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How to Fix a Luxating Patella (Bad Knee) in a Dog Without Surgery

Author:

Dr. Mark is a veterinarian. He has been working with dogs for more than 40 years.

Luxating patella treatments without surgery.

Luxating patella treatments without surgery.

What Is a Luxating Patella (Trick Knee)?

A "trick knee" in your dog is caused by an inherited deformity in the bones that allow the kneecap to move from side to side (a luxating patella). Patellas (kneecaps) can luxate (move out of place) towards the dog's body (medially) or away (laterally). The kneecap normally rides in a groove in the femur and works so well that most owners do not even realize that it is there. However, a trick knee does show up occasionally. It's often inherited in small dogs and sometime develops in larger breeds that have hip dysplasia.

Some dog owners will also say that their dog has a “trick knee” after a cruciate ligament tear, but ruptured ligaments are actually a lot more serious and have to be treated quite differently. If not treated properly they may even require surgery.

Your new puppy may have been diagnosed with a trick knee during his first visit to the vet. You may have just noticed your puppy running on one back leg, or running with both back legs together (bunny hopping). This is more common is some breeds, but it can happen in any size dog (and at any age).

If a luxating patella is ignored, the dog will develop arthritis.

If a luxating patella is ignored, the dog will develop arthritis.

Will My Dog Need Surgery?

When this problem is first noticed and diagnosed the vet will probably recommend strict confinement. She might try NSAIDs like Rimadyl or aspirin, and may even want to put your dog on a course of steroids. Sometimes these things will work.

Trick knees might respond to confinement or might get worse if not surgically repaired. There are four grades of luxations, however, and not all require surgery.

Four Grades of Luxations

  1. Grade I: Dogs are not in pain. When the knee moves out of place, it can be massaged back to where it belongs. Since dogs carry most of their weight on their front legs, this dog will probably never need surgery if the problem is taken care of right away.
  2. Grade II: Dogs have a few more problems with the affected knee. It can still be massaged back, but it usually moves out of place again as soon as the dog starts walking around. A dog with this grade is usually not in pain but may develop arthritis and pain in the knee, and will sometimes need surgery.
  3. Grade III: Dogs with this level of luxation are usually already arthritic and in pain by the time they are seen. The knee is out of the groove more than in it.
  4. Grade IV: Dogs no longer have a groove and the kneecap cannot be put back into place. If this has been going on for a long time the dog is arthritic and in pain. A dog like this always needs surgery.

Surgical repair of trick knees differs based on how the dog is built, how many changes have already occurred, and what the surgeon will think is going to work. Sometimes, a dog can get by with having the kneecap ligaments strengthened with non-absorbable suture, some will need a deeper groove cut for the kneecap to move in, and some even need surgical changes to the bone where the kneecap attaches. When the bone has changed a specialist may need to do the surgery and the dog will have less of a chance of recovering.

There are several nutritional, non-surgical alternatives. A non-surgical method is never going to change the anatomy of your dog's leg. You can choose to accept alternative theories or not, but of course by delaying surgery the chances of recovery after surgery are lessened.

What a nutritional alternative can do is improve the dog's health and the quality of the joint so that secondary changes are reduced. This is an important issue with knee conditions and a reason that so many dogs develop arthritis in their knees as they become older.

A luxating patella usually needs to be fixed surgically.

A luxating patella usually needs to be fixed surgically.

How Can a Trick Knee Be Fixed Without Surgery?

If your dog's trick knee is very mild, your vet can show you how to pop the knee back into place during his exam. It is easy to do if your dog is calm and not in pain. All you have to do to put the knee back in place is to straighten out the leg, massage gently and move the knee as you are massaging. I find that it helps a lot to talk to the dog and distract him so that he will be even more calm as you are doing this.

For more permanent results, however, you need to consider all of the following alternatives:

  1. Put your dog on a severe diet so that he is not overweight, and definitely not obese: Besides living a shorter life, obesity will cause extra stress on all of his joints. Overweight dogs with trick knees will have more problems walking, and the arthritic changes to the knee will happen that much faster.
  2. Walk your dog for a short distance several times a day: Exercise is good to treat many behavioral problems, and in this instance will also keep your dog physically healthier. Besides keeping off his excess weight, the muscles that hold his knee in place will be healthier.
  3. Improved diet: A raw or homemade organic diet may improve overall cartilage condition and make all joints, including the knee, healthier. A raw diet can even be made with beef traches and chicken legs, which will add glucosamine and improve the condition of the joint.
  4. Give glucosamine and chondroiton dietary supplements: These supplements improve the quality of the joint. They improve the cartilage and may even improve the fluid available in the knee. Some diets advertise the presence of chondroiton, but adequate amounts are only available in balanced raw diets.
  5. Give added Vitamin C: This still needs a lot more evidence. Dogs produce vitamin C but the amounts are probably not enough to help with strengthening the ligament when your dog is affected by a trick knee. Doses have not been worked out but you should probably give your dog 1000mg a day (500 mg for a smaller dog), and preferably use natural sources like acerola.
  6. Acupuncture: Consult a veterinarian who specializes in treating conditions of the knee.
Dogs with bad knees usually need restricted activity.

Dogs with bad knees usually need restricted activity.

More About Your Dog

If your dog has been diagnosed with a luxating patella it is not the end of the world. You can find alternative treatments, and if nothing works find a good surgeon to repair the knee so that your dog can live normally.

If your dog has a trick knee, however, she should not be bred! Bad knees are sometimes a sign of hip problems, which are inherited. Even if only the knee is affected, this condition is genetic—it will be passed on to her puppies.

There is still a lot of controversy in this subject so I cannot definitely state which method is best and which method will succeed or fail. In 2011, a report came out that stated the method used by most vets was not even successful. If you choose the surgical alternative for your dog please research this subject carefully. Find the best orthopedic surgeon you can afford, and take care of this problem as soon as you can.

When the knee is okay, anything is possible.

When the knee is okay, anything is possible.

Question: Our dog has been in for multiple surgeries and the knee still keeps popping out. What happens if the knee is not fixable?

Answer: If it is not possible for him to fix the kneecap, eventually the dog will develop arthritis in the joint and will either walk with three legs or may even have to drag her end. You might look into a wheeled cart that supports the hind end, similar to that which is used when Dachshunds undergo back surgery and are no longer able to walk.

I have seen some dogs that no one is able to repair. As long as they are small breeds, the owner just has to make adjustments. It is very difficult when the dog is large and not able to be carried around.

Q: My dog is old and has another problem. She cannot have surgery for her knees due to medical issues. Would leg braces be any good?

A: Some people claim they delay the onset of arthritis by keeping the patellas in place. (If that is true then the braces are well worth the cost.) Of course if the patellas are not in place when the brace is put on, they also keep the patellas from moving back into a normal position.

I would suggest carrying your dog up and down the stairs to reduce stess, put her up on the bed if she sleeps with you, etc. She may benefit from massage.

Q: How much does it cost for a patella surgery on a small dog?

A: The cost of the surgery depends on the severity of the knee and how many degenerative changes have taken place, by the location, by the skill of the surgeon, etc. It does not depend on whether the dog is a Yorkie or Maltese.

