Luxating Patella, Surgery Or Amputate?

[ali-oop]

Hello, I was hoping I could get some advice or insight from you all regarding the surgery for Luxating patellas.

At the end of April this year my cat with known luxating patellas, fell and now her leg will not go back into joint. I took her to the emergency vet about five days after the incident. They said she would either need to amputate or get the surgery to repair the joint. I called my vet and she recommended I bring Daisy in for a second opinion. So I did that. Her second opinion was to do a consultation before the surgery. Which was not at all helpful. Those visits alone were $330 and I had already known about her luxating patellas.

I was so upset when I took her to the emergency vet that I didn’t retain a lot of information and didn’t ask enough questions. From what I’ve googled, no one has said that the surgery would need to be done again, but she is only six years old. My fear is I would get the surgery and then they’re like OK see us again in 3 years! The other concern is that her other back leg has the same issue. So if I amputate one leg, it is putting more stress on the other leg.

I have a cashed in my personal and vacation time and gotten to a point where I can afford to amputate (1,200k). The surgery, which they’re saying around $3000, would require taking out a loan out of my 401k. Loans that would be a strain to pay back. The bank denied me a credit card. I know cats can live happily with only three legs, but it seems like a drastic choice. Especially if it’s going to aggravate her other leg.

She doesn’t act like he’s in pain. I keep her confined to my room. And then leave her for 10 hours a day. She still runs and jumps and acts like an idiot. Practically doing backflips playing with hair ties. I had to build her a ramp to my bed bc she would still jump up and down to it.

Anyway I know the post is long... I know ultimately it’s up to me but I want to do right by her. Anyone has experience with the surgery? Or decided to amputate? The leg is question was always the worst one. My poor (semi)sweet potential peg leg puss!!

 

[Daisy6]

Welcome to TCS. Your Daisy is a beautiful kitty! Our cats have the same name. Is it the left or right leg we are talking about?

Poor baby. I know tripod cats live normal lives, but would rather save her leg and do the less drastic surgery. Did the vet explain what happens during the surgery? (This is important to know.) Because both knees are bad, it would make no sense to amputate one leg and put more stress on the other leg. An already bad leg can get worse that way. Only her vet can say how likely that is to happen though.

 

[lutece]

I haven't had a cat myself with severe luxating patella. Many years ago, I have seen cats at friends' houses that had the repair surgery. It did improve their quality of life and did not have to be done again later. This was MANY years ago, though, so I can't just call up those friends and ask them about it.

If both her legs have luxating patella and you amputate one, I understand your concern that she would then put extra stress on the other one and possibly cause it to get worse. I would think that the best thing to do would be to repair the bad knee, but I understand the cost of surgery is a big hardship.

 

[ali-oop]

Welcome to TCS. Your Daisy is a beautiful kitty! Our cats have the same name. Is it the left or right leg we are talking about?

Poor baby. I know tripod cats live normal lives, but would rather save her leg and do the less drastic surgery. Did the vet explain what happens during the surgery? (This is important to know.) Because both knees are bad, it would make no sense to amputate one leg and put more stress on the other leg. An already bad leg can get worse that way. Only her vet can say how likely that is to happen though.

It is her left leg. Other than telling me they carve out a groove there wasn’t much more info. The whole thing will just be so much money. But I see your point about it exacerbating the condition of the right leg.

 

[Daisy6]

Amputating the leg is "so much money" too. It is not like when people decide they should let an injury heal on its own because surgery is too expensive. Your choice is this operation or that operation.

 

[silkenpaw]

Daisy6 ROFL!

 

[Daisy6]

What's so funny silk?

 

[ali-oop]

What's so funny silk?

I am also curious as to what’s so funny. About any of this.

 

[silkenpaw]

Well actually, I don’t remember, so I guess it wasn’t very funny after all. Im so sorry. I apologize.

 

[Kieka]

I'd second the worry that not doing the surgery would only cause additionally stress on the other knee and risk repeating the condition there. While surgery is expensive, if you can make it work that would be the best outcome long-term. Does your vet take CareCredit? The 0% interest really has helped me with pet expenses.

We've had some other threads on this that may be helpful:

Anyone Done The Luxating Patella Surgery?

The infamous Rare Luxating Patella

What Made Your "confined-to-crate-rest" Cat Relax? Offer Some Handy Tips...

PushPurrCatPaws do you have anything to add to this thread?

