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Be forewarned: this is a jumbled array of thoughts and sometimes I will go on a tangent.

I will add photos later.

I purchased a Pom puppy from a little old lady the other day. She’s your quintessential backwater backyard breeder. She is completely ignorant about musculoskeletal problems and heredity.

But she loves her little dogs. And she likely lives on a fixed income and needed the cash more than I did. Come to find out she is a widow of 15 years, and she started breeding dogs to make ends meet when she had to raise two grandchildren on her own.

The breeder’s Pom bitch is 8 years old with a recently developed unilateral cataract. But the dog looked well fed, just funky due to her blown coat, and the dog loved her owner. The dog was bowlegged, and therefore likely had luxating patellas. And since the puppy’s hips looked like the mother’s, I figured I was looking at a hereditary problem as opposed to an intrauterine one.

But most buyers probably wouldn’t have given the animals’ knees much thought because of the way the dogs pranced all about. With their untrimmed toenails clicking and clacking all over the hardwood floors, the dogs danced around their owner’s feet and then leapt into her lap the second the woman sat down. The breeder said she had problems with the mother dog climbing the fence and then getting stuck at the top. Lame dogs don’t willingly climb fences, so obviously this dog’s hips weren’t holding her back from doing what she wanted to do. And I would take wide hips over narrow ones any day. But the breeder had never heard of luxating patellas when I asked, and in all her years of Pomeranian ownership her own vet never thought to educate her about it. And her vet knew she bred dogs because she would bring the puppies in for their first vaccines.

I took the puppy to my vet about 48 hours later and confirmed the presence of severe bilateral luxating patellas. I wasn’t surprised. The knees had felt loose to me, and her coxa vara was so pronounced she could have ridden a horse.

So, why did I buy the dog? At first I was looking to purchase a potential female for breeding. But one good examination of her back legs told me that would be unlikely. I may not be a vet, but I have some common sense and a basic understanding of animal anatomy and physiology. I knew that the woman would likely breed her if she kept her…further perpetuating the orthopedic problems. And if someone else bought her, there’d be a chance that she would be bred, or someone might end up strapped with a really expensive vet bill if she needed surgery in a few years. Can the average puppy buyer in rural southern Virginia afford $2,000 in surgery bills? Maybe, but I knew I could, so I bought her. Besides, I knew she would be good with the kids. Yes, you read that right–I bought a toy breed FOR my young children. But that is a discussion for another day. And my kids loved her. My son continually asked me if we could keep her even though she has bad legs. What sort of lesson would I be teaching my kids if I got rid of a lovely baby animal because it had a relatively minor deformity?

I had recently noticed that my male Pom had luxating patellas, and this was later confirmed at the same vet visit as the new puppy. The vet said my male’s knees were almost as bad. Great. He has already sired a couple of litters. He was another dog I acquired FOR my children three years ago. My sister bought him to use as a stud for her Pom bitches, but when I told her I wanted him for my daughter, she gave the dog to me as a birthday present on the condition I let her use him as a stud.

I had worked at a vet clinic for a few years as a veterinary assistant. The vet always checked small dogs for luxating patellas but rarely recommended surgery. It just seemed like something all small dogs were prone to, and no one ever questioned why it was so prevalent. I don’t know that the vet I took the puppy and my adult dogs to the other day would have even checked the knees had I not specifically asked.

Look at most any breeder’s website or Wikipedia or any other source you can think of on small dog breeds and you will see that “patella luxation” and “small dogs” go hand-in-hand. Pomeranians have some of the worst incidence rates. According to the OFA’s 2011 numbers, out of 559 Pomeranians examined, over 41% of them had patella problems! In 2013, the percentage was still high at nearly 40%. And good luck trying to find a Pomeranian with good knees in Thailand. One study found that 75% of the Pomeranians tested had patellar luxation.

It is just taken as a given that small dogs are prone to having luxating patellas. It is so bad that small dog breeders refuse to cover them in their health guarantees. Based on the AKC breeders’ contracts I have read, they all seem to say that since luxating patellas could be caused by trauma, they won’t provide any guarantees.

Here’s the problem: unless a dog has a hereditary disposition to “trick knees” his patella is not going to pop out of the femoral groove just because he runs up the stairs or jumps off the couch. And it certainly won’t happen bilaterally unless he has STRUCTURAL deficiencies in the first place. Come on, breeders, an orthopedically-sound dog’s joints aren’t going to be popping in and out of place just because he does things ANY healthy dog would and could do. Patellar luxation truly caused by trauma is rare.

“Patellar luxation is not typically a congenital disease. Instead, it is a developmental disorder associated with abnormalities that are congenital in origin. These skeletal abnormalities include coxa vara, relative retroversion, femoral varus, genu varum, shallow trochlear groove, decreased height of the trochlear ridges, and medialization of the tibial tuberosity.

