Dog cruciate ligament injuries in dogs cause significant pain, lameness and mobility issues in the affected leg or legs. The cruciate ligaments are located in the knee joint and help to stabilise the joint during movement. There are two cruciate ligaments in a dog's knee; the cranial (anterior) cruciate ligament and the caudal (posterior) cruciate ligament. The cranial cruciate ligament is more commonly affected by injury.

There are two main types of cruciate ligament injuries in dogs:

• Cranial cruciate ligament rupture
• Partial cranial cruciate ligament tear

Cruciate ligament injuries in dogs can occur due to a variety of reasons. Injuries can occur suddenly, as a result of trauma for example, however it much more commonly happens gradually over time, due to degeneration of the ligament, much like a fraying rope. Certain breeds are more predisposed: Labradors, Rottweilers, Boxers, West Highland White Terriers, Staffordshire Terriers, Mastiffs, Saint Bernard’s and Newfoundlands for example. Other factors such as being overweight, conformation, hormonal imbalance and certain inflammatory conditions of the joint, are thought to also play a role.

At least half of the dogs that have a cruciate ligament disease in one knee will most probably develop the same or a similar problem in the other, sometime in the future. In addition to this, partial tearing of the cruciate ligament in dogs, frequently progresses to a full tear over time.

Signs and symptoms of a cruciate ligament injury in dogs:

• Limping or favouring one leg
• Difficulty in standing up or sitting down
• Reluctance to bear weight on a particular leg
• Swelling and inflammation around the knee joint
• Noticeable pain or discomfort during movement
• Changes in gait or walking pattern - it may appear stiff or abnormal
• Fluid accumulation
• Not wanting to go for walks
• Repeatedly getting up from a resting position.
• Resting in an unusual position e.g. leg sticking out to the side rather than tucked in like normal
• ‘Touching of the paw’ - When a dog is standing, the paw isn't placed flat on the ground. The dog won’t have its full weight on the paw pad of the affected limb. The dog holds the tip of its paw on the ground instead
• Muscle wastage around the knee joint because of reduced use
• Noticing limping after exercise

Limping is one of the most common signs that your dog has an injured cruciate ligament. It can be a sudden onset limp or develop over time.

If you think your dog has a dog cruciate ligament injury, it's crucial to consult with a veterinarian promptly. The vet will conduct a thorough examination, possibly including X-rays, to diagnose the severity of the injury.

If your dog’s ruptured a cruciate ligament or torn ACL symptoms, this can be identified and addressed through proper veterinary care. Early intervention is key to ensuring a smoother recovery process.

Causes of Dog Cruciate Ligament Injuries:

Several factors contribute to the development of dog cruciate ligament injuries. Common causes include:

• Age-related degeneration - the injury is due to long-term degeneration. The ligament fibres gradually fray and weaken and eventually rupture.
• Obesity - carrying extra weight puts extra pressure on joints and ligaments
• Hormonal imbalances - castration of male dogs increases the likelihood, with some estimates reporting double the occurrence. This is because hormones, or lack of, may influence ligament laxity.
• Breed predisposition (certain breeds are more susceptible) - Unfortunately, Labradors, Rottweilers, Boxers, West Highland White Terriers, Staffordshire Bull Terriers, Mastiffs, Saint Bernards and Newfoundlands seem more prone.
• Trauma or injury, perhaps caused by a sudden twist or turn
• Genetic factors - genes that determine the strength and structure of the ligament are compromised. 

If you think your dog's had a cruciate ligament injury, you must restrict his movement and activities until you can get him seen by a vet. Crate rest is recommended for the prevention of further damage. Don’t allow your dog to jump on and off furniture, avoid stairs and support them in and out of the car.

If your dog has a cruciate ligament injury, you need to work with a qualified veterinarian to develop a comprehensive treatment plan. This may include surgery, physical rehabilitation, pain management, and other modalities tailored to your dog's specific needs.

Once diagnosed, the veterinarian will discuss treatment options based on the severity of the injury. Depending on the specific case, Treatment may involve surgical and non-surgical approaches.

Treatment options for cruciate ligament injuries in dogs vary depending on the severity of the injury, the size and age of the dog, as well as their overall health. Conservative management may involve rest, anti-inflammatory medications, physical therapy, including wearing a brace and weight management. However, surgical intervention is necessary in many cases to stabilise the cruciate ligament and restore function.

