Dogs are commonly affected by cranial cruciate ligament rupture (CCLR), which can result in significant pain and decreased mobility. Our Neighborhood Veterinary Centers of Nederland team wants to help by answering frequently asked questions about CCLR, in case your dog is affected.
Question: What is the dog’s cranial cruciate ligament?
Answer: The cranial cruciate ligament (CCL), called the anterior cruciate ligament in humans, is an important stabilizing ligament inside the dog’s knee. The ligament is paired with the caudal cruciate ligament, and these structures cross inside the knee joint and attach the femur (i.e., the thigh bone) to the tibia (i.e., lower leg bone). The CCL functions to prevent the tibia from moving forward relative to the thigh bone while weight bearing.
Q: What causes cranial cruciate ligament rupture in dogs?
A: CCLR has several clinical presentations, including:
- Young large-breed dogs — Young, athletic dogs playing roughly can take a bad step and injure their knee. Breeds at higher risk for this phenomenon include Labrador retrievers, golden retrievers, rottweilers, Akitas, and St. Bernards.
- Old large-breed dogs — Slow ligament degeneration over several years can result in CCLR. Overweight and obese dogs are at higher risk.
- Small-breed dogs — While CCLR is most common in large-breed dogs, the condition has been associated with medial patellar luxation, which is common in small-breed dogs.
Q: What are the signs in dogs who rupture their cranial cruciate ligament?
A: Signs can vary depending on the CCLR severity, but typically include:
- Limping on the affected limb or elevating the limb
- Difficulty rising from a sitting position
- Difficulty jumping on or off surfaces
- Decreased knee range of motion
- Swelling on the inside of the limb
- Muscle atrophy if the condition is prolonged
Q: How is cranial cruciate ligament rupture diagnosed in dogs?
A: CCLR or injury is typically suspected when a dog presents with a hindlimb lameness. Specific diagnostics include:
- History — Our veterinary team will take a thorough history to determine the circumstances that led to your dog’s injury.
- Physical examination — Our veterinary team will examine your dog’s limb to check for muscle loss over the front of their thigh and thickening in their stifle.
- Limb manipulation — Our veterinary team will perform the cranial drawer test, a manipulation that will show whether the tibia can move forward in relation to the femur, which will indicate CCLR. We may need to sedate your pet for an accurate evaluation.
- X-rays — X-rays are necessary to assess joint swelling, determine if arthritis is present, rule out other diseases, and take measurements for surgery.
Q: Can cranial cruciate ligament rupture in dogs be managed medically?
A: Small-breed dogs and those who aren’t good surgery candidates can be managed medically, which includes:
- Activity restriction — Strict activity restriction allows the joint inflammation to subside.
- Anti-inflammatory medications — Nonsteroidal anti-inflammatories (NSAIDs) are typically used to decrease inflammation and pain.
- Weight loss — If your pet is overweight, our veterinary team will devise a safe weight loss strategy to alleviate strain on the affected joint.
- Rehabilitation therapy — Our veterinary team may recommend hydrotherapy or other rehabilitation exercises as your dog recovers.
Q: What surgical options are available for dogs affected by a cranial cruciate ligament rupture?
A: Surgical treatment is recommended for most dogs, especially medium- and large-breed dogs. The CCL doesn’t have the ability to heal, and the goal of these procedures is joint stabilization to minimize arthritis development. Options include:
- Osteotomy based techniques — These procedures involve cutting and moving part of the tibial bone so that the dog’s natural weight-bearing forces stabilize the joint. Techniques include the tibial plateau leveling osteotomy (TPLO) and the tibial tuberosity advancement (TTA).
- Suture based techniques — These procedures, which use suture material to stabilize the joint, are best for dogs weighing less than 45 pounds. Techniques include extracapsular suture stabilization and the Tightrope procedure.
Q: Is cranial cruciate ligament rupture in dogs associated with other complications?
A: Other complications associated with CCLR include:
- Arthritis — When the CCL ruptures, the unstable knee causes wear between the cartilage and bones, which leads to arthritis. While surgery can slow arthritis progression, existing damage cannot be reversed. In general, the earlier surgery is performed, the better the dog’s prognosis.
- Meniscal injury — Cartilage pads, called menisci, between the bones in the knee help distribute the compressive load. When the CCL ruptures, the medial meniscus frequently tears, and must be surgically removed or repaired. Meniscal injury can cause an audible clicking noise when the dog walks or their knee is manipulated.
Q: How should I care for my dog after surgery to treat a cranial cruciate ligament rupture?
A: Appropriate care after your dog’s surgery is important to improve their prognosis. After care typically involves:
- Confinement — A crate or a room with no furniture is ideal for large-breed dogs to restrict activity and prevent jumping on and off furniture. For small-breed dogs, an overturned child’s playpen can be used.
- Pain medications — NSAIDs are often used to reduce your pet’s pain and inflammation.
- Passive range of motion (PROM) exercises — PROM exercises can help maintain joint range of motion.
- Leash walks — Short, controlled leash walks encourage limb use.
- Professional rehabilitation — Our veterinary team may recommend professional physical rehabilitation to help your dog return to their normal activity level.
Knowing this information should help you be prepared should your dog have a CCLR. If your dog has a hindlimb lameness, contact our Neighborhood Veterinary Centers of Nederland team, so we can determine if they have a CCLR rupture and devise an appropriate treatment plan.
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