Dear Dr. John,

Our adorable Maltipoo dog is five months old, and has two conditions that he was apparently born with. Our vet has showed us that our puppy has a rather large umbilical hernia and has also let us feel the shifting of his kneecaps called luxating patellas. None of these issues seem to cause much discomfort for our dog at this time yet the vet suggests that we consider surgical correction of these issues. We also were thinking of breeding this dog later due to his fantastic temperament, but the vet advised against this. What do you think we should do?  D.B.

Dear D.B.,

Maltipoos are very cute designer breed dogs but, like many smaller breeds, can be prone to congenital issues such as luxating patellas wherein the kneecaps shift out of their normal place at the end of the femur or thigh bone. Just because your dog does not exhibit discomfort of the knees now does not mean that problems will not develop later as the kneecaps erode the femoral condyles which are the ridges that keep them in place with continued luxation over time.

However, many small dogs have this condition and surgery is only indicated when there is chronic pain and discomfort, therefore I think you can wait until this might develop. Many small dogs learn to live with this abnormality and adjust well. My own small dog is almost 14 and has had mild luxating patellas all his life without the need for surgery.

Large umbilical hernias should be corrected since a segment of intestine can pass through the hernia opening and get strangulated causing pain, infection, and even death. I agree with your veterinarian in that you should not breed a dog with congenital defects as the conditions may be passed on to their offspring. I suggest that you have the puppy neutered at around eight months and have the hernia corrected at that time.

I would ask how significant the patellar luxations are at this time and work with your veterinarian to do what is right for your dog.

Dr. John de Jong is President of the World Veterinary Association. He owns and operates the Boston Mobile Veterinary Clinic and can be reached at 781-899-9994.