Cranial Cruciate Ligament Injury in Dogs

The larger breeds such as Rottweiler and Labrador retriever are most likely to suffer from torn knee ligaments as are the dogs over the age of four years old. The spayed dogs also tend to be affected. Whether it is partial or complete will determine the extent of the injury. Also, keep in mind whether this is a sudden or long-term occurrence.

CCL injuries in dogs are one of the most commonly seen orthopedic problems. The Cranial Cruciate Ligament, or CCL – similar to the ACL in humans - is the ligament that connects the back of the femur (the bone above the knee) with the front of the tibia (the bone below the knee). Treatments options include both surgical and non-surgerical depending on the size of the dog.

The front ligament rupture will be demonstrated as a limp and the joint will contain fluid build-up. Your pet will hold a stance with the leg in a slightly bent position. The limp may be subtle or noticeable and may continue for weeks or months and this indicates a partial tear. If your dog is performing the usual activities, and suddenly becomes limp this could be a sign of deteriorating split. Look for other signs such as:

• Staggering while getting up
• Low activity level
• Limping of different severity
• Pain
• Stiffness
• Refusing to play

• The most common reason is repeatedly applying stress on the ligament in the same manner.
• Each time this happens the ligament changes alignment and over time this causes the rift.
• A sport injury –overexertion, jumping, Frisbee catching.
• Dogs who have been using Corticosteroid medication for a long time. It is not known whether it is because of the weight gain or the side effect being a lessening of ligament strength.
• Obesity can also play a role because if the disease is already present the extra weight accelerates the amount the same part of the limb is injured.
• A background in intense exercise
• A past incidence of a jump gone wrong.
• Osteophytes can happen within one to three weeks after injury.

The veterinarian will follow a few procedures to determine the cause of the injury. The assessment will consist of a cranial drawer test. This drawer test may not be reliable because a scared or nervous dog can temporarily keep the knee tense. A better way to achieve the right results is to sedate the patient. The doctor holds the femur with one hand and maneuvers the tibia. Now if this action appears like a drawer sliding open, this is an indication the ligament is torn.

Ligaments are diagnosed with an X-ray to assess fluid build-up and to acknowledge if an irregularity is present, or examine if there are any changes in arthritis. Tibia compression is also a test to check for ligament damage. Both hands are used; one holds the femur straight while the other flexes the ankle. In an affected ligament it makes the tibia move forward oddly. Another method is an arthroscopy placed into the joint to view if the joint is torn or the cartilage is impaired.

Many vets will recommend surgery as the only treatment worthwhile. Actually, the success rate is under 50 percent. These injuries can be expensive. Surgery is usually the first fix, but sometimes unsuccessful and age or other disease can make it impossible. Physical therapy, chiropractic adjustments, and massage are effective options but that is not to say surgery will not be required. Partial tears can benefit from physical therapy and exercise.

Immediate treatment is necessary otherwise the knee will swell. Other changes will begin such as bone spurs, chronic pain, loss of motion, and arthritis. A complete ligament tear will always need surgery-the knee will not work otherwise. For the partial type, a non-surgical option is given an 8 week trial period. If there is a positive outcome, there is non-surgical recovery ahead. If this technique does not produce any change, conservative management efforts can be used.

A simple strategy to help is to prohibit exercise. This means no running, jumping (on and off furniture included), and the stairs. When taking your dog to go to the bathroom put your pet on a leash. Shelter your dog in a small room. This should continue for at least 6-8 weeks.

Weight control is also a factor in reducing the pressure on the stifle joint. There are other methods rather than surgery used to attach the tibia to the femur and maintain strength. If you do not want a surgical procedure, your vet will suggest another option.

Once this condition has been diagnosed and you chose a treatment the time has come to manage it. The outside support of the knee is imperative and a leg brace is a big help for recovery.

Managing the inflammation is also necessary. The prescription for this is NSAIDs. You should understand inflammation will most likely cause cartilage degeneration and increase the incidence of arthritis. Glyocflex is a nutritional supplement that has New Zealand Lipped Mussel prescribed by Dr. Herschel, a certified veterinary acupuncturist. It works for joint and connective tissue health for senior and working dogs. She also treats it along with Adequan injections. This water based medication assist the cartilage from fading away. These doses are given 2 times a week in a two week period and then once weekly.

Most importantly, do not let your dog gain weight which can happen when their usual exercise habit stops. Their diet should include foods rich in protein and low in carbohydrates.