“Patellar luxation is considered a heritable disease process. Therefore, breeding severely affected patients should be avoided.”

Oliver Morgan, VMD, DACVS Cornell University Veterinary Specialists

Here are my thoughts on why this SERIOUS structural defect keeps popping up: breeders have been obsessed for decades with size and appearance to the point that they would linebreed and inbreed to such degrees that weird problems would pop up. And when those weird problems would show up, breeders would alter their breeding programs, inadvertently selecting for bad hips and/or knees. Or maybe simply by selecting for size, breeders were inadvertently selecting for orthopedic problems. Or maybe it was all just a coincidence, but somehow breeders have selected for dogs with orthopedic predispositions to patella luxation. And maybe many breeders were just unaware of the issue because the dog was asymptomatic during the breeding years. It is not like you can pour spilled milk back into its container. I suspect this last reason is why the disorder is so prevalent.

How are buyers supposed to know if the parents, or even the puppies, have this issue? How many breeders of small dogs have the parents AND the puppies checked and then freely share the information? Have you ever tried to examine a Pomeranian’s hips and back legs when its coat is full and fluffy? I can look at a Boxer’s hips as it runs and tell you if it is likely to give you problems, but I can’t do that with a fluffy toy-sized dog. On top of that, spay/neuter contracts and the widespread public awareness campaigns urging (and guilting and forcing) people to surgically alter their pets removes a lot of dogs from the gene pool–dogs that might have great musculoskeletal systems.

Backyard breeders, especially those in low income areas, often depend on the cash they get from selling puppies. They cannot afford to have a large breeding program and/or they are prohibited from doing so because of pet limit laws. Where I live, for example, you can only own 4 dogs or cats. Period. That means if I have three cats, I can’t also have 2 dogs. Someone has to go. So if I have four dogs, and I discover that my breeding bitch is passing on a problem, I can’t just go get another female without first getting rid of one of my pets. And for a lot of these backyard breeders, that is an impossible thing to ask of them. They love their little dogs.

For a little old lady on a fixed income, not breeding her bitch could mean missing out on $3,000 a year (assuming she bred her dog twice and each time the dog had 3 puppies selling for $500 a piece). $3,000 is a lot of money for someone who doesn’t have much in the first place.

And before your hair goes up in flames in righteous indignation because someone uses their dogs to bring them money, is this ANY different than someone raising livestock for sale or for meat? Is a dog an inherently more special creature than, say, a pig?

Personally, I don’t believe one should breed a dog when you become aware that it has a likely-heritable disorder that can greatly affect the dog’s quality of life (and the owner’s wallet.) But I can understand why someone with a low income would do so. I did educate the breeder on luxating patellas and advised her not to breed my puppy’s parents again. But will she stop doing so? I have no clue. And is it really so different from Show breeders deliberately breeding oxygen-starved Pugs or breeding Bulldogs that require surgery in order to reproduce? Is it any different than breeding long-bodied short-legged hounds (ie Dachshunds) that have a 25% chance of developing an excruciating back problem? At least the backyard breeder does it to make ends meet (and maybe to avoid welfare dependency) whereas the “professional” Bulldog breeder does it purely for his or her own pleasure. And come to think of it, I have never in my life met a wealthy backyard breeder. Ever. But I will bet there are some wealthy Show Pug and Bulldog breeders out there.

So, what do we do now? There is no easy answer. If we were to cull all small dogs with a luxating patella from breeding programs, the resulting population bottleneck could give us a whole new set of debilitating hereditary disorders.

Breeding recommendations for dogs diagnosed with luxating patellar should be made cautiously. “Patellar luxation is most likely a complex genetic disease involving several genes,” Roush says. “Breeders can select against the disease by not breeding dogs diagnosed with it, but this isn’t complete assurance.” …

“The dilemma is that while you’re selecting against patellar luxation, you may introduce other heritable prob- lems,” Roush cautions. “As a result, it is important to not cull dogs with quality traits because this could result in reducing genetic diversity. Dogs that carry this mutation also carry other important good genes that breeders may not want to lose from the breed.”

“Ideally, you would not breed pairs that produce puppies with patellar luxation, especially if there is a high incidence and high severity,” Cook says. “As with everything genetically based, you have to consider all factors and strike the best balance of desirable and nondesirable traits when breeding.”


