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What is Patellar Luxation?

If your dog’s patellar luxation is congenital (present at birth), the affliction may not be noticed until about six weeks of age because it can be mistaken for clumsiness or slow learning. Developmental luxation is usually thought to be from hereditary ligament or skeletal conformation and will be evident as your puppy ages. Any kind of injury to the leg such as a fracture or sprain, can cause immediate patellar luxation that is obvious right away.

The most commonly affected breeds of dog include the Shih Tzu, Toy Poodle, Chihuahua, Maltese, Pomeranian, Yorkshire Terrier, Japanese Chin, Beagle, Pekingese, Basset Hound, Chow Chow, Cocker Spaniel, Australian Shepherd, Chinese Shar Pei, Lhasa Apso, Shiba Inu, and Dachshund. Some large breeds that are affected include St. Bernards, Huskies, Boxers, Malamutes, Akitas, Golden Retrievers, and Labrador Retrievers.

A patellar luxation is a common disorder in which the kneecap is displaced or dislocated from the knee joint where it belongs. This may be a condition the dog has when born (congenital) or may develop later in life (developmental). Although trauma to the knee can cause patellar luxation, it is usually hereditary in nature and affects toy breeds most often.

However, other breeds have been reported as having patellar luxation as well. This condition causes mild to severe pain, depending on which grade of luxation your dog has. Unless it is caused by an injury, the grade starts at 1 (mild) and progresses to 4 (severe) without treatment. If it is caused by an injury, it can start at any grade, depending on the severity of the injury. Patellar luxation is almost always in the rear legs and will cause lameness eventually without treatment, causing a skipping type gait.

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Symptoms of Patellar Luxation in Dogs

The symptoms of patellar luxation depend on the cause and the grade of the condition. Most commonly, the signs include:

  • Limping
  • Abnormally carrying leg or legs
  • Inability to bend the knee
  • Pain when moving the leg
  • Will not run or jump
  • Refusing to exercise
  • Swelling
  • Weak legs
  • Crying out in pain when used or manipulated

Types

A patellar luxation comes in four different grades depending on severity. These grades include:

  • Grade 1 – Minimal lateral deviation, no cracking sounds, slight rotation of the tibia, and returns to the original position after extension
  • Grade 2 – Up to 30 degrees of torsion in the tibial crest, frequently moves from its intended position, almost permanently luxated, very difficult but possible to move patella back in place
  • Grade 3 – Flattened knee joint, permanently luxated with a tibial crest of 30 to 50 degrees, still usable but held in a partially flexed position
  • Grade 4 – Permanently luxated with up to 90 degrees deviation, knee joint is flat or convex, unable to use the leg normally

Causes of Patellar Luxation in Dogs

The cause of patellar luxation includes:

  • Congenital – Present at birth
  • Developmental – Develops over time but is considered to be a hereditary deformity or weakness in the ligaments or bones in the knee
  • Traumatic – Results from an injury or accident that damages the knee ligaments or bones

Diagnosis of Patellar Luxation in Dogs

If this is a congenital condition, your puppy will probably be diagnosed at his first appointment with your veterinary professional. However, in the case of hereditary or traumatic patellar luxation, the condition will make itself known when it is at a high enough grade. A physical examination will be performed right away, which will likely include auscultation, palpation, vital signs, lameness assessment, and behavioral analysis. 

Be sure to tell the veterinarian if your pet has been sick or injured recently and if you have given him any medication, even if it is an herbal supplement. Some medications can affect the symptoms and may not interact well with the drug your veterinarian proposes to use for treatment. The veterinarian will run some blood tests such as a blood count and chemical analysis as well as radiography like x-rays, CT scans, ultrasound, and an MRI.

Treatment of Patellar Luxation in Dogs

To treat your dog for patellar luxation, the grade and your dog’s health will be taken into consideration. Surgery is the most obvious and commonly chosen treatment, but the veterinarian may try a leg brace or bandage, cage rest, and medication instead.

Surgery

The operational technique depends on the grade of the condition and the results vary depending on the cause of the patellar luxation. The veterinarian may choose to use fascial release incisions on the side of the knee or knees affected, soft tissue realignment, inserting pins into the tibia to create a fixed position, or bone shaping to deepen the groove of the femur.

