Table of Contents
Understanding Patella Luxation in Dogs and Cats: Causes Symptoms, and Treatment
Commonality: Moderate
Transmission: Not Contagious
Impact on Health: Medium to High
Symptoms: Intermittent limping, Skipping gait or difficulty walking, Pain and discomfort, Stiffness, particularly after rest
Abnormal posture (bow-legged or knock-kneed stance), Decreased activity levels, Swelling around the knee joint, Audible clicking or popping noises from the joint
Treatment Cost: $1,000 – $4,500+
Treatment and Recovery Time : Surgical – 3-6 months for full recovery
Ease of Prevention: Medium
Most Affected Cat Breeds: Devon Rex and Abyssinian breeds
Most Affected Dog Breeds : Toy Poodles, Yorkshire Terriers, Chihuahuas, Pekingese, and Boston terriers and Pomeranians, Akita, Labrador, golden retriever, malamute, boxer, St. Bernard, and husky
Covered By Petsy : Yes, if not a pre-exisiting condition
Table of contents
What Is Patella Luxation
For The Non Vets
Think of patella luxation like a train sliding off its tracks. Imagine a kneecap (the train) travels smoothly along smoothly along the grove of the thigh bone (the train tracks) which allows your leg to extend and bend 1. When your pet has patella luxation, the kneecap also scientifically known as the Patella, slides off this track, leading to limping or awkward movement, much like how a derailed train can’t move properly.The Vets Response
Patella luxation, commonly known as kneecap dislocation, is a condition where the patella (kneecap) dislocates or moves out of its normal alignment. This typically occurs because the patella does not stay within the groove of the femur (thigh bone) where it normally glides smoothly during movement. This condition can be caused by genetic factors, trauma, or developmental issues, and it is particularly common in small breed dogs but can also affect cats and large dog breeds.Understanding Patella Luxation
Imagine the patella (kneecap) in its normal position and movement like a train running on a track. The patella is like the train, and the groove in the femur (thigh bone) where the patella sits is like the train track 2. Above the patella is the patellar ligament which is like the electricity lines of the train, which connects the large thigh muscle to the centre of the shinbone (tibia) 2. When the thigh muscles contract, the force is transmitted through the patellar ligament, pulling on the shinbone and resulting in the extension or straightening of the knee. In a healthy knee, the patella (train) moves smoothly up and down the groove (track) as the leg bends and straightens 2. This smooth movement helps protect the knee joint and ensures that the leg can move efficiently and without pain, much like how a train travelling smoothly on its track ensures efficient and safe transportation. When an animal is diagnosed with patella luxation, it’s like the train derailing from its track. Instead of the patella (train) staying in its groove (track), it slips off to one side (medial or lateral), causing instability and discomfort.
The type of derailment that occurs can be either medial or lateral.
Medial patella luxation (MPL) happens when the patella slips toward the inner side of the leg, which is more common overall and particularly prevalent in small dog breeds such as miniature and toy poodles, Yorkshire terriers, Toy Poodles, Yorkshire Terriers, Chihuahuas and Pomeranians, Pekingese, and Boston terriers2,3,4
Lateral patella luxation (LPL) occurs when the patella slips toward the outer side of the leg. While less common, it is more frequently seen in larger dog breeds or giant breed dogs, especially the St. Bernard 5,6
Both types cause significant discomfort and require appropriate veterinary care to manage and treat the condition.
Symptoms of Patella Luxation
Patella luxation can vary in severity, and the symptoms may range from mild to severe. Common signs that may indicate your pet is suffering from patella luxation include:
| Common Symptoms | Description |
|---|---|
| Intermittent Limping | Especially after exercise or physical activity. |
| Skipping Gait | Your pet may occasionally skip or hold up the affected leg for a few steps, then resume normal walking. This is often due to the patella temporarily slipping out of place and then returning to its normal position. |
| Difficulty Walking | More severe luxation can cause a persistent limp or difficulty walking, running, or jumping. |
| Pain and Discomfort | Signs of pain, such as yelping, whimpering, or reluctance to move, can occur when the patella dislocates. |
| Stiffness | The affected leg may appear stiff, particularly after periods of rest. |
| Abnormal Posture | Pets may adopt a bow-legged or knock-kneed stance due to the misalignment of the patella. |
| Decreased Activity | Pets may become less active or reluctant to engage in physical activities they previously enjoyed. |
| Swelling | In some cases, there may be visible swelling around the knee joint. |
| Creaking or Popping Sounds | You might hear creaking or popping sounds from the knee joint when your pet moves |
Diagnosis of Patella Luxation
Diagnosing patella luxation involves a combination of physical examinations and diagnostic imaging.