And rather than encourage all puppy buyers to spay or neuter their new dogs, animal rights groups and breeders and veterinarians should give buyers/adopters a checklist to determine whether or not it is worth it to preserve the dog’s reproductive capabilities. It might look something like this:

Is my dog overly fearful or aggressive towards other dogs?
Is my dog fearful or aggressive towards people?
Is my dog jumpy, nervous, or neurotic?
Is my dog obsessive compulsive?
Is my dog difficult to train?
Does my dog have an audible heart murmur?
Does my dog have an irregular heart beat?
Does my dog have difficulty breathing in the summer or during exercise?
Does my dog have musculoskeletal abnormalities predisposing it to hip, elbow, knee, or vertebral disorders?
Does my dog have allergies or an autoimmune disorder?
Does my dog have chronic ear infections?
Does my dog have chronic digestive problems?
Does my dog suffer from hair loss?
Does my dog have vision impairment?
Does my dog have a hearing impairment?
Does my dog have abnormal growths or lesions?
Do my dog’s parents have a history of these problems?

If an owner can honestly say no these questions, then for Pete’s sake don’t encourage them to neuter their pet! Stop spouting the lie that there are too many dogs. There aren’t. There are too many UNHEALTHY dogs and dogs with serious mobility issues, and there are too many dogs with awful behavioral problems that prevent them from cohabiting with humans. If the stigma of home breeding was removed, perhaps more informed and educated dog owners would be helping to improve the health and well-being of future generations of dogs by actively participating in breeding programs. Imagine if a breeder had 25 really good local studs to choose from rather than, say, five.

Of course, this might make the supply of healthy, quality puppies go up…driving down prices and driving down veterinary health care spending. By making it cost-prohibitive for the average person to purchase a quality puppy WITH REPRODUCTIVE RIGHTS, breeders are doing only one thing–protecting their bottom line. It is totally understandable why breeders do it. They have to eat too. But let’s cut the crap and stop the “it’s for the love of the breed.” We all know it is a bunch of hogwash.

Are dogs better off now than they were 40 years ago? How many dogs today go under the knife not just once for a neuter, but twice and sometimes more for various diseases and disorders? How many dogs spend YEARS in chronic pain? How many dogs suffer terrible deaths from cancer or other disease?

When a human suffers, even a child, he or she usually knows WHY they are suffering. They can appreciate the struggle and the suffering if it is for a greater good (like suffering through chemo to be rid of breast cancer.) But when a dog suffers, there is no higher purpose to be achieved. Is the dog’s character going to be improved through suffering? Will the dog be better able to empathize with the suffering of others? Will the dog’s soul be strengthened? Are an extra few years of life for the dog worth a year of its suffering?

One could argue that by caring for the suffering dog and sacrificing of one’s time, labor, and money, the owner’s character is improved. When we see a dog happily chewing a bone despite the amputation of a leg, it can teach us to prioritize and appreciate the little things in life. When a dog has suffered severe neglect and abuse, a human soul can practice compassion and mercy by feeding the animal and caring for its ailments. A bond is formed through care-taking, whether it be with an animal or another human. Maybe that is a supernatural mercy afforded to our increasingly narcissistic and childless society. If we refuse to learn self-sacrifice with our fellow humans, perhaps we can learn it with our pets. Perhaps through our pets we can learn how to be better people.


The Pom breeder called me today. She talked to her vet about the luxating patellas and had him check another one of her dogs. She said the vet acted like it was no big deal and he told her that a lot of small dogs have it. I wanted to slam my head on the counter.

Everyone screams about how backyard breeders are irresponsible and don’t do the breed-appropriate health checks, but does anyone question WHY some backyard breeders are so ignorant about canine health? When the man or woman with a DOCTORATE in veterinary medicine doesn’t even bother checking for common orthopedic problems in the first place, and when issues are actually brought to their attention they shrug them off like it is no big deal, is it any wonder that breeders keep on breeding DEFORMED dogs?

Yes, these are deformities. Maybe not grossly irregular ones like missing legs or three eyes, but these are real musculoskeletal deformities that cause the dog’s kneecap to slide around and literally pop out of place. Sure, little dogs compensate rather well for it so long as they don’t get fat, but how much arthritis do they suffer from as the years go by? How much chronic pain do these dogs simply learn to live with?

I read an excellent article the other day that quoted a veterinarian about this very topic of breeding dogs suffering from patellar luxation:

“You know, you people should be much more concerned about the illnesses and conditions that keep your dogs from living normal active lives, like luxating patellas, and other orthopedic issues! VwD [Von Willebrand’s Disease] affect only a small number of dogs, and you can test for it, but the only way you will ever help your breed get rid of these patella problems is to routinely have them checked on all of your breeding dogs before you breed them!”

Veterinarians should be honest with their breeder clients. If a dog has luxating patellas, they probably shouldn’t be bred. And when a veterinarian checks a dog and finds that along with being of good general health it also has a sound hind end, he or she should discuss the merits of breeding the dog rather than spaying or neutering it.