Medial Patellar Luxation (MPL) in Dogs
“Trick knees”, more properly termed medial patellar luxations, are a relatively common finding on physical examinations here at OCVH and in most veterinary practices of small breed dogs. In many cases, it is an incidental finding during a routine exam, while in other cases it is found when a dog comes in for sudden limping. When found on routine physical exam, veterinarians will mention it as a finding but may not go into much detail since it is not usually a cause for concern. But since it is so common, here is some additional information about the condition and what, if anything should be done about it.
What is it?
The patella is the fancy name for the knee cap. It is attached to the tendon of the quadriceps muscle in the front of the thigh and sits in a groove of the femur (thigh bone). The function of the patella is to act like a pulley and to facilitate the bending actions (flexing and extending) of the knee. The term “patellar luxation” means that the knee cap has slipped out of its normal position within the groove of the femur, most often toward opposite leg (medially). Sometimes it may slip toward the outward direction, which would be called lateral patellar luxation, but this is much less common. While patellar luxation can be seen in any breed, smaller breed dogs are much more prone to it. About 50% of affected dogs have the abnormality in both knees.
What causes it?
Medial patellar luxation (MPL) is most often due to a congenital (inherited) abnormality and is usually present from a young age. The groove in which it resides may be too shallow or an abnormal rotation of the shin bone may cause the attachment of the tendon to be more to the side. In either case, the patella is tends to pop out of place with normal motion of the leg. Trauma or injury can also cause luxation but this is relatively rare.
In most cases, there is no obvious sign to the owner that a pet has this condition. Some owners will note that the pet will occasionally hop or skip on one leg when running and then return to normal without ever acting painful, indicating that the patella has shifted out of groove but then popped back into place. Some dogs may become lame during exercise if the patella shifts and does not return to normal position, causing discomfort and inflammation. Long term effects of frequent displacements can lead to arthritis in some pets and may make them more prone to injury of ligaments in the knee.
Types of Luxation
Patellar luxation is graded on a scale of 1 to 4, with higher numbers indicating more severe luxation.
–Grade I – Patella can be manually moved out of groove during examination but immediately returns to normal position. These dogs are unlikely to show lameness.
–Grade II – Patella is able to be easily manipulated out of place but does not return to correct location once pressure removed. These cases are more likely to show mild signs of lameness.
–Grade III – Patella is always luxated, can be slipped back into place but immediately re-luxates. These dogs show more persistent lameness.
–Grade IV – Patella always out of groove and cannot be put back in place. These dogs will have significant lameness and cannot straighten knee. They may have bow-legged appearance.
MPL can be easily diagnosed on routine orthopedic examination. Radiographs or other imaging modalities may be needed to determine the extent of abnormalities (structural deformities, depth of femoral groove, etc).
Those pets with Grade I or II luxation that rarely or never show any clinical signs are unlikely to need surgical treatment. For those with Grade II or greater that show more persistent lameness, surgery can help to correct the underlying abnormalities. If both legs are equally affected, most surgeons recommend correcting one leg at a time and allowing time for the first to heal prior to correcting the second (at least 8 weeks). The exception to this may be a dog that is still growing as correcting one at a time may lead to conformation changes if the bones are still growing.
Trochlear Modification – this surgical correction is meant for those small breed dogs with a shallow groove. The goal is to deepen the groove by removing some of the bone below the cartilage, then replacing the cartilage to keep the smooth surface.
Tibial Tuberosity Transposition – this is a more complicated surgery which is meant to change the alignment of where the patellar tendon attaches to the top of the tibia (shin bone) to prevent the patella from being pulled to the side. The tibial tuberosity (crest where the ligament attaches) is removed and pinned in a different location to adjust the pull on the patella. In some severe cases, the entire bone must be cut and realigned.
Post- operative care
In simple cases of trochlear modification, 3-4 weeks of rest is sufficient for recovery. With more complicated surgery, a longer period of confinement, possibly up to 8 weeks or more, may be recommended. Some of these dogs also benefit from physical therapy.
Need More Information?
If you suspect your dog may have patellar luxation or another orthopedic problem please contact one of our veterinarians or schedule an examination.
Jenna Koenigstein DVM
Buy cheap and genuine Windows 7 product key |
Windows 7 Ultimate ISO download |
Windows 7 Product Key Generator For 32&64 Bits |
Windows 7 Product Key Online Store |
Windows 7 Ultimate SP1 Product Key Sale |
Windows 7 Key |
Get Free Newest Windows 7 Product Key |
Windows 7 Product Key for 32bit/64bit Updated 2016 |
Microsoft Office 2010 Professional Plus 14 serial key dowload |
Windows 7 Professional Download ISO Free Download |
windows 10 education key
windows 10 enterprise mak
office 2010 key
windows 7 key sale
windows 10 home-key
windows 10 education
windows 10 pro key
office 2016 key
windows 10 key
office 2013 key
windows 10 home edition
windows 7 key
windows 10 activation key
If pets could talk, many would probably ask for K-Laser therapy and to have those treatments done at OCVH, of course! Class 4 (the most advanced) therapy Lasers are used to treat arthritis, fractures, ear infections and many other conditions that affect our pets. Laser treatments have been used in human medicine in Europe for over 20 years and were approved for use in the United States about 10 years ago. Medical doctors, chiropractors and physical therapists all use the K-Laser to help their patients. Professional sports teams have also started using this healing modality.
Laser treatments work by delivering energy in the form of light waves past the fur and skin into deeper tissues where healing is needed – for example, an arthritic hip joint in an older dog. Arthritis occurs because hip joint has lost much of its joint fluid for lubrication and some of the cartilage has been replaced by bone. Why K-Laser? All of these changes lead to one thing – pain!! The Laser helps the body heal more quickly and dramatically reduce pain at the source. Some dogs with arthritis or back pain that needed assistance to get into the clinic for the first few Laser sessions and have been able to walk on their own again. The Laser also has many other uses such as wound healing, soft tissue sprains, infections, gingivitis and more.