If you are in NY it will cost several thousand, half of that in Kansas, and about $1500 for a small dog in Chicago.

Q: What kind of brace is used while a luxating patella is healing?

A: There is a temporary brace that you can use. Instructions on how to make it are on YouTube, or you can

The article also discusses a more permanent brace that you can purchase through Amazon. It is not always needed, and if your dog is very small and you can control her movements, then it will probably not be needed at all.

Q: Will walking help my dog get his dislocated knee back in?

A: Keeping your dog in good shape through walking is going to prevent rapid degeneration of the knee. Walking alone, however, is not going to allow the knee to pop back into place. If it is very early in the course of the disease, you can massage the knee gently when the leg is extended and it might go back in by itself.

Q: What kind of care does my dog need after patellar surgery?

A: If your dog has undergone a surgical procedure you should discuss this with your vet. He may have your dog taking anti-inflammatory drugs, antibiotics, or other medications to deal with the pain and swelling.

Most dogs also benefit from rest. When you take the dog out do not let him run, and in the evening lift your dog up onto the bed (if he normally sleeps in the bed.)

Q: Can any vet pop the knee back in place for my tiny dog (she has a luxating patella) or do I have to take her to a surgeon?

A: Your local vet can do this, but unless the knee is very bad, you can do it yourself. You might need someone to help you hold your dog on their lap, belly up, and then take the leg and extend it, holding on to the toes.

When the leg is straight, fully extended, just put your fingers on the kneecap and gently massage. Talk to your dog to get her to relax. Usually, it is easier to move it back into place at home where the dog is not so stressed out.

If this does not work, your vet may need to sedate your dog.

This article is accurate and true to the best of the author’s knowledge. It is not meant to substitute for diagnosis, prognosis, treatment, prescription, or formal and individualized advice from a veterinary medical professional. Animals exhibiting signs and symptoms of distress should be seen by a veterinarian immediately.

Questions & Answers

Question: What kind of care does my dog need after patellar surgery?

Answer: If your dog has undergone a surgical procedure you should discuss this with your vet. He may have your dog taking anti-inflammatory drugs, antibiotics, or other medications to deal with the pain and swelling.

Most dogs also benefit from rest. When you take the dog out do not let him run, and in the evening lift your dog up onto the bed (if he normally sleeps in the bed.)

Also discuss post-surgical wound care with your dogs surgeon.

Question: I have a ten year old papillon with Addisons. She cannot have surgery for her knees due to medical issues. Would leg braces be any good?

Answer: Some people claim they delay the onset of arthritis since they keep the patellas in place. Of course if the patellas are not in place when the brace is put on, they also keep the patellas from moving back into a normal position.

The most important thing you can do for your Papillon is carry her up and down stairs, put her up on the bed if she sleeps with you, etc. She may benefit from massage.

Question: Our dog´s surgeon is board certified and we cannot change since they don’t charge for repeated surgeries.

The first surgery put the kneecap back in the grove and things were tightened. The second time, he made the groove a little deeper and did something more with the sutures. I think the kneecap is all the way out again. Our regular vet believes so. The surgeon will see her in the morning.

What happens when it’s not fixable?

Answer: If it is not possible for him to fix the kneecap, eventually the dog will develop arthritis in the joint and will either walk with three legs or may even have to drag her end. You might look into a wheeled cart that supports the hind end, similar to that which is used when Dachshunds undergo back surgery and are no longer able to walk.

I have seen some dogs that no one is able to repair. As long as they are small breeds, the owner just has to make adjustments. It is very difficult when the dog is large and not able to be carried around.

If you would like to look down at the comments section and there is a Facebook link with a video of a small dog that is so severely affected that surgery is not an option.

Question: How much does it cost for a patella surgery on a Yorkie?

Answer: The cost of the surgery depends on the severity of the knee and how many degenerative changes have taken place, by the location, by the skill of the surgeon, etc. It does not depend on whether the dog is a Yorkie or Maltese.

If you are in NY it will cost several thousand, half of that in Kansas, and about $1500 for a small dog in Chicago.

Question: What kind of brace is used while a luxating patella is healing?

Answer: There is a temporary brace that you can use. Instructions on how to make it are on YouTube, or you can read this article and look at it there. https://hubpages.com/dogs/dog-cruciate-ligament-re...

The article also discusses a more permanent brace that you can purchase through Amazon. It is not always needed, and if your dog is very small and you can control her movements, then it will probably not be needed at all.

Question: My dog has been limping around the house for a day now and there is no evidence of glass or burr in her paw. I noticed today that her front right leg was dangling above the ground. This is the first time this has ever happened to her and she is within the weight limit for her breed (she’s a Shih Tzu around 12 pounds). She doesn’t seem to be in any pain. What’s wrong with her?

Answer: This could be a problem with a nail, a problem with arthritis in one of the joints, or even a sore muscle. There is no way to tell without doing an exam. You can read this if you want to learn more about diagnosing the front limb lameness at home.

https://pethelpful.com/dogs/diagnosing-your-dogs-l...

The treatment will depend on the damage. She might respond to a steroid, an NSAID, or even antibiotics. You will need to take her in to your vet for most treatments.

Question: Can a vet pop the knee back in place for my Toy Pomeranian (she has a luxating patella) or do I have to take her to a surgeon?

Answer: Your local vet can do this, but unless the knee is very bad, you can do it yourself. You might need someone to help you hold your dog on their lap, belly up, and then take the leg and extend it, holding on to the toes.

When the leg is straight, fully extended, just put your fingers on the kneecap and gently massage. Talk to your dog to get her to relax. Usually, it is easier to move it back into place at home where the dog is not so stressed out.

If this does not work, your vet may need to sedate your dog.

Question: My 7-year-old lab mix needs surgery on her knee but I am unable to afford it. Are there alternatives? If I wait will it get worse?

Answer: It is not unusual for a dog that has had a ruptured cruciate repaired to come up lame on the other knee years later.

Most surgeons will recommend the surgery, but there are alternatives.

The most important thing you can do for a lab with this problem is rest and weight loss. (Most lab mixes are overweight.) You can read some other recommendations at https://pethelpful.com/dogs/dog-cruciate-ligament-...

If your dog does have a problem with his patella, it may require surgery.

Question: Will walking help my four-year-old cockapoo get his dislocated knee back in?

Answer: Keeping your dog in good condition and providing adequate walking is important to prevent rapid degeneration of the knee. Walking alone, however, is not going to allow the knee to pop back into place. If it is very early in the course of the disease, you can massage the knee gently when the leg is extended and it might go back in by itself.

© 2012 Dr Mark

Comments

Dr Mark (author) from The Atlantic Rain Forest, Brazil on July 04, 2020:

Susan, no, surgery does not always work. If the knees have progressed to that stage alredy though there is not much alternative. Diet change and physical therapy are not going to change the anatomical problem, and your Chi is probably already developing arthritis and in pain every day.

The only thing I can suggest at this point is that you get a second opinion from another vet. I do not know where you are but you can search on the internet and see if you have a holistic vet in your area that might give your dog another option. (If your dog has grade 4 braces will not help, but anti-inflammatories still might be useful, as well as chondroitin injections.)

