Education

Introduction

Cruciate tears are the most common orthopaedic injury that the canine population endures, in fact, worldwide cruciate tears cost pet owners billions of dollars each year.

This ebook is our first part of a four-part series on Canine Cranial Cruciate Ligament (CCL) rehabilitation.

In part 1 we cover topics such as what is the CCL, why it’s a problem when it ruptures, various treatment options, and how rehabilitation can help.

Specifically, in this ebook, we will cover what to do in the immediate post-injury phase/prehab and how to best recover from surgery.

In our follow up ebooks, you’ll get more information on basic strengthening, functional movement, return to sport, etc.

Dr Rhys Donovan Director

Ba App Sc (Osteopathy) | MA (Osteopathy) Grad. Dip. Animal Biomechanical Medicine

Dr Matt Breeds

Director Ba App Sc (Chiropractic) | MA (Chiropractic) | Grad. Dip. Animal Biomechanical Medicine

What Is The CCL?

The Cranial Cruciate Ligament (CCL) is the main stabilising ligament inside the stifle (knee) of an animal. It performs a similar function as the Anterior Cruciate Ligament (ACL) in humans. The CCL is crucial to normal stifle function. It aids to resist shock, twisting, and shear forces back and forth. When the cruciate ligament tears, besides causing a tremendous amount of pain, the stifle also loses it’s structural integrity and renders the stifle unstable and unable to function properly. When this injury is merely mentioned, it brings tears to one’s eyes, because of how serious (and expensive) it is to x.
How Does The CCL Tear?

The cruciate can tear for a number of reasons, but usually, it’s the result of a slow degenerative process that happens over time. This leads to the cruciate becoming weaker, which is then more susceptible to a traumatic episode.

The classic presentation is a dog limping on of its hind legs after physical activity such as sharp turning/stopping when chasing a ball, twisting the stifle, jumping off something, or after playing with another dog. However, it’s not always like this. Sometimes you won’t know what happened, and other times dog won’t show any obvious signs at all.

On average

within 2.5 years most dogs will rupture their other cruciate

CCL Injury Symptoms

These are the more common symptoms, but your dog may experience other symptoms, or sometimes very little symptoms. Also note, that just because your dog is experiencing some or all of these symptoms, it doesn’t mean that a cruciate is definitely the problem – always seek a professional diagnosis.
Other symptoms may include:
Yelping/vocalising discomfort
May not sit or drop square
Limping/walking on 3 legs
Unwilling to place the injured leg on the ground
Other parts get sore like the back, hips, or the other hind leg (compensation).

The ARK Road to Recovery

Stage 1 Prehab/Early Stage Rehab

Non-Surgical Management (skip stage 2)

Surgical Management

Stage 2 Recover From Surgery

Stage 3 Reduced Activity, Proprioception

Stage 4 Strength & Basic Exercises

Stage 5 Functional & Advanced Exercises

Stage 6 Return to walking & other normal activity

Stage 7 Prevent Re-injury

Conservative Vs Surgical Intervention

If your vet suspects a cruciate rupture they will usually recommend either a conservative or surgical approach. Typically a surgical approach will be recommended, however, if your dog is older, they seem to be coping ok, the cost of surgery is prohibitive or diagnosis is inconclusive then a conservative approach may be recommended.

Conservative Treatment

Conservative veterinary treatment consists of everything else that isn’t surgery. Each case is patient specic, but may include some of the following:

Surgical Treatment

If a surgical procedure is recommended, the type of surgery will depend on several factors such as the size of your dog, cost, preference of the veterinarian, or availability of specialist surgeons. There are more options than listed below, but the ones listed below are the most common.