 

[PushPurrCatPaws]

I'd second the worry that not doing the surgery would only cause additionally stress on the other knee and risk repeating the condition there. While surgery is expensive, if you can make it work that would be the best outcome long-term. ...

PushPurrCatPaws do you have anything to add to this thread?

I do and I've been trying to make some time to draft a good reply since yesterday (when I saw this thread). --Multi-tasking-- . . . I feel that A ali-oop is in the midst of a very difficult decision, so I wanted to take some time with my comment. Still working on it, though now it might be anti-climactic once I reply.

 

[Kieka]

I do and I've been trying to make some time to draft a good reply since yesterday (when I saw this thread). --Multi-tasking-- . . . I feel that A ali-oop is in the midst of a very difficult decision, so I wanted to take some time with my comment. Still working on it, though now it might be anti-climactic once I reply.

Thank you!

 

[silkenpaw]

A ali-oop Did the vet quote you a price on amputation versus repair? Either way, it's a hospital stay and an amputation is a big surgery, too.

 

[PushPurrCatPaws]

Hello, I was hoping I could get some advice or insight from you all regarding the surgery for Luxating patellas.

At the end of April this year my cat with known luxating patellas, fell and now her leg will not go back into joint. I took her to the emergency vet about five days after the incident. They said she would either need to amputate or get the surgery to repair the joint. I called my vet and she recommended I bring Daisy in for a second opinion. So I did that. Her second opinion was to do a consultation before the surgery. Which was not at all helpful. Those visits alone were $330 and I had already known about her luxating patellas.

I was so upset when I took her to the emergency vet that I didn’t retain a lot of information and didn’t ask enough questions. From what I’ve googled, no one has said that the surgery would need to be done again, but she is only six years old. My fear is I would get the surgery and then they’re like OK see us again in 3 years! The other concern is that her other back leg has the same issue. So if I amputate one leg, it is putting more stress on the other leg.

I have a cashed in my personal and vacation time and gotten to a point where I can afford to amputate (1,200k). The surgery, which they’re saying around $3000, would require taking out a loan out of my 401k. Loans that would be a strain to pay back. The bank denied me a credit card. I know cats can live happily with only three legs, but it seems like a drastic choice. Especially if it’s going to aggravate her other leg.

She doesn’t act like he’s in pain. I keep her confined to my room. And then leave her for 10 hours a day. She still runs and jumps and acts like an idiot. Practically doing backflips playing with hair ties. I had to build her a ramp to my bed bc she would still jump up and down to it.

Anyway I know the post is long... I know ultimately it’s up to me but I want to do right by her. Anyone has experience with the surgery? Or decided to amputate? The leg is question was always the worst one. My poor (semi)sweet potential peg leg puss!!

This is such a tough position to be in, I wouldn't wish it upon anyone.

I have a cat who had congenital luxating patellas. She is just over three years old now and the surgeries are behind us. The surgeon states that her "repairs" should hold for her lifetime, at this point. Cross fingers!


We started seeing signs of her luxations when she was about 13-15 months old. I never even heard of such a thing before that time! A ali-oop , how long have you known about Daisy's knees? When you notified the vet at that point, did they go over possible knee surgery options with you then? If Daisy's issues are congenital, like with my cat, the luxations get progressively worse until lameness results if nothing is done. We decided on knee surgery for our cat, and scheduled the surgeries when the luxation issue with each knee had reached about Grades II-III. Once the patella is luxating so much that it is basically staying out of its trochlear groove and not going back in at all on its own (or with a vet's manual attempts), you pretty much have reached full lameness and Grade IV luxation. I don't believe the prognosis (to a full or nearly full recovery) is as good with a Grade IV luxation than with Grades I-III.

A lot of recovery depends on the damage to the knee and surrounding soft tissue, the weight of the cat, the age, etc. When my husband and I found out that our young cat had luxating patellas in both hind legs, we were able to decide on surgery as soon as it seemed necessary so that the prognosis for her would be better in the long run. Our cat is younger than yours and at a good weight. If your Daisy has a lot of good things going for her (good weight, activity level, healthy otherwise, successful enforced crate rest), she could very well have a good prognosis after a knee surgery. We were blessed to be at a time in our work lives where we had some extra money to do these expensive surgeries. I really feel for you in your position, with what you are going through right now financially. It makes this thing so hard for you! Daisy is a beautiful, well-loved kitty. I really don't know what I'd do in your position. I don't really know how long you've known of the knee issues with your cat, what your cat's weight is, what prognosis a surgeon might make, etc. I think that is why your vet suggested a consultation (probably meaning a consultation with an orthopedic vet surgeon), to find out how advanced the knee issues are with Daisy. I found our own consultation with the surgeon and the diagnostics like xrays to be helpful in getting us to make a decision on what to finally do with our cat. We didn't do MRIs and CT scans: our surgeon didn't need to see those prior to surgery-- I had some videos of my cat's knees as they were luxating, so he knew what was happening, what with his experience and all. Even then, this knee surgery can be a very grueling tough road to travel on, to recover from the surgeries. Cats are so much more independent and active than dogs in recovering from such surgeries. It's not easy to keep them calm.