Medication

Steroids, NSAIDs, and narcotics can be given for pain and inflammation. In addition, there are supplements such as glucosamine, Vitamin C, Vitamin E, and collagen injections that may be helpful for pain.

Recovery of Patellar Luxation in Dogs

Your dog’s prognosis is good but depends on the grade of the patellar luxation. In very severe cases, the limb may need to be amputated to stop the pain. Mild to moderate cases are treated with surgery or medication and should return your dog to normal health in no time at all.

Patellar Luxation Questions and Advice from Veterinary Professionals

Kenji
Shiba Inu
6 Months
Mild condition
1 found helpful
Mild condition

Has Symptoms

Limping

I have a 6 month old male Shiba. He had no luxating patella issue when he was examined before we brought him home at 8 weeks.

Last week, he heard a loud noise, jumped, and started screaming and yelling. Since then, he occasionally limps but doesn’t seem to be in pain.

I took him to the vet yesterday and he said he had grade II traumatic patellar luxation and would require surgery.

Should I get another opinion? Is there any chance it will get better without surgery?

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Madeline
Peekapoo
8 Years
Moderate condition
0 found helpful
Moderate condition

Has Symptoms

Limping

Our peekapoo had surgery 7 months ago for a grade III/IV patella luxation. She was off her feet for the 8 weeks required, then slowly returned to normal. She started limping yesterday and it is evident that it is the same leg that she had surgery on. Can this re-occur?

Dr. Callum Turner, DVM
Dr. Callum Turner, DVM
3317 Recommendations
The condition may recur but it is uncommon, but since it is the same leg as the surgery I would recommend that you visit your Veterinarian for an examination to determine if there is a recurrence or not. Regards Dr Callum Turner DVM www.acvs.org/small-animal/patellar-luxations

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Finn
Chihuahua
14 Weeks
Mild condition
1 found helpful
Mild condition

Our 1 year old chihuahua had surgery (depending of the groove) to correct Grade II/III patellar luxation, which he got when he slipped and fell down the stairs. It has been 6.5 weeks since the surgery. At week 3 we noticed that he skipped a step when he was trotting on our hardwood floor. This happened twice. He passed the 4 week checkup (with XRays) fine and we were told to increase his activity gradually from week 6 on. Since then he has been bunny-hopping more when trotting on our hardwood floor. The bunny-hopping now is worse than it was when we took him in for surgery. Is it likely that he has luxated his patella again? If so - what are the treatment options? We will be taking him to his surgeon for his 8 week checkup March 1, but we are really worried at this point and we would like an independent opinion. Thank you so much for your help with Finnie!

Dr. Callum Turner, DVM
Dr. Callum Turner, DVM
3317 Recommendations
Without examining Finn I cannot say whether or not there is a recurrence of the luxation or if any suture or implants failed; you should reduce Finn’s activity for now since he is bunny hopping and I would recommend visiting the Surgeon sooner if possible to examine him to determine a course of action. There are different surgical options, but it is dependent on the specific issue; deepening the groove, repositioning of tibial crest or fixation of soft tissues may be used but are done on a case by case basis based on the observation of the Surgeon. Regards Dr Callum Turner DVM www.acvs.org/small-animal/patellar-luxations www.fitzpatrickreferrals.co.uk/orthopaedic/patellar-luxation/

Thank you very much, Dr. Turner. Your suggestions are very helpful. We'll reduce Finnie's activity and try to get him in for his checkup sooner.

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Timmy
Poodle
2 Years
Moderate condition
0 found helpful
Moderate condition

Has Symptoms

Limping

My very active two year old poodle has always skipped when walking but 5 weeks ago I found him sitting in the garden refusing to move. He was shaking and trembling and for about a week hid under the bed and refused to come out. He almost refuses to walk and when pushed gives a yelp and lifts his back left leg after a few metres. He puts it down again and then it happens again. Or he walks holding the back left up. He won´t walk on hard surfaces at all. I have taken him to 3 vets and none of them have any idea what the problem is. He doesn´t react to manipulating the leg, the x rays don´t show anything and the blood tests are clear. I found some information on line about luxating patella. Is it possible that this would not show up on an x ray. Or one vet suggested it could be neurological. Or? We are getting a little desperate and our poor dog is depressed. Thank you.

