this does not necessarily mean that your dog will suffer or be lame as a result. Keeping your pet trim and encouraging swimming/walking rather than jumping/running will help prevent or minimize clinical signs of osteoarthritis. Oral supplements and/or a specific diet may be recommended to promote cartilage function and minimize the progression of osteoarthritis.
Some degree of knee cap instability will persist in up to 50% of cases. This does not cause further lameness in the majority of cases. Migration or breakage of surgical implants used to maintain bones in position occurs rarely. Infection is a rare complication.
[/I]
I have come to find out that they are quite common in most toy breeds. Whether they cause a problem depends upon the dog, its age, its condition and size and of course, the severity.
My female was diagnosed with a grade 2. But it does not seem to cause her any problem. I very rarely can see anything in her gait. Orthopedic vet said to leave it alone for now. Dont let her get fat, try to avoid jumping or dancing on hind legs and do lots of walking to strengthen.
My male had a grade 3 on one and 2 on the other! His went out and caused him to be lame and then was popping out and staying out. So he ended up having surgery. Did a big operation on the bad side, repositioning the leg, pins, etc (TPLO) and a smaller procedure on the other - tying over the patella to stay in the groove. That was in March. He was confined for 8 weeks with leash walks only. His muscles had weakened, so after 12 weeks when he hadnt progressed as I would have wished (little dogs sometimes get used to carrying the leg and it is hard to get them using it correctly again) I opted for doggy physical therapy. Got a vet referral and he received an evaluation, then laser threapy, balance ball work, and used the underwater treadmill. For homework, we have been instructed to do more leash walking (where I can make sure he is using it correctly) and also encourage him to back up. Having him stand with front legs on a step helps him transfer the weight, but avoid rapid direction changes, sudden jumps etc.
He has gained a lot of muscle strength and walks normally more of the time. Most importantly he is comfortable!
Most little dogs dont need surgery. Still, I would likely take him to an orthopedic vet for an evaluation. S/he will give you good advice about keeping her healthy and happy.
Good luck!
Thanks for the great replies! I’ve only had Clover for eight months (she was a ten month old stray at the shelter in December) so she very well could have had symptoms before we met her. I have an Aussie with a missing ulna so the glucosamine is already part of his routine . . . now, to figure out a teeny tiny dose!
Ditto. Really really common in small dogs.
Surgeons like to fix them. Many owners like to fix them.
Choice is yours. I don’t get excited if it doesnt’ bother the dog (or you, even it doesn’t bother the dog).
In general, the more exercise the better, unless he’s more painful afterward than he was before. Dogs that are super active, with great muscle tone, tend not to have problems. An occasional ‘skip’ I wouldn’t worry about at all. Persistent limping would be an issue to get checked out.
It is common in small dogs where the responsible breeders do not test their breeding stock!!! I have had dachshunds for 40 years, always test my dogs and no incidence of Patella luxation. :no:
Both of my dogs parents and three grandparents had patellas certified free of luxation. Pup lost out in that genetic lottery!
My female pit had her left knee done 2x. Once for the grII luxating patella and two weeks later to repair the damage my hardwood floors and lack of adequate confinement had created. Plus two hardware removals.
She has been surgery free for (knock on wood) almost 2 years. She was not insured. Every dog in my home now has health insurance. I learned the hard (and expensive) way.
I opted for the surgery, because she was in pain. She is a rather stoic dog, but she raised hackles and growled when I even looked at the knee. VERY uncharacteristic for her. I had multiple surgical consults before finding the surgeon I used. It was not cheap, but it was worth it. I found the right guy who treated both my dog and I amazingly well. The staff was wonderful as well!!
I couldn’t not do the surgery knowing how much pain she was in and knowing how much damage leaving it alone would do.
I’d suggest looking into the surgery. It’s not a good time. Post surgery sucked HUGE. The cost was not fun either, BUT I have a 4 year old dog who runs, swims, fetches and plays and has amazing and pain free quality of life. Eventually there will be arthritic changes, BUT it’s better than her having pain and or significant changes before she was 3.
I wanted to bump this and see If I could get more information.
I was pleasantly surprised with a new puppy on Wed. evening. Yes, I am over the moon! I have been waiting for a puppy for almost a year (I guess he thought the time was FINALLY right!!). We decided on the name Gunner, I pushed for Riker but I pick my battles
• Reading his paper work they did disclose the luxating patella Grade 3- However, they did tell my husband that they go through “grade 5” – And they never saw him have any problems… Research tells me that they go to grade 4 and 3-4 can be severe.