Diagnosing patella luxation involves determining the severity of the condition and identifying the appropriate treatment plan. The severity of patella luxation is categorised into four grades, each indicating the extent of the displacement (how derailed the train is) and the associated symptoms.
Grading Severity
| Common Symptoms | Description |
|---|---|
| Grade 1 | The patella can be manually luxated but returns to its normal position spontaneously. Pets may show intermittent lameness. |
| Grade 2 | The patella luxates with flexion of the stifle (knee) and remains luxated until the leg is extended and rotated. Causes frequent lameness. |
| Grade 3 | The patella is permanently luxated but can be manually reduced. This grade causes persistent lameness. |
| Grade 4 | The patella is permanently luxated and cannot be manually reduced. Pets with Grade IV luxation often have severe lameness and may have difficulty walking. |
Clinical Examination
The veterinarian will perform a thorough physical examination of your pet, focusing on the knee joints. They will palpate the knee to check for instability and to determine if the patella can be manually luxated. The severity of the luxation will be assessed based on the grading system.
Physical Examination
Gait Analysis: Observing your pet’s gait can provide valuable information about the presence and severity of patella luxation. The veterinarian will look for signs such as intermittent limping, skipping gait, and abnormal posture.
Imaging
X-Rays (Radiographs): X-rays of the knee joint are often taken to assess the alignment of the patella and the condition of the trochlear groove. This helps to confirm the diagnosis and to identify any associated abnormalities, such as arthritis or bone deformities.
Advanced Imaging : In some cases, more advanced imaging techniques such as CT scans or MRI may be used to provide a detailed view of the knee joint structures. This is particularly useful in complex cases or when planning surgical intervention.
Treatment and Recovery of Patella Luxation
Treating patella luxation involves both non-surgical and surgical options, depending on the severity of the condition and the overall health of the pet. The primary goals of treatment are to reduce pain, improve joint stability, and enhance the pet’s quality of life.
Non- Surgical – Conservative Therapies
For mild cases of patella luxation (typically Grade I and some Grade II cases), non-surgical treatments may be sufficient 9. With non-surgical treatments, recovery involves ongoing and consistent management. Regular follow-ups with the veterinarian are necessary to monitor the condition and adjust treatments as needed.| Conserative Therapies | Description |
|---|---|
| Weight Management | Maintaining an ideal weight helps reduce stress on the knee joints. Obesity can exacerbate the symptoms of patella luxation9. |
| Exercise and Physical Therapy | Controlled exercise helps strengthen the muscles around the knee and improve joint stability. Activities such as swimming and walking on soft surfaces are beneficial9. Physical therapy may include specific exercises to strengthen the quadriceps and hamstring muscles, which support the patella. |
| Medications | Non-steroidal anti-inflammatory drugs (NSAIDs) are commonly prescribed to reduce pain and inflammation. Other pain relievers may also be recommended9. |
| Joint Supplements | Nutritional supplements like glucosamine and chondroitin can support joint health and reduce inflammation. |
| Lifestyle Modifications | Providing soft bedding, using ramps to avoid stairs, and avoiding high-impact activities can help manage symptoms and reduce the risk of further injury. |
Surgical Treatment
For more severe cases of patella luxation (typically Grade II, III, and IV), surgical intervention may be necessary to correct the alignment of the patella and stabilise the knee joint. Here are the main surgical treatments:
1. Medial or Lateral Release:
Description
This is often the first step to alleviate tension from overly tight tissues pulling the patella out of alignment8. It helps to balance the forces acting on the patella. By releasing these tight tissues on the side of the knee where the luxation occurs (medial for inward, lateral for outward), the patella can move more freely within the trochlear groove, reducing the tendency to dislocate.
Rehabilitation for Juvenile Pubic Symphysiodesis
The recovery period is generally shorter compared to other surgical procedures. Approximate recovery time is 6-8 weeks. The initial 2 weeks include strict resting, followed by a gradual increase in activity. The gradual increase focuses on gentle range-of-motion exercises to prevent stiffness and promote healing over the remaining weeks.