Dr. Callum Turner, DVM
Dr. Callum Turner, DVM
3317 Recommendations
Patellar luxation is a possibility but it would be something which would be checked for by physically manipulating the patellar out of its groove which is easy to do in moderate to severe cases; x-rays may not show much if the patellar is in place at the time of x-ray. Neurological issues and spinal/hip issues are another possibility, but without examining Timmy myself I cannot really say what the specific cause is. Regards Dr Callum Turner DVM

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TBD
Shiba Inu
8 Weeks
Mild condition
0 found helpful
Mild condition

Has Symptoms

none

I am about to adopt a shiba inu when it is 10 weeks old. At it's 8 week vet appointment she had a grade 1/4 patellar luxation. The puppy currently is asymptomatic and no evidence of lameness in the affected leg. Since was diagnosed at this early age, what is the prognosis? As a hereditary condition is it highly probably that the condition will become symptomatic at some point and require surgery? I've looked at some peer reviewed articles and texts and haven't found a clear answer. I understand there are a lot of factors that play a role in worsening of the condition, but I'm just wondering from a practitioner point of view how often it is that as a puppy with this condition will need surgery later on vs. the condition doesn't become that severe. Thanks in advance!

Dr. Callum Turner, DVM
Dr. Callum Turner, DVM
3317 Recommendations
It really depends, what is more important is what happening whilst a dog is growing and the activity during the life; there are also various different factors including ligament laxity, malformation of the femur and tibia, other limb deformities which may impact severity as well as other factors apart from a shallow groove. However, I cannot generalise since there are too many factors to consider. Regards Dr Callum Turner DVM

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Squaw
Toy Poodle mix (Pooton)
1 Year
Moderate condition
0 found helpful
Moderate condition

Has Symptoms

Leg pain

I have a dog that was just diagnosed with stage 3 patellar luxation. She is 1 year and 3 months. You can tell that she is limping most of the time and she pulls her leg up or bunny hops when she runs. We have noticed a bit of a personality change since she has shown signs. What can I do to avoid surgery?

Dr. Callum Turner, DVM
Dr. Callum Turner, DVM
3317 Recommendations
In cases of grade III patellar luxation, surgery is indicated since the patellar spends more time luxated than in its groove; apart from advising you to restrict activity there is nothing else apart from surgery I can recommend in this case. Regards Dr Callum Turner DVM www.acvs.org/small-animal/patellar-luxations

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Lennon
Lab/Cocker Spaniel Mix
18 Months
Mild condition
0 found helpful
Mild condition

Has Symptoms

Limping

My dog has been diagnosed with a grade 2 luxating patella. However, my current vet doesn't do orthopedic surgery. A lot of other vets in my town have a very cold personality and I dont know if I can trust them with my animal. There is one that is on vacation for 2 weeks that could perform it and I trust. Only other option is to drive over an hour away for his surgery. Just wondering if it would be best to get it done this week or if waiting 2 more weeks would cause more serious complications.

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Rio
Lhasa Apso
4 Years
Mild condition
0 found helpful
Mild condition

Has Symptoms

Droop tail

I am looking for any professional advice as I am at wits end. My 4yo Lhasa Apso's tail dropped between her legs about 4 weeks ago. We thought it was digestive so we changed her diet to no avail. Our Vet cleared her digestive track but diagnosed her with a stage 2 petellar luxation (X-rays) and suggested rest and medicine. It has been two weeks since then with no change. She is still active, eating the same and always looking for her daily walks. Her weight is very healthy. She can not squat to poop so she spins instead. I have to wonder if it is something other/additional to the luxation. To summarize she is a happy healthy pup who eats fine and is very active but can not squat to poop with her tail down 24/7. Thank you in advance for your advice.

