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Diagnosing LP without xray?

957 Views 3 Replies 3 Participants Last post by  Hambonez
My dog has some problems with her left knee joint ever since she had a fall 3 weeks ago. She screamed in pain but was much better after a short rest.

1st vist with a normal vet immed after the fall and we were told her knee joints were not normal (she has luxating patellas) and might have injured her ligaments during the fall. We were given anti imflammatory and painkillers. She wasn't in much pain anyway, but I completed the course of meds.

A week later she was still limping intermittently so I brought her back to the vet, thinking they might xray her. But the vet did not and referred us to an orthopedic vet instead.

Week #3 we went to the orthopedic vet, he palpated her knees and observed her moving around (he also had her records to refer to) and he told us her knees were grade 2 with the left one showing clinical symptoms. He says to do the operation is still optional and depends on what we feel is necessary for her to maintain her quality of life. Sounds like a reasonable diagnosis BUT I still get this nagging thought that there is no XRAY AT ALL and he has already diagnosed her??? Is this 'acceptable'? He did mention that XRAY is included in the surgery charges though..

It's already week #4 now and the amount of limping is still the same. We are afraid of playing the usual games with her as we do not want to aggravate the joint injury. Why is it that she could run perfectly normal (though her knee joints were already genetically deformed) and just one fall and she has this problem? Could it be something other than the LP causing the problem too?
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Normal kneecaps cannot be luxated even with force, so luxating patella is something that can be diagnosed on a physical exam without x-rays. Especially with low grades, as positioning for the x-ray is likely to stabilize the kneecap in a normal position and make it look normal.

Having said that, it's not that uncommon dogs with LP to tear their ACL as well, and often in a dog with a history of LP without any symptoms who suddenly starts having problems that's the cause. If you choose to do surgery for the LP, that's something the orthopedist should be able to see and repair at the same time one s/he's in there surgically.
Thanks sassfras! That's really reassuring information....

This vet that I went to seemed to have 'ok' reviews on the forums here. He was really detailed and well-versed on the topic, and also other possible orthopedic problems a poodle may have like shoulder deformities or slipped disc near the head area (I asked what other problems my dog might have too). I even asked him to check her front legs too since her elbows look bent at an awkward angle when seen from the front(bow legged).

I'm now leaning towards going for surgery on the leg that's giving her problems. But I need to find more information on what happens after surgery.

Now she can't run like she used to (think gallop at breakneck speed!)... she lifts her bad leg up halfway, how likely will the surgery 'fix' it?

Post-op care: Must I be by her side 24/7? And for how long? She's actually quite independent and we normally leave her alone at home (up to 10 hours) during weekdays.

Physiotherapy: Massages? Swimming? Accupuncture?

I really miss her zoomies...... :(
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You could try finding a veterinary orthopedist in your area for a second opinion, or if there isn't one, a veterinary surgeon.

In terms of the questions, make a list and call your vet. They should take the time to answer all of them, and not all have the same post-op instructions. With many orthopedic surgeries, dogs require cage rest for a time to ensure they aren't stressing the joint, so in that case you wouldn't need to be by her side, but she wouldn't be able to have unsupervised time outside of her crate.
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