Patellar Luxation in Puggles: Signs, Treatment Options, and Costs

If you've noticed your dog walking unusually with a skip or hop, there's a high chance of an underlying condition present.

Patellar luxation is an extremely common condition that's diagnosed in 7% of puppies. If your loving little bestie is affected, physical therapy and medication may be enough to treat a luxating patella. However, some cases require corrective surgery if your Puggle's condition is severe and causes considerable pain.

For this reason, it's important to understand the risks of a luxating patella and when to contact a medical professional.

Patellar Luxation in Puggles Explained

Simply put, patellar luxation is when your dog's kneecap, or patella, moves out of its normal position. Luxating is another word for 'dislocated' or 'out of place', and the patella is another word for 'kneecap'.

Normally, the patella sits in the trochlear groove at the end of the thigh bone, or femur. It then healthily moves up and down when the dog's knee is extending and flexing. A luxating patella occurs when the patella slips out of its normal position inside the groove. This causes a dislocated kneecap and prevents your dog's knee from extending properly.

Patellar luxation can be a medial patella luxation, lateral luxation, or bidirectional luxation. Medial luxation is the most common diagnosis and can be generally seen in a small breed dog. Lateral patellar luxation occurs less frequently and can be seen in large breed dogs. Furthermore, patellar luxation is the reason your dog may be awkwardly hopping around as it's trying to pop its knee cap back into place.

From a medical standpoint, there are many degrees of patellar luxation severity:

• Mild form – the kneecap only dislocates when direct force is applied to it

• Moderate form – frequent kneecap dislocation

• Severe form – the kneecap is always dislocated

It's proven that around 50% of dogs with a luxating patella have both knees affected and 50% have only one knee affected. In any case, it's vital for your Puggle's health that you diagnose the problem and provide the necessary steps for treatment.

Clinical Signs Your Puggle Might Have Patella Luxation

As stated earlier, the most common sign of a luxating patella is a clear change to your Puggle's stride. You will notice lameness as your Puggle irregularly hops on one leg and tries to stretch the other leg to pop its kneecap back into place. As soon as the patella is back in place, your cute little Puggle will begin walking normally again as if nothing happened.

If both of the legs have patellar luxation, you may notice your Puggle bunny hopping or dragging its legs for short periods of time as it attempts to return its kneecaps to the normal position.

What To Do if Your Puggle Shows Signs of Patellar Luxation

If your Pug Beagle mix is showing signs of severe lameness or limping while walking, we recommend taking your loved one to a veterinarian for a physical examination. Your veterinarian will be able to diagnose the condition through a physical examination and offer the best options for your dog. Early diagnosis is always best to address problems as early as possible before any serious issues develop.

If left untreated, the patella may dislocate out of its groove more often which erodes cartilage and leads to arthritis and pain. Furthermore, other compositions in your dog's knee may become more strained, potentially leading to a ruptured cranial cruciate ligament. Lateral dislocation of the patella is also more concerning in puppies because it can lead to serious deformations of the leg as your puppy grows.

Causes of Lateral Dislocation of Patella in Puggles

There are two ways canine patellar Luxation develops in Puggles. The main reason why this condition develops is due to hereditary problems that cause joint or limb structure abnormalities. This means many Puggles have a genetic predisposition for structural abnormalities, and it isn't anyone's fault.

These abnormalities cause the groove in the femur where the patella sits to be too shallow, or it causes a displacement where the patella attaches to the tibia. These two hereditary issues cause an alternation in the forces placed on the patella, which is where the luxating patella comes from.

The second reason why a luxating patella occurs is through a traumatic injury. A potential injury would cause stretching or tearing of the joint and leads to patellofemoral instability.

How Is Lateral Patellar Luxation Diagnosed

A luxating patella is usually diagnosed in puppies because pet parents notice a problem with their Puggle's stride and gait. Next, veterinarians will perform a physical exam to see if they can manipulate the patella in and out of place. They will also be able to determine the severity of the problem as well.

It can be difficult to locate the patella at times, so the veterinarian may first need to find the tibial tuberosity and then follow the patellar ligament up to the patella. Furthermore, some cases require a more extensive X-ray to confirm the condition.

Patella luxation shares many similar symptoms with hip dysplasia and can also be seen together. This is why it's important your veterinarian finds an accurate diagnosis, so your dog can be correctly treated.

