我家小瑪（6歲）那天一打開門衝了出去！後來發現有時走一走腳會抬起來～有時又很正常！想說先帶去給附近的動物醫院看看～摸一摸說是膝關節異位～初期1～2級會這樣！要開刀才會好！後來又帶去啄x鳥動物醫院～一個女醫生（好像是新來的）～說明也是膝關節異位～他說會轉一下腳～結果我家狗狗因為痛叫了一聲～後來問我們要不要照x光看嚴重程度～就答應了!照完之後說是3～4級～我說先帶回吃藥觀察看看～再考慮開刀事宜！結果回家發現他幾乎都抬著腳～很少放下來！精神也變不好（本來醫生說止痛藥吃了會變活潑；反而造成腳負擔），目前已經關籠吃藥兩天～並沒有改善～
之後打去問醫生確說照x光腳要拉直～可能讓他不舒服才會一直抬著！
請問
有可能是照x光太粗魯造成的嗎？怎麼初期1～2級瞬間會變3～4級～有人的狗狗遇過類似情況嗎？
但是可以盡量控制不讓它惡化!
平時要帶出去散步(用牽繩~是慢走，不能奔跑或是快走)，鍛練大腿肌肉，
肌肉強健可以減低異位情況。
家中通常是磁磚地，很容易讓狗狗的腳打滑，請做好止滑。
嚴格禁止站或跳，雖然有時無法控制，但就是盡量!
通常只要沒有完全影響走路，不用一定要動刀!
我狗狗一開始也是抬腳，不過醫生有開藥吃三天，並不用吃很久，
先舒緩疼痛感，狗狗才會慢慢把腳放下
不能讓他們一直抬腳沒有使用那隻腳，會造成肌肉萎縮，
我狗狗目前情況控制良好，也沒有再抬腳。
不過教科書上似乎沒提到不能站或跳
但是適度的運動很重要
之前我持續在慢跑
但是鞋子選錯＋沒做核心運動
跑步完常會有膝蓋痛的問題
動物也一樣
一定要有一定的肌力＋適度的體重
Patellar luxation
Only animals showing overt clinical signs should have surgery.
Patellar luxation usually produces surprisingly little osteoarthritis, which is typically slow to progress.
In all but very young puppies and kittens, correction of bone deformities as well as soft-tissue repairs will be necessary.
Without surgical bone correction, a soft-tissue repair alone, even if it feels stable on the operating table, usually allows patellar reluxation by 3 weeks after surgery.
Concurrent cranial cruciate rupture must be addressed during the patellar luxation operation, since cruciate ligament rupture is frequently the chief source of the lameness being treated.
Physical rehabilitation for mild patellar luxations (grade 1, ± grade 2)
Exercises to strengthen quadriceps muscle function
一般來說Patellar luxation用手摸就可以區分等級了
應該不需要用到x ray
Grading system for degree of luxation:
Grade 1: patella is in place most of the time, spontaneously reduces if it does luxate
Grade 2: patella moves in and out of the trochlear groove, often with every stride. This is the grade most commonly associated with consistent, painful lameness.
Grade 3: patella is luxated all of the time but can be moved back into the trochlear groove by an examiner. This and grade 4 luxation produces a mechanical lameness due to deformity from abnormal joint positioning but is not evidently painful.
Grade 4: patella is luxated all the time and cannot be manually reduced. Resultant limb malpositioning is severe.
當然如果已經嚴重到十字韌帶受傷或斷裂
可能還是需要外科手術
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