This month we would like to focus upon an issue among pets as they approach their “middle age,” a torn CCL. We’ll explain what happens, how to repair it, and how to help your pet avoid such situations.

What is the CCL?
CCL stands for the Cranial Cruciate Ligament and it connects your pet’s upper leg (femur) to the lower leg (tibia). The CCL is one of the key ligaments in your pet’s knee that provides both stability and strength — keeping everything in proper alignment while providing movement. In people, the equivalent is our ACL, or Anterior Cruciate Ligament.

Knee Structures
How do you know if your pet has a CCL injury?
Pets with CCL injuries often demonstrate a range of mobility issues — from minor lameness to an inability to place any weight on the impacted leg. While these general symptoms may also indicate other orthopedic issues, a CCL injury often involves swelling in and around the impacted knee that an owner can see or feel. And typically CCL injuries occur over time, through ongoing activities which can lead to a partial or complete tear.

How can we tell if your pet has a CCL injury?
We will first conduct a brief range of motion test to see if the upper and lower legs can move away from each other in a specific manner. We do not encourage pet owners to conduct any such movements themselves. Our best diagnostic tool involves an x-ray to evaluate all structures within your pet’s knee, including bones, cartilage, and ligaments. We will also look for any excess fluid or other abnormalities that may indicate a recent/acute or ongoing/chronic (such as arthritis) damage.

How does a CCL injury occur?
While CCL injuries are not uncommon in pets under one year of age, they are most common as pets approach their mid-years. Older pets have the mindset to play like a youngster, but their body is not as strong nor flexible as it once was — and it is often heavier. So, prior activity levels that resulted in active play can result in straining, partially or completely tearing the CCL — or other structures of the knee.

Dogs Prone to CCL Injuries
Beyond age, activity and weight, some larger, more active breeds are predisposed to CCL injuries including: Golden Retrievers, Labrador Retrievers, Newfoundlands, German Shepherds and Rottweilers.

How is a CCL injury repaired?
The required corrective and rehabilitative actions are dictated by the degree of the injury — and the weight of the pet. Sprains and partial tears can, at times, be addressed through anti-inflammatory medicine and controlled activity until the injury has time to heal. For some active pets, this is a challenge. Without time to properly heal, the condition can go from bad to worse — turning discomfort to pain as the knee experiences progressive joint degradation which can include arthritis and bone-on-bone contact.

Post Operative CCL
As with humans, surgery is an option to repair knee ligaments. While there are a variety of surgical techniques, the process involves shaving the leg, a properly placed incision, often removing a portion of the tibia, and reconnecting the ligament and/or re-anchoring the ligament to the bone with sutures and screws, respectively. Post operatively, the greatest challenge is limiting your pet’s mobility allowing the repair to properly heal. Eight to ten weeks of crate living may be required, followed by very gradual, prescribed activity or rehabilitation.

How can I help my  pet avoid a CCL injury?
As the saying goes, an ounce of prevention is worth a pound of cure. Before playing ball, frisbee or other active sports with your pet, allow them to warm up for five to ten minutes. Fast walking or even running without jumping allows the body and joints to flex and naturally stretch, reducing the potential for injury.

Beyond avoiding the “weekend warrior” syndrome, it’s important your pet receive regular exercise and that you’re mindful of your pet’s weight. Not only will a fit pet enjoy a healthier and longer life, they are also less likely to experience joint issues — including those related to the CCL.

CCL injuries tend to occur from repetitive stress — such as those associated with landings, fast turns, or quick stops. When activities involve jumping, ensure the play location is dry and does not contain any loose material such as sand, dirt or gravel. Loose material may suddenly stop your pet’s lower leg while their momentum continues to move their upper leg. This lateral action can wreak havoc on knees and injure CCLs. Also, try to avoid other slippery surfaces when playing including tile, decking or other similar material.

Playing Again
And when your pet first seems tired, it’s time to stop. Injuries can occur when your pet does not have complete control of their body.

Contact Us
If you have questions about your pet’s knees, joints or any other health-related topic, please contact us. We’re always here for you.