The infamous Rare Luxating Patella

nolalola

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foxxycat foxxycat - Please forgive me for not responding sooner! My mom fell and broke her left shoulder (humeral head fx) and her right foot (navicular avulsion fx) and I have had to move in with her and take care of her 24/7. I’m so exhausted i can’t barely see straight. What’s up with these random ortho issues popping up all around me?

Zeus’s pain level seems to be pretty mild as long as that knee stays in place, but when it pops out and he sees me coming toward him to fix it, he cries and cowers so I know he has some degree of uncomfortableness. I’ve consulted with two other vets and they agree that surgery seems like the best option to prevent further damage to that knee down the road. His injury when he was a Kitten was a fracture at the right ankle growth plate, not at the knee. But my vet said that the way the bones healed may have made that leg more vulnerable to the LP because, in taking a closer look at his X-rays, the bones do look somewhat bowed out leading from ankle to knee.

The orthopedic surgeon - Dr. George Edwards from Magnolia Veterinary Surgery - is in town tomorrow and we had set a tentative surgery date before all this happened with my mom, but I made it clear I wanted to discuss all of this more in depth over the phone tonight and he never called.

Zeus’s kneecap pops out almost daily, sometimes multiple times a day, but usually he fixes it himself or I manually pop it... This intially began right at a month ago. I don’t know what to do. My vet is concerned about further damage if we don’t treat now.. that the grade could progress to a 4 and cause permanent damage or that early arthritis would set in with that knee grinding in and out daily. If I’m repeating things I apologize. I’m one step away from a nervous breakdown dealing with my mom!
 

foxxycat

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If it's been over a month-that seems reasonable. Honeybee's was popping out for only about 3 weeks then limped for another 3 weeks.

this sounds like a different issue-especially with the bone broken prior=the surgeon is correct. I would see what they suggest..we are now only 6 weeks away from January 1-can you have surgery after that?

I am sorry about the stress with your mom-I don't blame you for wanted to go insane..it's an awful lot to go through in a short time...

If you do decide to get the surgery at a later date-you will need to get two big dog cages to put together-so your cat has a place to stay for the post recovery-I think if I remember- 6 weeks. The cage needs to be big enough for litter/food/water and bed. The most important post recovery=NO jumping-so cage living for 6 weeks is what is recommended...I hope things work out better for you-but at least now you can start to prepare-you have time to gather supplies-think up where you will set up the cage....I am so sorry your cat has to get the surgery but yes it will prevent problems in the future..hugs hun!
 

nolalola

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Thank you. My husband and I had a prior obligation to be out of town for the week of Thanksgiving. Zeus already had a boarding reservation at the vet and the surgeon was going to be there, so he had surgery a week ago today and I was able to bring him home last night. I hated to make the decision so quickly, but it seemed ideal for him to be able to spend that first week post-surgery under the care of my vet. Poor kitty is already driving me crazy in the dog crate - how can i do this for 5 more weeks? Lol.

I have him in a dog crate that is big enough to fit his bed, food, and litter box but it’s only one crate so I may borrow another one from a friend to make his space bigger. He woke me up at 5:45 this morning with this awful forlorn cry. And my female cat was joining him from the back bedroom so I guess this is my life for the foreseeable future. I’m already exhausted. Zeus is allowed 5-10 minutes of supervised time a day outside of the crate. I feel so bad for him! Any tips to make cage rest easier on all of us are appreciated.
 

PushPurrCatPaws

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Hi nolalola nolalola ! I can try adding more to our last convo, to try to give you some ideas that may help but I can also mention a few things here!

Zeus probably got a bit discombobulated (I love that word) while at the vet's and has a wacky schedule from being at the vet. One thing that could begin to help his mood is --as much as you are able while he is being crated-- set up a very regular daily schedule. Food times the same, play/interacting times when you see he's bored or forlorn, sleeping times the same... and I highly recommend keeping the "supervised time for 5-10 minutes out of the crate" to be at the same time each day. If you do it at any time of day and vary it all the time, he will get more cranky and expect to "be free" at any time, at will... he will become a "crate darter" (similar to a "door darter", for animals that try to escape for the door when the humans open it). So, make the "freedom time" a set daily thing, and he will likely look forward to that regular time with less stress.

