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.

While many people think that osteoarthritis or arthritis develops later in dogs who have cruciate ligament disease, it in fact starts developing right from the beginning of your dog developing cruciate ligament diseases but it is often masked by other symptoms.

Limping is the most common sign of cruciate ligament injuries in dogs. This may appear suddenly during or after exercise, or it may be progressive and intermittent. Some dogs are simultaneously affected in both knees, and these dogs often find it difficult to rise from lying down and have a very “pottery” gait. In very severe cases, dogs cannot get up at all.

Signs and symptoms of a cruciate ligament injury in dogs:

• Sudden lameness or holding up their affected leg
• Noticing limping after exercise
• Swelling and inflammation around the knee joint
• Muscle wastage around the knee joint because of reduced use
• Showing signs of pain when the affected leg is touched or manipulated
• Difficulty in standing up, sitting down or not wanting to go for walks
• Resting in an unusual position e.g. leg sticking out to the side rather than tucked in like
  normal
• Repeatedly getting up from a resting position
• Changes in gait or walking pattern - may appear stiff or abnormal
• ‘Touching of the paw’ - When a dog is standing, the paw isn't placed flat on the ground so your dog won’t have its full weight on the paw pad of the affected limb. Instead, your dog holds the tip of its paw on the ground

As always, if you suspect your dog may have a cruciate ligament injury, it is important to consult your vet for a proper diagnosis. Your vet will perform a physical examination and may recommend further diagnostic tests such as x-rays or further scans. The sooner you have a diagnosis, the sooner your dog can be treated; early intervention and treatment means a swifter recovery and better outcomes for your dog.

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:

To understand what causes cruciate ligament injuries, it can help to visualise what is happening to the joint and ligament. The cruciate ligaments, in simple terms, are like two pieces of strong elastic that hold the knee together.

The knee is made up of the thigh bone (femur) and the shin bone (tibia). The elastic-like ligaments prevent the shin bone going too far forward from the thigh bone. If a cruciate ligament is damaged the knee becomes wobbly and this is what causes your dog to have pain and limp.

Any dog can injure their cruciate ligament, but it's more common in those that are overweight or that have an inherited weakness.

Several factors contribute to the development of dog cruciate ligament injuries.

Common causes include:

• Age-related degeneration – The majority of cruciate ligament injuries in dogs is due to long-term degeneration. The ligament fibres gradually fray and weaken over time until they eventually rupture. They can rupture as a result of your dog jumping, landing awkwardly or turning quickly and this is more likely if the ligament already has some damaged due to degeneration

• Breed predisposition – Any dog can develop cruciate ligament injuries or disease but unfortunately certain breeds are more susceptible. These breeds include Labradors, Rottweilers, Boxers, West Highland White Terriers, Staffordshire Bull Terriers, Mastiffs, Saint Bernards and Newfoundlands. However, the kind of activities your dog does and their weight are also major risk factors

• Being overweight – If your dog is overweight, this puts extra pressure on joints and ligaments, causing premature damage, which predisposes them to cruciate ligament injuries and disease

• Exercise and injury – Dog which are most at risk of cruciate ligament injuries are those that are running or chasing at speed over uneven ground, turning or twisting quickly, jumping and landing as well as skidding.

• Genetic factors – There is growing evidence that there is a genetic predisposition to developing cruciate ligament injuries or disease, this explains why it tends to run in families as well as affecting many dogs at a relatively young age. In addition, it will often occur in both knees. It is thought that genes which determine the strength and structure of the ligament are compromised.

Other factors thought to contribute are hormonal imbalances, which may influence ligament laxity.

Individual conformation can place increased stress on the knee joints, meaning they are at a higher risk of developing cruciate ligament injuries or disease.

How To Help Around the House:

Lack of traction increases the risk of sudden twists or falls, potentially then causing or exacerbating a cruciate ligament injury or disease. So if you have slippery floors at home, such as hardwood or tile, it can be a good idea to either cover them with rugs or mats or alternatively you could get some non- slip socks for your dog to wear.

Limit your dog’s activity and consider using a cruciate ligament brace to support the knee joint and to improve recovery time. Dogs who have one cruciate ligament injury will very often go on to develop a problem in their other cruciate ligament. You can help prevent this by putting a brace on your dog’s unaffected leg. Many dogs wear them on both legs, so the brace is significantly reducing the risk of re-injury and aiding recovery in the affected leg but also acting as a preventative measure to the unaffected leg.

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. Limit how much your dog is jumping up on furniture or into the back of your car for example. Either lifting your dog, carrying them instead or, if they are too big to do this with, consider getting them a ramp.