Even though she may not show much, your dog is already suffering if the knees have progressed to this stage.

susan31822 on July 03, 2020:

My dog has grade 4 luxating patella in both rear knees. I was quoted a price between 4 and 5 thousand dollars. I frankly can not afford the surgery. Is there an alternative to surgery such as braces? She limps occasionally but has no problem climbing steps, chasing squirrels and taking walks. My dog is a 7 year old Chihuahua mix, is there an age limit for the surgery? I was told that the surgery does not always work. It seems like I'd be putting my dog thru a lot of pain when it might not even help her. What questions should I be asking her surgeon? Could braces, massage, meds and condroitin help her? I do not want my girl to suffer, I really need some good advice!!

Bob Brady on June 06, 2020:

You're a great writer and very knowledgeable! Our pets thank you!

Dr Mark (author) from The Atlantic Rain Forest, Brazil on April 20, 2020:

Lola, does your Yorkie like cheese? It is a good way to hide a pill. There are also little treats available in pet stores to hide pills.

Lola on April 18, 2020:

My little yorkshire which is my service dog her knee went out of place again i cant afford surgery they want do on her they put baby on a amflamitory and another pain med tramadol 25 milgram twice a day and i cant even get down her she gets angry cause bitter taste im not going to force her ever take anything i dont knoe what do

George on January 18, 2020:

My 2.5 pound teacup chihuahua's rear knee seems to be out of joint, her foot seems to be flopping around.

SusanRL on September 23, 2019:

My 17 year old Maltese , mini-foxie cross has developed a sudden grade 3 medial Luxating patella. He has never displayed any symptoms of skipping or limping, although I have noticed the rear hind leg quivering during exercise. Last week he started having difficulty jumping up onto the couch (which is about 40-50 cm off the ground). He has always had no difficulty doing this before now.He tried to jump up and didn't succeed and fell back onto his leg and started limping immediately, and was clearly in a lot of pain (actually nipping at me when i went to touch him). The next day when there was no improvement, I took him to the Vet where she diagnosed the Grade 3 by way of touch (no xrays). She has prescribed the highest dose of Metacam a NSAID I think, and has done bloods on his kidney function which is just below average for his very old age, but has suggested he is too old for surgery and that he will have to stay on pain meds for the rest of his life. I am happy for this to occur if it keeps him comfortable, because he is very old, but its been 6 days and he seems pretty miserable (not his usual lively, happy energetic self). He is very stubborn and wants to get up and walk but mainly limps (hobbles).

My question is:

What sort of quality of life can he expect and is he likely to get a little better with time or is this it?

Dr Mark (author) from The Atlantic Rain Forest, Brazil on August 18, 2019:

Pamela, your Aussie sounds very borderline, and another vet may place it as a Grade II. If this were my dog I would want to get a second opinion before going on with the surgery. Yes, your concerns about the surgery and arthritis are important; some dogs develop arthritis despite a good surgery, so is it really that much help? The anatomic problem is not going away, but alternatives to surgery may be all that your Aussie needs at this point.

Again, I would urge you to get a second opinion from another vet in your area.

Pamela on August 16, 2019:

Dr Mark, Our 1 year old mini aussie was just diagnosed with luxating patella. The doctor recommends surgery although it is a grade 2. She is 30 pounds and loves to play catching the ball and frisbee and this is when the lamenness usually occurs. Would giving her a more quiet life be better than operating? I am really nervous for the procedure, but if we do choose to operate will that mean she could keep playing as much as she does or should she still have a calmer lifestyle without all the running? WOuld not going through with the operation cause her Athritis in the long term and is this something we should worry about considereing many older dogs get it any way?

Dr Mark (author) from The Atlantic Rain Forest, Brazil on July 29, 2019:

Louise, I certainly am not able to tell you if you should put this dog down based on a description. I can tell you however that I would not put his through surgery at his age. A deaf dog can do fine, and sometimes a little massage and manipulation will do a world of good for a luxating patella.

I hope things work out for all of you.

Dr Mark (author) from The Atlantic Rain Forest, Brazil on June 13, 2019:

Jeanene, all surgeons are not alike. If you want to do the best you can for FeeBee, you should take her to a veterinary teaching college in your state and consult with the orthopedics department there. If her bone is twisted, the glucosamine and rimadyl are only helping her to feel more comfortable but are not going to help the problem.

Best of luck.

Jeanene Boyd on June 12, 2019:

my girl FeeBee has luxated patellas in both hind legs. She has had surgery on the worst leg, that also has a twisted (curved) femur, but the surgery didn't work well . The patella is again luxated. and she is now unable to get her hind quarters off the ground most of the time as her better leg is no longer strong enough to lift her. It has been one year since surgery, and she isn't moving around very much.Should I look into repeat surgery. She is 6 years old and is taking rimadol and glucosomine condroitn. It has helped some but she is dragging her behind alot these days.

Dr Mark (author) from The Atlantic Rain Forest, Brazil on April 30, 2019:

Lauren, without examining your dog I cannot tell you for sure. However, you are doing everything right. This is not an emergency. Continue the weight loss program, see how she does. I would wait at least 6 more months before deciding anything.

Lauren M Calhoun on April 29, 2019:

Hello,

Last week, my 1 year and 3 month old Standard Dachshund mix was diagnosed with grade 2 luxating patella. She only has an issue if she's playing fetch. When she runs to get the ball, she yelps (sometimes) and starts limping or toe-touching on her right hind leg. But then after a minute or less, she starts walking on it and seems totally fine. We have reduced her food and treat intake to help reduce her weight (She's 17 pounds but we adopted her a month ago and that was what she weighed). I have also started her on hip and joint supplements. My vet strongly suggests we see a surgeon but I don't know if she should if it's just a grade 2...

Please Help!

Dr Mark (author) from The Atlantic Rain Forest, Brazil on April 17, 2019:

Sheri, the small amount of running that you describe is not bad at all. In fact 12.6 pounds is kind of big for a Chihuahua, are you watching his weight? Keep him thin. He will live longer, be healthier, and the patella may never be a problem.

Sheri Strauch on April 17, 2019:

My 3 1/2 yr old Chihuahua, weighing 12.6 lbs and healthy, was diagnosed with Patellar Luxating by my vet at 2 yrs old. His legs have not dislocated “yet.” He loves to run as fast as he can (about 30-40 feet) smiling all the way. He does this on his two 10-15 minute walks every day and also will race the neighbor dogs on our side of the fence as often as he can. Is running like this a good or bad thing considering his joint condition? I don’t want to make it worse! Thank you

Dr Mark (author) from The Atlantic Rain Forest, Brazil on April 04, 2019:

diana, it is a degenerative condition so does not usually get better, just worse. A knee brace might help but it will not help the dog to get better, just stop the problem from happening as often. As far as what you can do, that is what is outlined in the article. Sorry I do not have much to add to that.

