What is an Achilles Tendon Injury?

An Achilles Tendon injury is when the tendon is bruised, pulled or torn / ruptured.

Grade 1 - Mild - bruising
Grade 2 - Moderate - partial tendon tear
Grade 3 - Severe - complete disruption/tear of tendon fibers, there’s a complete lack of tension on the tendon when the hock is flexed (plantigrade stance)

The Achilles Tendon (or the common calcaneal tendon) is a large band of fibrous tissue, that connects the calf muscles to the heel bone on your dog’s hind leg, it involves five different muscles.

The Achilles Tendon plays a crucial role in allowing the extension of the hind leg, facilitating running, jumping and other every day activities of your dog. These injuries are very painful, and often your dog will not want to walk far or leave the house.

What are the early signs and symptoms of an Achilles Tendon injury?

Dog Achilles tendon injury symptoms include:

• Limping on the affected leg
• Reluctance to put weight on the affected leg
• A ‘crab claw’ stance - the paw will become crab-like, with the toes all curled up
• ‘Plantigrade’ or flat-footed stance - this is ‘dropped hock’, when the lower part of the leg, below the hock, is flat on the ground
• Swelling and tenderness around the tendon area
• Heat in the injured area
• Reduced range of motion in the affected leg
• Your dog may be exhibiting signs of pain - whimpering or yelping when walking or being touched in the affected area.

Achilles tendon injuries tend to be serious, so take your dog to the vet if you notice he’s stopped using his leg, or has hurt himself.

What should I do if I notice an Achilles tendon injury?

If you suspect your dog has an Achilles tendon injury, it’s essential to seek veterinary attention promptly. Restrict your dog’s activity to prevent further damage. Avoid administering any over-the-counter medications without consulting your vet.

What causes Achilles tendon injuries?

An Achilles tendon injury in your dog can occur for various reasons. These include trauma, repetitive stress, and degenerative changes associated with aging.

Acute injuries can happen because there’s been a trauma to the tendon. Athletic dogs, those participating in agility or high-impact activities, are particularly susceptible. Sudden twists or falls and overexertion can all cause injuries. 

A dog might push off from the limb but keep the paw planted. This can strain or tear the tendon. An avulsion can occur without outside trauma to the tendon, but just through normal activities.

Working breeds and large breed dogs seem more prone to Achilles tendon injuries and often, they happen in dogs who are 5 years old or older.

Chronic injuries, where the tendon has degenerated over time through overuse or overstretching, can mean the tendon eventually tears. 

What happens next? 

Restrict your dog’s activity until you can get a vet appointment so that they can’t make the injury worse. Consider crating your dog if he’s left unattended.

Firstly your vet will do a complete physical examination of your dog. Your vet will palpate the hock area to check for swelling and bruising. The leg’s range of motion will be tested to determine what’s been affected and where. The vet will also look to see whether there are any visible injuries to the skin of the hock. 

Radiographs of the region will likely be needed. This is to check for any bone breakages. Ultrasounds are also regularly used to identify the site and nature of the tear. They show the tendon itself and help determine the extent and type of Achilles tendon injury. 

Further imaging may be required. If so, your vet may suggest a CT Scan for a 3D evaluation or an MRI scan, which gives more information about the tendons, ligaments and soft tissues in and around the joints.

Sometimes a vet may suggest blood tests as well to check there’s no internal bleeding and that your dog has normal organ function.

Once your vet has all the information needed, you can discuss a suitable treatment plan.

Can I do anything to prevent my dog from injuring his Achilles tendon?

Overall, Achilles tendon dog injuries are generally unavoidable as they can happen when a dog is simply participating in normal activities.. There are a few preventative measures you can take to lessen the risk slightly, which involve optimising your dog’s general health:

• Maintain your dog at a healthy weight to reduce stress on joints and muscles
• Incorporate regular, moderate exercise
• Joint supplements to support joint health
• Consider appropriate warm-up routines before engaging in strenuous activities or agility

What breeds and ages commonly suffer from Achilles tendon injuries?

Certain breeds and age groups are more susceptible to Achilles tendon injuries.

