Expensive Knee surgery

Question
QUESTION: Hello, I have an adorable male (neutered) black pomeranian. He is the best dog I have ever been in contact with. His personality is fantastic and he is super affectionate. He is everything I have ever wanted in a dog and more. He is currently 3 years old and aprox 1 year ago I found out that he his slipping knee caps in both of his knees. My vet has told me he needs surgery because he is stage III, which is considered severe. Well, I had an estimate done and it would cost around $3500 to get both knees fixed. He is not lame yet but I can tell he is starting to have difficulty with exercise and walking, which is essential because he is overweight (something I am trying to tackle with exercise and food control). I have considered putting him on a low fat diet for his weight but he also has stomach problems which have placed him on prescription food (specifically ID from Hills). My main problem is that I simply do not have $3500 to get the surgery done soon. I make sure all of his essential health is covered, up to date on shots, flea and tick, and heartworm but after that I am pretty much broke in terms of additional vet bills. Is there any organization that would help me either do a fundraiser or help me pay for the surgery? I really want the best quality of life for my little guy and do not want him to be in pain. Are there any ideas you have to help me get money to finally get this surgery done? Thanks so much for any help.

ANSWER: Hi Rachel - Stage 3 will repair itself without surgery. He will Always have arthritis and some discomfort that can be controlled with drugs or supplements.  YOU do have choices - also, the surgery doesn't always work and they need to go IN 2 times...
As for help with the payments, I don't' know of any that would help. I am sure there are some out there but EVERYONE is asking for help with the bills, too.

I can suggest some good supplements and herbs that will help repair the areas.. All are low cost and safe.
YOUR vet can offer you an anti-inflammatory drug for use.
As for the weight - I can give you a recipe to cook for him. This will help with his special diet.  YOU can make it up weekly and freeze it.
Let me know if you want my help..

Thanks
Marie Peppers

---------- FOLLOW-UP ----------

QUESTION: I was told that his knee cap problem could only be corrected with surgery, how would this correct itself? It was not from an injury but genetic. I do not know the specific term but he has slipping knee caps. I will definately look into anti-inflamitory medicine from my vet as that would help with his mobility.

If he were to be placed on supplements, what kind would be best? Or should I consult my vet for these questions?

I am concerned to have him eat anything other than the prescription diet because he has very severe stomach problems on a variety of other foods. When he was younger the vet did not catch on to the food causing his problems so I had taken him in three times over a period of around 6 months and they put him on medicine and sent him home and said they didnt know what was causing it. On the 3rd visit they sent him home with the prescription Hills ID diet to rest his stomach for a few days. Soon, after he finished his medicine and the prescription food I returned him to his normal food (eukanuba). Within 1 month he had the same problems (diarrhea, surface blood, and mucus). I had to take him in again for the 4th time. When I went in they did the normal fecals and physical exam and came back and said they did not know what caused it for sure but think he ate something from the floor that caused it. Not until I mentioned to the vet about him having allergies to the food did the vet say it is a good possibility. Well, first the vet wanted to keep him on his usual food and see what happened but I insisted on switching him to the ID prescription because the cost of bringing him in, not to mention the stress on him, every few months was ridiculous. So, the vet agreed. It has been around 1.5 years and he has yet to have any stomach problems. Basically, he had severe food allergies. The only downside to the Id prescription diet is that it is not made for overweight dogs so it tends to cause weight gain. However, I am afriad to give him ANY other food because I do not want him to go through that again. Of course, I would love to be able to feed him something that will help him lose weight but I do not want to bring on the allergies. If you have any ideas of food I can make for him that will not cause any allergies or food I can slowly try I will consider it. I would appreciate if you would let me know your ideas about possible diets or even what I could feed him with his prescription diet. Thanks again.

ANSWER: Hi Rachel - He has a luxating patella - here are some links for you to look at - and yes, it can Adjust on it's own without surgery. Like I said, he will always have arthritis.
****take a look at all of this:
http://www.2ndchance.info/patella.htm

(Small breed dogs are very prone to luxating patellas and very rarely do we do surgery.  ( would have to be a level 4)
If it only pops out once in a while, then surgery is not necessary.
Arthritis is expected any time a joint is not functioning properly.


Grade I --  The patella can be manually luxated but easily comes back into normal position.  Patient may or may not occasionally carry the affected leg.

Grade II --  Patella luxates on flexion of the knee joint and remains out of place until manually replaced or patient extends and rotates joint.  Patient intermittently carries the affected limb with the knee joint flexed.

Grade III --  Patella remains luxated most of the time but can be manually reduced (placed back into position).  Flexion and extension of the knee joint reluxates the patella.  Patient transfers most of the body weight to the front legs, bunny hops or carries the affected legs, and appears bowlegged or knock-kneed.