Gunner has also presented 2x with classic signs that it is bothering him. We have only had him for 2 days and I am a bit concerned.
He was at the pet store in one of those crummy cages for a month and a half before we purchased him. I can’t help but think he received little to no exercise. With his active and rambunctious self I think the exercise and use could be the issue, until he is used to the activity anyway.
There are several things that we need answers too. The breed on the cage was JRT mix- Further questions led to a JFT/Fox mix. The papers list him as a Terrier/ Chihuahuas mix. On another paper there is a white out part of the dam that then reads Fox Terrier.
They also told him he was healthy and up to date on all his shots. When I read the papers it lists kennel cough/cold, which obviously will need to be checked.
He is set to go to the vets for a general check-up.
Did we get into more than we bargained for? It’s our first puppy and my husband was so proud of himself and he’s feeling very discouraged and cheated.
Obviously, after 2 days there are no plans to return him. He is our dog and his name is Gunner !
When we adopted Happy (a year ago yesterday 
) she was a one year old chihuahua. The shelter did not mention her bad leg and I didn’t know enough about dogs to realize her hitch was big deal and not just a gimp. :mad: My vet examined her and one knee was graded a 3 trending towards 4. We scheduled the surgery.
When he got in there he found that she lacked the groove on her femur for the patella to rest in. He created a groove and did some tightening of “stuff” in the area then sewed her up.
We followed the rehab to the letter but found out that Happy can’t read. :eek: You see, in the 6 weeks in our home prior to the surgery she would not go up or down the stairs in our house or deck, wouldn’t even try. Part of her issues were that she spent her first year in a cage or crate so she just didn’t know what stairs were. Anyway, on week 2 of rehab imagine my “Glee-horror-surprise-joy-fear” when one evening she followed me down the stairs without a problem at all! She has been picture perfect since the surgery.
Doc examined her second knee just this week when we did a recheck on her face. He said for now it is good, she isn’t limping and the best thing to do is keep the weight off of her. That will buy some time.
Superalter- honestly, if I had known that Happy would need a $$$ surgery I would have negoiated the adoption fee or passed on her. Since ignorance is bliss AND we are no longer paying university tuition for our daughters we rolled the dice and did the surgery. In hindsight, ignorance is bliss and it’s been a win-win situation. :winkgrin:
Gunner goes to the vet tonight at 5:30. They are going to review his papers and make sure he is UTD on everything and to also have his legs checked.
If our vet finds ANY discrepancies with what they disclosed to us we will be going back. If anything to try and recoup some $$$ to put towards surgery …if needed.
I can’t bring myself to take him back. Of course buying a puppy goes hand in hand with vet bills, but buying one knowing you are in for more than you bargained for really ruins the experience… Such is life I suppose!
Really the papers, breeders name etc etc…has puppy mill written ALL OVER IT. Of course, doesn’t help im an hour from the “Oprah puppy mill special of Lancaster, PA”.
Im much more educated for next time.
Good luck! It does sound like Gunner’s breeders might be shady. If you can’t recoup your cash, at least you’ll know how NOT to buy a puppy next time . . . and he’s lucky to have landed in your loving arms.
My chi’s mild patella issues seem to have resolved, but I think her issue was acute rather than chronic. We aren’t going to pursue agility or other high-range-of-motion sports, but she’s fine with hikes and playful daily life.
Oh SuperAlter- sounds like your bought a lemon 
No worries though, once fixed, they rarely have problems. Pet Store DID advertise him as grade 3 patella luxation? Dont think you would be able to get anything back from them if they offered up that information. Most rate it from 1-4, but some 1-5 depending on which scale you go by. 3’s are always the same however, and many 3’s do require surgical correction. 2’s usually dont. Keeping fingers crossed for you that it works out!!
JRT’s and Fox Terriers are often mistaken for the same breed.
Kennel Cough is something that is “sometimes” vaccinated for, but I would still consider a dog to have once had kennel cough as healthy. Most dogs in a kennel situation get this at least once in their life. There’s no residual effects.
I cant stand pet stores that “sell” puppies. Why not have an adoption center instead? The last thing the world needs is more mutt puppies when there are millions sitting in shelters waiting for homes. Hard to resist buying a puppy that has been sitting at a petstore for a month though
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