The infamous Rare Luxating Patella

carocats

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And - believe it or not, we now have our 4th luxating patella cat! AND - she's 10 yrs old and had never previously shown any symptoms! She was, however, rescued from the same prison system as the others, who are much younger. Hers went back in immediately, just one leg. She's a bit on the porky side so will have to try to reduce weight and just keep an eye on things.
 

liddle_spiders

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Found this thread and read through the whole thing after our vet surprised us with a diagnosis of luxating patella today in a 9 year old brother and sister. I'd been thinking this whole time that it was hip dysplasia! I talked a lot with the vet, but I'm confused now that I've read other people's accounts - I take it that in normal cases it's acute, painful, and causes severe difficulties with movement? They first showed signs of walking abnormally (knee twisting outward, limping) when they were around 18 months old, but the clinic vet at the time didn't see a problem and since they never slowed down and the vet wasn't concerned when we talked to them about it, we never saw a need to have them rechecked. They're both on the feral side and we were terrified of having to chase them down, and were having trouble finding a vet that would have been willing to sedate if necessary.

The brother is not terribly bad, but the vet said his is the worse of the two. He hasn't ever been much of a jumper or a runner, and just plods along. I notice a slight limp in his right leg at times, but for the most part he seems normal. I've never seen him in distress or holding his leg funny.

The sister looks frightening though when she walks. Her entire right leg pops out at a 90 degree angle to her body with every step. When she runs she sort of does a hop/skip on that leg so she doesn't lose speed. While she's slowed down in the last few years (no jumping up 6 feet to the top of the TV stand anymore), she does still jump onto the table and because she's so nervous she can fly pretty quick when she gets startled. Obviously the girl can still move because she evaded us for nearly 20 minutes when we had to get her into the carrier, and she nearly took my husband's hand off. (yay for gloves!) I just worry because in the last year she's become more withdrawn and doesn't want to do steps. For as bad as she looks, her knee is the better of the two.

The vet was quite certain they are not in any pain. She really mauled them up good and tested range of motion and neither reacted. The sister may have some arthritis starting in the opposite hip, but otherwise it's just the right knee for them both. Best we could figure is that her funny way of walking is her recapturing the knee cap on her own, so it doesn't seem to be affecting her much. She thought they were both still at Stage I, possibly Stage II for him.

So, because of the fact that he is walking normally and because she is semi-feral, and because they weren't showing any signs of pain, the vet suggested that surgery didn't even need to be considered at this point. We are to do Adequan injections and fish oil supplements to see if that makes any difference. We have the sister caged for the time being so we don't have to chase her down again in a few days for the next injection, she panics so easily that she's almost impossible to work with.

The vet will do xrays and send us out to an orthopaedic surgeon (they don't do the surgery in their office) if we ask, but she really didn't think it was necessary. I guess my question is, should I ask for this? I'm content so long as the cats are as comfortable as possible.
 

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I'd say "if it ain't broke, don't fix it"...or even if it IS broke! If they're not in pain or distress and can function, I wouldn't do anything; not confine them (how distressing for them), given them stuff (you can always get side effects), and certainly not consider surgery costing thousands of $$$ that could potentially injure or even kill them -- any surgery is inherently risky. My boy has recovered with just a little limb; happy as a clam! No surgery necessary. NOW the vet wh recommending it says that it's not uncommon for a torn ACL/CCL to repair itself -- or at least for other tendons/ligaments to compensate for it -- in SMALLER animals... ;)
 

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Found this thread and read through the whole thing after our vet surprised us with a diagnosis of luxating patella today in a 9 year old brother and sister. I'd been thinking this whole time that it was hip dysplasia! I talked a lot with the vet, but I'm confused now that I've read other people's accounts - I take it that in normal cases it's acute, painful, and causes severe difficulties with movement? They first showed signs of walking abnormally (knee twisting outward, limping) when they were around 18 months old, but the clinic vet at the time didn't see a problem and since they never slowed down and the vet wasn't concerned when we talked to them about it, we never saw a need to have them rechecked. They're both on the feral side and we were terrified of having to chase them down, and were having trouble finding a vet that would have been willing to sedate if necessary.

The brother is not terribly bad, but the vet said his is the worse of the two. He hasn't ever been much of a jumper or a runner, and just plods along. I notice a slight limp in his right leg at times, but for the most part he seems normal. I've never seen him in distress or holding his leg funny.