Grade IV --  Patella is permanently luxated and cannot be manually repositioned.  The quadriceps muscle group starts to shorten, making it difficult to extend the leg fully. Patient transfers most of the body weight to the front legs, bunny hops or carries the affected legs, and appears bowlegged or knock-kneed.



If your kid has a grade 3 - the knee will not heal itself but it Adjusts itself - also, you can learn how to pop it back into place.
Most of the time there is no pain unless it gets to a grade 4 level.
YOU can help avoid the grade 4 with supplements and weight loss. He is overweight and that causes too much pressure on his legs.
So I guess my word " Heal " was not a good choice of words... How about it will adjust itself many times over.

I hope this helps you decide what to do.

Marie


---------- FOLLOW-UP ----------

QUESTION: I greatly appreciate your help. He is definately not stage 4 yet, he can walk, run, and move normally and does not seem to be in any pain. The vet said he was in stage 3, which is believable because I have noticed that when I walk him for longer periods he seems to have discomfort in his back legs. This discomfort brought on by exercise is one of the main problems that is preventing weight loss. I have a local dog park I have been trying to have him play in but he is a very shy dog and when I put him down, without any dogs or people around, he just sits there by me and does not play or explore. He seems to like walking at the beginning but after just 5 minutes or so he begins to act like he is having problems walking. He has never yelped or shown very obvious signs of pain but I can tell he is experiencing discomfort. For example, his back legs are pretty normal if he has not been exercised but after exercise he begins to bow out his back legs and he stretches alot, almost like he is trying to adjust something that is bothering him. In other words, exercise adds to his knee problems. This has been a major cause of his weight gain because I do not want to make him hurt any more than he should. I know once he loses weight it will be much better but it seems like the exercise just makes things worse. Do you have any ideas as to how I can exercise him and possibly it wont bother his knees so much? Or should I continue to walk him even if he gets discomfort (for short periods a few times a day) to help him lose the weight which will make him get use to the knee issues? Is there such a thing as me making his knee problems worse by exercising him? Is there anything in particular I should avoid to not worsen his condition? Finally, what supplements should I ask my vet about to help him with his knee problems? He is only 3 years old so I am worried that I may exercise him, or do something else, in a bad way to cause his knee problems to advance very quickly. Thanks again for your help.

Answer
Hi again- The best exercise for him is short walks of 15 minutes or less.  Don't do any ball play because that is a quick stop and start.
Give him 2 -3 short walks per day , if possible.  We can get some weight off of him with a good diet and supplements.
 Here is my plan for your baby - I work with many Poms!!! Everything I recommend are safe and natural.
The only thing you need from your vet is a anti-inflammatory drug - there are many on the market that don't have the adverse effects on the belly... YOU can give a 81 mg baby aspirin, but in the long run the aspirin can upset his belly.

I will work with you on a weekly basis - Please give me weekly up dates.  Also, ask your vet if we can use the scale - just a monthly weight would be great.  Tell them you just want to stop in and use the scale.  If they care about your dog they won't charge you to just do a weight.  

1.  Please keep him on the diet from the vet - give him less of what you have been giving.... We will give him some green beans - 2x per day to fill him up.  Put a "dash" of Parmesan cheese ( the grated kind) on top of the green beans.
Most dogs love green beans and will loose weight ..... The green beans can be the canned kind with no added Salt.
Let me know if he won't eat them...He should, I hope.

2.  Next - We need to get some NuVET Plus and NuJOINT Plus into this boy - It will cost you about 1.25 per day - NuVET will be about .50 cents per day and the NuJOINT will be about .75 cents to 1.00 per day.
Not sold in stores - must have a VET's code or Breeder's Code - use mine and they can sell to you - they don't sell to the public without a code -  Marie Peppers LPN MA ( All Experts) # 81098
NuVET
https://www.nuvetlabs.com/order/default.asp?cat1=Dog+Products&cat2=NUVET+PLUS
NuJoint
https://www.nuvetlabs.com/order/default.asp?
cat1=Dog+Products&cat2=NUJOINT+PLUS

TESTIMONIALS on the Products :

All guaranteed or your money back -
60 Day Money back trial offer:
http://www.nuvet.com/testimonials.asp


Also, I would like to add a few other supplements to his program.  At first let's get him onto the NuVET , NuJOINT and the Green Beans -
After a few weeks I have a few other Low cost supplements and oils to place him on.  Very low cost and natural...
They will be from the site : Nature's Sunshine Products - Most of my clients take NuVET and the Nature's Sunshine line - I know they are quality and they work well.

Please let me know if you would like to work with me and my suggestions... I am here for you and your boy.

Marie Peppers LPN MA
Ask a VET / Pet Nurse
Doggie Hotel Owner - The Doggie Chalet  
Pet Chef
mtnmom@gci.net

Nature's Sunshine Products:
http://www.mynsp.com/nuvetpetnurse/index.aspx