The infamous Rare Luxating Patella

rodges mumma

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So glad I found a forum on this where other people are dealing with it. My beautiful natured cat Rodge was three when he first had surgery for his luxating patella. It was a bit of a shock and was caused from our puppy frightening him and he jumped up somewhere and landed really badly. I'm in Australia and surgery for one leg alone was $2500 at least! Then last night he was in pain and wouldn't walk properly so took him to the vet this morning for them to tell me it's the same thing in the other back leg. Main cause was increase in weight as he doesnt really excercize (indoor only)What's even worse our pup who is also a rescue dog has it genetically in both back legs but doesn't give him pain so he will need the surgery eventually to. I just want to see if anyone who is in the same situation with a cat the same age has avoided surgery and how they are going. We can't afford the surgery and even if we do surgery there is still a chance it can keep happening. I love my pets so much, but I want to know if there is an alternative. I'm going to reduce his food to help with weight but not sure what else to do!?
 

tuvalu

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I have a 6.5 year old rescue tabby who all of a sudden has problems with both hind leg knees. It started when I tossed her a treat to chase a few weeks ago and she took one step forward and then staggered back about 5 feet. Since then she has had off and on limping and her activity level has plummeted. Prior to this she was a healthy and feisty...albeit overweight girl with never any visible problems in her legs. I took her to the vet and they determined she had Luxating Patella in both knees and gave me some pills for her to manage the pain.

I really don't have the money for surgery but is there a possibility this could clear up with weight loss? It kills me to think of her in pain the rest of her life.
 

ritamarie

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Hi Tuvalu
I am in your same situation. My Rocky is having first surgery tomorrow. Unfortunately there are many issues with chronic pain meds . Surgery is only option. Make sure u have an orthopedic vet to get best results. See if they offer care credit financing . Rocky is only a year and a half with a long life ahead of him - praying for good outcome.
 

dcat

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Hi, we are new to this forum and stumbled on this thread doing research for luxating patellas in cats and so glad we found it.  

Our Dexter is a male Tuxedo that we adopted as a stray in late July.  He was about 7 to 8 weeks old then, so as of today he's a little over 7 months old.  

Dexter was an extremely acrobatic and strong kitten, always jumping and flying through the air while playing.  Out of nowhere, we noticed a limp 2 weeks ago but no apparent pain.  We argued over whether it was his left or right (of course it was both) and he was just diagnosed with luxating patellas - stage 2 - in both legs.  Stage 2 means the patella pops out and goes back in by itself when he stretches his leg.  Stage 3 means the patella remains out most of the time but can be manually put back in position and in Stage 4 the patella can not be placed back in position.   Our vet says he's too young for surgery and that it might go away on its own as he grows.  He no longer jumps but still plays with our younger kitten but usually while lying on his back.  The surgery would entail deepening the trochlear groove in which the patella sits and tightening the ligaments around it so it holds in place better.  

Here is an excellent video describing the nature of the condition and surgical treatment:  


Needless to say we are heartsick over this.  My once 6-month old super-cat, flying through the air, now walks around like he's 16 and he's starting to put on weight from less activity.  We'll go for the surgery when he's old enough unless it repairs itself on its own as he grows.
 
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catpack

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So sorry to hear about Dexter. Our rescue, Holly, went from stage 2 to stage 4 in a matter of a weeks time when she was 8 mo old. Surgery was done on knee #1 at 9 mo and knee #2 was done at 10 mo of age.

She too had the groove deepening/ligament tightening procedure done on both knees. She is now 9 mo post surgery #2 and is doing very well. She still has weakness in knee #2; but, she can jump and climb without any problem.
 

cprcheetah

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I had to have bilateral patella surgery on my boy Munchie.  He had complications with his recovery so now he has pretty bad arthritis in his knees, but he does better than he did before.  He had grade 4 in both knoees.
 

dcat

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Dexter is getting worse.  It might be moving from stage 2 to stage 3.  He limps almost all the time and is always laying down with his legs in the air.  We found an experienced surgeon locally who has performed the surgery.  Dexter had an exam at the vet office from which this surgeon works and the vet is recommending we proceed with the surgery ASAP because at his age, Dexter is like 90% grown and we simply don't want to wait another 5 months (he'll be one year old in May).  He's waiting to hear back from the surgeon for approval of this.  

Not looking forward to the recovery period.  Of course they will do one leg at a time with about 4-6 weeks in-between.  We are still in disbelief about all of this.  
 

cprcheetah

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Dexter is getting worse.  It might be moving from stage 2 to stage 3.  He limps almost all the time and is always laying down with his legs in the air.  We found an experienced surgeon locally who has performed the surgery.  Dexter had an exam at the vet office from which this surgeon works and the vet is recommending we proceed with the surgery ASAP because at his age, Dexter is like 90% grown and we simply don't want to wait another 5 months (he'll be one year old in May).  He's waiting to hear back from the surgeon for approval of this.  