The sister looks frightening though when she walks. Her entire right leg pops out at a 90 degree angle to her body with every step. When she runs she sort of does a hop/skip on that leg so she doesn't lose speed. While she's slowed down in the last few years (no jumping up 6 feet to the top of the TV stand anymore), she does still jump onto the table and because she's so nervous she can fly pretty quick when she gets startled. Obviously the girl can still move because she evaded us for nearly 20 minutes when we had to get her into the carrier, and she nearly took my husband's hand off. (yay for gloves!) I just worry because in the last year she's become more withdrawn and doesn't want to do steps. For as bad as she looks, her knee is the better of the two.

The vet was quite certain they are not in any pain. She really mauled them up good and tested range of motion and neither reacted. The sister may have some arthritis starting in the opposite hip, but otherwise it's just the right knee for them both. Best we could figure is that her funny way of walking is her recapturing the knee cap on her own, so it doesn't seem to be affecting her much. She thought they were both still at Stage I, possibly Stage II for him.

So, because of the fact that he is walking normally and because she is semi-feral, and because they weren't showing any signs of pain, the vet suggested that surgery didn't even need to be considered at this point. We are to do Adequan injections and fish oil supplements to see if that makes any difference. We have the sister caged for the time being so we don't have to chase her down again in a few days for the next injection, she panics so easily that she's almost impossible to work with.

The vet will do xrays and send us out to an orthopaedic surgeon (they don't do the surgery in their office) if we ask, but she really didn't think it was necessary. I guess my question is, should I ask for this? I'm content so long as the cats are as comfortable as possible.
I have to wonder if them being feral is masking any potential pain they may be experiencing? Cats by nature hide pain, but a feral cat, in my experience, can tolerate more than even a house cat.

I know the surgery specialists I work with have had differing opinions than our general practicing vets when it came to orthopedic matters. I think getting x-rays and a consult by the orthopedist would possibly give you a better idea of what is going on. Or, may confirm and at least you have peace of mind that you have addressed the problem adequately.
 

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the next step would be to get Xrays to see if any damage to the joints- once they have this information-you could better decide what to do. The key with surgery is not to wait until the joint breaks down BUT this doesn't sound like they need surgery. Also try dasquin for Cats=it's a supplement for bone health. Don't be surprised if the Xrays don't show much. It could be a soft tissue injury that may just take time to heal. The Adequan is a very good idea. Don't dispare-I wouldn't do surgery either! Some cats are born with defects=it could be CH.

Here's a link: About CH Cats | Cerebellar Hypoplasia Cats

I would just try to encourage light movement-walking up/down stairs instead of jumping. Keep them active-that's the best thing to do for any injury=you don't want them to loose muscle tone but you don't want them jumping off the walls!

Let us know how it goes!
 

ritamarie

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Found this thread and read through the whole thing after our vet surprised us with a diagnosis of luxating patella today in a 9 year old brother and sister. I'd been thinking this whole time that it was hip dysplasia! I talked a lot with the vet, but I'm confused now that I've read other people's accounts - I take it that in normal cases it's acute, painful, and causes severe difficulties with movement? They first showed signs of walking abnormally (knee twisting outward, limping) when they were around 18 months old, but the clinic vet at the time didn't see a problem and since they never slowed down and the vet wasn't concerned when we talked to them about it, we never saw a need to have them rechecked. They're both on the feral side and we were terrified of having to chase them down, and were having trouble finding a vet that would have been willing to sedate if necessary.

The brother is not terribly bad, but the vet said his is the worse of the two. He hasn't ever been much of a jumper or a runner, and just plods along. I notice a slight limp in his right leg at times, but for the most part he seems normal. I've never seen him in distress or holding his leg funny.

The sister looks frightening though when she walks. Her entire right leg pops out at a 90 degree angle to her body with every step. When she runs she sort of does a hop/skip on that leg so she doesn't lose speed. While she's slowed down in the last few years (no jumping up 6 feet to the top of the TV stand anymore), she does still jump onto the table and because she's so nervous she can fly pretty quick when she gets startled. Obviously the girl can still move because she evaded us for nearly 20 minutes when we had to get her into the carrier, and she nearly took my husband's hand off. (yay for gloves!) I just worry because in the last year she's become more withdrawn and doesn't want to do steps. For as bad as she looks, her knee is the better of the two.