What Are the Different Types of Patellar Luxation

Medically, there are 4 different grades of Puggle patellar luxation which are based on severity:

Grade 1

The patella can be manipulated out of position manually by a veterinarian but immediately returns to the proper position when released. However, the luxation doesn't occur spontaneously and doesn't cause any clinical symptoms.

Grade 2

The patella can be manipulated out of its normal position by a physician and remains displaced until manually adjusted. This can happen spontaneously but with varying frequencies. This is potentially painful depending on the damage caused to the cartilage by the frequent luxation.

Grade 3

The patella is out of position the majority of the time. Although the patella can be manipulated back into place, it will quickly luxate again. Since the Puggle's patella frequently luxates, this grade will experience more pain, and your dog will show more signs of limping.

Grade 4

The patella is permanently out of position and cannot be moved back into the trochlear groove at all. There are usually severe limp structure issues that are present, and your Pug Beagle mix will have extreme mobility struggles.

How To Care for and Treat Your Puggle for Patellar Luxation

Treatment

As you may have guessed, the level of treatment required for your dog depends on the severity of the patellar luxation. Most cases requiring surgical repair will use a combination of soft tissue and osseous techniques. Diagnostic imaging is necessary to see the amount of leg bone deformity and the method of treatment.

For grade 1 cases, surgery isn't required and you should monitor your hound for more severe symptoms.

Grade 2 cases will require surgery depending on the frequency of the current symptoms. It ultimately depends on how much your Puggle limps and the severity of the lameness.

However, most grade 1 and 2 cases are treated through non-surgical procedures such as:

• Pain and anti-inflammatory medicine

• Weight management

• Exercise restriction

• Physical therapy

Your veterinarian will discuss the best option to improve your Puggle's quality of life.

For grades 3 and 4 surgery is always recommended to treat the luxating patella because of the pain these grades cause. These more severe cases will erode your Puggle's cartilage and may cause the development of osteoarthritis.

Medial Patellar Luxation (MPL) Surgery

The exact surgical treatment required to heal your pet depends on the severity of the luxating patella. However, each surgical intervention is aimed at keeping the patella in the trochlear groove where it belongs.

Some procedures focus on correcting the soft tissues around the Puggle's kneecap, while other procedures focus on correcting the bones. For the majority of cases, the trochlear groove will be deepened to better maintain the patella.

This is performed with one of the following methods:

• Trochlear wedge recession

• Block recession

• Trochlear block recession

• Soft tissue imbrications

• Femoral osteotomy

If your Puggle's patellar ligament is attached to the tibia in the wrong position, the solution is to create a cut in the tibial crest and reattach the bone in a way that allows the patella to be properly aligned within the trochlear groove. The surgeon will then use pins to secure the bone.

There are also cases where the misaligned patella and its attachments to the bone cause a twist in your dog's femur as it grows. If this is the case, your Pug Beagle mix may also require corrective surgery to the femur.

Medial Patellar Luxation Surgery Risks

As with any surgery, there are always some risks to keep in mind.

One common complication due to MPL surgical correction is infection. It's important to understand that arthritis will likely develop over time. For this reason, you should make sure your Puggle isn't overweight or obese. Leanness has been shown to decrease the level of arthritis buildup.

With a higher grade of patella luxation, there's an equally higher risk of re-luxation after the operation. If this happens, your pup will require a second surgery.

The good news is most risks can be eliminated by giving your dog extreme rest during the recovery time. You should strictly follow your veterinarian's rehabilitation guidelines and limit the amount of exercise and movement your Puggle receives.

Medial Patellar Luxation Surgery Cost

It will cost around $1,200 to $2,500 for the MPL surgery. The precise cost depends on your location, surgeon, and hospital. Most often, general veterinarians will charge less than board-certified veterinary surgeons. Keep this in mind as you are looking for treatment options. Furthermore, the cost usually includes the pre and post-surgical obligations: bloodwork, anesthesia, post-surgical care, and medications.

What if You Can’t Afford MPL Surgery

If medial luxating patella surgery is out of your budget, you can offer your Puggle rehabilitation (physical therapy) instead. Each session usually costs between $40 to $100. Physical therapy will help strengthen your Puggle's muscles to support the knee joint and hold the patella in the right position.