You, however, will be exhausted. Catch sleep whenever you can! You're going to get really sick of cleaning the litter box, too, as it probably needs more continual attention when inside the closed system of crate(s), to keep that environment nice. You don't want Zeus peeing in the wrong places!

Also, yes, I recommend putting two crates together to give him more real estate to move around in the crate(s). For my cat, we had about 3 ft X 8 ft of crate space for her to move around. Inside the crate, put the dish, the litter box, the bed, always in the same place, so he can come to rely upon his territory in there. And I recommend putting a small scratch post in the crate, so he can stretch and scratch and mark territory. Also, I set a gently ticking clock (an analog, travel clock that had a gentle, quiet "tick - tick -tick" sound) right near my kitty's main sleeping area. I don't know if the regular, gentle sound of it (that only cats can hear) throughout the two months of crate rest helped her calm a bit when the humans weren't around, but I like to think so.

The most important thing is NO RUNNING, No jumping up onto anything, even a jump of a few feet can mess up the surgeon's work during that first 6-8 weeks. If you can get through the enforced 6-8 weeks of crate rest without the cat having run around or jumped, you've conquered most of the battle.

I can convo you more later, but I am prepping for a trip myself this week and don't have a ton of extra time. Going to go visit my parents soon.
:)
 
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nolalola

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My mom is having surgery today on her broken foot - they just wheeled her back, so I have some time to post! Guys, Zeus is so unhappy with his cage rest. I can tell in just a few days that his little spirit is dampening and it is heartbreaking! At least at the vet when he was boarding last week he was in the same cage as Zephyr (his sister) and the techs showered him with love and treats all day long. I’m not able to be home with him all the time because of the situation with my mom.

Zeus is a very affectionate, loving cat that craves lap love and belly rubs. He also has a ton of energy and loves to run and play. This morning when i let him out for his 5 minute walk, he hid under our bed and wouldn’t come out for any bribery (wet food or a wiggle of da bird toy usually works every time). I had to drag him out from under the bed and when i left the house to pick up my mom for surgery, he was howling in his cage. I feel awful. Cage rage is already setting in. Did y’all feel like it had a psychological impact on your cats? Also, my husband and I were discussing - how does 6 weeks of cage rest not stove them up completely? Seems like hardly any exercise at all would make that knee and leg so stiff.

I did add the extra dog crate to his current cage, but there is a size discrepancy so the additional cage is really only big enough for his litter box. We had to attach them together with duct tape and carboard! I didn’t realize when I borrowed the second crate that they weren’t the same size. It does give him room to just have his bed and food bowl in the bigger crate and room to stretch. But it’s not double the room like I initially thought. I’ll upload a pic of his grumpy self this morning before i let him out. I tried to add it to this post but it took half my text away.
 

PushPurrCatPaws

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My mom is having surgery today on her broken foot - they just wheeled her back, so I have some time to post! Guys, Zeus is so unhappy with his cage rest. I can tell in just a few days that his little spirit is dampening and it is heartbreaking! At least at the vet when he was boarding last week he was in the same cage as Zephyr (his sister) and the techs showered him with love and treats all day long. I’m not able to be home with him all the time because of the situation with my mom.
Good luck regarding your mom's surgery!

Cage rest is no fun for an active young cat, that's for sure. Were you able to have an informational discharge appointment with the veterinary nurse or surgeon, regarding what to do for a cat's mood during cage rest, etc.?

Zeus is a very affectionate, loving cat that craves lap love and belly rubs. He also has a ton of energy and loves to run and play. This morning when i let him out for his 5 minute walk, he hid under our bed and wouldn’t come out for any bribery (wet food or a wiggle of da bird toy usually works every time). I had to drag him out from under the bed and when i left the house to pick up my mom for surgery, he was howling in his cage. I feel awful. Cage rage is already setting in. Did y’all feel like it had a psychological impact on your cats? Also, my husband and I were discussing - how does 6 weeks of cage rest not stove them up completely? Seems like hardly any exercise at all would make that knee and leg so stiff.
When you do the daily mini-walking, it's better to do it in a confined small room where you've removed any chairs or tables that the cat can jump up on. That goes for trying to have a room where he cannot hide under things, like a bed or couch, as dragging the cat out from underneath of a bed can injure the knee and rip the sutures. Do you have a little room like that? We were lucky to have a small foyer area where we could take out the chair and console, and close off access to the rest of the apartment.

