Our 5 year old dog had one painful episode lasting part of one day & we could not pinpoint the origin. There was no tell-tale lameness. Our local vet detected patellar luxation, but we did not know if this was related to his pain. (We still don’t know for sure, but it could have been.) We went to orthopedist Dr. Melissa Stoll who suggested that progressive arthritis could occur with the congenital misalignment in the joints and recommended patellar (knee) surgery on both knees. She commented that, at some point, surgery could not even help substantially arthritic joints. She recommended we act soon. We considered all we had heard and then called to schedule surgery. After some months passed with no pain and no lameness we took the dog to the North Carolina State University (NCSU) Vet School in Raleigh for a second opinion. The NCSU vet agreed that the patellas were moving but found them not to be painful; he also found minor lumbar-sacral arthritis (which was slightly painful) & mild hip dysplasia (also somewhat painful when manipulated to the extreme for diagnosis). The patellar luxation and lumbar-sacral arthritis, he said, are directly related to the way the dog is built. He suggested that these three conditions would be best treated with management, not surgery, and that surgery on the knees would actually do the dog harm in that, during recovery, he would be extremely restricted in movement which would make the arthritis worse. When I contacted Dr. Stoll’s office many weeks after our appointment (but before going to NCSU) to request (again) that records be sent to our vet, I was told by the receptionist that the records were not ready. Dr. Stoll later reputed that. (In other words, we had to ask twice for records to be sent to our referring vet.) When I called to postpone surgery (before we had gone to NCSU; for another reason) I was told by the receptionist that Dr. Stoll would not be in the office the week of our dog’s scheduled surgery. Later Dr. Stoll reported that her plans for leave were not finalized until after I called to cancel surgery. The communication problems did not make me feel confident about in the clinic’s work. After the NCSU consult, I wrote Dr. Stoll to ask about the difference in diagnoses. She stood by her diagnosis and referred me to a document from the American College of Veterinary Surgeons which, in addition to describing the problems associated with patellar luxation, specifically states that if the luxation is low grade and not causing clinical signs (i.e. pain) that surgery is not recommended. I wonder why Dr. Stoll did not identify the other problems our dog has, as she is an orthopedic specialist. I am concerned that we almost put our dog through major joint surgery that would have probably exacerbated his other conditions. I would advise clients of Eastern Carolina Veterinary Referral Animal Hospital to pause and consider if a second opinion is warranted.