I cannot tell you if it is a grade 3, or how bad it is really without an exam.

diana on April 04, 2019:

hi. my 6 year old Pomeranian jumped off 3-4 steps of stairs one day and he was on 3 leg and limping. I took him to the vet and the vet said he has stage 3 luxating patella (knee dislocation). He seems fine after observing him for a couple of days but suddenly his knee would pop out and very quickly he would walk it off and back to four legs like within seconds or mins. Since this is due to injury, will the popping of the knee get better? What can I do besides surgery? Would a knee brace help? Could this really be a stage 3? What should I do?

please help, Thanks...

BriShae from Jacksonville on January 06, 2019:

I’m hesitant to take our 7yo, happy & healthy chihuahua to the vet for something that I know will cost at least $500 for X-Rays, bloodwork, etc....just to figure out what’s causing her to suddenly walk(& oddly enough, still run!)around on only 3 legs all the time. My GUT’S telling me that it’s either claw/nail related or a strained ligament from jumping off our 3’ high bed for the umpteenth time. I say this after a thorough examination of the offending paw & leg(back right)& finding nothing abnormal except for a thin, hairline fracture across one of her overly long nails, very close to the quick-full disclosure....my shame as a doggy momma has always been my illogical fear of trimming the claws of any dog I’ve owned TOO short/close to the quick,& inadvertently hurting them....after doing exactly that to our first dog; which means I procrastinate & as a result I end up neglecting her claws

Dr Mark (author) from The Atlantic Rain Forest, Brazil on December 18, 2018:

Christie, yes, I do mean all the time on the leash. I know it is not easy, but it is one of the only options.

Christie on December 17, 2018:

Thank you Dr Mark.

Just to clarify, when you say keep her on a leash do you mean everytime we go for walks for the rest of her life?

Im not sure if i can afford the surgery and aftercare so this may be a condition that we will have to tackle any other way we can if the medical interventions dont work.

Dr Mark (author) from The Atlantic Rain Forest, Brazil on December 15, 2018:

Christie, I would not rush into surgery at this point. Yes, she may eventually need it, but it is certainly worth trying the medical interventions that I recommend in this article. See how things are in six months.

As far as exercise, you should definitely keep her on a leash so that she does not run excessively. Probably not what you want to hear.

Christie on December 15, 2018:

My 1 year old Jack Russel has just been diagnosed with luxating patella. The vet said it was geade 1 and will have xrays next week.

She has always hoped but over the last few weeks she has started doing it more and more to the point where shes holding up her leg more than its down. She is ful of energy and does not seem bothered by it. She runs in the park lime a loon and jumps very high. She plaus with other dogs normally.

The vet has said she will need surgery. I am unsure as everything i have read says stage 1 should not require surgery. Is surgery advisable as she is so young and it may help to stop any other problems in future?

What are non surgical treatments that work and fix the problem?

Also because she has so much energy she gets a lot of exercise. Could too much exercise be making the problem worse? I have been told to shorten her walks to 20 minutes and on the lead for the next week. It just seems cruel asshe wants to run and play all the time.

Any advice is welcome as i am just so worried and not sure what to do.

Dr Mark (author) from The Atlantic Rain Forest, Brazil on November 12, 2018:

Lesley, your shihtzu probably does not need a brace and it will not really help her. Look at the recommendations above (preventing weight gain, a good natural diet, exercise but not excessive) and keep her from jumping up and down.

Lesley Ann Gilmour on November 12, 2018:

My 7month old shitzu has movement on her back leg knee cap and is limping would a small leg brace help vet said it’s not that bad and to leave it the now

Candi Collins on October 26, 2018:

This is not a question it is more of a praise for what advice the doctor has given. I have been giving my dog supplements with vitamin C in them and turmeric and the results have been amazing. I give her one supplement a day and she acts like nothing is wrong with her knees! She is an 8 lb Pomeranian Chihuahua mix soon-to-be 3 years old and in very good health. Thank you so much for your recommendation of vitamin C and turmeric to deal with her luxating patellas! She used to be in quite a bit of pain and that appears to be gone.

Dr Mark (author) from The Atlantic Rain Forest, Brazil on October 25, 2018:

Pepita, this is very normal. Do not encourage him to jump up as he is just going to injure the knee even more. Try to teach him to lie down on the floor so that he does not jump down when excited.

Dr Mark (author) from The Atlantic Rain Forest, Brazil on October 25, 2018:

Maureen, I personally would not do a cruciate ligament sugery for a dog as small as Tessie. Most of them will eventually do okay on their own and since she is so small you can carry her up and down any steps in the meantime. The weight control suggestions in this article are important for all knee injuries.

If you would like to learn more here is another article on this injury: https://pethelpful.com/dogs/dog-cruciate-ligament-...

Maureen on October 23, 2018:

Dr Mark , my Havanese Tessie is 12 yrs 5months old . Tessie has a ruptured cruciate legament of the right back leg , I’ve had her seen by her vet & a othropedic surgeon. They have left it up to me to do surgery or not and I’m not sure what to do ! I’ve tried resting it. Walking her for short walks no change She has been on pain meds for about two months also taking Glucosamine DSbut I don’t see any change Because of her age how risky is surgery ?

pepita on October 22, 2018:

My Chihuahua hurt his petala bone abut 3 weeks ago. we took him to the vet and got an x-ray he said he should be OK but he's still limping and he's afraid to jump up. Is this normal?

Dr Mark (author) from The Atlantic Rain Forest, Brazil on August 02, 2018:

Stephen , did your Yorkie also have a urinalysis done as part of her senior panel? If not, you should really consider that first before going to a brace. Also, consider a hormonal based cause. Talk to your vet about this.

As far as a brace, there is one available on Amazon that I have used with cruciate injuries but a lot less with luxating patellas. There is also one that can be ordered from your vet that fits well because it is measured by the dogs xrays. It costs a lot more.

If you want to try the one from Amazon (it is not expensive), there is a link here on my crucuiate ligament article:

https://pethelpful.com/dogs/dog-cruciate-ligament-...

StStephen on July 31, 2018:

Dr Mark and any others with knowledge of this,

My 13 year-old, 2-1/2 lb. female Yorkie has a Luxating Patella (Left Rear). She isn’t in pain. Our vet doesn't feel it's serious and advises against surgery. I am able to walk her a 1/4 to 1/2 block before she stops, due to her condition, but when let out in the yard alone, she gets around enough to do her business, hang out for a while and get back. I don't mind carrying her - especially since her partner, a 3 lb male Yorkie passed a couple of years ago and when I saw her getting low in spirit, I bring her around to everywhere that I can, and since she's, "the cutest dog in the whole-wide-world," - their opinions - she gets more attention then I do (curses foiled again! - I thought I might get a few dates out of it...;-) ).

The problem now is that she is beginning to pee in her bed, while she's lying in it, and it seems to be the result of not being able to/or comfortable getting up and letting me know - although it's been overnight or when I'm napping. She just had a Senior blood panel last week with Everything A-OK!

Well, to make a short story long, I have perused articles and advice and something that I thought could help was not mentioned, so here goes,

Is there a brace of some sort that could help her get around more and more often? I have seen photos of dog leg braces, just not any expert advice that they would help a Luxating Patella.

Thanks.

Dr Mark (author) from The Atlantic Rain Forest, Brazil on June 25, 2018:

Amy, dogs tend to sit a lot, so I am not sure about your comment about your Poodle being in pain.

