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Dr. Kara
Dr. Kara, Board Certified Veterinarian
Category: Vet
Satisfied Customers: 15918
Experience:  Over 20 years of experience as a veterinarian.
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We have a 5 month old English Bulldog and it appears s right

Resolved Question:

Good afternoon, we have a 5 month old English Bulldog and it appears his right leg has Luxating Patella. Should he have an operation or is there anything we can do to strengthen it without surgery? He walks brilliantly, its just occasionally when he gets up from a seating position his right leg gives way momentarily. Like I said its not constant just occasionally.
Submitted: 11 months ago.
Category: Vet
Expert:  Dr. Kara replied 11 months ago.

Hello, my name is***** and I have over 20 years of experience as a veterinarian. I am sorry to hear that Winston has been diagnosed with a luxating patella. These are not uncommon in English Bulldogs because of their over leg conformation.

With a patellar luxation the kneecap slides out place rather then staying in the patellar groove. When that occurs the leg cannot bend or flex as it should and the dog becomes lame.

This condition is usually congenital, meaning the puppy is born with the genetics to develop the condition as they grow. It doesn't mean that the pup is affected as soon as they are born however, and in most cases it is a condition that we see develop as the bones, ligaments and tendons that form the knee joint grow and develop or in an older pup that gets arthritic. Not all pups in a litter are necessarily affected.

In some puppies the patella luxates but as the musculature grows and develops and the ligaments and tendons develop the knee gets "tighter" and the luxation stops. But if this hasn't happened by 5 months of age it is unlikely to do so in Winston's case.

Your veterinarian can examine him, take some radiographs and tell you whether surgery is needed now or if he could benefit from joint supplements such as glucosamine/chondroitins and omega 3 fatty acids or a supplement called Duralactin as well as pain medication. There may be some things that a physical therapist could suggest to improve muscle strength in that leg which could help delay the need for surgery.

If you'd like to read more about pateller luxations here is a link to an excellent article written by the American College of Veterinary Surgeons:

https://www.acvs.org/small-animal/patellar-luxations

In mild cases while some dogs do learn to kick their rear leg and pop the knee cap back into place over time because of the constant wear and rubbing of the knee cap moving in and out of place we see secondary arthritis forming. Whether he needs surgery or not now will depend upon how severely he is affected. The basic rule of thumb though is dogs with a knee cap that is always out need surgery immediately. In less affected dogs in most cases the dog does need surgery at some point, but we can sometimes delay it to wait for the pup to attain full size, or for a period of time until the kneecap starts to ride out of place more consistently.

In the meantime treatment may be a simple as medications to control his pain and lessen his arthritis formation or he may need surgery now to keep him comfortable.

I would start with medication/supplements to see if we can get him relatively comfortable now.

Long term for any joint pain I recommend using a combination of a glucosamine/chondroitin product (examples are Dasuquin or Cosequin) and an omega 3 fatty acid (like 3V Caps or Derm Caps). I recommend an omega 3 fatty acid dose based upon the EPA portion (eicosapentanoic acid) of the supplement as if we do that the rest of the supplement will be properly balanced. Give him 40mg of EPA per kilogram of body weight per day. For example a 15 kilo dog could take 600mg of EPA per day.

Omega 3's and glucosamine/chondroitins work synergistically and improve cartilage health and joint fluid quality and quantity as well as reducing inflammation. They can take several weeks to see full improvement but some dogs do very well with them alone. They are available over the counter.

Another option is a product called Duralactin. This is an anti-inflammatory product derived from milk proteins and it also has omega 3 fatty acids incorporated into it which can be very helpful. See this link for further information: http://www.duralactin.com/products_canine.htm

If those medications are not enough his veterinarian can prescribe drugs that are more potent. Veterinary drugs we can add include a nonsteroidal like Metacam, Deramaxx, Previcox or Rimadyl. If those aren't enough we can add another drug in the opiod family called Tramadol and/or another drug called Gabapentin.

Ideally surgery would be done to give his knee normal stability because without surgery secondary arthritis formation will occur sooner and to a more severe degree then with surgery. It is also more likely that he will rupture the cruciate ligament in one of both of his knees because she will be putting more stress and strain on his knees.

Your veterinarian will likely examine him, paying close attention to the ability to manipulate the patella to see how easy it is to luxate. We will often sedate our patients if they are very nervous or painful to check the knee and take radiographs of the knee joint to look for a characteristic change in the knee joint.

If surgery is absolutely not in your budget you can try strict rest and supplements.

Surgery or not I also recommend keeping him on the thin side to decrease stress on her knees.

Long term for joint disease I recommend using a combination of a glucosamine/chondroitin product (examples are Dasuquin or Cosequin) and an omega 3 fatty acid (like 3V Caps or Derm Caps). As with the other conditions we are trying to slow arthritis formation.

Best of luck with your pup, please let me know if you have any further questions.

Dr. Kara, Board Certified Veterinarian
Category: Vet
Satisfied Customers: 15918
Experience: Over 20 years of experience as a veterinarian.
Dr. Kara and other Vet Specialists are ready to help you
Customer: replied 11 months ago.
Hello Dr Kara, many thanks for your informative answer, we want the best for Winston and its unfortunately looking highly likely that he will have to have surgery on his luxating patella's.
Best Regards
Mick
Expert:  Dr. Kara replied 11 months ago.

The best treatment usually is surgery, especially in dogs bigger than 5 kilos or so. They seem to do so much better long term with surgery that it really is worth it. Please let me know how things go for him, and/or if you have any further questions.

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