Sunday, September 1, 2013 

Dr. John De Jong

Dear Dr. John,

We own two little teacup poodles and they both have issues. Both have pretty bad teeth according to our veterinarian, so we plan on having their teeth cleaned in the near future. We are told that extractions may be needed, and we are ready for that.

The reason we are writing is to ask your opinion on whether or not we should address and pursue orthopedic issues that each have. The 11-pound dog suffered a cruciate ligament rupture about a year ago, and we have been putting off surgery, but at this point she is running and isn’t lame at all. The 5-pounder has trick knees, and we have been told that they are grade 3, which we are told is pretty bad. This dog also seemingly has not too many issues with getting around. The question is should we have them get surgeries for these problems when we have their teeth cleaned next month? Our vet does not seem to be too concerned, but we want to be sure that we are doing the right things. Thanks.— F.S.


Dear F.S.,

Let me start by stating that if your veterinarian is not too concerned then you probably do not need to have orthopedic surgery for either dog. However, let me explain a little bit about both conditions. Ruptured cruciates often need surgery to avert lameness issues and further degenerative joint disease over time, but studies have shown that in small dogs, like yours, conservative rest and time may lead to some bony changes and eventual stability to the knee joint, thereby eliminating the need for surgical intervention.

Luxating patellas or trick knees are graded on a scale of 1-4. Dogs with grade 3 luxating patellas often show a fair amount of lameness that suggests that surgery might be a good idea, but again, given the very light weight of your dog and her ability to get around, surgery may not be needed for the dog.

As time goes on and if the dogs start to show some signs of discomfort and lameness, then rest and the use of NSAIDs and/or joint protective agents may suffice.

If surgery were indicated for either dog, I would advocate for having it done at the time of dentistry since the dog is already under anesthesia and it would avoid the need for two anesthetic procedures. Hope this proves helpful. When the dogs have the dental cleanings done, ask again and see what you are advised. If surgery is avoidable then I would follow that suggestion.