Have you had the knee examined? Are you able to put it into place when it goes out, or does it stay fixed all of the time?

Is it going to get worse with time? Yes, it is. Does that mean you need to have surgery soon? Not at all. Try some of the things suggested in this article in the meantime and decide how he is responding. If things are not getting better, surgery will be his only option.

Amy on June 24, 2018:

My toy poodle has a bad knee. He holds it up a lot when he runs/walks and he tries not to put weight on it. He also tends to sit a lot, so it is causing him a little bit of pain.

He is over half a year old.

I don't know if it will get better or worse in age because he is so young.

Should I get him into surgery sooner or later?

Kim on May 17, 2018:

Thank you Dr. Mark. I sought PT but the canine PT said she wouldn't take my money because PT won't help as the luxating patella is hindering her knee from stabilizing by forming scar tissue on its own. Basically, she said that it will never heal on its own due to her patella movement. That is when I felt like I had to give up the good fight and try surgery. I will look at the link you sent. Thanks again, any further insight you may have would be appreciated.

Dr Mark (author) from The Atlantic Rain Forest, Brazil on May 17, 2018:

Kim, you have obviously done a lot of reading already but you should get several opinions before proceeding. Surgery for CCL rupture is never a good idea, or even necessary, in a small dog like your Shorkie. Yes, the patella might need surgery, but you should not put your dog through both procedures.

There are several good sources out there on CCL ruptures and non-surgical treatment. Take the time to read https://pethelpful.com/dogs/dog-cruciate-ligament-... and check the results from surgery by looking at the refereces at the bottom of the article.

I with you two the best of luck. Sorry she has to go through so much.

Kim on May 17, 2018:

Should I have sx on my shorkie? 7 y/o, 19 lb. Acute left ccl rupture chronic grade 3 patella luxation. 12 weeks past injury-limited improvement. Gets around ok but still limps and tripods. Sx is correction via etracapsular nylon and patella correction w aid of femoral trochleoplasty. Medial menisectomy (partial) if indicated at time of stifle exploratory. Very afraid to do more harm, very likely her other leg will rupture after.

Dr Mark (author) from The Atlantic Rain Forest, Brazil on May 12, 2018:

Hi Missy, if my dog had PLE and was on all of those meds I too would be very hesitant to go through with surgery. Is surgery the only fix? According to a surgeon, it is always the only fix. We know how wrong that is so often, but often not until it is too late.

I cannot guarantee that your dog will not develop arthritis in the joint with the luxating patella. I can tell you that even if he does that is a preferable choice to dying subsequent to the drugs he will receive during surgery.

My suggestion is that your try some of the non-surgical therapies described in the article above. (glucosamine, vitamin C) It may not be enough, so after a reasonable time (6 months) I would try to get him in to see a veterinary acupuncturist that deals with luxating patellas that are not able to be surgically improved. I do not know that anyone will be available in your area--you will just have to search.

Best of luck to your little Pug.

Missy MM on May 10, 2018:

Hi. I commented a few days ago but for some reason my comment never posted. My 7 year old pug has been diagnosed with a grade 3 luxating patella. The orthopedist said the only fix is surgery. I’m hesitant to do that as last year my dog was diagnosed with protein losing enteropathy from inflammatory bowel disease and has had bouts of pancreatitis as well as they detected a possible congenital liver abnormality. He’s acquired multiple liver shunts. He’s on a lot of meds to keep him stable and has been doing well on that front. He’s on chlorambucil, metronidazole, metoclopramide, clopidogrel, and dexamethasone. I was informed that surgery can be done but there’s concern of flare up of other diseases and delayed healing. I’m very afraid to have surgery for these reasons and don’t know what to do. I do notice the clicking of the knee when he walks but he’s walking a lot better than last week when it first started. I do think he may have gotten hurt stepping off the curb and I know his meds can cause muscle wasting and weakness. What should I do? I’m so scared and don’t want to do the wrong thing. He doesn’t seem to be in pain at all.

Dr Mark (author) from The Atlantic Rain Forest, Brazil on May 08, 2018:

Angie, please read the section above on "will my dog need surgery?".

Angie on May 07, 2018:

I have a 2 1/2 year old Chihuahua and I was told she has trick knee. She sometimes holds it up and other times can run and jump no problem. When she holds it up it's usually o lt for a few minutes then she is ok again. I'm nit sure about surgery at what point should surgery really be considered

susan menser on May 02, 2018:

Patty, I am now the owner of two Bostons, girls. The oldest jumped up on my bed fell and dislocated a knee. I took her to the vet, you could see him popping it back in place. Told me to give her half on a baby aspirin once a day. Surgery would be $500.00, but I could do it 6 months from now. She wasn't in pain.

Another girl told me that her's did the same thing, and it healed itself in about a month. Smaller dog but I am hoping Rudy will heal before the 6 months which will give me time to get the money.

Hey mine are 1 year and the other is 5 months. Love them but have never this bred. Totally different!!! Good luck hopes this helps.

Dr Mark (author) from The Atlantic Rain Forest, Brazil on May 01, 2018:

Patty, what pills is she on? Does the knee come out of place every time she walks?

I realize this is an expensive surgery so if you are strapped at the moment since your husband has lost his job then you should definitely wait. Continue to use non-surgical methods to keep Minnie comfortable, and then get the surgery when you can afford it.

Patty on May 01, 2018:

We are looking for a surgeon now. Minnie is 2 year old Boston, we have tried the pills but she continues to carry her leg up all the time now. Seems that she is in pain part of the time, she has a rambunctious sister who she wants to play with. Not sure what to so, my husband just lost his job. I am aware this is quite expensive surgery and not sure what to do?

Dr Mark (author) from The Atlantic Rain Forest, Brazil on April 02, 2018:

John, of course the surgeons that perform it and the company that sells the implant (ridgestop) will tell you it is great. The question is whether or not you want to put your Aussie through a surgery. Will it prevent an ACL problem in the future? No one can guarantee that.

No, they do not clear up on their own but non-surgical techniques can allow you to avoid sugery. Was it just from trauma? No, not likely. She had underlying anatomic issues.

It is diffcult for me to tell you what to do without an exam. Before rushing into any procedure however you should get a second or third opinion. This is not an emergency and you have plenty of time to think about this.

John C on April 02, 2018:

My 15 mth mini aussie was playing with another dog, she yelped when her leg got stretched and twisted and over the next couple days would lift her leg up on occasion which she never did before. The two vets I took her to said she had about a grade 2 Luxating patella. One recommended the 4-part surgery(very invasive!) to prevent a possible future ACL issue and one said to give it several weeks since it was also swollen a bit. I've kept her on leash and now short runs and she hardly ever has the problem. Have you ever heard of a LP clearing up on it's own? Could she have stretched the ligament or torn some facia that held it in place? Her other patella is fine. Finally, I read about the new less entailed Ridgestop technique to correct the problem and there are vets here in CO that offer it. Have you heard of Ridgestop? Thanks and thanks for all the postings!! I never even heard of this type of condition till three weeks ago. Now I know way too much!!

Dr Mark (author) from The Atlantic Rain Forest, Brazil on March 30, 2018:

Dick, based on the fact that he gets around and is not in pain, if you were in a similar situation would you put yourself through the surgery if you were 75 years old?

