Cruciate Ligament Damage and Treatment in Dogs
The cranial cruciate ligament helps stabilise the dog's knee, or stifle joint. Damage may develop gradually through degeneration or occur suddenly during activity.
Which Dogs Are Affected?
Any breed, age or size of dog can develop cranial cruciate ligament disease. Factors that may increase the risk include:
- Being overweight
- Poor muscle condition or fitness
- Sudden twisting, turning or strenuous activity
- The dog's conformation and the shape of the knee joint
- Age-related weakening or degeneration of the ligament
- Previous cruciate disease in the other knee
Possible Signs
A dog with a complete rupture may suddenly become very lame and hold the affected leg off the ground. The knee may be painful or swollen.
With a partial tear or gradual degeneration, the lameness may be intermittent. The dog may appear stiff after resting, be reluctant to jump or climb stairs, sit with the affected leg held out to one side, or improve temporarily before becoming lame again.
Sudden or persistent lameness should always be assessed by a veterinary surgeon. Other injuries and joint conditions can cause similar signs.
Diagnosis
Your vet will examine the knee and may check for abnormal movement known as cranial drawer or tibial thrust. Sedation is sometimes needed if the dog is painful or tense.
X-rays do not show the ligament itself, but they can reveal swelling, arthritis and other changes within the joint. Further imaging or examination of the inside of the joint may occasionally be recommended.
Treatment
The most appropriate treatment depends on the dog's size, age, activity level, degree of instability, other health conditions and whether the ligament is partially or completely damaged.
Surgery is commonly recommended for an unstable knee, particularly in larger or active dogs. Procedures may include TPLO, TTA or an extracapsular stabilisation technique. A veterinary orthopaedic surgeon can explain which option is most suitable.
Some dogs may be managed without surgery, particularly when the tear is partial or surgery is not appropriate. Management may include:
- Strictly controlled lead exercise
- Weight reduction when necessary
- Veterinary-prescribed pain relief and anti-inflammatory medication
- A structured veterinary rehabilitation programme
- Hydrotherapy or underwater treadmill work when approved by the vet
Non-surgical management may improve comfort and muscle strength, but the knee can remain unstable and arthritis may continue to develop.
Recovery and Rehabilitation
Recovery instructions vary according to the injury and the treatment performed. Follow the individual plan supplied by your vet or surgeon.
Exercise is normally restricted during the early stages of recovery and then increased gradually. Running, jumping, stairs, slippery floors and uncontrolled off-lead exercise may need to be avoided.
Rehabilitation can help rebuild muscle, improve joint movement and support a safe return to activity. Progress should be reviewed regularly so that the programme can be adjusted.
Long-Term Outlook
Most dogs can return to a good quality of life with suitable treatment, weight management and rehabilitation. Arthritis commonly develops in an affected knee, even after successful surgery, but early diagnosis and appropriate treatment can help limit its effects.
Dogs that develop cruciate disease in one knee have an increased risk of later developing a similar problem in the other knee.
My Experience With Ted
Ted came running—or perhaps I should say hopping—down the field one day. He was still happy and trying to gallop around with the girls, but he was using only three legs.
After resting him, I arranged a course of hydrotherapy and restricted his exercise to short walks on the lead. Five weeks later he appeared almost completely recovered and had built up the muscles in his hind legs considerably.
All seemed well for several months until he ran out of the house and twisted sharply. He immediately became lame again. We returned to restricted exercise and swimming, but after three weeks there was little improvement, so I feared that he had ruptured his cruciate ligament.
Our vet agreed that a cruciate injury was possible and referred Ted to an orthopaedic surgeon for examination and X-rays. Fortunately, the knee was stable and the ligament was only partially damaged, so surgery was not required.
Ted was treated with veterinary-prescribed pain relief and joint medication, together with controlled exercise and hydrotherapy. His medication and rehabilitation were regularly reviewed by his veterinary team.
After several weeks he was fully weight-bearing and his lead walks were gradually increased. This was Ted's individual experience; another dog with apparently similar signs may require very different treatment.
Julie Growcott
Further information
American College of Veterinary Surgeons: Cranial Cruciate Ligament Disease