Patella Luxation Recovery

Following surgery, the total recovery time is approximately 8 to 10 weeks long. During this time, your Puggle should avoid bearing weight on the injured leg for several days post-operation. Your veterinarian will dispense anti-inflammatories and pain relief medication to help your Puggle deal with the swelling and bruising.

More importantly, you should give your Puggle 4 to 6 weeks of strict rest time. This means your dog will need to stay in a crate or small room and only go out on a leash for potty breaks. After the strict resting period, your Puggle will be able to start moderately walking. We recommend starting off with shorter walk and gradually building to longer lead walks, and your Puggle should not be allowed off lead exercise for the full 8 to 10 weeks of recovery.

If your Puggle needs both legs operated on, you should allow 8 weeks of time between surgeries, and both legs shouldn't be operated on at once.

Dogs that have grades 1 to 3 in severity can usually expect a great outcome and functionality to their patella. In fact, over 90% of owners are pleased by the outcome of the surgery and their dogs' progress. On the other hand, the outcome of grade 4 cases varies because the problem is more challenging to correct and requires more changes to the bone.

On top of proper rest and recovery, there are some changes you can make at home to keep your Puggle as safe as possible. Pet owners are recommended to keep their Puggle's nails trimmed and to cut any excessive hair at the bottom of their paws to maximize traction as they're running. It's also a good idea to lay rubber mats or yoga mats in your home if you have slippery floors. Finally, you should avoid blocking any stairs or areas your dog is used to jumping over.

If your crossbred pup is overweight, having him shed a few pounds greatly improves his life expectancy and aids in the recovery process.

Is a Luxating Patella a Life-Threatening Condition

Simply put, patellar luxation is not a life-threatening condition, and it usually isn't an extremely painful condition.

However, if you leave your Puggle untreated, your dog can develop:

• Mild arthritis

• Loss of strength of hind limbs

• Walk with a bowed and hunched appearance

These 3 problems will all decrease the quality of your Puggle's life since their mobility will be constrained. With this in mind, it's best to diagnose and treat any symptoms as soon as they arise.

Can You Walk Your Puggle With a Luxating Patella

If your Puggle is diagnosed with a luxating patella, you can still take your pooch for gentle walks. If you're Puggle only has a grade 1 or 2 diagnosis, it may be able to tolerate the patellar luxation for many years or its entire life.

How To Help Your Puggle Live a Fulfilling Life With Patella Luxation

Luckily, most canines with a luxating patella don't require surgery to live a normal life. The issue can be simply solved with rest, relaxation, or therapy.

We recommend talking with a veterinarian to plan out the optimal time limits for exercise and rest, and rehabilitation with a professional physician can greatly improve the strength of your Puggle's limbs and joints. However, if your Puggle does require surgery, it will be back to its normal playful self once it has recovered.

What Is the Prognosis of Patellar Dislocation in Your Puggle

The prognosis heavily depends on the severity of the patellar luxation, as well as the stage and grade of the condition. If you're able to perform the surgery before arthritis or other knee condition arises, the prognosis is great. Your dog will most likely regain full use and motion of its leg. However, your crossbred dog may experience periodic pain in its leg if arthritis is already present.

If left undiagnosed and untreated, underlying arthritis may also progress and worsen. Your veterinarian will provide the proper anti-inflammatories, joint supplements, and special therapeutic joint diets to curb the progression of arthritis. We also recommend weight reduction for Puggles that are overweight.

If your pooch has a higher grade of luxating patella, it will also be more prone to further luxations post-surgery.

Conclusion

Patellar luxation is a prevalent orthopedic condition seen in Puggles. Most affected dogs won't need surgery to resume their normal life.

Physical rehabilitation has been instrumental in helping Puggle's recover after surgery and is also an option for Puggle's that don't require surgery. Going through physical rehab after surgery helps strengthen the affected muscles and improves the Puggle's ability to bear weight on its leg by 8 weeks after surgery.

The specific rehabilitation program your Pug Beagle mix needs depends on the type of surgery he received. Patients that have had bone reconstruction will most likely be given low-impact exercises and routines. In the end, pet parents should seek advice from a certified physical rehabilitation provider to best help their Puggle recover.