1. Surgery  - TPLO Surgery for Dogs:  

Surgery has a high success rate of 85-90% however, good post-operative care is essential. Following surgery, your dog will require a period of rest and restricted activity to allow for proper healing. Physical therapy and rehabilitation exercises may be recommended to help regain strength and mobility in the affected leg. It is also important that your dog’s joint is supported, this can achieved with a supportive brace.

Tibial Plateau Levelling Osteotomy Surgery (TPLO Surgery) is a common and effective procedure to address cruciate ligament injuries. It involves reshaping the bone to stabilise the knee joint and promote healing. One of TPLO Surgery’s main aims is to alter the biomechanics of the knee joint, reducing stress on the damaged ligament and promoting long-term stability. TPLO means the CCL is no longer needed to stabilise the knee joint. 

There are two other types of knee surgery for cruciate ligament injury: Extracapsular Lateral Suture Stabilisation Surgery (ELSS) and Tibial Tuberosity Advancement (TTA).

After cruciate ligament surgery on your dog, your veterinarian will provide specific post-operative care instructions for a successful recovery.

Surgical options, such as TPLO Surgery for dogs, are often recommended for moderate to severe cruciate ligament injuries. Non-surgical treatments may include rest, pain management, physical therapy or conservative management. When a dog is an unsuitable candidate for surgery, using a wheelchair might be an alternative option for maintaining mobility.

Recovery time can vary, but it generally takes several weeks to a few months for dogs to fully recover from a cruciate ligament injury, depending on the severity of the injury and the chosen treatment approach

2. Conservative Management 

Rest, restricted activity, anti-inflammatory medications, physical therapy and wearing a brace can be recommended for less severe cases or for dogs that are not good surgical candidates. 

Wearing a dog brace for the ACL might be recommended, depending on the severity of the injury. A brace can also be a cruciate ligament alternative to surgery for dogs where surgery isn’t recommended or possible. Braces stabilise the knee joint in place and stop excessive movement (sliding) between the femur and tibia. They also reduce lateral movement and rotation of the knee, which gives the cruciate a chance to heal. 

A brace may prevent further, more severe injury to the affected knee.

Braces can also be used pre-and post-operatively. We suggest consulting your vet to decide on the most appropriate brace/support for your dog’s condition.

Please note that if there’s a fully ruptured cruciate ligament in your dog’s knee, the ligament won’t repair, even if your dog’s wearing a brace.

Rest and restricted movement will also be a part of your dog’s recovery in this scenario.

3. Physical Therapy - Physiotherapy and hydrotherapy can help a dog who’s healing from a cruciate ligament tear or post surgery. 

4. Laser Therapy - Although unlikely to be the primary therapy for your dog’s cruciate ligament injury, laser therapy might be used. Laser therapy can be good for pain management, increased blood flow (promoting healing), stimulation of cellular activity, muscle relaxation and anti-inflammatory effects.  The effectiveness of laser therapy can vary between individuals.

5. Alternative Therapies - Anecdotally, some alternative therapies such as dog massage therapy, acupuncture and Prolozone therapy (Ozone and Vitamin B12 injections) are believed to benefit a dog who’s suffered a cruciate ligament injury. Always check with your vet before pursuing alternative therapies for your dog, so they can provide guidance on your dog’s specific circumstances. 

6. Wheelchairs - Wheelchairs can be used to rehabilitate a knee injury (by reducing load on the limb.) A wheelchair allows your dog to remain active without exacerbating the injury. For dogs with a fully ruptured ligament but can’t have surgery, wheelchairs help maintain mobility and preserve muscle mass. They also provide mental stimulation and exercise. All of these elements help keep a good quality of life for your dog.

7. Medication - Pain relief and NSAIDs (non-steroidal anti-inflammatory drugs) may be prescribed for the pain and swelling that can accompany a dog’s cruciate ligament injury.

Not all dog cruciate ligament injuries can be prevented, particularly if the ligament is frayed due to age-related degeneration. Here are some steps you can take to minimise the risk:

1. Maintain a healthy weight for your dog
2. Provide regular exercise to keep muscles and joints strong
3. Use caution during play, avoiding excessive twisting or high-impact activities
4. Consider joint supplements to support overall joint health
5. If your dog has had a cruciate ligament injury on one leg, your vet may recommend bilateral bracing, even if the other leg is unaffected. There’s a strong possibility that a dog with a cruciate ligament injury in one leg will injure the other one within the year. This is possible because of the increased pressure put on the healthy knee joint.
6. Avoid inappropriate exercise on slippery surfaces. Running or playing on slippery surfaces, such as hardwood or tiled floors, can contribute to slipping and sliding. Lack of traction increases the risk of sudden twists or falls, potentially leading to cruciate ligament injuries. Non-slip socks are good for wooden floors if you have a particularly active pup.

