Nell has LP - tell me about it

Kyle took Nell to the vet tonight for her rabies vaccine and the vet gave her a fairly thorough exam I guess and told him she has a grade 3 LP. She is 8 now (will be 9 in Sept) and this is the first time a vet has ever mentioned it to us. Over the past year or so we've noticed some really sporadic, minor limping that'll last a few days then she's fine. I've just been attributing it to the extra weight she put on when she was on the steroids and maybe some arthritis starting. I obviously would like to avoid surgery.

Can you suggest any supplements I should be starting her on and anything else I can do to at least try to keep it from getting worse? She could still stand to lose some weight. Ever since she was on the steroids and gained a few pounds, it's been a struggle to get it off. For her age, she's still fairly active. She'll chase Ava around the house and is always under my feet so she doesn't just lay around 24/7. She is very solid though and there's nothing gentle or graceful about her so I'm sure that doesn't help her joints.

Of course Kyle didn't really ask the vet any questions so I'll have to give them a call as well. He said the vet also said something about the fact that, over time, the tendons will sometimes just stretch and accommodate the luxation so the issue is still there but it doesn't really cause any pain or mobility issues. I don't know if that's the exact explanation as that's the story I got from Kyle.

ok, so LP is something many of us have experience in.

though I'm not going to give you the answer you want to hear.

LP is one of those things that never gets better. And if he's calling it grade 3, I would suggest that surgery is imminent, regardless of what you try.

It's always a good idea to keep their weight down, and the glucosamine/chondroitin supplements don't hurt. but they won't fix it, and she'll limp around with her knee popping out from time to time.

When we were evaluating Bello's LP, we discussed options such as you've mentioned. "is it bad enough to require surgery", "can we do anything to avoid surgery", "can we wait for a while", etc. His was diagnosed by the specialist as a grade 3, and surgery was recommended as the best solution. Granted, he was much younger than Nell, with a high activity level (which is more important than age IMO).

My discussions indicated that at grade 1, surgery is optional (the wait and see approach), at grade 2, it's a maybe (depends on the dog, activity level, how much it's bothering them, etc.). at grade 3 or 4...surgery is the way to go. the grades are determined by how easily the kneecap slips out of place from what I understand. And if it's doing it enough that she's limping - even occasionally - it's cause for concern. it'll just get worse with her activity (the knee is rubbing down the joint/bones and so it's popping out of place).

yes, it's expensive (Bello's was $1400, and done by a specialist, not my general vet). but the outcomes are generally very positive, and it's a once and done expense.

I believe some general vets will do LP surgery, just depends on the vet, and their experience with it. I've seen costs more in the $900 range when that is the case (and of course, the cost can vary by geographic area). My vet referred us to the specialist, as this wasn't a surgery he was comfortable doing.

the recovery was not a ton of fun - several weeks of crate rest (seriously, crate rest with little cheating). the first week he could only come out to potty, and then if I carried him in and out, kept him on a leash, and he didn't get to walk on it. the next week he could take a few steps, but that was it. then we gradually increased it. there was physical therapy involved too to rebuild the muscle and regain mobility.

I saw them do an LP surgery on Dogtown where they put a cast on the knee which allowed the dog to be more mobile and less restricted at the beginning. I wish that would have been an option!

so there ya go.

Thanks Allie! I appreciate all the information. I think I want to make an appt to go back to the vet and talk to her myself. Not only was I not there (and Kyle didn't really ask anything) but this was also a new vet with the practice who I've never met.

I went back and reread your initial note - you mentioned a possibility as the tendon stretching out. That's part of the LP surgery.

I got the diagram demonstration of what they'd do.

LP surgery does a couple of things: deepened the joint that the kneecap sits in, making it harder, if not impossible to slip out; and tightening the tendons to sit around the knee and hold it into place better.

I'd definitely call and get more info - the grade, why they think that, and ask your questions. Absolutely!!

I agree with everything Allie said. It doesn't ever get better even with supplements. Basically, the groove in the cartilage has worn down over time and cartilage does not rebuild. They cut a deeper groove in the cartilage and tighten up the support ligaments (and put pins in).

Both Thurston and Kimchi have had LP surgery - Thurston in January of 09 (he was 1 1/2) and Kimchi before she came to the US and decided I was her her new Mommy. The surgery was MUCH more daunting that the actual experience. It was difficult to keep BOTH of them quiet afterwards - it's a long period of time for healing. Thurston was not used to being in a crate and was generally bored stiff. However, he a pretty mellow dude and did ok sitting with us. I did keep a leash on him so he wouldn't suddenly jump. Kimchi is a spitfire and, even though she had had a lot of healing time before she came to me, she still took a long time to stop favoring her leg. There was a period of time with BOTH of them that we though another surgery on the cruciate ligaments would be necessary, but it never had to happen.