The vet was quite certain they are not in any pain. She really mauled them up good and tested range of motion and neither reacted. The sister may have some arthritis starting in the opposite hip, but otherwise it's just the right knee for them both. Best we could figure is that her funny way of walking is her recapturing the knee cap on her own, so it doesn't seem to be affecting her much. She thought they were both still at Stage I, possibly Stage II for him.

So, because of the fact that he is walking normally and because she is semi-feral, and because they weren't showing any signs of pain, the vet suggested that surgery didn't even need to be considered at this point. We are to do Adequan injections and fish oil supplements to see if that makes any difference. We have the sister caged for the time being so we don't have to chase her down again in a few days for the next injection, she panics so easily that she's almost impossible to work with.

The vet will do xrays and send us out to an orthopaedic surgeon (they don't do the surgery in their office) if we ask, but she really didn't think it was necessary. I guess my question is, should I ask for this? I'm content so long as the cats are as comfortable as possible.
Very surprised at what the clinic vet said. Cats are in pain but cats try to hide it....Our rocky had to have both knees operated on- X-rays confirmed damaged at 18 months old - we did both at separate times which is more costly but easier on the cat... he is now 5 years old and so happy . He keeps up with our other two and is so loving...It is a brutal surgery Not for the faint hearted parents...
 
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liddle_spiders

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Maybe it's because they've been living with it for almost 7 years with no issues? I know the vet was very worried about the recovery from surgery at their age (9 in Sept.) and the fact that the sister is so hard to work with that even medicating her could cause her to panic enough to cause further injury.

That was my big question, whether or not they were hiding pain. The vet was really digging in there and doing full range of motion with no reaction. She was pretty well convinced that if they were hurting they would have reacted in some way. I say semi-feral because that's how the sister reacts, but they were born in our home. The four of them are a little mentally unbalanced, their biological mother turned aggressive after birth so we couldn't get near her or the kittens until they started walking on their own and could escape her 'nest'. After that she turned on her kittens and started beating them so badly we ended up having to rehome her for their safety.

I don't understand how CH would relate? That's a neurological issue present from birth that causes issues with balance because of damage to the cerebellum in utero due to the mother contracting panleukopenia at just the wrong time during gestation. What these two have is a congenital physical deformity that the vet could easily feel.
 

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I was just throwing out ideas about the one where the leg is turned the wrong way-I wasn't sure if it was related-just me thinking aloud. I would say just keep watch and don't do the surgery. Often it bothers us more than it bothers them..
 

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My 12 year old cat started limping and stretching her right hind leg straight out behind her on July 4th (Tuesday). After several hours at the emergency vets, X-rays, meds, and exam they told me there were no fractures, her knee cap was fine, and it was probably a soft tissue injury. I gave her the medications prescribed and she looked better on Thursday, but has since gotten worse. She will still run to me if I offer treats, but it is a limping run, and if she is standing (to eat, or beg for attention) she stretches the leg out more then she stands on it, and after a few steps, she collapses onto her left side. I hate to spend another $500 to be told "its nothing" when she is obviously having issues, but I don't have a regular vet. Should I take her back to the "nothing wrong" place or try somewhere new? How long is reasonable to see if it gets better on her own? We tried to keep her upstairs, but every time the basement door was opened, she would run down there, so when she want's to move, she can...she is just spending 98% of her time laying on her bed.
 

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If you want to get her looked it it wouldn't be a bad idea. It shouldn't cost more than $60 to get an office appointment. you won't need xrays because they were done already. They can do a short term or long term steroid shot if you want. They may send home with pain meds-but hard to say. Normally soft tissue injuries take at least 3 weeks to heal. Most often it's 4-6 weeks. I would keep an eye on the eating/drinking. If that has changed then take her in otherwise just try to keep her from jumping or horsing around too rough.
 

PushPurrCatPaws

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My 12 year old cat started limping and stretching her right hind leg straight out behind her on July 4th (Tuesday). After several hours at the emergency vets, X-rays, meds, and exam they told me there were no fractures, her knee cap was fine, and it was probably a soft tissue injury. I gave her the medications prescribed and she looked better on Thursday, but has since gotten worse. She will still run to me if I offer treats, but it is a limping run, and if she is standing (to eat, or beg for attention) she stretches the leg out more then she stands on it, and after a few steps, she collapses onto her left side. I hate to spend another $500 to be told "its nothing" when she is obviously having issues, but I don't have a regular vet. Should I take her back to the "nothing wrong" place or try somewhere new? How long is reasonable to see if it gets better on her own? We tried to keep her upstairs, but every time the basement door was opened, she would run down there, so when she want's to move, she can...she is just spending 98% of her time laying on her bed.
The problem with x-rays in diagnosing an early stage luxating patella is that if the knee is in its place properly during the x-ray itself, the knee will look fine. Did the ER vets try to manually luxate her patella during that day that she was with them? (I assume they did, if they said the knee cap was fine - but just asking.)