Dick on March 29, 2018:

My 13 year old peke has a luxating patella. He has no pain. He can run and jump on the furniture, but his leg wobbles all over. I have noidea whether to go the surgery route, or not.

Dr Mark (author) from The Atlantic Rain Forest, Brazil on March 26, 2018:

Renee, without an exam I cannot tell you if your Pom needs surgery or not. You can try the non-surgical options listed here and if he gets bad again proceed with the vets suggestions. If he never goes lame again, however, and has no clinical symptoms, why put him through the surgery?

Renee on March 26, 2018:

My 1 yr old POM was on 3 legs last Sunday. We took him to the vet where she manipulated his knee back in. Then set up surgery for a luxating patella. Since then he’s been fine. Walking, running, jumping. He’s never cried out in pain. I’m not sure he really needs the surgery. I’ve been watching him closely and he’s on all 4 legs. I’m confused as to what to do. Any thoughts?

Candi Collins from Alpena, Michigan, USA on March 25, 2018:

Thank you Dr Mark for your encouragement and sound advice!

Dr Mark (author) from The Atlantic Rain Forest, Brazil on March 24, 2018:

Mel, from your description it sounds like your dog is not a surgical candidate. Read the recommendations above (weight control, glucosamine, etc) and your Poodle may never need surgery. If he seems to be in a lot of pain you should consult a local vet.

Mel on March 24, 2018:

My dog is a Toypoodle, he is 1,5 years old. Yesterday I just heard a "click" sound from his leg, it was happening just for a while when he walk and it's gone. He's not in pain at all. But today morning, he's totally fine.... and there is no " click " sound from his leg. But tonight, I heard it again the "click" sound. And the way he is walk is a little bit weird, but it just a very short time. He's no pain at all. His weight 2.9 kg. Please let me know is he really need to take the surgery?

Dr Mark (author) from The Atlantic Rain Forest, Brazil on March 23, 2018:

Rachel, your puppy is not even lame, so certainly you should try some of the non-surgical options before even considering going to surgery. If the vet told you that your dog HAD to have surgery, you should consider getting a second opinion from a holistic vet.

Rachel on March 22, 2018:

We just bought a 6 month old English Bulldog and when we took him for his new puppy exam they said he has bilateral luxating patellas. He is 36 pounds. Would these be good alternative for him. We can’t afford the sugery. We know EB are expensive to raise but were not anticipating a 5000 surgery a week after buying him.

Dr Mark (author) from The Atlantic Rain Forest, Brazil on March 18, 2018:

Candi, I have seen many dogs of her type and weight that did fine and never needed surgery. Follow the recommendations in the article, especially about keeping off the excess weight. Do not proceed with surgery at this time, but if she gets worse have her knees examined by a veterinary surgeon and get a second opinion.

Candi Collins from Alpena, Michigan, USA on March 18, 2018:

My dog is approximately one year old and in excellent health. Except that when I adopted her from the humane socialist they did a wellness veterinary visit and diagnosed her with "floating kneecaps". She is not overweight and her breed is a Pomchi and she weighs 8 pounds. They said she would need surgery to repair both knees but my regular Vet said if she experiences no pain not to worry about it. Last week she was in pain for about 8 hours and I restricted her movement and the next day she was fine and has been fine and playful ever since. I am on a limited income and heard that surgery could cost up to $2000.00. I love my dog and if she needs surgery I will do whatever it takes to get it for her. What is your opinion on the matter?

Dr Mark (author) from The Atlantic Rain Forest, Brazil on March 05, 2018:

Marcia, if your dog really has a grade IV luxated patella he will have some symptoms. Their will be no patellar groove and the patella will always be out of place.

Who told you it was Grade IV? Can you seek a second opinion. If the dog has no symptoms, he is a candidate for the non surgical techniques described in the artile. If he is really already a grade IV he is a surgical candidate.

marcia lloyd on March 05, 2018:

stage four luxated patellar, no symptoms at all, treatment?

Dr Mark (author) from The Atlantic Rain Forest, Brazil on February 27, 2018:

Kim, your Morkie could not have gone from grade I to grade IV just from running on ice. If he is grade IV, and does have arthritic changes and no longer has a groove so that the kneecap can go back into place, he will need surgery. I do not think it is grade IV. If you have any doubts about his diagnosis from your first vet get a second opinion from a different local vet.

Dr Mark (author) from The Atlantic Rain Forest, Brazil on February 27, 2018:

Bev, that sounds like his opinion. Your dogs still have a grade I luxation, based on the lack of symptoms, so unless he felt any arthritic changes, which I do not know, your dogs may respond to weight control and the other things listed in this article. If things get worse though they may need surgery eventually.

Bevvrobinson on February 27, 2018:

My dogs just saw a new vet he said both have dislocated knee caps neither of my dogs showing any signs no limping or lifting legs they run around with no bother. The vet said my puppy will need op costing 1800 when she turns 18 months is this right no x-rays no signs of any pain and previous vets not mentioned this and my other Chihuahua is 2 years old .

Kim on February 26, 2018:

My Morkie is 4, he had a stage 1 luxating patella when he was little and after running hard on ice he now has a stage 4. Is there any non-surgical recover for a level 4?

Dr Mark (author) from The Atlantic Rain Forest, Brazil on February 13, 2018:

Shannon, knee braces have a lot of problems in dogs. They do not usually leave them on, so even if they help (they do not always keep the knee in place) the dog is unlikely to leave it. You can give it a try if you want be be prepared for failure. (It sounds like you already are since the vet told you 60%.)

If your Staffy has not developed arthritis, you can try the non-surgical methods described in this article. The problem with a dog that big is that she is going to be hard to handle if she does becomes lame in the future.

If she were my dog I would get a second opinion before proceeding with the surgery.

Shannon on February 12, 2018:

Would some sort of knee brace or wrap assist with keeping the knee in place. I have a 62lbs staffy that I rescued. Both of her knees have this problem. Vet suggested surgery @ $4000 a knee with a 60% chance of success. It seems to be an on and off issue with her. She just turned 4 we discovered the problem about a year ago.

Andins Mom on February 03, 2018:

Thank you so much for your quick and informative response

Dr Mark (author) from The Atlantic Rain Forest, Brazil on February 02, 2018:

Hi Andins Mom, yes the luxating patella does slide out laterally. The stairs are a good idea, and with a Yorkie/Bichon I guess that is not a big problem. I cannot tell you if he damaged that leg in the fall but it is more likely a congenital problem, and something that may get worse over time (with arthritis) or may stay about the same.

With a small dog like that it is okay to try non-surgical options, but monitor for arthritic changes.

