Written by: Dr. Bo Bergman, DVM
[Editor’s Note: Dr. Bo Bergman—a.k.a. “the Dogtor”—has graciously agreed to answer questions about dog health and care from Orvis Dogs readers. If you have a question for the Dogtor, leave it in the comments section below. Click here to read his introductory post.]
Last week, Bill asked about treatment options for his dog with a strained “ACL.” Most people have likely heard of athletes tearing or rupturing the anterior cruciate ligament in their knee, and the same thing can happen in dogs (and cats)—only we call it the cranial cruciate ligament. The cruciate ligament helps to stabilize the knee, and its rupture or tear can cause instability and inflammation. Such an injury not only limits mobility, but it’s also painful!
Every cruciate injury presents with a variety of factors to consider before selecting which treatment is best for you and your pet. I always remind clients that this is not a life-threatening issue—it’s a quality-of-life issue. Surgery is often the best treatment for an unstable knee to get the dog back to normal function. Non-surgical options include:
therapeutic options, such as therapeutic laser treatments and stem-cell therapy (both of which we use often at West Mountain Animal Hospital)
Any of the aforementioned options might work well in certain scenarios, but you’ll have to consider the age of the dog, its level of activity, your finances, or any concurrent diseases the dog may suffer from.
Determining how much pain your pet is in can be a challenge. We can’t ask them to describe how they feel, but we can make reasonable assumptions based on careful observation. For example, watch for any of the following and your veterinarian what you see:
Is the pet limping?
Can it climb the stairs?
Can it jump into the car normally?
Does it put full weight on a particular limb?
When choosing a treatment, I also encourage clients to use foresight—the more inflammation, the more likely arthritis will develop in the future. I always warn clients that 30-50% of patients will tear the ligament in the opposite knee. Maybe the pet can get around by limping on one leg, but can it limp on two hind legs?
Bill has a 13-year-old dog who sometimes holds up the leg with the strained cruciate. Choosing the best treatment depends on what her lifestyle is. Does he want her taking long hikes, chasing after frisbees, doing agility competitions? If so, it might push the scales towards surgery. But if she’s content being a house dog, rest and physical therapy might be the best options. A glucosamine joint supplement and a veterinary prescribed non-steroidal anti-inflammatory often help as well.
Want other options? Take a look at the football games on Thanksgiving Day and count the number of knee braces you see. Dog-knee braces are newer in the veterinary world and have potential to help, but there’s not much proof from the scientific world yet. That said, we have used custom-fit braces in our clinic in a few cases with some benefit, but unfortunately it’s not as easy as putting an Ace bandage on. Often it requires sedating the dog and building a cast molding to to ensure that the brace fits properly.
My hope is this has helped shed light on the world of cruciate disease in dogs. For more specific information, I like this handout from the Colorado Veterinary School. And remember that your personal veterinarian will know you and your pet best!
Dr. Bo Bergman, DVM, is a graduate of NC State University College of Veterinary Medicine and works at West Mountain Animal Hospital in Vermont.
14 thoughts on “Ask the Dogtor, I: Treatment Options for Strained Knee Ligaments”
Thank you for highlighting non-surgical options for canine cruciate ligaments. When this happened to my dog, I got enormous pressure from my vet to have the surgery. He didn’t even have a complete tear! I just thought there had to be a better way to manage this injury that didn’t involve going under the knife. I used a brace from Woundwear and put my dog on a diet (he had put on some pounds as he got older and became lazier). Anyway, I’d say “the jury is in” about the effectiveness of these types of braces and I’d definitely recommend it!
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My large dog had a completely torn acl or ccl and could only walk on 3 legs. Instead of buying the painful acl or ccl tplo or tta dog knee surgery, get a custom posh dog knee brace that will support the knee and in several months or sooner your dog will be walking normally without surgery. From day one, once we got the brace fitted, my dog was able to start on short dog walks, and the walks increased as the days and weeks went by. No down time like with a new injury from a painful surgery.
Those poor dogs that get the tta or tplo surgery have a high risk of needing surgery on the other knee. It doesn’t matter if its a mixed or any breed dog, huge, large, medium, small or tiny, they can use a posh dog knee brace to start walking normally in only a few months. There is no need for the pain and high risks of dog knee surgery, severe infections, sepsis, leg amputation, never able to walk normally again after surgery, in pain forever after surgery, and bone cancer at the surgery site happens frequently. I have read many nightmares of those that went thru that horrific tplo or tta surgery.
There is a lot of helpful info at PoshDogKneeBrace .com My dog wore the posh brace for about 3 months for dog walks, and now it has been years and is still walking normally and never had to get that painful tplo or tta surgery.
The vets will not tell you there are more effective solutions for healing a ccl or acl dog knee tear like a posh dog knee brace. The tplo or tta surgery is painful and risky. Fortunately we found out just in time that a posh brace is a more effective solution for acl or ccl dog knee tears so we canceled the surgery. It has been several years now and that was the best decision ever.
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Rest the knee. Avoid putting much weight on your knee if it’s painful to do so. You may need to use crutches for a time.