Think of the 6 weeks of cage rest as a healing and muscle/ligment/bone/sutures mending time period. Almost like if you make a balsa model airplane... you don't want to try flying it before the glue has had a chance to dry and cure. He needs to walk, walk only, as much as the vet permits.... and after the cage rest, he can be more of a cat. You have a much better chance of a successful surgery if you can get through that bone and small tissue mending time period. Everything was likely reworked in his knee by the ortho surgeon. That needs time to "meld" and grow together again. Does that make sense? If you let him be too active too soon, you might be facing a 2nd surgery to repair a 1st surgery that got "broken".

I did add the extra dog crate to his current cage, but there is a size discrepancy so the additional cage is really only big enough for his litter box. We had to attach them together with duct tape and carboard! I didn’t realize when I borrowed the second crate that they weren’t the same size. It does give him room to just have his bed and food bowl in the bigger crate and room to stretch. But it’s not double the room like I initially thought. I’ll upload a pic of his grumpy self this morning before i let him out. I tried to add it to this post but it took half my text away.
Poor Zeus! I assume the surgeon passed along a bit of pain killer to help him for another week or so? There is also a med that can help with his mood; the vet nurse or surgeon would know more about that.

I think it's good the litter box has its own little space now, and that gives him a smidge more room to --lol-- pace around a bit. Poor Zeus! He can do it, though!
:vibes: :vibes: :cheerleader:
 

liddle_spiders

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Wanted to update on our 9 year old who has had LP since around 18 months.

Since last posting her activity level has gone downhill, no more jumping on things or walking up or down steps. We took her to an orthopaedic surgeon expecting they would want to do surgery, but even at a grade 4 they said it would do nothing for her. Her kneecap is always out and she has mild arthritis and some small bone spurs, but she shows no signs of being in any sort of pain to where surgery would be helpful. The doc thinks it is all age related changes and has her on anti-inflammatories and Cosequin. Next step would be heavier drugs to relieve swelling. No surgery at all, it would not improve her life in any way.

I was really surprised by being told that after having read through this topic a few times. This office is not known for turning away money so I believe them when they say there is no point to it!
 

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I would get a second opinion. Sounds like horse crap to me. Humans have benefited from scraping of bone spurs n arthritis. It seems cruel to not be able to do surgery. Especially at 9 years old. That's wayy too young to be handicapped.

You may have to travel out of state to find another ortho or do some research to see if you can find similar cases in veterinary journals. Maybe call the teaching hospitals like Tufts etc and see if you can consult with someone on the phone. It may only cost $20 but that would be worth the hassle so you can get some concrete answers. Perhaps we don't have small enough equipment to do these kinds of repairs?

That's the only thing I can think of.
 

nolalola

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L liddle_spiders Im so sorry to hear that your kitty’s activity level has gone down. 9 years is still young for a cat, a second opinion is certainly worth considering if surgery can get her back to her usual favorite activities. I respect the surgeon’s opinion, but I’m surprised, too, given all the research I’ve done regarding grade 4 luxation. I could tell that Zeus’ kneecap being out was making him more and more uncomfortable and the ortho that did his surgery said if the knee is constantly out it sets them up for a worse injury down the road.

While I’m on here I may as well update - we are now on week 8 of recovery and Zeus is doing pretty good. He did manage to break a tooth (front top fang!) on his cage during week 2/3 of cage rest so then he had to see a feline dentist! Lord have mercy. He will either have to have a root canal or a total extraction. Seriously sometimes I think I’m on candid camera. He is still mildly stiff on that leg, but the surgeon said let him have full activity back so he’s running, jumping, chasing his sister, etc. Behaviorwise you’d never think anything had been wrong.

Some things are a little different like he doesn’t extend that leg completely straight when he’s bathing and when he hops onto things he sort of looks like a rabbit. He’s definitely learned to maneuver himself and adapt to the knee. I had a phone consultation with the surgeon today and he said give him about 4 more weeks and if he isn’t completely back to normal we will X-ray it to make sure all working parts are settled into the groove properly. But overall he’s 95% better than what was happening pre-surgery.

Hope everyone had a safe and happy holiday!
 

