Why Does my Dog Sometimes Skip? It may be due to Patella Luxation.
Has your dog ever been trotting along when you’ve noticed them suddenly lift their rear leg, skip along for a step or two, then kick their leg behind them before placing it back down? If so, your dog may be experiencing patella luxation, a not uncommon orthopaedic condition in dogs. While it is mainly seen in smaller dogs, such as the toy poodle or chihuahua, it can also occur in bigger dog breeds. So what is patella luxation?
The patella is the medical terminology for the knee cap. Luxation means dislocated. So a luxating patella is simply a knee cap that has moved out of its normal anatomical position.
The patella is a small bone situated within the patella tendon. It is this tendon that holds the patella in place. The tendon sits within a groove at the end of the thigh bone, and patella luxation occurs when the knee cap pops out of this groove when the dog bends its knee. While there are a multitude of reasons why a dog may develop patella luxation, the two main reasons are:
The dog has a shallow groove.
There is abnormal alignment of the thigh bone, shin or hip.
Patella luxation is typically a young dogs disease, and is usually diagnosed before a dog is three years of age. It is also more prevalent in females than males. Neuter status has also been identified as a risk factor, with neutered dogs being three times more likely to develop patella luxation than dogs who remain intact. Genetic studies have also identified chromosomal abnormalities in specific breeds.
The patella can slip either medially (to the inner aspect of the leg) or laterally (to the outer aspect of the leg). In smaller breeds it is more common for the patella to dislocate medially, while lateral dislocation is more often seen in medium and larger breeds and often occurs in conjunction with hip dysplasia.
Patella luxation is diagnosed by a physical examination performed by your veterinarian, alongside diagnostic imaging.
The below radiograph shows the x-ray imaging of one of my dog clients, a Cavoodle who required surgery for a right, medially luxating patella. The area circled shows the knee cap sitting to the side of the groove.
There are four grades of patella luxation. These are:
Grade I: When the patella is able to be dislocated manually by placing pressure on the side of the bone, but it pops back into place when the pressure is released.
Grade II: When the patella pops out on its own and remains out of place until the leg is hyperextended and rotated, either manually or by the dog learning to relocate the patella itself by kicking the leg out behind them.
Grade III: When the patella is out of place the majority of the time, but is still able to be manually pushed back into the groove.
Grade IV: When the patella is permanently dislocated and is unable to be manually repositioned.
The more times a knee cap dislocates the weaker the structures supporting the patella become. This in turn leads to the patella luxating more easily and with increasing frequency. Unfortunately this then increases the risk of secondary problems, such as osteoarthritis and cruciate ligament rupture. In regard to the grades discussed above, the higher the grade the more likely it is your dog is also going to develop these long term issues.
So, how is patella luxation managed?
For dogs who have a Grade I diagnosis, the condition is managed conservatively. This means that no surgical intervention is required. Conservative management in these cases consists of all, or a combination, of the following:
Ensuring your dog maintains an ideal weight.
Joint supplements.
Pain medication.
Exercise restriction or modification.
A rehabilitation exercise program.
Grades II - IV require surgical intervention, the success rate of which is deemed to be very good (as high as 90%). Surgery generally consists of:
Relocating the point of attachment of the patella tendon to the correct position on the shin bone.
Deepening the groove that the patella sits in.
Tightening the capsule around the knee joint.
In my experience each veterinary surgeon prescribes a slightly different rehabilitation protocol post surgery, but in general your dog should recover full function within 12-16 weeks. It is important you follow the protocol set out for your dog, as most post-surgical complications arise when owners fail to do so (think letting your dog jump off the couch before adequate healing as occurred). If you are unsure whether you are carrying out the prescribed exercises correctly, or you have concerns about your dog’s progress, never hesitate to contact your veterinary clinic or local canine rehabilitation specialist to help guide you through your dog’s recovery as needed.
If your dog has been diagnosed with Grade I patella luxation, and you are unable to access a Canine Physiotherapist / Physical Therapist to assist you with a rehabilitation program, then the following are simple but effective exercises you can do at home with your dog (most likely with lots of treats involved!):
Massage to the front (quadriceps) and back (hamstrings) thigh muscles.
Sit-to-Stand: These are the equivalent to squats. It is best when this exercise is done slowly and with lots of control (rather than your dog plopping down into a sit!). Build up to your dog doing 3x10 reps in a row.
Figure 8’s: Imagine a large figure 8 on the ground, 10-15 feet in diameter. Walk your dog around the figure slowly in each direction. This assists with the dog’s proprioception (their perception and awareness of where the different parts of their body are in relation to the ground while moving).
Controlled and slow stair walks - both up and down.
Controlled and slow hill walks - up, down and across the slope.
Balance exercises on a disc: You can usually find balance discs at stores such as Kmart, The Warehouse, Walmart or Asda (depending on where you are in the world) fairly cheaply. There are a number of different exercises you can do using a balance disc and most are easily found by searching on YouTube.
Three-legged stand: With your dog standing square, sit or stand behind them. Place one hand under their lower torso for support and then gently lift their good rear leg off the ground so they are balancing on their two front legs and the leg with the issue. Again this is not only a good strengthening exercise, but helps improve their proprioception.
Hopefully this has given you a greater understanding of why your dog may do the odd skip when they walk, or, if your dog has already been diagnosed with patella luxation the treatment that may be required to ensure they continue to live a full and pain free life.
If you have a dog who has, or has had, patella luxation I would love to hear about their rehabilitation journey so please feel free to add a comment below. And, as always, if you have any questions please do not hesitate to contact me via email which you can do by clicking here.
If you are concerned your dog may be experiencing pain then my eBook, ‘How to Tell if Your Canine Companion is in Pain’ is a helpful resource full of advice & tips that help you monitor them. You can purchase a copy for only $19.95 (AUS) by clicking here.