Surgery at 8 isn't easy but having pain and discomfort for another 5-8 years isn't a good option either.

wow, you guys got it covered! Zoe had LP surgery in 2005. She was just 7months old.

all this LP talk has got me going through old pics of when Zoe had her surgery.

she had hot pink cast. I had to crate her for 30 days (not easy with a puppy!) but occassionally let her out if I watched her carefully.

here she is on the bed enjoying a bone:




in her crate after a frozen yogurt kong:





and just for fun, Zoe's wearing a special shirt Amanda might recognize.

Wow, maybe we need a poll here for how many of us have had our babies go through LP??

My Ichiro had it done...when he was just 11 months old. His was severe! One day, he just couldn't walk. It was not occasional at all - it was immediate. Poor baby! The vet thought both knees would need it, but it ended up only one. Now he is 6, and he occasionally limps, but nothing like it was...which has me thinking, that other knee might be getting ready to act up and need the surgery. The initial surgery cost for us was somewhere around $1300.

He was pretty traumatized by the surgery, and we didn't have a crate, so he just stayed on a pillow on the floor. I layed with him every night, and my grandma watched him during the day. We didn't do any physical therapy, but I wish I had known about that. It took a few months of recovery, but after that, he was and is just fine. I have never regretted the surgery.

The funniest thing to me was the big old patch of fur they shaved off his side, so they could stick on the pain med patch. It took, no joke, 6 months for that fur to grow back!

So, I agree with everyone else....talk with the vet, maybe even get a second opinion, but start getting prepared, I think.

Oh yeah, pics! Plus, if you REALLY want to have some fun, have Kyle have hernia surgery the same day so you have 2 sickies to take care of. Here are my 2 drugged darlings. One can't walk and one can't lift more than 12 pounds (Thurston is 19).

Rudy has LP, it was diagnosed when she was about a year old. It has barely ever had any visible effect on her, she's very active and even competed in agility for a number of years. She's almost 11 now.

We saw a specialist who did not recommend surgery unless the dog was coming up lame. He said there was a possibility it would become necessary later, due to loosening ligaments like you mentioned, and arthritis was highly likely with or without surgery. Lots of walking on varied surfaces, off leash if possible. You just want to keep the area around the knee as muscled as possible and keep them very lean.

LP can be caused by an injury, but typically it's something they're pretty much born with.

I find it very interesting that some vets do casts and some don't. I think I'd feel a whole lot better with a cast!

Anyway, I'm going to call the vet and see what else I can find out. I'm certainly not going to rush to surgery but at least want to have all the information. I really don't believe it's bothering her currently but like some have said, it could become a problem overnight. We're definitely going to work on diet and exercise for a bit and see how things go. The tough thing with LP, though, seems that it's not the type of thing where we could work on her weight and exercise and take her back to the vet to check and see if there's any change. It's not something likely to improve, just perhaps not progress.

Mel wrote:
and just for fun, Zoe's wearing a special shirt Amanda might recognize.

Aw! My little Piggy! Man, I miss that boy!

I haven't had a case severe enough for surgery. Lola was graded at 1/2 in both legs, but did fine until this last year when both back legs were worse--largely due to age and arthritis. At 14, LP surgery just isn't an option for her and she's still highly mobile, if wobbly.

I use Sasha's Blend for her as a supplement. And she goes swimming once a week to help keep the other muscles toned. And she's gets Previcox for the arthritis.

The one thing I was cautioned about with any dog with hip or knee issues is to avoid repetitive activities like leash walking--the repetitive pounding of the walking is harder on joints than "free range" exercise where they can start and stop as they need to.

I was told by our new vet that Murphy has a grade one. It's not bad enough for surgery but she suggested that I keep his weight low.

I have a friend who's pug has LP, not sure what grade, but they swear by acupuncture. I'll get more info for you on this.

Thanks Sam. I intended to do some reading on LP tonight but our internet is down. I only have the patience to do so much from my phone!

That is what my fosterpug, Sherman, is getting surgery for on Tuesday... It wil cost about 1,500 bucks up here... Then he has two weeks in a splint, then 3 or more weeks theerapy after. Sherman is 6, but from a very bad BYB breeding. His brothers all have bone issues, too.