Hi Mary,

The condition is undoubtedly patellar luxation. It’s very common in the breed.

Stage 4 is rare. I have seen this condition many times and I perform the surgery to correct it. The average veterinarian does not perform this surgery. Most veterinarians simply refer to a board certified surgeon who will be much more expensive, but also, much more skilled.

Here’s the first issue though. It is rare that I actually have to do the surgery. I will only perform it if the patient has clinical symptoms that are significant. That is to say, that the patient is lame or bothered by the leg on a daily basis. Most cases don’t need surgery in my opinion. A grade 4 patellar luxation requires surgery to correct it, but I would only really consider this if it needs to happen based on how she is dealing with it.

Having said that, if surgery is deemed necessary, then having a board certified surgeon perform the surgery is ideal, albeit expensive.

At this time, I am not aware of any alternative therapies. I have tried giving anti-inflammatories to calm the tissues down due to the sliding knee cap, but after they finish, the symptoms typically return. No amount of medication will change the conformation and physical structures in the knee joint to improve the condition. Braces and supportive devices have no confirmed benefit either but its possible that a company that produces these devices, may have some owners that have said it helped their dog. No research trials or studies exist for these devices and all the evidence is anecdotal, meaning that the occasional person has made a claim that they thought there was a benefit.

I’m not aware of acupuncture, physiotherapy, or chiropractic treatment helping with this condition. Again, I don’t see how any of these treatment modalities would change the position and conformation of the structures of the knee.

It is truly a surgical disease. All of the treatments listed above are valuable during the recovery from surgery, but the only thing that can fix patellar luxation is surgery.

I hope this helps,

Dr. Clayton Greenway