May 24, Patellar Luxation: Understanding this problem, Causes, Solutions

May 25, 2023

16

by Janice Jones |Last Updated 05-24-2023

Patellar
luxation, luxating patella, dislocated kneecap, trick knee, and floating kneecaps are terms that refer to a condition where the kneecap can move in and out of
position.

Patellar luxation, luxating patella, dislocated kneecap, trick knee, and floating kneecaps are terms that refer to the same condition.

Patellar luxation occurs mostly in toy and small breeds of dogs weighing
22 pounds or less, but can occur in dogs of all sizes.

In the majority of cases, luxation is a congenital condition
and shows up as soon as puppies begin to walk.
In other dogs, it may appear some time later.

It is most likely inherited though the exact mode of transmission is not
known.

Breeds Affected with Patellar Luxation

Most breeds
that are affected are tiny, small or medium sized dogs. According to the Orthopedic Foundations of
America, the breed most acutely affected is the Pomeranian with a whopping 37.2 percent affected followed by the
Yorkshire Terrier at a rate of 24.4 percent affected.

Patellar Luxation is very common in Yorkshire Terriers

Other small breed dogs that may be affected include:

Less common, but still an issue, patellar luxation is diagnosed in these
small breed dogs:

Symptoms

A little dog
could be having fun running around and playing.
Suddenly he stops and holds up his leg as if he can no longer walk.

The next instance, his leg is back to the ground,
and he’s back to running and playing.
There is usually pain associated with the knee popping out and then again
when it pops back in. In young dogs, it’s hard to notice this pain because it is
fleeting.

You might
just see a
short limp, even a skip as the dog runs or trots, or a sudden loss of
support. Some dogs sit oddly where their
knee is placed outward rather than tucked in.
Any of these symptoms will be intermittent with the dog returning to
normal within a very short period of time.

Over time,
the knee cartilage wears thin because of
the frequent movement in and out of the grove.
At this point, there will be a bone to bone contact,
and this is when the dog begins to feel severe pain.

Some dogs
may rupture their cranial cruciate ligament. Dogs Naturally Magazine reports
that at least 15% to 20% of dogs with patellar luxation will at some point
suffer from a cruciate ligament rupture.

Levels of Severity

Veterinarians
grade the degree of severity by assigning
it to one of four levels:

Grade
1: The Kneecap pops out and then pops
right back in. (The veterinarian can
manually do this manipulating during a routine office visit) Often
newborn puppies will show signs of abnormal hind leg carriage as early as when
they start walking.

Grade
2: The kneecap pops out but doesn’t pop
back spontaneously and may need help to manually manipulate it back into place.

Grade
3: The kneecap rests outside the grove most of the time, but it can be manually set
back where it will only stay for a small time period.

Grade
4: The kneecap remains outside the grove
and won’t stay in place even when
manually put back in place. Often newborn puppies who eventually get
diagnosed with Grade 3 or 4 will show signs of abnormal hind leg carriage as
early as when they start walking.

Diagnosis

Veterinarians
will likely be able to palpate the knee joint and manually manipulate it in and
out of place.

Sometimes sedation is
necessary to do this. X-rays or a CAT
scan will be helpful and likely ordered if surgery is to occur.

They are also done to rule out or identify other orthopedic problems that may also be affecting the dog.

Treatment Options

Surgery would be the last
treatment of choice, especially if the
dog diagnosed with a grade 3 or 4 luxated patella.

During surgery, the veterinarian will carve
out a deeper groove at the end of the femur so that the kneecap can remain in
place. If there is a ruptured ligament,
it can be repaired at the same time.

But before
surgery is scheduled there are other things that you can do to improve the dog’s
overall quality of life.

Most dogs with
a mild problem will live their entire life without needing surgery. A few life changes can keep the dog quite
comfortable.

According to
Dr. Karen Becker, there are several steps that you can do. She recommends that dogs with this problem
maintain a healthy body weight. Less
stress will limit any stress on those joints.

She also suggests that the dog should keep moving, which is in direct
contrast to older thinking that recommended dogs remain as still as possible.

Lastly, she encourages you to provide an oral joint supplement such as chondroitin/glucosamine.

Dr. Julie
Mayer, a holistic vet, and owner of
Integrative Pet Care and operator of Therapist
in Chicago, recommends certain exercises
that can help with the condition.

Among
the treatments that she encourages includes swimming and underwater treadmills,
going up and down carpeted steps several times a day and leg weights.

Pain
relievers and anti-inflammatory drugs may also be prescribed and may make the
dog more comfortable.

Changing the
diet or adding additional nutrients can also be effective. The goal of supplements is to control inflammation
and inflammation and prevent osteoarthritis.

At the same time, the diet should supply antioxidants, provide building
blocks for the synthesis of collagen and promote healthy connective tissue.

Breeding

Since this
is an inherited condition, dogs that are
affected should not be bred.

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