How To Manage Your Poodle’s Patella Luxation

black poodle looking distance

The Standard Poodle is highly intelligent, friendly, and graceful. Not to mention stylish. They are known for their eye-catching poofy coat that comes in black, white, and apricot shades. The Standard Poodle’s coat is low-allergen and can be left at its full glory of clipped short revealing the Standard Poodle’s athletic, lean muscular build underneath. Though they may look quite “fancy,” the Standard Poodle is an athletic and agile breed. The Poodle is affectionate and loving and can make a great family dog with the proper training and socialization. Poodles come in three varieties of sizes: miniature, toy, and standard. At more than 15 inches tall from the shoulder, The Standard Poodle is the largest of the breed and considered the athlete of the family. The male Poodle can weigh 60-70lbs. A female Poodle can weigh between 40-50lbs. The average life expectancy of the Poodle is 10-18 years. Poodles are proud, eager, and whip-smart. Though they are considered a non-sporting breed, they are athletic and excel at obedience training. The Standard Poodle enjoys physical activity and sports such as doggy agility, flyball, and field tracking. The Standard Poodle thrives on interaction and connection with their human. Overall the Poodle is a happy-go-lucky dog, though because of its sensitive nature can sometimes be prone to anxiety.

cute <echighlighted>poodle</echighlighted> running outdoors

Your Poodle’s Luxating Patellas Explained

Let’s set the scene: You and your Poodle are taking a nice morning walk together. Suddenly your sweet Poodle is hopping on three legs and seems to have a bit of a hitch in her giddyup. She stops for a moment with her leg suspended in the air at an odd angle. Then she places it back down and keeps walking. And just like that, the hitch is gone as if it never happened. Your Poodle has luxating patellas. Luxating patellas? What the heck is that?! The patella- or kneecap- refers to the thigh bone (femur) and the knee. The term “luxating” or “luxation” means out of place or dislocated. The two words together basically mean your Poodle has a dislocated kneecap. The condition of a luxating patellas is common among Standard Poodles, as well as small dog breeds. And while luxating patellas are not life-threatening to your Poodle, they can have an impact on your Poodle’s daily life.

Patellar luxation is primarily a hereditary condition found chiefly in small breed dogs (and cats). Poodles of all sizes have a genetic predisposition to patella luxation. Patellar luxation is associated with deformities of the hind limb and involves the femur, hip joint, and tibia (shin bone). When functioning normally, the kneecap (patella) sits in the trochlear groove of the femur and is secured in place by a tendon connected to the tibia (shin bone). When your Standard Poodle is experiencing patellar luxation, the knee is dislocated and slides out of the trochlear groove; this is called medial patellar luxation (kneecap dislocation). Medial patellar luxation is the most common form of patellar luxation.

Though less common overall, lateral patella luxation is more likely to be found in large breed dogs. A recent study observed 65 dogs of all breeds with lateral patellar luxation; medium and large breed dogs were the most affected. In contrast, less than 10% of small breed dogs were affected. The best way to describe lateral patella luxation is that a medial patella luxation is a dislocation closer to the body. In contrast, a lateral luxation is a dislocation away from the body. With lateral patellar luxation, the kneecap can dislocate more often, which can lead to erosion of the cartilage. Lateral patellar luxation is more commonly associated with injury in large breeds dogs (like the Standard Poodle), while medial luxation is a genetic disorder.

Causes of Poodle Luxating Patellas

Poodles of any age can be affected by luxating patellas. Female Standard Poodles are 1.5 times more likely to suffer from patellar luxation than male Poodles. Age also plays an important role. A Poodle puppy may have an intermittent skip or hitch in its gait. You may notice your Poodle holding its leg up for a short while and then placing it back on the ground and resuming a normal gait.

Clinical signs of luxating patellas in a mature Standard Poodle may show as consistent lameness of the hind limb. Osteoarthritis can be present, as can hip dysplasia. Usually, a dog with luxating patellas has exhibited signs of the condition since puppyhood, and the luxation has only gotten worse as the dog ages. Cruciate ligament rupture is generally present at the same time as patellar luxation. The cruciate ligaments are two bands of fibrous tissue located in the knee that join the femur and tibia together. Over time these ligaments can rupture. Cruciate ligament rupture and medial patellar luxation often go hand in hand in older dogs. As many as 20% of dogs with patellar luxation rupture their cranial cruciate ligament. This is usually due to various factors: Standard Poodle’s with luxating patellas also have an internal rotation of the tibia, which puts stress on the cranial cruciate ligament.

