Rear Leg Limping in Small Breed Dogs

Dislocating kneecaps are a common cause of intermittent lameness-especially in overweight dogs. Weight loss & surgery will stop the pain.

 

Question:

I’ve got a Pomeranian named Sarah. All of a sudden she started yelping (just on occasion) every once in a while. My mother took her to a local vet who said she had dislocated her hind leg in the knee. She put it back in place, and Sarah was fine for about a month, and then suddenly she started yelping again. The vet recommended surgery. My mother has scheduled the surgery but for the last two weeks Sarah has been just fine. We don’t want to cause her unnecessary pain by surgery if we can avoid it. More importantly, though, we don’t want her to hurt if the knee gives her trouble again.

 

Dr. Nichol:

Sarah sounds like a great little dog. It lifts your spirits to watch a high energy small breed dog having fun. But when she has leg pain no one is having a good time. Sarah’s problem definitely needs attention

 

On again-off again lameness is common in small breed dogs. It is often due to a problem called luxating patella-dislocating kneecap. To understand the anatomy you can use your own knee. While standing, straighten your leg and hold your kneecap. Then flex and extend your knee and feel the kneecap slide up and down at the end of your thigh bone. It does this because there is a groove near the end of the femur (thigh bone). This groove is like a valley that is formed by a ridge of bone on either side. If the kneecap somehow shifts over the top of one of the ridges it’s no longer in the groove and the leg can’t function properly. It is also painful.

 

So why would this happen? I’m glad you asked. Many small breed dogs like the Pomeranian, Miniature Poodle, and Yorkshire Terrier are born with bowed rear legs. This allows the kneecap to be pulled out of its groove sometimes; hence the intermittent nature of the lameness. To correct Sarah’s problem we simply need to get the kneecap to stay where it belongs. It does require surgery to move the attachment of the tendon below the knee, but she’s in for bigger trouble later if you delay. Each time she dislocates that kneecap rubbing its backside rubs on a bony ridge. Eventually this wears off the normal cartilage surface of the kneecap and severe pain and lameness results. If you get her knee repaired soon she should do fine. If not her arthritis will be crippling.

 

Ask her doctor if she (Sarah, not the veterinarian) is above her ideal weight. If so get her advice on the proper amount to feed. Reducing the workload on he joints may eliminate the problem. On the other hand, if the doctor reports Sarah’s weight as normal, have the surgery done. The procedure will correct her faulty anatomy and allow her sad little kneecap to ride happily again in its groove.

 

 

 

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Question:

Our 7-year-old female part Chihuahua needs help. She weighs 18 pounds, at our vet’s suggestion she needs to lose weight. Her left knee slips in and out of place and she was probably born that way. Now she has trouble with her right knee too, sometimes limping a lot. Her x-rays showed a little arthritis in one knee. What should we try?

 

Dr. Nichol:

It’s hard to watch an active and joyful dog struggle with joint pain. We can help her but first you must have the resolve and the discipline-she’s depending on you.

 

Knees are the most vulnerable joints in the body. Unlike a stable ball and socket like a hip or shoulder, the knee is simply the end of one bone sitting on top of the ends of two others. Thick straps of connective tissue called ligaments are all that hold the joint together. Sounds kind of flimsy, doesn’t it? It gets worse. Your Chihuahua, like many small breed dogs, was born with bowed rear legs. Her kneecap slips out of place when her knee bends. She limps because her leg’s geometry doesn’t work. Faulty anatomy is surely to blame on her right leg too but the sudden onset of severe lameness also suggests a damaged anterior cruciate ligament (ACL).

 

I’ve painted a dismal picture but I know that this little girl can do much better. Your veterinarian is right-she must lose weight. The extra load on those painful joints is causing them to breakdown faster and hurt more. Feed her prescription diet r/d only. NO table food. When she reaches her normal weight have corrective surgery on the more painful joint. (Ask her doctor for her ideal weight-it should take only 2-3 months to get there.) Long term anti-inflammatory medication will also help.

 

Does that sound like a lot? If you really commit to helping the dog you love you can make all the difference for her. Don’t cut corners. Go for the good life.

 

 

 

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Question:

We have an 18 month old half Chihuahua-half Pomeranian who is holding his rear leg up when walking or running. The vet says he needs surgery to keep his “knee-joint” from ‘popping out’. Is there an alternative? What if the problem occurred to his other legs? He doesn’t seem to have pain.

 

Dr. Nichol:

Dislocating knee caps (luxating patellas) are common in miniature breeds. If the rear limbs are somewhat bowed, the knee cap can’t move up and down properly in the groove at the lower end of the femur (thigh bone). When your dog bends his knee his knee cap can slip out of place, causing him to carry the leg. If he shakes the leg just a little he can finesse his knee cap back into position and he’s off and running -until the next time it slips out.

 

If your dog is overweight, and his knee caps have a mild degree of dislocation, he could loose his lameness just by losing weight. But there are many cases where the knee caps are always out of place regardless of the load they carry. These little dogs need surgery.

 

Correction is a fairly straightforward procedure in experienced hands. The knee jerk reflex tendon (patellar tendon) connects the kneecap to a bony prominence just below the knee. That small piece of bone can be moved and reattached so the knee cap lines up straight, allowing normal joint function. We also remodel the groove in the lower end of the thigh bone to provide a deeper trough for the knee cap to help it stay in place. Your dog should end up with a pain-free knee that works first time-every time.

 

Correcting your dog’s lameness isn’t an emergency but I wouldn’t wait more than a couple of months. If you delay surgery your dog could pay the steep price of degenerative joint disease. Severe arthritis is treatable with medications but the biomechanics will ultimately fail for some dogs. It’s a tragic pet who can only drag himself.

 

 

 

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Luxating Patella Best Treated Surgically

Question:

Louie, 3 year old Pomeranian, has a luxating patella that bothers him a lot recently. Would stem cell treatment help him? Or should I try acupuncture or go directly to surgery?

 

Dr. Nichol:

Louie’s luxating patella (dislocating knee cap) is causing him serious pain. By slipping in and out of the groove at the lower end of his thigh bone its slick cartilage surface is starting to wear off. Without surgery the resulting bone-on-bone contact in his knee will lead to serious degenerative joint disease-and a whole lot more pain. If a luxating patella is corrected early the long term results are usually excellent. Without surgery it will become badly arthritic over time.

 

If an x-ray of Louie’s knee shows severe arthritis he may do just as well with medications or acupuncture. Stem cell injections can really help advanced cases because they regenerate new cartilage and other supportive joint tissues. My best advice for limping dogs is to forget watchful waiting. Early surgical repair is the only way to go.