Dr. Callum Turner, DVM
Dr. Callum Turner, DVM
3317 Recommendations
The patellar luxation may cause some difficulty when trying to defecate due to issues with bending the knees, however I cannot determine any specific cause for the issue that Rio is having without examining her first. I really do not know what to suggest for a case like this and would recommend visiting another Veterinarian for a second opinion to see if they can shed some light on another possible cause. Regards Dr Callum Turner DVM

My dog is having the same symptoms, she does also have the luxation but I don’t think that’s it neither does the vet, they think pinched nerve in her back, did your dog recover, my dog is a Pom and her tail is down to, she can’t squat to poop or pee either, I’m desperate to help her, thanks Lisa

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Russ
Mix breed
6 Years
Mild condition
0 found helpful
Mild condition

Has Symptoms

Takes time to get in or out the car
Less energef

Medication Used

Genuphil
Mobic

It has been 5 days since i found my dog is less energetic although he walks on his four legs,he cant go down the stairs without trying to lift his back legs, but he walks normally but slower than the usual
I took him to the vet today and he showed me how easily he moves his leg that has patellar Luxation, he told me to let him take medications for a weak and then decide whether it should be treated medically or by a surgery
My question is which grade he has if he walks normally but has a problem in going down the stairs and takes time to sit down as welll going in or outside the car

Dr. Michele King, DVM
Dr. Michele King, DVM
1607 Recommendations
We grade patellar luxations based on how mobile the kneecap is and where it sits normally, and I can't give you that answer without seeing Russ. If your veterinarian felt that giving him medication for a week and re-evaluating was a valid treatment plan, that makes sense, and we do that for lower grade luxations fairly commonly.

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Lexi
Small terrier mix
10 weeks
Fair condition
0 found helpful
Fair condition

We think my puppy has bilateral luxating patella's she is a rescue from Puerto Rico and we have a vet appointment on Wednesday.
She appears bow legged and it doesn't appear to bother her.
Should I let her run around the yard with my older dog, they definitely run fast change direction quickly and her leg appear more bow after she doesn't seem to have pain

Dr. Callum Turner, DVM
Dr. Callum Turner, DVM
3317 Recommendations
If Lexi doesn’t seem to be in pain I would just keep an eye on her, but reducing her activity would be best until you’ve had your Veterinarian take a look at her; there are many issues which may be causing problems with her leg but your Veterinarian will be able to examine her and determine whether any treatment is required. Regards Dr Callum Turner DVM

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Boomer
Boxer Pug
3 Years
Moderate condition
0 found helpful
Moderate condition

Has Symptoms

Holding leg up

Boomer has had mild Patellar Luxation since he was young (he is 3.5). About 2 years ago we had some issues, he lost weight and has had no problems since. He got wrapped around his leash and whipped back around a few days ago at the beach and is having issues in one knee again. Today, the vet (new vet)said he is level 3. I am going to get a 2nd opinion but is is possible to have NO issues for 2 years and suddenly he is at a level 3?? TIA!

Dr. Michele King, DVM
Dr. Michele King, DVM
1607 Recommendations
Thank you for your email. The grades of patellar luxation depend on the stability of the ligaments involved in stabilizing the knee. If he damaged those ligaments, it is possible that the knee is less stable at this point, and may have moved to a point where surgery might be recommended. It never hurts to have a second opinion, but that might be what is happening with him at this point. I hope that everything goes well with him.

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Dash
Labrador Retriever
1 Year
Mild condition
0 found helpful
Mild condition

Has Symptoms

Limping

Is patellar luxation genetic? We raise labrador retrievers and one of the puppies we bred was diagnosed with this condition. Both parents are OFA certified. Neither of the parents show any signs of having this condition. What information you can give me would be much appreciated.
Thank you

Dr. Callum Turner, DVM
Dr. Callum Turner, DVM
3317 Recommendations
There is evidence that patellar luxation is hereditary, however it isn’t fully understood; I’ve provided two links below for further information on this. It is recommended that affected dogs are not bred however, if other pups from the same parents are also affected you shouldn’t breed them either; there is debate in the breeding community about how to manage this, if you are a member of a society I would recommend reaching out to them regarding their guidelines. Regards Dr Callum Turner DVM www.ncbi.nlm.nih.gov/pmc/articles/PMC1524842/ www.acvs.org/small-animal/patellar-luxations

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