Though small dog breeds (like toy and miniature Poodles) are more prone to patella luxation, an increasing number of large breed dogs are being diagnosed with medial luxation. The majority of cases of luxating patellas are due to hereditary causes. Some injuries can occur due to trauma, as is often the case with lateral patella luxation. Dogs with hip dysplasia (which is common in large dog breeds like the Standard Poodle) are also predisposed to developing patellar luxation. Diagnosis and classification of your Poodle’s patellar luxation are made with radiography.

cute <echighlighted>poodle</echighlighted> sitting outdoors

Four Types of Patellar Luxation Are Classified by Level of Severity:

Grade I

Is considered mild. The patella will luxate when pressure is applied directly but will return to the trochlear groove.

Grade II

This is when the patella is manually manipulated but does not return to the trochlear groove on its own and stays luxated until manually placed back into the groove.

Grade III

This is when the patella is in a luxated position and stays in a luxated position. It may be manually manipulated to return to the trochlear groove but will not stay there. Lameness can be present with Grade 3 due to the patella’s inability to remain in the trochlear groove on its own.

Grade IV

Is when the patella is in a luxated position and cannot be returned to the trochlear groove even with manual manipulation. Lameness, arthritis, and limb deformity are usually present with Grade IV.

How Luxating Patellas Affect Your Standard Poodle’s Quality of Life

The impact of patellar luxation on your Poodle’s quality of life can vary depending on the grade of your dog’s condition. Luxating patellas are not life-threatening. Many Grade I and II Poodles will never experience lameness and will be completely asymptomatic. Managing your Standard Poodle’s weight and keeping their exercise routine light can usually help stem the tide of any further damage to the patella. Joint supplements such as glucosamine and chondroitin can also maintain the health of your Standard Poodle’s joints. Your vet may also prescribe anti-inflammatories to reduce inflammation. Physical therapy, massage therapy, and hydrotherapy have also been shown to help promote wellness and comfort. Give your Poodle a nice massage and take them for a swim!

Poodles with Grade III or IV classification will almost always experience some form of lameness, as well as pain or discomfort. Grade III and IV cases often require surgical correction.

poodle looking into distance

How to Treat Your Poodle’s Luxating Patellas

Surgical correction is usually recommended early in the diagnosis of Grade III and Grade IV of patellar luxation to avoid any further skeletal abnormalities from forming as luxation Grade can progress as your dog ages. The focus of surgery is to restore normal alignment of the quadriceps muscle. Surgical techniques can be categorized as those reshaping the bones (osseous) and those that focus only on soft tissue reconstruction. Most Standard Poodles that need corrective surgery will have a combination of both osseous and soft tissue techniques performed.

In most Poodles, the soft tissue on either side of the patella is either too loose or too tight. Soft tissue techniques include medial desmotomy, lateral imbrication, anti-rotational sutures, and release of medial musculature. These procedures are usually used to supplement osseous procedures. They rarely are able to correct patellar luxation on their own.

Tibial tuberosity transposition (elevation on the proximal, anterior aspect of the tibia) is a vital component of surgical correction for luxating patella since quadricep misalignment is a feature of all grades of patellar luxation. The procedure involves realigning the insertion of the tendon between the patella and tibia. Bones tend to heal faster than tissue, and so the bone that this tendon is attached to is cut and repositioned.

Deepening of the trochlear groove is another surgical option for luxating patellas. Called sulcoplasty, this procedure is to modify the shape of the trochlear groove and to accommodate the patella. There are different types of techniques to deepen the trochlear groove.

Abrasion trochleoplasty is the least complicated of the three techniques and involves removing the articular cartilage along with several millimeters of subchondral bone using a high-speed bone spur or bone rasp. A major disadvantage to this procedure is the loss of the cartilage lining of the femoral trochlea. This can lead to subsequent erosion of the articular cartilage of the patella.

Trochlear chondroplasty is a technique that can be performed on Poodle’s younger than 6 months. An incision is made in the articular cartilage of the trochlear. Then, the hyaline cartilage is elevated from the subchondral bone. The trochlear groove is then deepened by removing a few millimeters of subchondral bone with a curette or rasp.

Wedge and block recession trochleoplasty involves deepening the groove of the trochlear with the collection of an osteochondral autograft from the trochlear sulcus. The autograft can be in the shape of a triangle (wedge) or rectangular (block). A fine-toothed saw is then used to perform the osteotomy.