How to Help Around the House:

Limit activity and consider using a cruciate ligament brace to support the knee joint and to increase recovery time

During your dog's recovery, creating a comfortable environment is crucial. This may involve providing a soft and supportive bed, limiting stair access, and minimising activities that could strain the injured leg. Follow your vet's advice for a smooth recovery process.

Consider a ‘worry mat’ or similar product which will entertain them while they have to be more sedentary

Cruciate ligament injuries in dogs can occur at almost any age, but it is most commonly seen at 2–10 years of age. Generally, if your dog develops a cruciate ligament injury under the age of 4 years, it is caused by trauma, whereas over the age of 5 years it is more often due to degenerative changes.

Dog cruciate ligament injuries can occur at any age, but they are more common in older dogs because of ‘wear and tear’ to the ligament. However, certain breeds may be predisposed to these injuries at a younger age. 

Cruciate ligament injuries can happen at any age as a result of traumatic incidents, such as a fall, collision, or forceful impact. A sudden twisting motion or direct trauma to the knee joint can cause damage to the cruciate ligament, even in a younger dog. 

Intense physical activity, especially sudden stops, starts, or direction changes, can stress the knee joints. So, dogs participating in high-impact activities like running, jumping and playing rough may be more vulnerable to cruciate ligament injuries.

Some dogs with certain anatomical factors, such as a conformation that places increased stress on the knee joints, may be at a higher risk of cruciate ligament injuries.

Conclusion

If your dog has suffered a dog cruciate ligament injury, it can be a challenging time for both you and your dog. Timely veterinary intervention, accurate diagnosis, and appropriate treatment choices are essential for a successful recovery. By understanding the signs, causes, and preventive measures, you can actively promote your dog's joint health and overall well-being.

Q&As from Zoomadog Customers

Q: “Hi - my lurcher is having cruciate ligament surgery on Monday and I would like to get him a support to help with recovery. What would you recommend?”

A: There are the variety of knee braces that we have available. The highest level of support is the Balto Ligatek - if you were considering that, it is probably helpful to get your vet's opinion on it for post-surgery - it works for some dogs and not for others, depending on the individual situation. The Balto Jump is very popular. The Balto Jump is a good choice as it is excellent for post-surgery support but not rigid like the Ligatek.

Q: "My dog has a ligament issue in the one leg and I see the Balto Plus brace can be worn as a single or double. I know a ligament issue can arise in the healthy leg also, so could you please tell me, will this the Balto Plus brace support the legs tightly and securely, so there is no slip from thigh bone over the stifle joint? My dog is female, 2yrs old and weighs 21-22kg. She is very mobile, running and jumping in the garden but then suffers a limp for the evening but is usually back to normal by morning. I have opted not for surgery in the hope the brace can give her time to heal."

A: When one cruciate ligament ruptures, it is known that the second cruciate ligament can often go soon after. Many dog owners buy a double so that the second ligament is given support to reduce the chance of this ligament rupturing in the future. Having a Balto Plus Double will obviously provide equal support to both cruciate ligaments at the same time, this can help guard against the pressures the healthy cruciate sometimes has to withstand, if the other leg is injured.

These braces fit securely if the sizing is correct. Very rarely a brace won't work on an individual dog for whatever reason, but if you get the size right it should provide good support and not slip and so help to prevent your dog getting reinjured. The Balto Plus Double comes with all the necessary straps to use as a single leg brace or a double.

Q: "My little chihuahua has had a cruciate ligament operation on both legs. One leg didn't do well and he was allergic to the metal clip inside and so had to have it removed. Additionally he has developed arthritis. Also he has luxating patella. He is nearly 10 and not having any more operations as it nearly finished him off. He struggles walking, especially in cold weather. His problem is he has no muscle mass but if he could walk more, he would build up muscle mass. It’s a vicious circle. Which support would you recommend please?"

A: The Walkabout Cruciate Knee Brace is generally good for smaller breeds of dogs. Are you able to send over your dog's measurements and then we can check the sizing? If you could send the circumference at the top of his leg and just below his knee. Also if you would like to email a short video of your dog walking, we can take a look and see if there are any other products that might be able to help him.