2. Tibial Tuberosity Transposition (TTT)
3.Trochleoplasty
4.Soft Tissue Reconstruction
Cost of Treatment
The cost of treating patella luxation in dogs and cats can vary widely based on the severity of the condition, the chosen treatment method, and the geographic location. Patellar luxation surgery can cost anywhere between $1,000 and $5,000 per affected knee with addition of veterinary vet checkups, physical therapies, and medications 6. Financial preparedness is essential, and options such as pet health insurance, savings funds, and payment plans can help manage these potential expenses. Early diagnosis and appropriate treatment can significantly improve your pet’s quality of life, so consulting with a veterinarian for an accurate diagnosis and tailored treatment plan is crucial. Disclaimer : These costs can vary based on the veterinary practice and the specific needs of the pet.Prevention Tips
Getting Patella Luxation Covered with Pet Insurance
What is Petsy Pet Insurance?
Petsy Pet Insurance is an insurance policy that reimburses 80% or 90% of vet costs for the treatment of your pet if they suffer an unexpected injury or illness (provided these occur after any applicable exclusion period has ended symptom free).
Our policy is customisable and you’ll be able to tailor the level of coverage, based on your preferences for the Benefit Percentage, Annual Limit, Annual Excess, whether or not you’d like Optional Extra Benefits (if your pet is less than 3 years old) and whether or not you’d like to include costs of Vet Consultations for your cover.
You get to see a summary of the cover when completing an online quote and have the option to select a preferred start date. After making the payment, you’ll receive a confirmation of cover and your policy documents by email.
For added peace of mind, we offer a complimentary Pre-Existing Condition Assessment for all our members. This includes collecting your pet’s vet history upfront which helps to fast-track any future claims and we’ll also let you know whether there are any pre-existing conditions noted in their medical history that might affect your ongoing coverage.
Claims are quick and easy, and your vet can submit claims on your behalf. Approved claims are paid into your nominated bank account.
What is a pre-existing condition?
Under the terms of the policy, Pre-existing Condition is defined as:
An Injury, Illness, Dental Illness, Behavioural Condition or Specified Condition (including Bilateral Conditions, recurrent Conditions and other conditions that are related to, secondary to, or results of) that:
- first occurred or showed symptoms of; or
- was identified or investigated by a Vet; or
- You were aware of or a reasonable person in the circumstances could be expected to have known about, before Your Pet’s First Date of Cover; before a change of coverage became effective, or during any applicable Exclusion Period.
Whether a condition is considered a pre-existing condition depends on when the signs or symptoms occurred and when the exclusion periods on your policy end. Anything that happened before the exclusion periods ended is considered a pre-existing condition because it started before your coverage began.
Covered by Petsy
We cover Patella Luxation as long as it’s not pre-existing condition and your pet hasn’t shown signs or symptoms of the condition within the exclusion period.
A specified condition includes specific health issues, including cruciate ligament damage, intervertebral disc disease (IVDD), hip dysplasia, patella luxation, elbow dysplasia, osteochondritis dissecans (OCD), cherry eye, entropion, ectropion, and lumps.
Patella Luxation is a specified condition that has a 6 month exclusion period.
Once this period has passed and as long as your pet hasn’t shown symptoms, we can help to cover the vet costs for unexpected injuries and illnesses like Patella Luxation.
Can Petsy Insurance Cover My Pet’s Hip Dysplasia?
It depends on when you started your policy. If the signs or symptoms of Patella Luxation appeared before your policy began or during the exclusion period, it won’t be covered. But if you had an active policy and Patella Luxation happened unexpectedly, we can help to cover the costs.
If you’re a Petsy customer and are unsure about your exclusion periods and when the symptoms first appeared, you can request a pre-existing condition assessment. We’ll reach out to your vet for your pet’s medical history and let you know if your policy can cover it.
If you’re considering Petsy Pet Insurance, you can also reach out to our customer care team on 1300 952 790 for more information.
Does Petsy cover Patella Luxation?
Yes, Patella Luxation is covered under our standard policy. However, we can’t cover it if it’s a pre-existing condition, for example, if signs or symptoms appeared before your policy started or during the exclusion period. Petsy is here to protect you against unexpected vet costs.
How Petsy Pet Insurance can help with Patella Luxation
At Petsy, we understand how difficult it is when your pet faces Patella Luxation. Our insurance can help cover the costs of treatment, but it’s important to start your policy early, before any signs or symptoms appear.
Stay alert to any signs of Patella Luxation, and seek veterinary care proactively. Catching things early can make a big difference in your pet’s well-being and help them receive the best possible care.
Waiver Form
You can apply to reduce the 6-month exclusion period for Specified Conditions by using our Waiver Form. Simply take this form to your next vet visit and make sure to submit the completed form back to us within 14 days of the visit.
The conditions that this waiver applies to include cruciate ligament damage, intervertebral disc disease, hip dysplasia, patella luxation, elbow dysplasia, osteochondritis dissecans (OCD), cherry eye, entropion, ectropion, and lumps.
