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Writer's pictureGenevieve Kirk

Cranial Cruciate Ligament Disease – about it, causes, treatments…

 

This is one of the major injuries that so many dog owners are aware of, so it seems a good place to start! While it may sound complex at times, understanding the causes behind injuries like this can help us better care for our four-legged family, so that we can better enjoy their full-power energy, and hopefully for longer!


What is the Cranial Cruciate Ligament (CCL)?

Anatomy diagram of the canine stifle, highlighting the cruciate ligament uninjured (left) and ruptured (right)

The cranial cruciate ligament is crucial to stabilizing the knee during movement. It is similar to the anterior cruciate ligament (ACL) in humans. In dogs, the CCL helps prevent excessive forward movement of the tibia (the lower limb bone) relative to the femur (the thick and long bone that connects to the hip).


What can cause Canine Cranial Cruciate Ligament (CCL) Injury:

  1. Trauma and Sudden Injury: Something humans can often take for granted is that dogs can experience similar sudden trauma or injury that damages their joints and ligaments. The CCL is particularly susceptible to injury with rough play, sudden twists and turns, and rough landings. Large, athletic dogs, or those that are sedentary and then taken on a walk with sudden outbursts of power often fall victim to this injury. “Ball chuckers” or even just ball games, can be especially high up on the list of causes of injury, because of the fast and hard turns that dogs take with this game. With some surgeries starting at $4000, it is one that would be great to avoid… More on how to prepare your dogs for those games soon!

  2. Age and Breed Predisposition: Certain dog breeds are more susceptible to CCL injuries due to a) genetic factors or b) anatomical differences. Breeds such as Labrador Retrievers, Golden Retrievers, Rottweilers, and Newfoundlands are among those commonly affected.

  3. Obesity and Excess Weight: Overweight dogs, even slightly, can add surprisingly large strains to tendons, ligaments and joints. This means the CCL will take extra strain, likely more than it is conditioned to manage, and increase the risk of injury. Obesity also indicates more “slow-living” dogs, which means they are less likely to be fit and strong enough to absorb the forces of activity, which further increases risk of injury.

  4. Conformational Abnormalities: Dogs built with straighter hindlimbs, or too angulated hindlimbs can increase the strain on the CCL, which runs through the stifle joint. Repetitive and uncontrolled strain can increase the risk of damage.

  5. Degenerative Changes: As dogs age, the ligaments and joint structures can undergo degenerative changes, weakening the integrity of the CCL and predisposing them to injury, even with normal activity levels.


Rehabilitation of a CCL Injury:

Diagram of TPLO surgery of a canine cranial cruciate ligament
  1. Step 1: YOUR VET! If you have noticed your dog squeal during play and become non-weightbearing, sore or slow to move, and very guarded of a particular limb, it is strongly advised to seek your vet immediately. It may not be the CCL that has been injured, but your dog wants to be checked on. Your veterinarian will perform a thorough examination, possibly including diagnostic tests like X-rays or MRI scans, to confirm the diagnosis and recommend an appropriate treatment plan.

  2. Treatment Options: Depending on the severity of the injury, treatment options may include conservative management which involves rest, anti-inflammatory medication and physical therapy or surgical intervention such as TPLO, TTA, or extracapsular repair surgeries.

  3. Physiotherapy and Rehabilitation: Therapeutic modalities, manual therapy, rehabilitation exercises, hydrotherapy, and targeted physical therapy should all be applied with the help of a qualified and experienced therapist. These approaches can help to strengthen the muscles surrounding the knee joint, as well as monitor the condition of the rest of the body, and helps to maintain and improve range of motion, and facilitate a return to pre-injury form.  

  4. Environmental Modifications: With the help of your animal’s physiotherapist, adjustments to your home environment are advised to minimize the risk of further injury. Sadly, it isn’t uncommon for the other CCL injury to happen within a year of the first one being damaged. Provide supportive bedding, use ramps or steps to assist with mobility and reduce the need to jump anywhere, and avoid activities that place excessive strain on the knees.

  5. Weight Management: Maintaining a healthy weight is essential for dogs with CCL injuries to reduce stress on the affected knee joint. Your veterinarian can provide guidance on an appropriate diet and your physiotherapist can offer advice with a suitable exercise plan tailored to your dog's rehabilitation needs.


Understanding the causes of canine cranial cruciate ligament (CCL) injuries gives owners a chance to pre-empt the risks, and control unnecessary hazards where possible. With the help of an animal physiotherapist, you should be able to strengthen and support your pet, pre- or post-CCL injury, in such a way that allows you both to continue enjoying a very active and fun lifestyle together.


https://www.mdpi.com/2306-7381/8/9/186 (biomechanics, management, rehabilitation)

 

 

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