Not looking forward to the recovery period.  Of course they will do one leg at a time with about 4-6 weeks in-between.  We are still in disbelief about all of this.  
I am so very sorry.  It sure is a rare thing in cats, my dad was a vet for 40 years and has only seen it in one other cat besides my Munchie.  Munchie had the surgery before he was a year old as well.  He still grew a lot after he had the surgery.  He did pretty good other than a complicating infection he got post surgery. 
 

zoomy

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First time poster...found this thread while searching for more info. on this condition.  Yesterday our 11ish month old adopted polydactyl girl (Seven, in my avatar) slipped jumping out of our son's bathtub (she loves to hop in there as soon as he's out of the shower.  She does the same in ours.  Apparently that water tastes better than what's in her fancy filtered fountain 
 ).  She immediately started howling in pain and couldn't walk.  This was about 80 minutes before the vet was to open, so we were panicking.  Then a few minutes later she was running and jumping like nothing had happened.  I figured she'd just given herself a painful bruise.  But then it was maybe an hour later that she was in pain and limping, again.

The vet was able to get her in an hour after opening.  They kept her for the better part of the day and performed x-rays, which confirmed no fracture (phew!), but also found that she'd had lateral luxation of her right patella.  I take it lateral movement is even more rare than the already rare medial patella luxation, since most of what I've been reading really refers specifically to medial luxating patellas.

She's on a 3 day course of Onsior + 7 days of buprenorphine.  She continues to have bouts where the patella is slipping out and leaving her unable to walk, then it's clearly popping back into place and she's back to usual mobility and happiness.  The vet's going to examine her again in 2 weeks and surgery may be in the cards.  I believe she said that Seven's luxation is grade 2.  

Poor girl has had it rough.  She was rescued from a house with 26 cats and kittens, spent a couple of months in a cat shelter before we adopted her 6 weeks ago, then came down with a URI virus (likely feline herpes) just days after we brought her home that developed into a bacterial infection requiring 10 days of 2x/day antibiotics -- which she was NOT a fan of!

It appears that most of the cats here who have had this condition and required surgery did not develop the issue as the result of an injury.  Can anyone weigh-in on the odds of her knee healing on its own.  I hope we can avoid surgery.  It's not cheap, but mostly I hope our sweet girl can finally catch a break and go more than a month without feeling unwell.  She's so sweet and playful and our younger male (6 years old) adores her and loves to play with her.
 

stephanietx

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Welcome to the forums!  I'm sorry to hear about your kitty, though.  You might want to start a new thread since I'm not sure if people will see your post and reply.
 

cprcheetah

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She's on a 3 day course of Onsior + 7 days of buprenorphine.  She continues to have bouts where the patella is slipping out and leaving her unable to walk, then it's clearly popping back into place and she's back to usual mobility and happiness.  The vet's going to examine her again in 2 weeks and surgery may be in the cards.  I believe she said that Seven's luxation is grade 2.  
It appears that most of the cats here who have had this condition and required surgery did not develop the issue as the result of an injury.  Can anyone weigh-in on the odds of her knee healing on its own.  I hope we can avoid surgery.  It's not cheap, but mostly I hope our sweet girl can finally catch a break and go more than a month without feeling unwell.  She's so sweet and playful and our younger male (6 years old) adores her and loves to play with her.
Luxating Patellas in cats is rare.  My boy Munchie had grade 4 and had to have bilateral surgery when he was about a year old.  His was congenital, but did not show signs until he was 11 months old.    It did not go well for him, he ended up with a staph infection in one knee after surgery and now has horrible arthritis.  Depending on the stage of the patella, it's not going to go from a stage2 and improve.  Once it has a grade, it has a grade.  Usually surgery is considered from stages 2-4 but it depends on the frequency of the patella popping out of joint or not.    For best healing you may want to confine your cat to a small room without objects it can jump on to reinjure the leg. 
 

zoomy

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Oh, poor Munchie. What a rough time he had.

Seven has been really quiet and mostly laying in her favorite spot, under our coffee table. We bought a small cat box for our main floor half-bath and she's only gone upstairs to our bedrooms once -- yesterday. Managed to get up on our high bed (we have a bench at the foot of the bed, but it's still 2 big climbs). Our downstairs is very open and she doesn't deal well being in a room without people (who says cats are antisocial -- I've yet to live with one who wasn't very clingy and more dog-like). I think I'm going to go out and buy a big dog crate...large enough for her to have the small litter box, a scratcher, and room to sleep. We can set that up in the main part of the house so that she can see and hear us during waking hours. She'll be confined, but not isolated.

