Find out how to prevent and/or aid recovery of a ruptured or torn Dog Cranial cruciate ligament as we guide you through the causes, options of rehabilitation, and what you can do at home to help.
Here at our Dog Hydrotherapy center, we see more and more new patients struggle through our doors suffering from Dog Cranial Cruciate Ligament Disease (CCL). Some are at the Post-op stage of their Rehabilitation, whilst others are yet to have surgery or may not be required to have surgery. Every case is different, and every dog recovers differently, so where do you even start? Being a Canine Hydrotherapist means we have to be adaptable, altering treatments to reflect each and every patient we take on – so let us shed some light to help you and your dog.
Firstly, what is CCL and where is it?
There are four main ligaments in the stifle joint of a dog (in human terms this is the knee); two outside called the collateral ligaments and two inside the joint called the cruciate ligaments. The cruciate ligament nearest the front of the joint is the Cranial Cruciate Ligament (CCL). The ligament attaches the femur (our thigh bone) to the lower leg bones, tibia, and fibula.
Whilst the CCL is a small part of the stifle it has a mighty purpose of preventing the lower leg bones from moving forward relative to the femur which would lead to over-extension and rotation.
Cruciate damage is an injury to one of the two ligaments, either a little tear or a complete break in the ligament (see image). So now we have the location down, let’s see why it can become so damaged.
What causes CCL injuries in dogs?
In humans damage to this ligament is generally caused by trauma, and whilst this can also occur with dogs, for example when playing catch, it is not always the case. Unfortunately, dog ACL damage is mostly caused by a degenerative condition called Cranial Cruciate Ligament Disease.
Whilst CCL disease is common it is not yet fully understood why this condition develops in dogs, and why certain breeds are more prone to it. It is thought that some small breeds may have conformational abnormalities leading to increased pressure on the ligament, which in turn causes damage but we also commonly see this condition in Rottweilers, Retrievers, and Boxers. However, being a degenerative disease, it is a condition that progressively worsens over time which can make the diagnosis a shock for owners. Previously I mentioned trauma – inappropriate exercise or movements play a big part in causing ruptures of the CCL when a dog suffers from the disease so it’s important to understand the signs.
How can I tell my dog is suffering from CCL Disease?
The most common sign of cranial cruciate ligament disease is your dog will become lame (limp) on their back leg. This can occur suddenly, or it may develop over time. Some dogs cannot put any weight on the leg, whereas others can show a slight limp which is either hard to notice or may come and go. Your dog may show signs of stiffness after rest which can be confused with Arthritis and/or after exercise. Occasionally both hind limbs can be affected at once meaning that the dog can struggle to rise after lying or sitting.
Other signs of pain:
Reluctant to exercise
Chewing limbs
Lip licking when you touch the leg
Bunny hopping (walking or running with both hind limbs together)
How will my dog be diagnosed?
Your Veterinary Surgeon should always be your first port of call and a diagnosis can be straightforward if the ligament is completely ruptured with a confirmation usually on examination. If it is a partial tear, this can be more difficult to diagnose. If this is the case, other tests may be required such as x-rays or assessment under anesthetic. The x-rays may show signs consistent with the presence of Osteoarthritis which is commonly present with a Dog Cranial Cruciate Ligament injury. In the majority of dogs, exploratory surgery may be used to confirm the ligament is damaged.
What are my recovery options?
Non-Surgical
On occasions surgery may not be recommended for a number of reasons by your vet, so the condition may be managed by controlling your dog's weight, exercise control, hydrotherapy rehabilitation, physiotherapy, non-steroidal anti-inflammatory drugs (NSAID), and dietary supplements. Dogs undergoing this non-surgical management may improve in the earlier phases of treatment, but long-term outcomes are often poor. Small dogs may respond better than bigger dogs but again the outcome is unpredictable.
Surgical Management
Dog cruciate ligament surgery can be very expensive in the UK and TPLO (tibial plateau leveling osteotomy), seems to be the most common procedure at present by Veterinary surgeons, but there are alternatives your vet may discuss with you.
This form of surgery has been shown to be the most likely procedure to return maximum limb function. The TPLO procedure does not rely on the presence of the ligament but instead changes the forces in the joint to create a more stable ‘platform’ when the dog is weight-bearing on the leg. To improve stability in the joint plates and screws are used which tend to be tolerated well, with many dog’s weight-bearing on the leg within 48 hours of surgery. To know more about what is involved with TPLO surgery and other surgical options visit Fitzpatrick Referrals.
Research has shown that 90% of patients have a good to excellent outcome following TPLO and expect dogs to be able to return to off-lead exercise and be free of medication. The athletic performance of a show, working, or agility dog may not quite achieve the same levels of ability after surgery.
Ongoing care and prevention is simple
Both ongoing and prevention go in hand in hand once your dog has been diagnosed with a CCL injury or disease.
Weight management
Ensuring your dog is an ‘ideal’ weight is very important as this may well put excess pressure on their joints, increasing the risk of your dog suffering from CCL damage in the other leg or stunting recovery progression in the affected leg.
Arthritis management
Dogs who have had CCL disease are at much higher risk of developing arthritis later in life, because of this, your vet may suggest joint supplements or anti-inflammatory pain killers. This is also another reason why weight management is important.
Appropriate exercise routine
Once your dog has recovered, they should be able to exercise almost as they used to but please try to avoid activities such as chasing a toy or jumping, as this will minimize the risk of further injury.
Home environment
Quick changes around the home can hugely benefit your dog:
Your dog should have an appropriate bed to sleep in.
Raised feeder can help take the pressure off forelimbs.
Rugs to prevent skidding.
Be mindful of what encourages jumping or running, e.g. busy house moments, postman.
Dog Hydrotherapy, physiotherapy & Laser therapy can help with each of these management points. Let’s find out more…
Rehabilitation is key
Once the OK has been given by your veterinary practice it will most likely be encouraged to start your treatment plan with your nearest Registered Canine Hydrotherapist/Physiotherapist.
A Registered Hydrotherapist will use controlled Hydrotherapy techniques that use the properties of water and appropriate movement shaping to improve your dog’s gait pattern. This will not only improve the strength in the affected leg but also increase strength in your dog’s other leg as well as reduce compensatory patterns that can lead to further injuries or CCL damage.
A Registered Physiotherapist can help reduce inflammation using laser therapy and/or electrotherapy, reduce muscular guarding with soft tissue massage techniques, and provide a guided home exercise routine.
Both Hydrotherapy and Physiotherapy work together to increase range of motion, weight balance confidence, and improve gait patterning. These 3 elements create the basis of every treatment plan but are reached differently to suit your dog’s pace. Within 6-12 weeks post-surgery recovery is gradual and it may seem like a slow process, but this type of recovery takes time. However, after 12 weeks it is hoped that your dog may return to normal exercise.
Please note that rehabilitation plans should only be followed under the guidance of a qualified rehabilitation professional, who will be able to provide a tailored plan based on the individual patient and the rehabilitation programme they require.
Dog Cranial Cruciate Ligament injury is very common, so it's important to remember that whilst you may feel lost there are veterinary professionals well equipped with experience and advice to help guide you through. It is also important to know that every dog is different, give them time to recover, and provide them with a new way of living that suits them, whilst protecting them from future risks.
To find out more about Cruciate Ligament Dog recovery or check out our Dog Rehabilitation programme, send us an email at info@fit4dogsuk.com or chat to a member of our team on 01482 888509 and we will get back to you as soon as possible.