If there is a significant misalignment (femoral varus) of the tibia or femur, corrective osteotomies may be performed. Femoral varus is the most common abnormality in dogs with luxating patellas. Lateral closing wedge ostectomy and medial opening wedge osteotomies are common procedures. The first consists of taking out a wedge of bone and reducing and stabilizing the proximal and distal segments using plates and screws. The lateral closing edge technique does result in bone loss but stabilizes the correction. It can, unfortunately, also lead to limb shortening. The medial opening wedge technique does not result in bone loss but needs to be fixed with a plate or double plating. Leg shortening is avoided, but this technique can result in complications such as delayed union or non-union.

Detorsional osteotomies are performed to address long bone deformities. Once the osteotomy is completed, the distal fragment of the femur is rotated so that proper alignment is achieved. The osteotomy is secured with plates and screws.

So what happens once the surgery is done? After surgery, a soft padded bandage is placed on the site of the incision to help reduce swelling and prevent your Poodle from licking, biting, or injuring the area. Your vet will perform radiographs to assess the success of the procedure. The post-op recovery period for your Poodle should involve restricted exercise and activity for the first 6-8 weeks after surgery. Slow lead walks and physical therapy exercises that focus on range of motion, strength, and flexibility can help speed up the healing process. Physical therapy can also help protect your Poodle from muscle mass deterioration. Your vet will perform more radiographs at the 6-8 week mark to check healing progress. Once your vet has given you the all-clear, your Poodle can resume normal activity.

Complications from corrective surgery can arise and can include patellar reluxation (recurrence of the luxation), delayed union, or fixation failure at the osteotomy sites, infection, and osteoarthritis. The post-surgical prognosis is good in most cases. The risk of complications or recurrence is usually related to the Grade of the luxation and the severity of the deformity. Correlation between Grades was also found with 11% of dogs with Grade III classification experiencing reluxation and 36% of dogs with Grade IV classification. Dogs with Grade I and Grade II classification had the lowest rates of reluxation. Studies have also detected a correlation between weight and reluxation.

poodle walking on grass outdoors

Helping Your Poodle Live a Fulfilling Life with Patella Luxation

No matter what grade classification for luxating patellas your dog falls in, it is possible for her to live a happy and fulfilled life. Luxating patellas aren’t always painful and aren’t life-threatening. Nutrition can play an essential role in helping to manage patella luxation. Foods high in Vitamin C and fatty acids can help promote healthy connective tissue. They can also protect against osteoarthritis and inflammation. Additional vitamins to make sure you are incorporating into your Standard Poodle’s diet are, Vitamin E, an antioxidant that can stabilize cell membranes and reduce inflammation that can lead to osteoarthritis. And Vitamins B1 and B6, which aid in collagen synthesis. If you suspect your Standard Poodle has a luxating patella, a visit to the vet is necessary. An exam and a radiograph will give you peace of mind. You and your vet can create a care plan to help manage your Poodle’s condition. Your vet may want to start your dog on an anti-inflammatory medication regimen. Anti-inflammatory medications can help reduce inflammation as well as help manage any pain your Poodle may be experiencing. In recent years, many dogs owners have been opting for more homeopathic alternatives to NSAIDs to manage their Poodle’s pain. CBD oil therapy is an alternative option to NSAIDs for your dog. Speak with your vet to see if CBD is a good option for you and your Poodle.

As mentioned previously, hydrotherapy is a great option for your helping your dog live with and manage luxating patellas. It has the benefit of providing both resistance and buoyancy. It can help strengthen muscles without putting undue strain on your Standard Poodle’s limbs. Hydrotherapy can also help with managing osteoarthritis in older dogs. As mentioned above, osteoarthritis and patella luxation often occur at the same time in dogs. Hydrotherapy consists of swimming or walking in water, as well as underwater treadmill walking. It can be done in a pool, at the beach, or at a therapy clinic. Not only can it help with muscle development it can also help with weight management. Weight management is essential when dealing with luxating patellas. Extra weight puts pressure on the joints and which can cause further damage. It is also a great way to bond and spend quality time with your Standard Poodle.

Physical therapy, like hydrotherapy, can do wonders for your Standard Poodle. Therapy can include soft tissue massage, electrotherapy, heat therapy, neuromuscular stimulation, and underwater treadmill work. Your Poodle’s physical therapist may also create a home exercise program for your dog.

When caught early and with the proper regimen put in place you can get a head start on making sure your Poodle stays happy and healthy.

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