All You Need To Know About a Dog's CCL

What is a Dog CCL Injury?

A dog CCL injury is a rupture or tearing of the cranial cruciate ligament (CCL) in a dog's knee joint. The CCL is one of the major ligaments that stabilize the knee joint in dogs, and it is similar to the anterior cruciate ligament (ACL) in humans.

CCL injuries are relatively common in dogs and can occur due to sudden trauma, such as a fall or collision, or due to degeneration over time. Breeds particularly prone to CCL injuries include large, giant breeds such as Labrador Retrievers, Rottweilers, and German Shepherds. Gradually, the condition may become worse until there is a complete rupture of the ligament.

Are They Prevalent in Dogs?

One of the most common types of injuries occurring in dogs is a torn CCL, with CCL repair being one of the most common orthopedic surgeries veterinary surgeons perform. Contributing factors seem to be a genetic predisposition, obesity, poor fitness, neutering at too young, immune-mediated disease, bacteria within the joint, and an excessive sloping of the tibia plateau.

The Role of the CCL in a Dog's Knee Joint?

The primary roles of the CCL are to provide stability to the inside of the stifle or knee joint in a dog's hind leg and prevent hyperextension and internal rotation. The ligaments are two bands of fibrous tissue within the stifle or knee joint that connect the femur and tibia so that the stifle works as a secure, hinged joint.

Reasons Behind CCL Injuries

More commonly, a CCL injury is the cause of a combination of factors, such as the age of the ligament, obesity, poor physical condition, conformation, and the breed of dog.

Injury Caused by Trauma

CCL injuries caused by trauma occur when a running dog suddenly changes direction, causing an excessive rotation with shearing forces placed on the ligaments. Avoiding what's known as "weekend warrior" syndrome is essential. Suppose your dog receives little to no exercise during the week and can run excessively on weekends. These types of injuries can also occur with very athletic dogs at play.

The Role of Genetics

Some leading causes of chronic dog CCL injuries are poor breeding and hip dysplasia. Dogs with conformational defects, such as a luxating patella, may more likely to rupture their ligaments. Genetics plays a role in certain breeds more predisposed to having a CCL injury. Prevalent breeds, such as the Labrador Retriever, have a high incidence of this injury.

Sudden Turn or Jump

If you have an athletic dog that loves to twist and turn while running or turn and jump, try to curtail this behavior as much as possible to prevent a CCL injury from occurring. This type of movement is one of the most common contributing factors to an acute, traumatic injury. Try to avoid activities such as frisbee or other fetching games.

How Age Can Be a Factor

As a dog ages, its joints may naturally degenerate, with arthritis developing. With most CCL injuries occurring due to degeneration of the ligaments, older dogs are more susceptible. Due to arthritis developing, older dogs may become less active due to discomfort, increasing the risk of a potential injury.

Are Certain Breeds More Prone?

Large breeds such as the Rottweiler, Newfoundland, Staffordshire Terrier, Mastiff, Akita, Saint Bernard, Chesapeake Bay Retriever, and Labrador Retriever all seem to have a higher frequency of cranial cruciate injuries. However, any size breed of dog can have this type of injury.

Symptoms of a CCL Injury

Some of the most common signs of a potential dog CCL injury are limping or hind-leg lameness, holding a leg up, reluctance to walk, trouble climbing stairs, difficulty jumping up, sitting slowly, and not putting the injured leg squarely underneath.

Sometimes a sudden lameness can be caused by a soft tissue injury and will resolve in a few weeks. If your dog has persistent lameness that lasts longer than a day and seems to be in obvious pain, it's essential to contact your veterinarian.

How Can You Diagnose a CCL injury?

If you suspect your dog has suffered a CCL tear, seeking veterinary care is the first step. Your vet can diagnose properly by combining tests, observations, and radiographs. Two of the most common tests include:

The Cranial Drawer Test allows your veterinarian to see how far forward the tibia moves in relation to the femur.
The Tibial Thrust Test helps your dog to mimic weight bearing to see how far the front of the tibia pushes forward in relation to the femur.

Using radiographs is an invaluable tool in confirming the diagnosis of a CCL rupture. Other diagnostics may include examining muscle loss, joint swelling, or scar tissue formation around the stifle (knee). Your veterinarian will have your dog's medical history and be able to help guide you with the best solution for your pet. Ultimately, the final decision will be up to you, but having expert guidance will provide you with the information necessary to decide.

What Treatments are Available?

Depending on the severity of your dog's injury, there are options. When it comes to dog CCL injuries, there are many variables. The degree of damage will determine what options are available for your pet. CCL surgery is one of the most common orthopedic surgeries performed on dogs.

There are three common types of surgical treatments for a torn CCL in dogs:

Lateral suture or extrascapular repair is one of the most common and oldest procedures for this type of injury. Stability is restored by placing sutures outside of the joint.
TPLO, or Tibial Plateau Leveling Osteotomy, is currently one of the most popular surgeries and has proven to be an effective long-term solution.
TTA, or Tibial Tuberosity Advancement, changes the knee dynamics so that the CCL is no longer necessary for joint stabilization.

While surgery might be the most common option, only some pets are good candidates for surgery. Older pets may be at higher risk, and some dogs are more sensitive to anesthesia, making it risky for them to undergo a surgical procedure. For some people, the cost of an expensive orthopedic surgery is unrealistic and beyond their means.

Non-surgical options can include physical therapy and low-impact exercises such as swimming, gentle stretching, and walking. Physical therapy will help manage your pet's weight, build muscles, and assist with the range of motion. Pain can be managed with the aid of NSAID drugs (non-steroidal anti-inflammatory drugs).

With new developments in orthotics for pets, there are effective alternatives to surgery. A customized stifle or knee brace used with pain management and physical therapy will allow your pet mobility during healing.

A stifle brace will help stabilize the area and distribute your dog's weight more evenly, which allows your dog to walk more correctly and not overcompensate on one side. A brace will help prevent premature deterioration of the good leg and manage pain. Consult with your veterinarian before starting any type of treatment plan.

For example, Duke is a 12-year-old mixed breed who presented to his primary veterinarian for right hind limb lameness in March 2016. He was diagnosed with a right cranial cruciate ligament tear and chronic joint effusion, a common dog injury. An ACL, a CCL or CrCL tear, is the same injury seen in humans. When surgery isn't an option due to age, health, financial reasons, or any other reason, OrthoPets can offer an alternative solution via a custom-made orthosis.

How to Prevent Injuries

The ideal situation would be to prevent a painful and potentially costly injury from occurring in the first place. There are actions you can take to avoid a CCL injury, such as making an effort to manage your pet's weight. Obese pets tend to be more prone to developing orthopedic injuries. Exercise your dog regularly; if they're not properly conditioned, don't allow them to overdo it.

Schedule radiographs to be taken of your dog's hips and lumbar spine to check your dog's body structure for any potential problem areas. Comprehensive radiography will give you peace of mind and more knowledge before issues occur or identify any pre-existing conditions. Understand the early warning signs of arthritis and what to watch for in your dog's behavior. Be proactive and start your dog on helpful joint supplements such as glucosamine to maintain good joint health.

Explore Your Pet's Options with OrthoPets

Whether your dog needs assistance with post-surgical recovery from a CCL injury or you're seeking an alternative to surgery, options are available for your pet. New medical technologies are available to assist you in promoting your pet's healing while ensuring comfort.

If your pet requires a customized stifle (knee) brace to help stabilize a CCL injury, OrthoPets can guide you toward the proper selection. Our friendly and knowledgeable staff can help you get your pet fitted for the perfect knee brace. Contact us today and get your dog moving in the right direction.