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Tomorrow I'm seeing a 3 lb, 10 week old Havanese puppy with previously diagnosed medial patella luxation. I explained to the owner that surgery will likely be necessary... but she wants me to look at it anyway in hopes that I can "manipulate the knees back into place". Okey dokey!

My questions - Assuming this pup needs surgery... when would you do it? After growth plate closure?

Is "pre-hab" beneficial? Even if so, I imagine it will be challenging to get such a young pup to do exercises.

Any other ideas or thoughts appreciated!

Hi Jan!

I know you posted this questions onto the VetREhab Forum as well. Sorry I didn't get to answering this for you sooner!

Anyhoo! I totally think it's worth trying Pre-Hab. I've had some young pups show up with patellar laxity that are currently 4+ years old with no issues. I had the owners work on strengthening ++ and the dogs compete in agility. They've gone from grade 2's to grade 1's.

See what happens. Otherwise, for a little dog like this, that distal femoral epiphysis & tibial condyle ephiphysis are likely closing around 5 - 6 months (??) . So surgery doesn't need to be rushed into.

I would caution that jumping into a femoral osteotomy (if needed) CAN have unintended consequences of a potential quads contracture in a juvenile dog. (I've seen one in my past.) So, if surgery is needed in a growing dog, you'll want to be very pro-active in maintaining ROM and regular check ups! I don't trust owners to 'catch it'!!!

Go to the Conservative Management of MPL handout / videos for ideas on exercises. It can be done. Lot's of mini cookies for motivation! Sometimes it's just a matter of general conditioning and some easy stretches (active if possible - ie cookies reaching up - front feet on a stool to stretch iliopsoas and part of sartorius.)

Best of luck!

Laurie

Thanks Laurie! I saw the puppy and it has LATERAL patellar luxation, a grade 3-4/4. (movable, but can't get it into the patellar groove). The pup was bunny hopping, and reluctant to stand for more than a few seconds. Already has loss of flexibility of the hamstrings, and I had difficulty getting the legs into extension. Ugh. Went to see a surgeon last week and is scheduled for surgery this week. Thanks for the advice on following up post-op!

Okay... all good.
So, now you just be vigilant with post-op rehab and watch for complications and address them asap if they come up!

L