At OCVH we like use the K-Laser because it is a pain-free, drug-free treatment option for many degenerative conditions in our pets. Typically a Laser session takes around 5 minutes for each area to be treated. For a chronic condition like arthritis, pets would likely need to have treatments several times each week for the first 2-3 weeks, and then the frequency of visits decreases. Some pets continue to have treatments on an as needed basis to maintain their comfort. During therapy you will be with your pet and you get to wear fancy, protective safety goggles. Pets very quickly learn that the Laser does not hurt and actually helps them feel better. My own dogs love the extra TLC. It feels good!
I have been able to witness the beneficial effects of this treatment on my very own dogs. Ginger, Sara, and Ernie have all gotten K-Laser treatments and are still doing well. Ginger, is 11 years and weighs 90 pounds. She tore one of the cruciate ligaments in her knee – this is the most common orthopedic injury in large dogs. She had surgery on her knee over a year ago. We used the K-Laser on her injured leg as part of her rehabilitation program. She is able to walk normally now, and still gets the treatments once per week. Sarah, our 8 year old German Shepherd dog has one of the worst cases of hip dysplasia (her hips have been this bad since she was the age of 5 when we first rescued her), yet she is able to run and play without any arthritis drugs. Ernie came to us with a broken back and although he is still paralyzed in his back legs, he is pain free and we are hopeful that he will walk someday – with the help of the K-Laser. Thanks to the K-Laser my dogs are living a better quality of life with more walks, more play, and lots more happy pain-free time.
There is hope, if your pet is in pain he or she may be helped by Laser therapy. Contact one of our staff members to schedule an appointment for a consultation to get started with K-Laser therapy. Your pet will thank you!
Laurie Pearlman DVM
We are well into 2013 now and one may wonder, how well are the New Year’s Resolutions coming along? Some of us may be doing well while others may have let them slide. So, instead of fretting about our own personal resolutions, how about making a few to benefit your pet?
Recently I have been reading some articles about resolutions for our pets and I wonder if any of our readers have made resolutions aimed at making our companions happier and healthier?
I would like to take a moment to share a few resolutions that maybe you can work into your family.
1. Protection. We all protect our pets. Keep them in fenced yards, on leashes or prevent them from escaping outside but is there anything else we can do? Keeping identifying tags on them is another step. Make sure they have current contact information on them too. For those pets (or owners) who don’t like dangling tags there are always the embroidered collars where your info is directly sewn onto it. Microchipping is another way to get extra protection in case your pet goes missing. If your pet is picked up by animal control, brought to a veterinary hospital or a shelter they will be scanned and if chipped they will contact the owner. Already have a chip? Make sure your current contact info is registered with the manufacturer. It is so disappointing to us when we are lucky enough to find a chip in a lost animal only to call the company and find out it has never been linked to an owner. (The Res-Q chips we use have a back-up registry to our hospital.) Since their invention, microchip companies have reunited more than 100,000,000 pets and owners! Keep current copies of vaccine records, documents of any chronic diseases your pet has and medications they are taking in case of emergency.
2. Prevention. Resolve to keep up on preventative care. Yearly physicals (twice yearly for those with chronic conditions or senior pets). Start brushing teeth! We can help you develop a home care program for your pet. Do some early detection blood work. Keep up with monthly Heartworm prevention and flea and tick control. The maker of Heartgard has created a free app to help you remember when it is time to give the monthly tablet. Go to www.heartgard.com to download. Use the reminder to do your flea and tick medicine the same day!
3. Diet and exercise. The category we all hate! Vow to feed well and use portion control. We can get your pet set up with a weight reduction plan if you need one. Hills has just introduced a new prescription diet, “Metabolic Advanced Weight Solution,” for obese dogs and cats that promises easier weight loss with lasting results. Do homework on the foods you feed including treats as there have been too many recalls in the last few years. Resolve to do more walks or play more laser light chasing or whatever gets your pal going.
4. Spend more time with our pets. If given the chance, this is the one I think our pets would choose. Pledge 10 minutes a day to: brush them if they enjoy it, belly rubs, road trips and lots of cuddles in the lap – it’s been shown to reduce people’s heart rate and blood pressure so we can benefit too. Win Win!
5. Get a New Look!
In 2013, give your pet the gift of glam! A regular grooming regimen will make your pet feel proud, pampered and healthy.
Now that we know what we need to do in 2013 for our pets, let’s see what it would look like if our pets wrote their own New Years Resolutions…
It might look like…..
– Don’t get in the trash
– Drink from my bowl not the toilet
– Play more ball, chase more mice/squirrels
– I will go willingly to the vet as they tell me it is in my own best interest
– Perfect my begging eyes
– Improve my manners
– I will come when I am called
– Try to stay off the furniture
Some celebrity pet owners were asked what their resolutions were for their pets. Actress Hilary Swank responded that her two dogs are so great that she vows to take them everywhere she goes including interviews. Bob Barker wishes his rabbit would use his litter box every time not just when it’s convenient! Glee actress Lea Michele says her cat Sheila needs to resolve to stop going into the bathroom and taking all the cotton balls out of the jar and scattering them all over.
I hope this New Year finds all of you and your pets well and happy. Again, if you wish to speak with our staff about teeth brushing, wellness programs, weight loss or micro chipping contact us anytime. Happy Belated New Year!
Revitalize your pet’s quality of life! Call 732-363-7202 today to schedule your consultation and learn more about how K-laser therapy can revitalize your pet! You can also visit our Laser Therapy page at www.ocvh.com