Andins Mom on February 01, 2018:

I have a Yorkie/Bichon that will be 9 this May. Last September he tumbled down about 4 stairs and blew out a disc. He required emergency surgery which I had to borrow money to pay for it. When he was 18 months old he had I think it is called FHP surgery (I've only had him for 3.5 years) on the right leg. The doctor at that time said he might require patella surgery down the road but I don't remember which leg he was referring to. After the disc surgery his surgeon stated as he healed that his left patella was luxating and suggest rehab. At $100 a pop I couldn't afford it for long. He doesn't act like he is in pain but my question is twofold. He doesn't have full strength in the left leg when peeing and when he shakes himself the leg will slid out, more like a hip thing. Do you think he damaged the left leg when he fell down the stairs as well as the back? And would a luxating patella have that structural response of sliding laterally? I carry him up and down the stairs just as an added precaution. Thank you in advance

Jeannett on January 25, 2018:

Thanks Dr Mark I appreciate your advice

Dr Mark (author) from The Atlantic Rain Forest, Brazil on January 24, 2018:

Hi Jeannett, you are correct in that your dog really needs an x-ray before going ahead with anything. Maybe the luxation is very bad and the vet was recommending surgey based on that. If your dog is not lame though I would want to keep her thin, try glucosamine, etc (as outlined in the article). I cannot promise you that your dog is not going to need surgery down the road, but in the meantime I would try some non-surgical methods.

Your vet is correct about the steroids. They just mask the pain, and since the dog does not feel it she is more likely to bear weight on the joint and cause it to deterioate all the faster. The same thing happens with human athletes when taking steroids.

Jeannett on January 24, 2018:

My dog is 9 years of age my vet said it’s my choice to wait or do the surgery what bothers me no x rays was done can she tell me that my dog needs surgery without x Ray. My dog don’t seem to be in pain slips when she first starts to walk once she is outside she runs now I walk her on the lease is it ok to give her a child’s asprin. I gave her a steroid she was great but the vet said never to give her that

Dr Mark (author) from The Atlantic Rain Forest, Brazil on January 24, 2018:

Hi Jeric it sounds like you already know what is the best for her so not a lot else I can recommend. She may not jump up just because of her personality; some dogs are like that. It has nothing to do with weight or a bad patella.

You already know to keep her as thin as possible. I would definitely give her the natural glucosamine.

Jeric on January 23, 2018:

I have a 3 yo Shihpoo and she has luxating patella and she's about grade 1 or 2. It sometimes pop out and not often but rarely limps without pain of course. It can be popped back in with a little massage so she wot't limp but it pops back out the moment she moves. At that time the limping stops. She's been using the stairs since puppyhood but idk if that helps her knee overtime. A bit over weight due to my parents feeding her human food. (She Prefers human food over dog food and spoiled rotten from my parents) I'm trying to put her on strict diet but sometimes my parents secretly feed her scraps. Shes unable to jump but is it due to the defect or her weight or both? Should I put her on supplements? She's very quick when climbing those 20 step stairs and overcomes it seconds. Any recommendations?

Dr Mark (author) from The Atlantic Rain Forest, Brazil on January 23, 2018:

Jeannett, how old is your dog? How bad is the knee? DId the vet tell you how soon the surgery needs to be done? I cannot recommend anything without more info.

Jeannett on January 23, 2018:

My dogs right back knee pops in and out my vet got her on supplements and metacam but she wants to do surgery but I just can’t afford it my dog is a shi chu what do you recommend

Dr Mark (author) from The Atlantic Rain Forest, Brazil on January 23, 2018:

HI Denise, did your vet give you any indication of how easily the kneecap slipped from its normal place? I think you need to decide if it is worth it based on how bad it is, and also that all dogs will eventually develop arthritic changes in the joint without surgery. Of course he may also develop arthritic changes in the joint with surgery.

Your JRT is 11, and is able to walk okay. Are you interested in giving the non-surgical option a try? It would involve keeping your dog thin even as he got earlier, dietary changes (as outlined in the article), and maybe carrying him around and giving supplements if he did eventually develop arthritis.

I cannot make this decision for you, but if he were my dog I would not rush into the surgery. Whatever you decide, put your JRT on a natural glucoasamine supplement ASAP.

Dr Mark

Denise on January 23, 2018:

Hi

Our 11 year old jack Russell ruptured his cruciate ligaments and had a TTA performed. He is now approximately 8 weeks post op and is recovering slowly. He walks well now on all 4 legs but still lifts the affected leg when he runs. We visited the vetinary surgeon this morning and he says the kneecap is still dislocating and needs another operation. He says he needs to add a groove through the plate (that was put in originally) to stop the kneecap slipping and this is going to cost us another £2500. I'm not sure what to do now. I felt he was doing well after a few weeks but don't know what is the normal rate of progression is for these type of operations. I don't want to put my dog through another big operation (not including another £2500) if it's not needed. Your opinion would be grately appreciated.

Dr Mark (author) from The Atlantic Rain Forest, Brazil on January 08, 2018:

Stephen, if it is a luxating patella read the part about helping your dog without surgery.

stephen w fish on January 07, 2018:

My little Morkie jumped off the counter a week ago and hurt his Leg he limped around so I took him to the local vet she said the part of his knee that's like a knee cap is moving back and forth and it's not suppose to she gave me some pills to give him after taking x-rays and said give 2 weeks if he's no better he will need knee surgery. so today I looked around on the internet just to get a Idea about how much I was looking at. Let just say I was ready to fall out could cost up to 3000 dollars or more.I am on SSI there's no way I have that kind of money I don't know what to do any suggestions

Dr Mark (author) from The Atlantic Rain Forest, Brazil on January 07, 2018:

Diane, please follow the suggestions above before putting Sukie through surgery, you may not even have to. I have not examined her, but it is always better to try alternatives first. And you are correct, recovery does usually take a lot longer than you were told.

Diane on January 07, 2018:

By the way from just sent email, Sukie my Maltese/bichon, she doesn't seem in pain & runs like a whippet most days !

Dr Mark (author) from The Atlantic Rain Forest, Brazil on December 15, 2017:

Paul it will get worse over time, but since you have a Cairn terrier, and not a Great Dane or Mastiff, you have the option of picking him up to take out. At this point I still feel that the outlie above is his better option

Paul on December 15, 2017:

Hello Dr. Mark, Thanks for the quick response. I have not taken him yet to see the vet orthopaedic surgeon but my friend is a human orthopaedic surgeon and he said that these surgeries are only done as a very last resort. So he’s hes only limped 2 times in 3 yrs and each episode lasted 24hrs or less. But I’m worried that because he is young and the problem gets worse over time to the point if and when we decide to take him in for surgery it would be to late because of age complications. He’s a very healthy and active dog right now and is not fixed yet.

Dr Mark (author) from The Atlantic Rain Forest, Brazil on December 15, 2017:

Paul, if your cairn has only shown lameness 2 times in 3 years I cannot recommend surgery. I cannot see any arthritic changes in the xray. At this time, if he were my dog I would follow the steps outlined in the article, but keep in mind since he is very young if there are more problems surgery may be your only option. Have you had him examined by the orthopedic sugeon? What is his opinion?

Not sure I can be much help since I have not examined him, but let me know if I can answer any more questions for you.

Paul on December 14, 2017:

Hi Dr. Mark, I have a 4.5 yrs old cairn terrier with pattela luxation. It’s only showed signs of it 2 times in the last 3 yrs but you can definitely feel and hear it when you massage his back leg. During the last episode I took Marty to the vet and he took x rays which revealed that he was at level 2.5-3 — so the vet referred him to an vet orthopaedic surgeon who specializes in this corrective surgery. I’m wondering if I can do without the surgery and just focus on a good diet and exercise.