With either leg surgery that you decide to do for Daisy, there will be recovery and crate rest. I don't believe you'd have to have surgery again for a repaired luxated patella UNLESS the cat did not do well with crate rest and/or she re-injured the knee, joint and/or soft tissue before the area was fully healed and strong. It can take several months. And the leg won't be 100% recovered until 8-12 months later. That's why you have to follow the surgeon's instructions very closely during the recovery and rehab time period (for many months post-surgery). It just helps to ensure that more surgeries won't be needed to repair the knee joint in the future.

Daisy has issues with her other knee, too, it sounds like... nothing is easy about your decision. I think doing the luxated patella surgery still puts some temporary stress on her other leg, but she'll recover from that as she strengthens and mends. And she'll have both legs. The thing is, if you let the other knee get just as lame and if you had decided to amputate the current knee -- well, then, what to do at the point when the other knee goes lame? This is really tough. Can a cat only have two legs? If you read one of the 'luxating patella' threads from start to finish (the one with "infamous" in its title that Kieka pointed out above), you'll find several examples of cat owners deciding to do both knee surgeries at once. That's not the route I took with my cat (her surgeries were spaced one year apart), but others had success with it, I think.

Either way, the surgeries cost money and the recovery and care costs money.

Kieka gave some advice regarding financial issues, and maybe you can also start a GoFundMe page, if you decide to do the knee surgery route versus the amputation (it sounds like you have money already set aside for the latter, if you decide on that).

What is your input, A ali-oop ?

 

[ali-oop]

A ali-oop Did the vet quote you a price on amputation versus repair? Either way, it's a hospital stay and an amputation is a big surgery, too.

Yes, approx 1200 for the amputation and 3,000 for the repair.

 

[Daisy6]

That's crazy. Why would the more dastric option be less expenisve? The risks of a catastrophic complication are much higher with amputation because the whole leg is cut off.

 

[ali-oop]

This is such a tough position to be in, I wouldn't wish it upon anyone.

I have a cat who had congenital luxating patellas. She is just over three years old now and the surgeries are behind us. The surgeon states that her "repairs" should hold for her lifetime, at this point. Cross fingers!


We started seeing signs of her luxations when she was about 13-15 months old. I never even heard of such a thing before that time! A ali-oop , how long have you known about Daisy's knees? When you notified the vet at that point, did they go over possible knee surgery options with you then? If Daisy's issues are congenital, like with my cat, the luxations get progressively worse until lameness results if nothing is done. We decided on knee surgery for our cat, and scheduled the surgeries when the luxation issue with each knee had reached about Grades II-III. Once the patella is luxating so much that it is basically staying out of its trochlear groove and not going back in at all on its own (or with a vet's manual attempts), you pretty much have reached full lameness and Grade IV luxation. I don't believe the prognosis (to a full or nearly full recovery) is as good with a Grade IV luxation than with Grades I-III.

A lot of recovery depends on the damage to the knee and surrounding soft tissue, the weight of the cat, the age, etc. When my husband and I found out that our young cat had luxating patellas in both hind legs, we were able to decide on surgery as soon as it seemed necessary so that the prognosis for her would be better in the long run. Our cat is younger than yours and at a good weight. If your Daisy has a lot of good things going for her (good weight, activity level, healthy otherwise, successful enforced crate rest), she could very well have a good prognosis after a knee surgery. We were blessed to be at a time in our work lives where we had some extra money to do these expensive surgeries. I really feel for you in your position, with what you are going through right now financially. It makes this thing so hard for you! Daisy is a beautiful, well-loved kitty. I really don't know what I'd do in your position. I don't really know how long you've known of the knee issues with your cat, what your cat's weight is, what prognosis a surgeon might make, etc. I think that is why your vet suggested a consultation (probably meaning a consultation with an orthopedic vet surgeon), to find out how advanced the knee issues are with Daisy. I found our own consultation with the surgeon and the diagnostics like xrays to be helpful in getting us to make a decision on what to finally do with our cat. We didn't do MRIs and CT scans: our surgeon didn't need to see those prior to surgery-- I had some videos of my cat's knees as they were luxating, so he knew what was happening, what with his experience and all. Even then, this knee surgery can be a very grueling tough road to travel on, to recover from the surgeries. Cats are so much more independent and active than dogs in recovering from such surgeries. It's not easy to keep them calm.