Courtforshort27

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My kitten Mikko was diagnosed with luxating patellas in both legs, grade 2, at just 5 months old. My vet recommended we just watch and wait, with the possibility of surgery in the future. Since he has been getting Dasaquin supplements but I don’t see much improvement, in fact it’s getting worse.. poor baby. They dislocate almost every time he walks. He can’t run or jump. However I am thankful he is able to pop them back into place by lying down, and he often eats/drinks with his legs sprawled out behind him. He is now reaching 10
months, and I think it’s time I finally try to find a orthopedic surgeon/experienced vet who has preformed the surgery before to get their recommendation. I have read this whole thread, and would prefer the option of getting both of his legs done at once (if the vet agrees)
 

Courtforshort27

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Oops I posted without finishing! Cat mom brain. Anyway, my only concern post-op is since I am a nurse, he will be alone for 12 hours at a time. I am not very fond of the crate rest because that just seems like torture. But it is necessary. And who am I kidding, he basically lays in the same favorite spot of his all day anyway! I’m assuming as long as he is in a crate, he will be fine left alone for periods of time. He had to have his part tail amputated when he was younger, and the worst part was the cone of shame, and I know that will also be involved post op. I learned so much from reading this thread and hearing all of the good outcomes, prayer for everyone who has a kitty dealing with this rare disorder (my vet said he has never seen it in a cat in his 30 years of experience)!
 

dshank1

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Oops I posted without finishing! Cat mom brain. Anyway, my only concern post-op is since I am a nurse, he will be alone for 12 hours at a time. I am not very fond of the crate rest because that just seems like torture. But it is necessary. And who am I kidding, he basically lays in the same favorite spot of his all day anyway! I’m assuming as long as he is in a crate, he will be fine left alone for periods of time. He had to have his part tail amputated when he was younger, and the worst part was the cone of shame, and I know that will also be involved post op. I learned so much from reading this thread and hearing all of the good outcomes, prayer for everyone who has a kitty dealing with this rare disorder (my vet said he has never seen it in a cat in his 30 years of experience)!
Good Afternoon,
Once we knew what Roadie’s issues where, I didn’t want to delay her surgery. The doc did say we could wait but I did not agree with making her not have a normal kitten life. I also work very long 12 days but was able to schedule vacation time to be home with her at first. We kept her in a large soft sided crate that enough room for her bed, litter box, food & water. She was also medicated for a couple of weeks which helped her hyper kitten self. Several years later she has made a full recovery and she does not favor that leg at all. They do say when she gets older she will more than likely have arthritis. I was also blessed to have signed her up for pet insurance when she was of age and that was a financial relief as well because her surgery and after care was expensive.
Good luck on your kitties surgery and I hope you find a great surgeon.
 

Courtforshort27

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Well a few months later and Mikkos is home post op day 2 from his bilateral surgery. I found a orthopedic vet who did both legs for $2,000, and I live in VA. We’ve already made one trip back to the vet for ripping out staples, and the poor guy definitely isn’t doing too well. He’s still purring but can’t walk at all and I knew the recovery process was going to be a long one but I just hate seeing my little man in pain. Any idea as to when he might be able to walk again? I just keep telling myself each day will get easier.
 

dcat

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Well a few months later and Mikkos is home post op day 2 from his bilateral surgery. I found a orthopedic vet who did both legs for $2,000, and I live in VA. We’ve already made one trip back to the vet for ripping out staples, and the poor guy definitely isn’t doing too well. He’s still purring but can’t walk at all and I knew the recovery process was going to be a long one but I just hate seeing my little man in pain. Any idea as to when he might be able to walk again? I just keep telling myself each day will get easier.
My Dexter had the double knee surgery for a pair of luxating patellas. We knew that doing both at once would lead to a more challenging initial reccovery, but felt it was better than going through the procedure one knee at a time a year apart. For the first couple of days at home, Dexter was capable of limping a little. In fact, we were shocked when he ever so slowly limped to his litter box. Week by week his pain subsided and he was back to his old self within 6 weeks. Be patient. Sounds like your little guy may have a rougher recovery... but he WILL recover and be back to his old self... Promise!
 

Courtforshort27

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My Dexter had the double knee surgery for a pair of luxating patellas. We knew that doing both at once would lead to a more challenging initial reccovery, but felt it was better than going through the procedure one knee at a time a year apart. For the first couple of days at home, Dexter was capable of limping a little. In fact, we were shocked when he ever so slowly limped to his litter box. Week by week his pain subsided and he was back to his old self within 6 weeks. Be patient. Sounds like your little guy may have a rougher recovery... but he WILL recover and be back to his old self... Promise!
Thank you so much for the reply. That gives me so much hope! He is doing a little better today, he was able to get up once and hobbled to the front of his kennel, which is definitely progress!
 