Her knee has popped-out here and there since her vet appt., but seems quick to slip back into place. Maybe 2x yesterday and just a bit ago. She's really not doing any of her usual jumping or tearing-around, so she's self limiting her activity to a good extent.
 

catpack

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My understanding it the knees do not heal themselves. Surgery is put off depending on the severity of the luxation and the frequency.

With Holly, she started off similarly to Seven. The first time her knees slipped, we rushed to the vet. They initially thought she had dislocated her hips due; but, quickly realized it was the knees.

We too started a "wait and see" process and pain meds. Two weeks later, we were scheduling her first surgery.

I've heard of surgery being "delayed" longer, it just depends on how quickly Seven's condition deteriorates.
 

zoomy

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So both of Holly's knees were bad? That's one thing I wonder...did she injure her knee in the fall, or did it go out from under her and cause the fall. Seven's left kneecap appeared in the proper spot on the x-ray, to the best of my knowledge.
 

zoomy

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8 days post-injury update:
It's been days since we noticed any sign that Seven's had issues with her right knee and she's not exhibiting any signs of pain, discomfort, or hampered knee function (after several nights of enclosing her in a cage we let her have free roam last night, since she's not been bonkers after dark at any point since we brought her home 7 weeks ago). It almost makes me wonder if it's possible that her kneecap could have repaired itself. Nearly everything I read about luxating patella in dogs or cats refers to the kneecap displacement as medial, but hers got knocked laterally. Is it possible that her kneecap dislocation wasn't in any way related to a too-shallow trochlear groove, but was instead similar to runner's knee in humans or other temporary knee injuries after impact that resolve themselves once swelling resolves?
 

zoomy

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I should add that our vet has only been practicing for about a year, so I wonder if it's possible that this is simply not a scenario she's encountered before, given that luxating patellas are relatively rare in cats and Seven's presents differently than what appears to be the vast majority of cases.
 

zoomy

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Well, darn...I think I jinxed my girl by posting. Within a couple hours of my last post she had her kneecap pop out, again. It's still happening a few times/day. Looking more and more likely that she'll end up needing surgery.

Which brings me to a question: is there an ideal age for this surgery to be performed? She's only ~10 months old, according to the woman who rescued her. Would it be best to wait a few months, until she's fully grown, or go ahead and take care of the problem ASAP?
 

catpack

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Holly had her first surgery when she was 9/10 months old. I was told that she didn't have to be full grown to have the surgery. It really would have been a disservice to have waited since she progressed so quickly and was lame by the time we could get her in for surgery. Holly didn't reach her "adult" size until she was about 18 months or so.

She will be 2 in April. And, while she still has some weakness in ther left leg (the 2nd one done) she can run and jump with the best of them!

Talk with the surgeon who will be working on her to determine if she is currently a candidate. (We had a specialist do her surgery vs the regular vets we use. We felt better knowing he had done the same surgery before and had great results.)
 

zoomy

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Back from the 2 week follow-up at the vet. No decision yet on surgery. Her right kneecap still luxates out of place in the lower thigh-bone groove, but less so than it did 2 weeks ago upon manual examination; which the vet then deemed grade II patellar luxation. It seems like her issue is relatively fleeting as time passes. The vet is recommending having the knee re-assessed in another 6 weeks to see if somehow the tendons/ligaments surrounding the kneecap may be holding it in track better with some more healing time. By then she'll essentially be 1 year old, too, and less loosey-goosey kitten physique. And we'll know for sure if this is a short-lived symptom simply from a moment of clumsy injury or more congenital in nature.

CatPack, if/when she does require surgery we'd have it done at a veterinary orthopedic surgeon about 30-45 min. away. Our vet doesn't do anything that specialized. Even if they did, I'd definitely want someone with specific experience handling such a delicate and necessary structure.
 

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My kitty took a fall out of his cat tree a couple days ago and injured his knee. We took him to the ER right away and they did x rays of spine and hips, reported no fractures and sent us home with pain meds. He had 4 more "attacks" that night so we took him back in the am. They had to sedate him to get x rays and discovered the luxating patella. Jut like yours, due to injury and it's slipping outward, not inward like most. They put a splint on him, cast like when he was under to do a few weeks of rest. He had a complete breakdown and ended up getting out of the cast (with an e collar on) within 3 hrs of being home. We took him back and they would have to sedate him again to get another one on. I was not ok with 2 sensations the same evening. Plus he would prob just get out of it again. We're on day 2 of caged rest with pain meds. They want to give it 2-4 weeks to see if he heals himself. Please keep my posted ZOOMY on your experiences. I REALLY don't want to do surgery as our little guy ALSO has Mega Esophagus - which is also rare for cats. It just makes a lot of complications with the sedation. It's also already cost over $1000 just for 2 ER visits for an accurate diagnosis, and meds. Which is fine, but ugh. : /
 
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