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Injuries to the cranial cruciate ligament are now the most common cause of hind leg lameness in our dogs. As veterinarians, we always want to do what’s best for our patients. It’s often tough to know what is best when there isn’t enough data and reliable information to make solid recommendations. The cool thing is that there are always new studies that help us make better, more educated decisions.
For those of you that don’t know, the cranial cruciate ligament is a ligament within the knee (stifle). This provides stability to the knee and typically becomes damaged over time from run, stop turn activity.
It causes chronic discomfort until it tears completely, where we see reluctance to use the leg to any significant degree. The best treatment for a torn ACL is surgery. This is an expensive procedure and it is important to know what the benefits of surgery are.
A recent study published in the Journal of the AVMA took a look at treatment of overweight dogs treated for this injury with surgery and non-surgical treatment in addition to weight loss, physical therapy and non-steroidal anti-inflammatory drugs.
Does My Dog Need Cruciate Surgery
Overweight dogs with CCLR treated via surgical and nonsurgical methods had better outcomes than dogs treated via nonsurgical methods alone. However, almost two-thirds of the dogs in the nonsurgical treatment group had a successful outcome at the 52-week evaluation time. Source
This study was helpful in two ways. The first was that dogs with surgery benefit significantly from other treatments in addition to the procedure itself. Overweight dogs are much more likely to tear a ligament in the knee. With post op treatment including physical therapy, weight loss and pain medication, dogs showed more improvement than with surgery alone.
The second point was that even without surgery, 2/3 of the patients showed a satisfactory outcome within a year. They, however were not as likely to improve as dogs that had surgery.
If your dog has a torn cruciate ligament, surgery with ancillary treatment is the best option. If surgery is not an option due to financial concerns, then medical management can be quite helpful in a majority of dogs.
I hope this information helps you explore all your options if your dog has a torn cranial cruciate ligament 🙂
bob
says:My dog was not overweight as we feed a more natural diet with pastured organic raw eggs, frozen green beans, tsp of codliver oil, a green powder supplement of kelp, chlorella, spirulina and a red powder supplement with cranberry and sprinkle of chia seeds for fiber, firm poop, and canine powder supplement. My dog was out running and playing, and came back limping. At first, thought it was a sprain, but it never got better, sometimes less limping or more limping. Finally went to a vet and it was confirmed to be a ccl and or acl like knee tear. The vet was really pushing to refer to a friend surgeon for a tplo surgery or a tta surgery. After researching this, there were just too many painful complications and high risks of a painful knee surgery. More researching, found a custom acl ccl posh dog knee brace featured at the VMX Veterinary World Meeting Expo. This poshdogkneebrace had a more progressive custom brace available without a cast. I then decided on a posh brace and it has provided great support of the injured knee for dog walks with no down time. Within a few months, my dog was walking normally and we used the posh brace less and less. My dog has returned to normal walking wearing a brace for several months during dog walks, and never got the painful surgery.
thomas
says:Last year my black lab was limping. I didn’t do anything because I thought it was a sprain. It healed in a few weeks. A few months later the limping started again, and again it healed in several weeks. My dog did a hard run and came back limping severely walking on three legs. I knew it was bad as he was holding his leg up. Off to the vet to find out is was now a fully torn ccl or acl. My vet said the previous limping episodes were a partially torn ccl or acl, and because I didn’t get it fixed, it was now a full blown completely torn ccl or acl cruciate ligament in the knee. The vet recommended a surgeon for TPLO for $4900 right away. This was terrible, that I went home and searched on the internet and came across an acl ccl posh dog knee brace. We got a casting kit to make a cast and sent it back for a custom made brace. The brace was substantial and made well. They did a skype call and helped make sure I put it on correctly. My dog got use to it quickly and we were out walking wearing the posh dog knee brace. He was able to walk again wearing the brace without surgery. He is improving more and more as the weeks go by. Fortunately we avoided surgery and this brace stabilizes the knee so we can dog walk daily. When the brace is off at home, his walking has improved, he now walks on all four legs, so I know his knee is healing. Very lucky that I found this posh brace so he could avoid surgery.
Gayle C.
says:My lab was diagnosed with torn ACLs in both knees. Only 5 months old. We decided to have TPLO. We waited until 9 months per the surgeon’s suggestion — he wanted more growing before cutting. The second was about 7 weeks ago. Both knees are healing very well, but it’s been difficult to keep a puppy entertained. He’s had months of lockdown if you include activity restriction pre-op. He’s feeling so much better, but he’s still on very restricted movement. getting grumpy. It’s becoming harder and harder to keep him amused, but the end is in sight and I can’t imagine having to make any other decision — we could afford it, but who wants to? Good luck to anyone. The first week is the worst! You’ll get through it and so will your dog.
Kathleen Huczek
says:Dr. Smith, I’m wondering if prolotherapy was part of the ancillary treatment in this study. I have a young (1 y.o) boxer/pit mix (rescue) who the vet believes at some point broke (tore) both acl’s. Additionally, it appears the growth plates in his knees never fused properly. They are recommending surgery. While I’m concerned about the cost, I don’t know how we would get through almost a year of recovery (6 mo/per knee). Prolotherapy is a relatively non-invasive treatment that has shown promise for dogs and humans. I would appreciate your input/opinion if possible.
Thank you! Kathleen
robin
says:i have a black lab/ sheppard/ pyr mix…. he had this and could not and would not walk. he had the tplo surgery done and as tuff as it was to go thru the surgery and healing process it is worth it. now although he is still recovering the playful, not in pain sweet baby boy is back!!! he is goofy again and full of life
barbara otten
says:We have a rescue lab/shepherd mix who had this surgery done and I am thrilled with the outcome thus far. Its only been two weeks. He was a brave boy and has been hard to hold him back anxious for physical therapy to start with some hydrotherapy.