If things like cruciate ligaments (and/or other soft tissues) are injured and you don't want to do surgery, the best situation for your cat to be in is "98% of her time laying on her bed". You really want to limit running and jumping and use of that leg for at least 4-6 weeks, regarding several types of possible injuries. (Even with surgery, it is a long recovery time -- but surgery can sometimes really help decrease further damage to the area.) Also, several types of these injuries are painful to the cat. Was one of the prescribed meds a pain medicine?

What specific soft tissue injury did the vets say it was? Also, at 12 years old and a senior kitty, it is a wise idea to have a regular vet for her. Is this something you might consider doing at this point?
 

Ambam00

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The problem with x-rays in diagnosing an early stage luxating patella is that if the knee is in its place properly during the x-ray itself, the knee will look fine. Did the ER vets try to manually luxate her patella during that day that she was with them? (I assume they did, if they said the knee cap was fine - but just asking.)

If things like cruciate ligaments (and/or other soft tissues) are injured and you don't want to do surgery, the best situation for your cat to be in is "98% of her time laying on her bed". You really want to limit running and jumping and use of that leg for at least 4-6 weeks, regarding several types of possible injuries. (Even with surgery, it is a long recovery time -- but surgery can sometimes really help decrease further damage to the area.) Also, several types of these injuries are painful to the cat. Was one of the prescribed meds a pain medicine?

What specific soft tissue injury did the vets say it was? Also, at 12 years old and a senior kitty, it is a wise idea to have a regular vet for her. Is this something you might consider doing at this point?
1) they did try to manipulate her knee cap/patella, but couldn't feel it out so they did the X-rays.
2) Both medications were for pain, I was just disappointed that they only gave 3 days worth of meds (for about $50 of the bill)
3) Last night, Miss Birdie started moving around more, coming out to beg for attention and considering (but not) jumping onto the couch and the top of the litter pail (where she likes to beg for treats).
4) I'd love a vet. All the ones I've researched expect you to purchase one of their "care packages" at either ~70/month or $300+/visit. I know it sounds terrible to put a cost on a pet's health, but I don't have an extra $70/month (double if I wanted to take both cats). I'd love somewhere that would do an exam and discuss treatment/diagnostics for less than $80/visit, but I haven't found it (I realize the diagnostics and such would be more. do I need x-rays for every older cat? 3 visits a year? Lab tests at over $200? Why?)
5) As she is now moving better (I even caught her drinking this morning--I've been watching but hadn't seen her yet!) and I've got the basement door shut (she wants to use the litter box down there, but there are 2 upstairs, she'll live) I think watchful waiting is ok. I was just worried when there was no improvement early on.

Ambam
 

nolalola

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Wow... after all my cat and I have been through in the last 3 weeks, I can’t believe I found this forum! My 3 year old male rescue tabby, Zeus, has just been diagnosed with a luxating patella in his back right leg.

I came home from a three day trip to find him lame on his right side with no apparent cause/injury. My mom had been coming to feeding him, love on him, and send me videos once a day and all seemed normal. I got home and found him limping on that back right leg and my female cat growling at and attacking him.

Of course this was a Saturday, but luckily my vet takes weekend calls so he met me at the clinic Sunday morning. Magically, as others have mentioned, Zeus was running around the clinic as if nothing was wrong. All X-rays and bloodwork were normal. I’m sure most of you know that LP only shows up on an X-ray is the patella is actually out of place at the time of the exam. So.. we decided maybe he has sprained something - he stayed at the vet for a few nights on cage rest and meds (onsior). All seemed fine by Tuesday. He came home.

Two days later - he’s lame again! Zeus is super active and jumps on anything and everything. The higher the better. He goes 90 to nothing all day long and it’s very hard to reign him in. I started noticing that the lameness was coming in and out based on what he was jumping on and off of. It got so bad he wasnt even limping anymore, just hobbling around on 3 legs and not even using the back right one at all. I called my vet again. More tests. They did a ligament test where they sedate and test the cruciate knee ligaments. Normal. My vet recommended taking him to the state vet school if he didn’t get any better by the end of the week.