Courtforshort27

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It’s been almost 2 weeks and he doing so well. He has started to walk and actually puts one foot in front of the other which is a big step from the little hobble he was doing. He hasn’t had any pain medication and hasn’t shown any signs of pain in a week. He is doing amazing!!! He is actually sitting like a normal cat too, which he never did before because his knees would pop out so this was a very happy moment! He’s feeling better and better each day
 

catpooch

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Hello!
Was doing some googling, trying to find as much information as possible and came across this forum & it’s been so insightful.
10 days ago our cat ‘Pooch’ we think misjudged a jump and fell badly (we heard it, didn’t see what happened!) and for a whole day she was hiding & acting so sad. Took her to the vets a few times and eventually one of them confirmed it’s Luxating Patellas in Both back legs - although her back left leg is the most prominent and the one she seems to be limping on more. She is only 3 years old and a stray. Never had any problems with her legs before and they said this is probably just something she will need to live with, and surgery is very distressing for them and that her case didn’t seem too severe.
But I wanted to know - what makes this severe and non severe?! Pooch still loves to run and jump up on things! (she is an indoor cat) but on a night when we get home we notice it happens 2-3 times where she will try to walk up onto something higher like a small step and her back knee will buckle and she will start limping. since figuring this out 2 days ago I have been helping her when I notice it and picking her up to help stretch her leg.
I just wanted to see how often this happened with other cats, is it something that happens in spurts, maybe a couple times a day for a few weeks and then gets better? Or will this be every day for the rest of her life?
it is so sad to think that animals have this problem at all :(
Any help or insight to your cats dealing / living with this would be so great! Thanks :)
 

Courtforshort27

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Hello!
Was doing some googling, trying to find as much information as possible and came across this forum & it’s been so insightful.
10 days ago our cat ‘Pooch’ we think misjudged a jump and fell badly (we heard it, didn’t see what happened!) and for a whole day she was hiding & acting so sad. Took her to the vets a few times and eventually one of them confirmed it’s Luxating Patellas in Both back legs - although her back left leg is the most prominent and the one she seems to be limping on more. She is only 3 years old and a stray. Never had any problems with her legs before and they said this is probably just something she will need to live with, and surgery is very distressing for them and that her case didn’t seem too severe.
But I wanted to know - what makes this severe and non severe?! Pooch still loves to run and jump up on things! (she is an indoor cat) but on a night when we get home we notice it happens 2-3 times where she will try to walk up onto something higher like a small step and her back knee will buckle and she will start limping. since figuring this out 2 days ago I have been helping her when I notice it and picking her up to help stretch her leg.
I just wanted to see how often this happened with other cats, is it something that happens in spurts, maybe a couple times a day for a few weeks and then gets better? Or will this be every day for the rest of her life?
it is so sad to think that animals have this problem at all :(
Any help or insight to your cats dealing / living with this would be so great! Thanks :)
Hello! I’m so sorry to hear about Pooch! My cat was diagnosed with bilaterally luxating patellas when he was 12 weeks old. He never was able to jump/run without them dislocating, so he lived a very pitiful first year. But he did learn how to pop them back in, and I’m sure Pooch will too. Since it was caused by an injury, and it does not seem to be too severe, I think the surgery would be a little over kill in your case. The surgery was very extensive and expensive, and Mikko had to be kept crated for about 3 months. His surgery was in May so he has healed very well, and his knees haven’t popped out at all! He doesn’t really jump, but he never has. He uses stairs to get on my bed and uses mainly his front legs to claw up the cat tree. And he walks like a little T Rex now, but it’s actually really cute. I’m just glad he is pain free now. If you haven’t heard of them already, I would try a Cosequin (I could be spelling that wrong) supplement for cats. The cheapest place I have found it is on Chewy.com. When Mikko was still suffering from this, I found that the supplements really decreased the amount of times it happened during the day. It works by thickening the fluid in the joints, making it a little bit harder for that joint to slip and giving it more cushion. I hope all goes well with Pooch!!
 
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