Doberman pinschers, German Shepherds, and Labradors seem to be more prone to grade 2 strain injury of the gastrocnemius tendon (part of the Achilles tendon) than other dogs. Large breed dogs are also more vulnerable to wear and tear. They can also suffer more easily from swelling of the Achilles tendon (Achilles’ tendonitis), just above the point of the hock.

Any age of dog can sustain an Achilles tendon injury however younger dogs are more likely to sustain traumatic tendon injuries from things such as severe stretching/pulling, repetitive strain, lacerations, overexertion etc. In contrast older dogs are more likely to have atraumatic Achilles tendon injuries from chronic and degenerative causes. Because of natural wear and tear, older dogs are at higher risk of Achilles tendon injuries.

Dogs who are engaged in intense physical activities may also be more prone to Achilles tendon injuries.

Treatment Options: How Can I Help My Dog?

Your dog’s Achilles tendon injury treatment plan will be entirely dependent on the severity of the Achilles tendon injury.

Mild to moderate injuries will be treated by conservative management, which can take roughly 6-8 weeks:

• Rest
• Restricted Activity
• Cold and heat treatment. Cold packs on your dog's tendon several times a day for between 15 and 30 minutes, or run cold water over the leg for the same time periods. After the first couple of days, you might start using warm, not hot, compresses on the leg several times daily, for a few days. Get your vet to advise you on best practice for this.
• Pain medication when necessary
• Physio or hydrotherapy to activate the correct muscles to support the joint as it heals
• Laser therapy 
• Support or splint to support the tendon and joint. The tendon needs loading to start repairing ie exercise. However, the tendon also needs to be protected from overstretching. Splints help to achieve this balance in a safer way. (NB splints/braces won’t heal a ruptured tendon)
• Consider crating your dog when left unattended, so that they can’t make the injury worse
• Periodic ultrasounds to check progress

Severe injuries require surgery

If the tendon has completely torn, ruptured or has detached from its attachment point, surgery will be necessary. When the tendon is ruptured, the muscle contracts and results in a permanent deformity unless operated upon. Complete healing can take 9 to 12 months:

• Tendon repair - the ends of the tendon may be sewn back together. 
• Tendon replacement - if repairing a tear or rupture is too complicated, a synthetic ligament might be used to achieve a successful outcome. This is a new area of treatment. As with tendon repair, the tarsal joint will need to be immobilised and protected.
• Tendon reattachment - reattachment of the tendon to the calcaneus bone is achieved by tunneling through the bone in order to anchor the suture.
• Arthrodesis of the Tarsus (ankle fusion) - when there’s a complete tear, joint fusion might be needed so that the joint can function. The operation fuses the joint into one long bone. The joint is stabilised in a normal standing position, using screws, plates or pins. Unfortunately, the normal flexion and extension of the joint isn’t restored, but arthrodesis eliminates pain and lameness.

Post Surgery Aftercare

• It’s essential the tarsal joint is immobilised to protect the tendon and allow the surgery to consolidate. Your dog will be given a cast, splint, brace or external fixator, or the joint may be temporarily held in position by a screw, for this stage of healing.
• Platelet-rich plasma, extracorporeal shockwave therapy and stem cell therapies may all be recommended.
• Physiotherapy and hydrotherapy
• Laser therapy
• Crate your dog when you go out

Better aftercare increases the odds of the surgery being successful, avoiding potential complications (re-rupture or breakdown of the surgical site) and your dog making a good recovery. 

After surgery, it’s been cited that between 70% and 94% of dogs have a good to excellent return to function.

Help Around the House

Try and restrict the amount of activity your dog is doing, encouraging them to rest. If you have a young and active dog which find this difficult, you can try something such as a snuffle mat, which can help to mentally stimulate them while keeping them less mobile.

Applying an appropriate brace to help support your dog’s joint. Whether your dog has surgery or can be treated conservatively, recovery can be very slow, sometimes taking years, so often a supportive brace needs to be applied for long periods. Try and restrict activities such as going up or down the stairs or jumping on or off furniture.

Conclusion

Achilles tendon injuries in dogs can be challenging. With timely intervention and proper care, many dogs can recover successfully and studies show good to excellent results following an Achilles tendon injury. 

Although recovery time can be long, and there may be some residual pain and dysfunction, many dogs recover enough to live a normal life.