Whether your dog needs to have an operation or not, a period of very limited exercise is usually recommended. Consider teaching your dog some new tricks to stop them getting bord or alternatively a snuffle mat can help keep your dog mentally stimulated.

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 (non-surgical) management typically involves rest, anti-inflammatory medications, physical therapy (including wearing a brace) and weight management.

However, in most cases, surgical intervention is necessary to stabilise the cruciate ligament and restore function.

Each dog is individual and your vet will know which treatment is most appropriate for your dog however generally dogs which weight less than 15kg may be able to heal without surgery, as long as they are kept on strict cage rest for at least 6-8 weeks, although usually recovery takes several months and is not guaranteed.

Dogs weighing over 15kg have a very poor chance of recovery with non-surgical management and usually need surgery to stabilise their knee.

The outcomes from non-surgical treatment can be unpredictable and for this reason surgery is often recommended but conservative management can be recommended for less severe cases or for dogs that are not good surgical candidates.

Non-surgical management

• Rest – Strict cage rest for at least 6-8 weeks is recommended, followed by controlled exercise

• Medications – A combination of painkillers and anti-inflammatory medications will likely be prescribed by your vet to treat the pain and swelling your dog will have

• Therapies – Physiotherapy, hydrotherapy and laser therapy can be used individually or collectively to try and treat your dog. Physio and hydro therapy aim to try and rebuild strength and muscle tone to support your dog’s knee joint Laser therapy can be good for pain management, increasing blood flow (promoting healing), stimulation of cellular activity, muscle relaxation and anti-inflammatory effects. 

• The effectiveness of laser therapy can vary from dog to dog 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

• Dog wheelchair – A dog wheelchair 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 who can’t have surgery, wheelchairs can be literally life changing, by helping maintain mobility and preserve muscle mass. They also provide mental stimulation and allow your dog to exercise freely. All of these elements help keep a good quality of life for your dog

• Knee Brace - Wearing a dog brace  might be recommended. A brace can be used to manage symptoms of a cruciate ligament injury as an alternative to surgery, where surgery isn’t recommended or possible. A brace can stabilise the knee joint and help stop excessive movement (sliding) between the femur and tibia. It can also reduce lateral movement and rotation of the knee, which can give the cruciate a chance to heal. However, please note that if your dog has a fully ruptured cruciate ligament, the ligament won’t repair, even if your dog’s wearing a brace.

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.

Weight management to reduce further strain on your dog’s joint and a joint supplement are also
crucial. Many people believe that arthritis or osteoarthritis develops as cruciate ligament disease
progresses, but the truth is that it is there from the beginning however symptoms are often masked
by the greater pain which your dog experiences from ligament damage. Started a join supplement
early on helps to slow its progression and keeps your dog more comfortable for longer.

Surgical management

Surgical repair is often recommended for dogs with cruciate ligament injuries. There are many different surgical techniques available and which surgery you dog has depends on which is the most appropriate option for your individual dog, but will broadly depend on their size, weight, type of injury and your vet.

One of the most common and successful surgeries is Tibial Plateau Levelling Osteotomy Surgery (TPLO). It involves reshaping the bone to stabilise the knee joint and promote healing.

One of TPLO 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 cranial cruciate ligament is no longer needed to stabilise the knee joint.

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

Surgery generally has a high success rate of between 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 will likely be recommended to help regain strength and mobility in the affected leg. Much of the conservative management outlined above will apply to your dog post-operatively.

It is also important that your dog’s joint is supported, this can achieved with a supportive brace.

Once your dog has healed form their cruciate ligament injury, good ongoing care is vital. About 1 in 3 dogs who have had a cruciate ligament injury in one knee will go on to develop a similar problem in the other knee, so it is important to protect and prevent your dog from injuring themselves again.

• Keep your dog slim – dogs which are overweight are much more likely to develop a cruciate ligament injury due to the extra strain on their joints. Try to keep your dog fit not fat!

• The right kind of exercise - keep your dog fit but build their fitness up gradually, never push them hard to do more than they are used to. Low impact exercise is ideal, especially swimming or hydrotherapy. Try to control or strictly limit strenuous exercise such as jumping, skidding and chasing. Repetitively fetching a ball for example can be highly stressful on your dogs’ joints

• Joint care – from the beginning of your dog developing cruciate ligament injuries or diseases, osteoarthritis will be present. By starting your dog on a good quality joint supplement (one containing glucosamine and chondroitin) as early as possible, you can help slow the progression of this, giving your dog a better quality of life

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.