Grade 4 MPL, teeny tiny yorkie....

[K9Rehab]

Good morning,
Any thoughts on bracing a 3.2 lbs 19m yorkie with MPL bilat (grade 4 diagnosed by ortho - owner doesn't want surgery and has been researching braces instead). Owner has never seen the dog sit and she's losing muscle mass in the hind end at a quick pace. Started on a rehab program today just focusing on basic weight shifting/bathtub swimming etc and will follow up with the owner at monthly intervals (financially feasible for her). Any suggestions from past experience would be greatly appreciated.

[David Lane]

What does she hope to accomplish with the brace? It won't reduce the patella, nor will it increase ROM. Is she just trying to prevent secondary cruciate disease?

[lehughes]

I agree with David, there is no brace that works for patellar luxations in dogs. The patella's are too tiny to create a force that would push it back in... and really, with a grade 4, it's not possible.

You can work on function and strengthening. It might help a bit. But if the dog is significantly reduced in function, then surgery really is the best option.

But... in a scenario such as this, I would offer rehab / strengthening. I would let the owner know that you are willing to work with them to try this route. I would tell them that surgery really would be the best option and that MPL's often develop cruciate tears because of the abnormal forces through the knees... so that they would need keep that in the back of their minds if they saw a dramatic reduction in function or if the dog started to hold up it's leg. However, if you present that you are willing to work with them to strengthen and 'see' if conservative therapies will help... then they might be willing to consider surgery on down the road if the improvement she makes is not enough for their satisfaction - and at least they can say they tried!

Best of luck with this one!

Laurie