With either leg surgery that you decide to do for Daisy, there will be recovery and crate rest. I don't believe you'd have to have surgery again for a repaired luxated patella UNLESS the cat did not do well with crate rest and/or she re-injured the knee, joint and/or soft tissue before the area was fully healed and strong. It can take several months. And the leg won't be 100% recovered until 8-12 months later. That's why you have to follow the surgeon's instructions very closely during the recovery and rehab time period (for many months post-surgery). It just helps to ensure that more surgeries won't be needed to repair the knee joint in the future.

Daisy has issues with her other knee, too, it sounds like... nothing is easy about your decision. I think doing the luxated patella surgery still puts some temporary stress on her other leg, but she'll recover from that as she strengthens and mends. And she'll have both legs. The thing is, if you let the other knee get just as lame and if you had decided to amputate the current knee -- well, then, what to do at the point when the other knee goes lame? This is really tough. Can a cat only have two legs? If you read one of the 'luxating patella' threads from start to finish (the one with "infamous" in its title that Kieka pointed out above), you'll find several examples of cat owners deciding to do both knee surgeries at once. That's not the route I took with my cat (her surgeries were spaced one year apart), but others had success with it, I think.

Either way, the surgeries cost money and the recovery and care costs money.

Kieka gave some advice regarding financial issues, and maybe you can also start a GoFundMe page, if you decide to do the knee surgery route versus the amputation (it sounds like you have money already set aside for the latter, if you decide on that).

What is your input, A ali-oop ?

Thank you for the thoughtful response.

I’ve known about the luxating patellas for awhile. Probably at least 3 years. But for whatever reason, I never grasped the gravity of the situation. Maybe the vet didn’t take care in informing me of the potential outcomes or maybe I ignored it. Usually I worry a lot so I feel like either the severity wasn’t stressed or I just didn’t pick up on it. I (stupidly) likened the diagnosis to being double jointed or something. A quirk but nothing catastrophic.

From the get-go, I had always intended to go for the repair surgery. But almost everyone I spoke to was dumbfounded by that choice. Especially knowing my financial situation. It just seemed unfathomable. And then it took me 2 1/2 months to get half the money needed, and it was solely because I was able to cash in my personal time over the span of a few months. And she is just getting worse and worse. As is my anxiety bc I know she’s in pain and at a certain point I flipped to leaning more toward amputation, bc it’s something I can do NOW.

And after reading your post, I am more worried because she is at the point of lameness. the emergency vet she said she tried to pop it back into joint, but it would not stick. But she still suggested the surgery. I feel better knowing that it lasts for a lifetime.

I’m biased but I think she’s in pretty good shape. She is a tad over weight, at under 11lbs. Other than the apparent lameness, she’s pretty healthy.

I’ll call tomorrow to set up the consultation. I know it’s only gotten worse. She hasn’t been confined to a crate at all, just one room.

I have another cat with a heart murmur and in feb I paid the $600 for an echocardiogram. She is supposed to have a follow up in August to see the rate of progression and it’s going to cost $300 but I know have to cancel it for Daisy’s sake. I didn’t qualify for care credit. I had some debts to pay off.

Thank you again

 

[Daisy6]

If you cancel the ECG will you get all $600 back?

Heart murmurs are serious too, but that can be tackled later. Daisy needs srugery ASAP.

And just as I wrote that, my own Daisy jumped up for a cuddle.

 

[ali-oop]

The first ECG has been completed. I know that Freaky has hypertrophic cardiomyopathy. (Pictured below) That money is gone. The vet suggested a 6 month check to get an idea of how it quickly its progressing. She said it’s about half the cost though. It sucks because there’s nothing that can be done, it’s really more to give me an idea of what to expect. I figured she had HCM. The tests confirmed that. But there was no diet change, medication, or prognosis given. Just a bit of peace of mind.

Hopefully Daisy’s consultation won’t be too expensive. I get a bonus in sept. I’ll just have to bite the bullet and take loans out. Thanks for listening

 

[Daisy6]

Freaky is a beautiful girl.