Patella luxation – Grades Of Severity

Patella Luxation – Dislocation Of The Kneecap

Patella Luxation is a health problem commonly found in small breeds of dogs such as Pomeranians, Toy and Miniature Poodles, Chihuahuas, Pekingese, Yorkshire Terriers and other small dogs and some cats as well.  Environment as well as genetic influences play a big part in the health of your Pomeranian. Correct Diet and Medication may improve this health issue. Feeding your puppy a balanced diet may help prevent many health problems later in life. 

normal patella

Figure 1 : Above 0 (normal) patella.

The kneecap (patella) is a very small bone found deep in the tendon of thigh muscles. The tendon is a tough inelastic band of tissue joining the bony attachment and the muscle. With patella luxation, the kneecap can slide out of its tendon and then slide back in again.

There are five grades, based on severity of the problem. Normal = 0. Number 1 signifies minimal movement of the kneecap and the dog’s owner might not be even aware of the problem. As time goes on and this disease may progress in terms of severity and duration, the lameness may occur more often until it’s there all the time. Pomeranians with severe patella luxation appear to have “bow-legged” back legs.

In grades  2, 3  and 4, surgical intervention usually proves successful. 

Patella luxation – Grades Of Severity

Patella luxation – Grades Of Severity

Patella luxation has five distinct grades. Pomeranians should have patella’s evaluated yearly as grading can become progressively worse with age.

Grade 0: The patella fits snuggly into the knee joint and no movement is felt on examination by a veterinarian.

Grade 1: The patella is close to being normal. The only way to cause it to become dislocated is for digital pressure to be applied to the knee joint. Kneecap will pop back into place.

Grade 2: When the patella  becomes dislocated  it will stay that way. Pomeranians that suffer from this problem may have secondary osteoarthritis and joint cartilage problems if the patella is repeatedly being dislocated.  Your Pom may carry his back leg for a couple of steps before putting it on the ground and walking normally.

Grade 3: Your dog’s patella is dislocated more often than not. If it’s put back in place, it has the tendency to slip out again repeatedly. Pomeranians who have this level of patella luxation also face a higher risk of the anterior cruciate ligament in the stifle rupturing. Dogs falling into this level often suffer some loss of functionality. There are more “skipping” incidents and he’ll try to avoid jumping up as it can cause pain. The patella can’t always return to its normal position.

Grade 4: Your Pomeranian’s patella is always dislocated. His legs have so much pain that he tries not to use them. He may be unable to straighten the leg and he may have little to no desire to jump or run.

severe patella luxationFigure 2 : Above 4 (severe) patella luxation. The kneecap is dislocated out of the groove.

Correct Diet and Exercise may help prevent Patella Luxation.

Pomeranian puppies going through the teething stage who are lacking sufficient calcium in their diet might suddenly start limping or even carrying one leg. Other signs of a diet deficient in calcium include down on pastern, east west front, flopping ears and tails doing funny things. Your Pomeranian’s diet needs to be reassessed. No red meat at all. Feed puppy tinned food and dry PUPPY food and lots of dairy products until 12 months. Do not consider any type of patella surgery until at least 12 months. If your Vet does want to perform patella surgery on a Pomeranian under 12 months of age, serious consideration should be given to changing your Vet.

It’s vital that you feed your Pomeranian a well-balanced, nutritious diet and ensure his weight stays within a healthy range. All-Natural Hip & Joint Supplement for Dogs – With Glucosamine, Chondroitin, MSM, and Organic Turmeric – Supports Healthy Joints in Large & Small Canines – 90 Chewable Treats Oral joint supplements for dogs may prove beneficial.

Don’t let your Pomeranian jump up and down from furniture, beds or steps and while mild and regular exercise to build muscle may help Pomeranians with lower patella grades, avoid too much exercise.

If the problem is severe and your Pomeranian is in pain, surgery may be the only option.

Pomeranians should be removed from breeding programs if the grading is a 2, 3 or 4.

When Is Patella Repair Surgery An Option For Your Pomeranian?

Most vets generally recommend undergoing surgery if your pet has been diagnosed with a luxating patella.

Personally, I don’t often advise undergoing surgery if your dog has a floating kneecap except if your pet’s quality of life is seriously affected. If your Pomeranian can’t walk or run without feeling  pain, that’s when it’s time to think about the surgical options.

If your pet’s patella is a grade 3 or 4, there are two operations to choose from.

One is to make the trochlear wedge deeper. If your pet’s joints are flat, the surgeon will make a deeper V-shaped incision to hold his kneecap in that grove.

The other option is to tighten the joint capsule to ease tension on the ligament or patella capsule.

I recommend analysing ALL other possible non-surgical options that can add stability to your Pom’s knee BEFORE even considering correction of the problem through surgery.

If surgery is the best choice, be aware that there are always potential risks during surgery, especially from infections and anaesthetic. However, the list of risks grows longer because the procedure is carried out on one of your pet’s moving parts that’s also a weight bearing part.

The list of risks include:

Pin problems.

If a pin is inserted into your pet to assist with the task of holding the joint in position. The pin may move and that means more surgery to take it out. At the pin’s site, an abscess (also called a seroma) may be created and either surgery or drainage is needed. 

A repair may collapse.

After your beloved pet Pomeranian has undergone surgery, he’s not allowed to jump or run for approx. two months because that’s the length of time needed to fully stabilise your pet’s health once more. It’s nearly impossible to prevent your dog from being physically active so the repair may easily break down during that “restful” period.

Failed surgical procedure.

10% of canines don’t demonstrate any significant improvements after undergoing surgery. They still feel pain and it’s possible for this problem to cause more issues with other joints and bones.

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