After spending $600 at my vet clinic with no results, I decided to do my own research and I came across an article on LP. It was really the only condition that matched his symptoms but my vet had never once mentioned it as a possibility. I texted the doc and said I think Zeus has a luxating patella! He called me immediately and said, “you know that NEVER happens in cats... like in less than 1% of cats..” But Zeus also has a history of mast cell tumors and they also said those were very rare in a cat his age (two removed by the time he was 1.5 years old) so.. telling me something is rare at this point means nothing to me.

Anyway, I decided to test this theory myself and the next time Zeus started limping I just reached down and found that knee cap and sure enough it had rotated around to the medial side of his leg and I just popped it into place. I took him BACK to the vet and they were able to pop that knee in and out as well.

So.. short story long (sorry) - we are waiting on a consult with an orthopedic surgeon because Zeus’ knee pops in and out a few times a day and it’s causing him a lot of discomfort. It’s really my only choice. Hopefully they will do the surgery before thanksgiving, but reading some of the posts on here it sounds like the recovery is not so fun.

If anyone is interested, I’ll post more as I know it and I’m sorry so many people on here are going through this with their kitties.
 

foxxycat

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I would wait another 6 weeks-my Honeybee had a luxating patella and 6 to 8 weeks later her limp was gone. We started her on dasquin and she got pain injections when it was bothering her. I am glad I waited 2 months. That is a hard surgery for a cat due to cage confinement afterwards.
I figured she jumped or fell and it bent the knee just enough to stretch the ligament that holds the patella=of course no tests that prove my theory but I am sure this is what happened-the dasquin seemed to help and we kept her on it for 6 months. So far no issues now 3 years later.

I know it's stressful watching this but remember soft tissue injuries take 4 to 6 weeks to heal- I would hate to see him go under the knife if it can be avoided..my girl limped around for 5 weeks. Xrays were good. Nothing damaged...so we just waited. I suggest you do the same.
 

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I'm happy to report (after all this time) that my cat healed COMPLETELY without my doing anything. Apparently this isn't as uncommon in small, light animals -- as opposed to huge dogs -- as the veterinary surgeons might lead one to believe? I catch him jumping on and off the sofa again! Very fortunate and very grateful. Definitely give it a chance to heal first...
 

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Yes=cats are AMAZING at healing from injuries..things we never believe would heal will. Just give it a month or so before jumping onto surgery bandwagon...that's a lot harder on all involved-the pet parent-and pet- cage rest is not easy for a kitty.
 

nolalola

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Thank you for your replies foxxycat and all4mom. I asked my vet about waiting until after the holidays just to see if it resolved itself. He said we are looking at a grade 2-3 luxation, probably a 3 considering how frequently the knee is popping out. Another monkey wrench to throw in the situation is that Zeus broke this same leg right at the growth plate when he was 8 weeks old. The shelter vet casted him up for several weeks and he was fine. But now my own vet and I are wondering how much that may have to do with the luxating patella and whether that leg is now prone to injury and how much this will contribute to early arthritis/complications down the road as he gets older. Once again, Zeus is only 3 years old. I think my vet’s thinking is the younger he has to have the surgery, the better? I will discuss it further with him and the surgeon.

I did start him on dasuquin and I certainly don’t want to jump on any surgery bandwagon. Waiting a few more months is something I’m certainly willing to do. I just want to do what’s best for my cat in the long run now that I’m armed with more information. I consider the experience and opinions of people on this forum part of that information, as well. I wish our babies could just talk to us and tell us what they wanted!
 

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nolalola nolalola That's new information I didn't know=the break in the bone-was it near the knee cap? Wonder if that's why the vet wants to operate...I would if you could-wait 2 weeks at least-see if it's a ligament injury..I saw slow improvements at the 3rd week and the 5th week much improvement...it was weird how long it took to get some relief. I don't know if the dasquin helped but it didn't hurt to try it..I hope your baby heals quickly so no surgery is needed. Also he's young so will bounce back.

The vet probably worried that arthritis may impact the joint if it doesn't resolve on it's own..it is so hard to figure out what the treatment should be.

I too wish they could talk to us...I just wish more people would slow down and look at the big picture=not you-just in general-it seems we have a hard time being patient for time to do her thing. Whether it's a month or 3 months. I wonder if there's any physical therapy they can do to help like we do for humans...We should see more options in the next decade for this I imagine. How is he pain wise?
 
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