I have attached the link to his x Ray. https://instagram.com/p/BctYuLogiqO/

Dr Mark (author) from The Atlantic Rain Forest, Brazil on November 29, 2017:

Mahir, sorry to hear that. If he were my dog I would just put him on aspirin (not one of the new NSAIDs, which may have side effects), and give a chicken foot at each dosing so that he would have a natural source of glucosamine. (It is not going to make things better, but may help him be in less pain.)

No idea about life span. I guess it really depends on how he is doing with the pain medication.

Mahir Zolota on November 29, 2017:

Hello Dr. Mark

Thank You very much for Your fast reply, there isn't any surgeon in my or near countries who "will take" this surgery, We have searched for one, but lots of them refused to do it. We already neutered him because we know he cant mate, on your opinion what are the best "safe for daily usage" painkillers for him or something like that ad what can we expect for future, is there any chance he can live long life ?. Again thank You very much for answer.

Dr Mark (author) from The Atlantic Rain Forest, Brazil on November 28, 2017:

Mahir, I really do not think you can help him until he has surgery, and even if you find a good orthopedic surgeon where you live his patellas are so out of line that it may be impossible to cut a groove deep enough for them to start working. His poor little legs are so badly deformed that it is a wonder that he still gets around, and he is probably already developing pain in the joints so the behavioral changes you have noticed are most likely due to the problem with the knees.

Why did your regular vet not want to put him under anesthesia? That is his only chance. If you are in a country where you can get a second opinion from a board certified orthopedic surgeon you need to do so. Nutritional therapies like I describe above are not going to help him.

Get him neutered when under anesthesia for the patellar surgery. He is unlikely to ever mate, but being neutered might help with aggression issues.

Good luck. I am sorry that I could not be of more help.

Mahir Zolota on November 28, 2017:

Hello Dr Mark,

Can You please answer me a few questions. My wife and I have adopted one straight dog like one and half year ago. We recently found out he is Mini poodle and he probably had an owner before he got dumped on the street. Out vet said he was around one year old when we got him, so simple math says he around 2 and half years old. He have what we bealive is "Luxating Patella" affected his both last rear legs ( we have found him "Luxating Patell"). Our vet said that he cannot be put under the surgery because it isn't possible and he would have to live with this. At first that wasn't a huge problem for his life, he was managed to do almost all as a healthy dog. He was a very happy dog. But now he is very unfriendly, not so happy and he plays very little. I will send you his x-ray image and other images of him. And finally my questions is can he be cured and with or without surgery.

His x-ray image : https://imgur.com/a/iPw1K

Few other images : https://m.facebook.com/story.php?story_fbid=108306...

(Those images are 1 and half year old ).

Dr Mark (author) from The Atlantic Rain Forest, Brazil on November 19, 2017:

Flo, since your dog is a senior he might leave the brace alone, but with most dogs they chew off the bandages and braces at night so that is not even an option. Ask our regular vet if he can make a brace out of soft metal, and give it a try. I hope it helps, you definitely do not want to put him through surgery at that age.

Flo on November 19, 2017:

What about a knee brace? My dogs knee acts up at night . He likes to sleep during the day and then walks about in the kitchen at night. Then at 2am the howls of pain begin. I manipulate his knee and calm him down. He's 14 . Will a knee brace at night help?

Dr Mark (author) from The Atlantic Rain Forest, Brazil on November 14, 2017:

Jolie, it is definitely not an emergency situation. When you take her in the vet will manipulate the knee and show you what is going on. I hope it is not too serious for you both.

Jolie on November 13, 2017:

Rescued a 14 pound dog off the street and the very nextday I wake up she is having puppies. One of the five pups is bending his knee to stand on it but dragging it behind him. I can gently move it back in to place and he stands on it but as soon as hetakes a step it pops out. He is seeing the vet tomorrow....but does anyone have any idea what i can do or can confirm that it is likely a case of luxating a petella? I am greatfull for any infor insights.

Dr Mark (author) from The Atlantic Rain Forest, Brazil on November 09, 2017:

Liza, she will be in some pain but since she is small you will be able to carry her around. Not much of a quality of life however. The vet was probably vague because the progression is so different in so many dogs, and it is no different for Chihuahuas than any other breed. I wish I had a better option for you.

Liza on November 09, 2017:

I recently rescued a young female Chihuahua and didn't realize what her strange gait was caused by until the vet diagnosed her with stage 4 luxated patella. It seems that surgery is the only option to actually correct this condition, but it's very daunting! It doesn't seem to slow her down at all at this point, and I'm curious to hear what is the typical timeline. The vet was super vague, simply stating I need to speak with a specialist. Do I need to get the surgery right away? What does lameness look like for Chihuahuas? If I can't come up with the money, would she still have an OK life quality? I'm trying to decide if I need to rehome her with someone who can better afford costly vet bills than myself, a single mom. It's a tough choice! I live in SE USA, if that matters.

Cher on November 08, 2017:

My little bisheon is in alot of pain she hurt her knee now she kust sits we hve to carry her everywbere

sonja caroto on October 13, 2017:

Good morning

I have a 7 year old Min. Doberman with a floating knee (patella)

the doctor said they will operate within a few weeks but is there anything else I can do to prevent this.

She is constantly walking with the right leg lifted up and can't jump on her coach , we have to pick her up.

michy_40@hotmail.com on October 01, 2017:

Hi good day I have a pug who is one year and 11 months old she suffers from luxating patella she had a surgery and a thread that could hold about 50 1bs was used to hold a foreign object and the knee in place according to the vet well the knee is back out again after about 10 to 12 days

My concern is should a thread be used or is there some sort of pins that cannot pop that could be used this is a very very active dog who jumps on the chair to sleep or jumps up and down the bed would she ever be able to be like this anymore this anymore .I took her back to the vet and he said that he would have to go back in the knee to fix the problem I would not like it to pop with the same material used before can you tell me what to do she is due to have surgery next Tuesday .Thank you

Natalie Morris on August 30, 2017:

Hi. Xray yesterday showed luxating patella in my daschund. This was a result of a blow to the leg. Some research says to keep her confined and some say exercise. She has pain in the leg and muscles are already getting smaller through not being used. What do I do to avoid operating or is it necessary.

Lesley Robson DVM CCRT on August 29, 2017:

Medial Luxating Patellas grades 1/4 , 2 /4 and young animals with 3/4 may be corrected by seeing a trained rehabilitation veterinarian. Stretching the Sartorius muscle and strengthening, gluteal muscle group, cranial tibial muscles and hamstrings group also help support and stabilize the knee and hip...

Skipping may be caused by other orthopedic problems not just medial patellar luxation.

Dogs with severe MPL ( medial patella luxation ) must be also evaluated for patella alta (high) and baja(low)- if severe MPL 3/4 or 4/4 and not corrected surgically when young there is tibial rotation. These dogs are at greater risk for cranial cruciate ligament injury. Not evaluating for high or low patella position and subsequent patella ligament length has been associated with surgical failures. if severe and the dog is young surgical