luxating patella in old cats

Question
My cat is coming up to 14 years old.  She has just been diagnosed with a luxating patella and offered Metacam (NSAID) for the pain.  Should we go for surgery? Considering her age, I am a bit worried about general anesthesia - she has also recently suffered from an acute bronchial infection.

Answer
Hi Chris.  There is certainly a lot to consider here.  How much lameness is it causing?  Is she just a little stiff when getting up to walk, or is it to the point that she's limping all the time and limiting her activity?  How well has she responded to the Metacam?  Theoretically, if pre-operative blood work comes back normal (blood counts, liver, kidney and pancreas screening) and there is no evidence of heart of lung problems, she should come through anesthesia as well as the next cat, but recovery is another story.  In general, an invasive treatment like knee surgery should be considered in a geriatric cat if the pain is significant enough to alter her quality of life and all other possible treatments have proven ineffective.  If this were my own cat, I'd try her on the Metacam for a couple weeks.  And if that doesn't work, there are other pain medications that might.  I have a cat with arthritis who receives a different NSAID, Rimadyl injections (labeled for dogs but also used by many vets to treat cats), when his arthritis really flares up.  It takes a couple of days before full relief is achieved, but it does work for him.  And Ketofen, yet another NSAID, is well-tolerated in cats.  

I had a younger cat with laxating patellas in both legs, and the five doctors at my vet hospital all took a look at his x-rays and felt that surgery would be a little drastic for him (though he was stiff only occasionally).  So they recommended putting him on a supplement called Cosequin.  It's the cat version of glucosamine/chondroitin and is excellent for cats with joint problems (arthritis, luxations, dysplasia, etc.).  Of course, it doesn't correct the underlying problem but may help minimize joint damage and pain caused by irregular wear on the bones.  Cosequin comes in a premeasured capsule containing tuna-flavored powder that is sprinkled over the cat's food and is available at some pet stores, online and through most vets.