What is a luxating patella?
A luxating patella is when the knee cap moves out of its natural position. The patella lies in a cartilaginous groove and sometimes the knee cap pops out of that groove. It is one of the most common orthopaedic conditions in dogs. Diagnosed based on an unstable kneecap during palpation of an orthopaedic exam it can have genetic, chronic or traumatic causes. A luxating patella is then assigned a grade. A grade 1 is when the knee cap slips easily back into place and is the least severe. Grade 4 is when the kneecap is actually stuck outside the groove and is fixed outside of where the placement should be.
Diagnosed with a luxating patella
Q-Tip was diagnosed with luxating patellas when she was about 18 months old. She is affected on both sides with the left being a bit worse than her right side. She was diagnosed at about a grade 1 and then the year after it was a grade 2. It stayed like that until she was four years old when during an agility course over a couple jumps she started skipping. I actually have a video of the run when her knee popped out the first time. I knew what that was so I stretched and massaged her but suddenly she was skipping more and shaking her leg before use during the day. Another trip to the vet and she was grade 3, borderline 4. We scheduled in a consultation with an orthopedic surgeon and went through our options with that team. Surgery was recommended as was physiotherapy. I chose the physiotherapy first and was going to book the surgery later.
Physiotherapy for dogs with luxating patellas
I started physiotherapy with her and we had a ton of homework. Exercises and stretches every day. I researched fitness routes and fitness conditioning exercises. Our physiotherapist was surprised at how fit Q-Tip already was. She had been doing agility since she was a year old, along with trick training, she was a fit little dog. She recommended underwater therapy as a way of strengthening the legs and a joint supplement. We started underwater treadmill 2 to 3 times a week for a few months with light therapy, and shockwave therapy occasionally to help. Along with daily exercises we saw her muscle tone improve and the skipping stopped. I went to the vet after 3 months and she was a grade 2 again! Yay! So I decided to leave the surgery option and continue with physiotherapy. Her muscle tone continued to improve and we saw she was not skipping or shaking her leg. She also had a large trigger point on her spine where they believe a ligament was pulling. We had more exercises for that and then that trigger point was non existent. We gradually got to where we were doing underwater therapy once every 2 weeks and then every 3 weeks and did not see any regression.
Luxating patellas are different for many dogs
Depending on the cause of the luxating patella and the size of the dog, your journey will be different. 90% of surgery is successful and have wonderful results. Larger breed dogs generally have more severe consequences, where as smaller breeds can sometimes live their whole lives with luxating patellas and not really be affected.
Being that Q-Tip is very active, this affected her greatly so our choice to go the physiotherapy route was right for us. She enjoys hiking and agility and trick training but I am always aware of the work that needs to be done for her to stay healthy and strong. Her exercises are based on strengthening the hind end and making sure her body is in alignment.
We decided no surgery for now as this path is working for her. It may change in the future but for now this journey is right for us!