You might associate ligament tears with athletic professionals of the human variety, but actually, a cranial cruciate ligament (CCL) injury is one of the most common orthopedic problems that San Diego veterinarians like us see.
Being a complex joint, the knee (the stifle joint in dog terms) consists of two cruciate ligaments that meet inside the joint to help connect the shinbone and thighbone. The cranial cruciate ligament also helps stabilize the joint and prevent your dog’s bones from shifting poorly when exercising and playing.
What Causes CCL Injuries in Dogs
CCL injuries can happen suddenly or develop over a longer period of time. When these injuries occur suddenly, they are incredibly painful. When left untreated, they can develop into a degenerative joint disease.
CCL tears, injuries, and diseases usually develop in dogs when they are overweight or out of shape, as in the case of performing a physical activity uncommon to them. Even dogs who are lean and well-exercised can experience a CCL rupture when they jump, land, or twist wrong, like when dogs slip or fall in icy conditions or other slippery surfaces.
Obviously, pups who’ve had previous CCL injuries are prone to more tears, especially in the opposite limb. And although there isn’t a whole lot of research to support genetic predispositions, many veterinarians see these conditions in older dogs and large-breed dogs of varying ages.
Signs and Symptoms of a CCL Injury
If you’re present when the actual rupture occurs, the signs will be obvious: CCL tears are incredibly painful, and most dogs will respond by whining, yelping, or even howling.
But not every dog is that demonstrative about injuries, especially if he or she is suffering the degenerative and chronic onset kind of joint disease.
Your dog may be suffering from a CCL injury when you hear crackling noises in his joints when he moves along with a severe limp. Other signs and symptoms of a CCL injury include:
Decreased activity, range of motion, or limited mobility
Sit signs (when their hind leg extends after sitting)
Pain responses when you touch the injured stifle joint
Joint inflammation
Stiffness after a walk or other exercise
Being as a ruptured cruciate ligament is the most common knee injury in dogs, the most typical sign involves a rear leg that is suddenly so sore, the dog can hardly bear weight on it. If left alone, it may appear to improve over the course of a week or two, but the knee will be notably swollen and arthritis can set in quickly. That’s why it’s important to take your pup in to see the vet as soon as possible when identifying these signs.
Diagnosing a CCL Injury
The key to diagnosing a ruptured cruciate ligament is the demonstration of an abnormal knee motion called a “drawer sign.” It’s not unusual for animals to be tense or frightened at the vet’s office, and tense muscles can temporarily stabilize the knee, preventing demonstration of the drawer sign during examination. For that reason, sedation may be needed to get a good evaluation of the knee.
Eliciting a drawer sign can be difficult if the ligament is only partially ruptured, so a second opinion may be recommended if the initial examination is inconclusive. Since arthritis can set in relatively quickly after a cruciate ligament rupture, radiographs are helpful in assessing arthritis. Arthritis present prior to surgery limits the extent of the recovery after surgery, though surgery is still needed to slow or even further curtail arthritis development.
Treatment for CCL Injuries and Disease in Dogs
Our biggest priorities with pups who suffer CCL injuries is to alleviate pain, improve their joint function, and prevent osteoarthritis. Treating CCL disease specifically will depend on a few different things. Smaller, inactive pups might recover simply by getting lots of rest, receiving physical therapy, and taking pain medication. Larger & more active dogs, however, are likely to require surgery, especially if your goal is to get him or her back to normal functionality.
Here’s the breakdown of 2 of 3 different types of common surgical repairs available to treat CCL injuries:
Extracapsular Repair
The knee joint is opened, inspected, and the torn cruciate ligament is removed. If the meniscus is torn, that portion is also removed. We will then create a strong suture to tighten the joint and effectively replace the job of the cruciate ligament that has been removed.
Your pup may carry the leg for about 2 weeks post-surgery, but will increase his knee use over the next 2 months, eventually returning to normal.
He will also typically require 8 weeks of exercise restriction
Tibial Plateau Leveling Osteotomy (TPLO)
With this more complex surgery, biomechanics stabilize the joint. The tibia (shin bone) is rotated in such a way that your dog’s natural weight-bearing actually stabilizes the knee joint.
Typically, most dogs can touch their toes to the ground by 10 days after surgery, although it can take up to 3 weeks.
As with other techniques, 8-12 weeks of exercise restriction will be needed.
Full functionality can generally be achieved 3-4 months after surgery.
Less arthritis will develop in the stifle with this & the below technique compared to the extracapsular repair & is strongly recommended for active dogs.
The third technique, Tibial Tuberosity Advancement (TTA) is similarly complex and involves biomechanics of the knee to create stabilization.
These kinds of injuries and ailments are the risks that pet parents take in order to have one of the healthiest, loving relationships there is: the kind between dog and pet parent. As pet parents ourselves, we understand what it’s like to want your pet to have the best life they can have while also managing a very human budget. For that reason, providing affordable and accessible pet healthcare is one of our biggest passions. Providing your pet with the best quality of life possible means providing you, their pet parent, with the best life, too.
Whether your pup has already been diagnosed with a CCL degenerative disease, arthritis, or has recently endured a CCL injury, we’re prepared to treat your pet and get them back on the path to a functional, happy lifestyle. Call us at (619) 448-0707 to schedule an appointment today.
And if your pet’s issue is non-emergent, contact us so we can chat and answer any questions you may have!