Unfortunately, a very common injury for dogs is a Cranial Cruciate Ligament (CCL) tear, similar to an ACL tear in humans. The cruciate ligaments connect the femur to the tibia in the rear legs. They keep the knee from bending or moving in the wrong direction. Here are some common questions about CCL injuries and its treatment.
How does a Cranial Cruciate Ligament Injury Happen?
This common injury usually appears in one of two situations:
- A young athletic dog running and playing that suddenly comes up lame, or…
- An older, overweight, large breed dog that has, over time, had more difficulty getting around and then comes up lame.
What Breeds are Susceptible to Cranial Cruciate Ligament Injury?
Common breeds affected include, but are not limited to, Labrador Retriever, Golden Retriever, Rottweiler, Newfoundland, Mastiff, Akita, Pitbull, and St. Bernard.
Small breed dogs can also be affected as it is an athletic injury, but also because many small breed dogs have luxating patella/knee caps that may predispose the dog to more stress on the ligaments.
How do you Identify a Possible Cranial Cruciate Ligament Injury?
Common presentation on a veterinary exam is a dog that has been holding up its rear leg when at rest, not using the rear leg at all, or is toe touching lame. The exam findings may reveal instability in the joint, but if the pet is very tense or in pain, please be aware that sedation may be needed for a proper examination.
What is the Treatment for a CCL Injury?
Without an intact cruciate ligament, the knee is unstable. Wear between the bones and meniscal cartilage becomes abnormal, and the joint begins to develop degenerative changes. Bone spurs called osteophytes develop, resulting in chronic pain and loss of joint motion.
This process can be arrested or slowed by surgery, but it cannot be reversed. The ideal treatment for a torn cruciate ligament is surgical repair – this is best done by a Board Certified Surgeon. Your regular vet should be able to refer you.
There are three types of procedures that are typically done for repair – TPLO, TTA, and Extracapsular Repair. The type of procedure used should be discussed with the surgeon. The decision will be decided on based on your pet’s size, the extent of the injury, their activity level, etc.
What if it’s an Old CCL Injury Not Previously Diagnosed?
If the injury is not discovered or checked for months to years, arthritis occurs due to long term inflammation and instability of the joint. These dogs may still benefit from TPLO or TTA surgery – please discuss this with the surgeon at time of consult.
If the meniscus or cartilage of the joint was damaged when the cruciate ligament is torn, removal of the damaged cartilage will be indicated (Note: this can only be fully evaluated during the surgery when the joint space is opened).
Non-steroidal anti-inflammatories are usually instituted to alleviate much of the pain from torn ligaments or arthritis, and these will be discussed by your vet.
How Can we Enhance Recovery After CCL Surgery*?
Confinement – Enhancing recovery post-operatively is largely about strict confinement early. This cannot be over-emphasized. Be prepared to crate your dog our employ a pen such as a child’s playpen depending on the dog’s size. A corral of sorts can be constructed with boxes and a baby gate. Be sure you understand the instructions with regard to gradual return to exercise over several months.
Adequan Injections – A series of Adequan injections can help with joint inflammation, as well as lubrication. Typically injections are given twice a week for a total of eight injections.
Glucosamine – Oral joint supplements such as glucosamine contain cartilage building blocks to help the body repair cartilage damage. This is an excellent time to begin supplementation and there are numerous brands.
Weight Management – Overweight dogs have an increased risk for arthritis and for cruciate rupture. A weight management program can reduce the potential for arthritis and can reduce the risk of rupture of the opposite cruciate ligament. If your dog is overweight, ask your vet about a weight management plan that might be started during the recovery period.
Professional Rehab/Physical Therapy – Nothing compares to professional rehab for return to function. If you are lucky enough to have such a facility in your area, consider utilizing their services. A list of home exercises may be obtained and/or the dog can visit weekly or a few times weekly for exercise and treatment. Some facilities allow the dog to board and have daily treatment. Ask your vet about this option.
Contact Compassionate Animal Care Today
As ever, if you have any concerns about your dog’s health and wellbeing, please talk to us, or your own veterinarian. Please call 480.774.6995 to schedule a clinic appointment with Compassionate Animal Care today, or call 602.359.2031 for a mobile vet appointment within the East Valley.