Cranial cruciate ligament injuries (CCL, or “cruciate injuries”) are a common issue for dogs. Fortunately, they can be treated, but they usually require surgical intervention, which can be costly for dog parents.
The cruciate ligaments help stabilize the knee joint. Injuries to these ligaments can start out as partial tears that eventually rupture completely and cause the knee to be very unstable with lameness and pain. The complete rupture of the ligament is often the result of gradual degeneration that can take place over months or years and can be influenced by a number of factors, for instance:
- Obesity – puts added weight on joints and ligaments (This is the most common risk factor for ligament damage.)
- Intermittent strenuous activity — “weekend warriors” dogs who only get out for vigorous exercise once a week or less are prone to this injury
- Poor overall health
- Age of the dog — because it’s a degenerative disease, the ligament may weaken over time
Breeds at Risk
While any dog can suffer a cruciate ligament injury, certain breeds are predisposed to this condition. These include:
- Chesapeake Bay Retrievers
- German Shepherds
- Golden Retrievers
- Labrador Retrievers
- Saint Bernards
- Staffordshire Terriers
Other breeds seem to be affected by cruciate ligament injuries less often. For instance, it’s not seen as often in Bassett Hounds, Dachshunds, Greyhounds, and Old English Sheepdogs. Cruciate ligament injuries are rarely seen in cats.
CCL injuries are painful for dogs and result in decreased mobility. Other symptoms vary depending on the severity of the injury, but can include:
- Limping or lameness because the knee is unstable and weak
- Stiffness, which you may notice when your dog gets up from a long rest
- Difficulty getting up from a sitting position or jumping into a car
- Decrease in overall activity level—your dog might be less interested in going for walks or refuse to engage in games they normally enjoy, like fetch or chase
Symptoms can come on gradually as the ligament endures more damage over time. You might not even notice any symptoms until the cruciate ligament ruptures completely.
When to see Your Veterinarian
If your dog is in pain and has noticeable, persistent lameness, you should consult with your veterinarian. These are frequent signs of a cruciate ligament injury that requires diagnosis and appropriate treatment.
In any case, please remember: never give your dog any medication without talking to your veterinarian first. Aspirin, Tylenol, Advil, and other pain relievers can be harmful to your dog.
Learn about other common household items that can be problematic for your dog at 101 Things You Didn’t Know Could Harm Your Pet.
The diagnosis of a cruciate ligament injury typically involves gathering information about the dog’s medical history and a complete physical exam. During the exam, the veterinarian will carefully examine the knee to assess any instability or pain, which are the signs of ligament damage.
Blood work and other diagnostic tests may also be performed to rule out underlying illnesses. In addition, X-rays may be conducted, which can’t necessarily reveal small tears in the CCL, but can help assess the condition of the knee joint.
It’s important to seek treatment for a cruciate ligament injury. Although it can seem to improve over time in certain cases, especially with small dogs, a damaged (stretched or partially torn) ligament can lead to painful issues in the future, such as arthritis.
There are some non-surgical treatment options, which may be useful in with smaller dogs. This typically includes medications to control pain and reduce inflammation along with restricted activity to rest the knee. If the dog is overweight, some gentle exercise might be recommended to help improve overall health.
There has been some recent interest in knee braces and orthotics to help treat dogs with cruciate ligament injuries. However, the benefits of these new treatment options for dogs have yet to be proven. While they have been shown to help humans with ligament injuries, there are significant mechanical differences between biped (two legged) and quadruped (four legged) knee joints. You can’t simply assume it will work for dogs like it does for people.
Surgery is usually the preferred option for canine cruciate ligament injuries since it is the only way to control instability in the knee joint. There are two different surgical techniques that can be used:
- Internal Knee Sutures – In this procedure, the veterinarian uses sutures (stitches) to tighten the ruptured ligament. This repair can be less costly, but is often reserved for smaller dogs, since it is not so consistently effective.
- Osteotomy – This surgical technique is more expensive and requires a bone cut to stabilize the knee.
Like any surgery, both of these options carry risks, such as infection or a failure to resume normal function. The risks can increase in older dogs, dogs that are markedly overweight, or for those with existing health conditions. However, it’s often worth taking these risks to alleviate the pain and return the dog to normal function.
Post-op care for this surgery is critical, and it’s essential that you follow your veterinarian’s instructions carefully. If your dog puts weight on the leg too early, it can cause further injury. Restricted activity is usually recommended for the first six to eight weeks or more depending on the type of procedure and your dog’s condition.
It can be tough to keep a normally active dog calm and quiet during this recovery period. If your dog is crate trained, you can put them in the crate to rest safely when you can’t supervise them. Rehabilitation therapy under the care of a veterinarian may also be recommended to assist in recovery.
Prognosis for Surgical Intervention
The prognosis for surgical intervention depends on the situation, but most dogs should be back on all fours after a few months. Some dogs can have ongoing issues with the joint even after surgery, such as arthritis, which may need ongoing treatment or medication. Dogs who have a cruciate ligament injury in one leg will often develop the condition in the opposite leg as well.
Cost of Cruciate Ligament Surgery in Dogs
The costs of surgery and other treatments including medications, hospitalization, and aftercare can be expensive. In fact, ASPCA Pet Health Insurance has received claims for CCL injuries ranging from a few thousand dollars to over $8,000. Luckily, those dog parents had insurance that helped reimburse them for these costs.
Is your dog covered? Get a free quote now so that you can take care of your dog’s medical needs with less worry about the costs.