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I just adopted a 12# male dog (chiuaua & shitzu mix) from a shelter. Age 3 ~ 5. The shelter told me the dog had grade 2-3 LP (luxated patella) on both knees. I took him to two different vets. Both vets spent less than 10 seconds of palpating and said definitely grade 4, meaning the patella are always out of their knee grooves. He shows no symptoms. Only when one vet manipulated a leg in a certain way, the dog expressed pain. One vet also said that the dog's showing symptoms of collapsed trachea, which makes him a poor candidate for a surgery. I can return the dog back to the shelter but I don't think I can live with myself since we're already bonded. So I'm trying to learn as much as possible about luxated patella. But everywhere I read says grade 4 LP needs surgical intervention. If any of you know any way I can delay the onset of dog LP deterioration without surgery, please let me know.
 

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I only have experience in a grade 2 for a puppy. You can give joint supplements also not stress the knees (no jumping... or long walks) I carried him around alot wed start out walking and then I'd carry him (he'd stop and look at me and I'd pick him up). I have a condition and use alot of joint supplements and just gave him my supplements according to his weight (vet approved)
 

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He may not be showing any clinical signs yet, but unfortunately as time goes on he will likely develop severe osteoarthritis as a result of his muscles and joints not moving the way they should. Here's an article which does a great job at outlining some info on the condition:

Patellar Luxation

As for his trachea issues, I would be chasing a more definitive diagnosis before ruling out surgery all together, something like x-rays at the very least. Is he showing signs of respiratory distress? To properly care for thus dog, you need to know what state of tracheal collapse he is in as well.

If surgery isn't an option in the end, I would be looking at palliative care, with a good joint supplement such as Antinol or similar and pain killers once things get bad, with eventual euthanasia once even those are no longer keeping him comfortable. You will need to restrict movement to a certain extent with no running, but some slow walks are still important for muscle condition and to keep his weight in a healthy range - you want to avoid obesity at all costs.
 
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