Here’s how to apply:
- Fill out Part 1: You start by completing Part 1 of the form.
- Vet Examination: Have your vet examine your pet and complete Part 2 of the form.
- Submit the Form: Send the completed form along with your pet’s full veterinary history to us within 14 days of the examination.
- Receive an updated Certificate of Insurance: Once the review is complete, we’ll issue an updated Certificate of Insurance detailing any reduced exclusion periods for specified conditions.
You can find the waiver form on our website under the ‘Policy Documents’ section, or contact us directly and we’ll send it to you.
Conclusion
Patella luxation is a serious condition that can significantly impact the quality of life of pets, but with early detection and proper care, many animals can achieve a full recovery. At Petsy Pet Insurance, we understand the emotional and financial strain that patella luxation can place on pet owners. That’s why we’re committed to providing comprehensive coverage that supports not only the necessary treatments—from surgery to physical therapy—but also preventive care measures that can mitigate the risks associated with this condition.
We encourage pet owners to take proactive steps in maintaining their pet’s joint health through regular veterinary check-ups, appropriate exercise, and nutrition tailored to their breed’s specific needs. Additionally, using preventive aids like ramps and supportive bedding can further protect your pet from potential injuries.
Frequently Asked Questions
Patellar luxation signs include limping, reluctance to put weight on the affected leg, intermittent skipping or hopping, and sudden lameness episodes.
Diagnosis involves a physical examination by a vet, X-rays to assess the joint alignment, and sometimes additional tests like CT scans or arthroscopy.
Yes, untreated patellar luxation can cause arthritis, chronic pain, and mobility problems in pets as they age.
Treatment may involve medication for pain management, physiotherapy, weight management, or surgical correction depending on the severity of the condition.
With appropriate treatment and care, many pets can lead normal lives post-treatment, although some may require ongoing management for optimal quality of life.
References
- Medicine. 2023. Available from: https://www.vet.cornell.edu/departments-centers-and-institutes/riney-canine-health-center/canine-health-information/patellar-luxation#:~:text=Patellar%20luxation%20is%20a%20common
- L’Eplattenier, H. and Montavon, P., 2002. Patellar luxation in dogs and cats: pathogenesis and diagnosis. Compendium, 24(3), pp.234-240.
- Hayes AG, Boudrieau RJ, Hungerford LL. Frequency and distribution of medial and lateral patellar luxation in dogs: 124 cases (1982–1992). Journal of the American Veterinary Medical Association. 1994 Sep 1;205(5):716-20.
- Patellar Luxation Fact Sheet [Internet]. Davies Veterinary Specialists. Available from: https://www.vetspecialists.co.uk/fact-sheets-post/patellar-luxation-fact-sheet/
- Di Dona F, Della Valle G, Fatone G. Patellar luxation in dogs. Veterinary Medicine: Research and Reports. 2018 May 31:23-32.
- Di Dona F, Della Valle G, Balestriere C, Lamagna B, Meomartino L, Napoleone G, Lamagna F, Fatone G. Lateral patellar luxation in nine small breed dogs. Open Veterinary Journal. 2016 Dec 21;6(3):255-8.
- Arthurs GI, LANGLEY‐HOBBS SJ. Complications associated with corrective surgery for patellar luxation in 109 dogs. Veterinary surgery. 2006 Aug;35(6):559-66.
- Gibbons SE, Macias C, Tonzing MA, Pinchbeck GL, McKee WM. Patellar luxation in 70 large breed dogs. Journal of small animal practice. 2006 Jan;47(1):3-9.
- Fitzpatrick Referrals. Patellar luxation [Internet]. Fitzpatrick Referrals. [cited 2024 Jul 4]. Available from: https://www.fitzpatrickreferrals.co.uk/orthopaedics/patellar-luxation/#:~:text=Non%2Dsurgical%20treatments%20for%20patellar
- Melbourne Pet Surgery. Medially Luxating Patella (MLP) Dog Surgery & Cost [Internet]. Melbourne Pet Surgery. [cited 2024 Jul 4]. Available from: https://www.melbournepetsurgery.com.au/medially-luxating-patella-surgery-dogs
- L’Eplattenier H, Montavon P. Patellar luxation in dogs and cats: management and prevention. Compendium. 2002 Apr;24(4):292-300.
- Bond Vet. Luxating Patella in Dogs: Symptoms, Treatment Options & Prognosis [Internet]. Bond Vet. Available from: https://bondvet.com/b/luxating-patella-dog#:~:text=While%20you%20may%20not%20be
