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Scan the sports’ headlines and it won’t take long to come across a story featuring an athlete sidelined with a knee injury. Our local high school has had two key players fight through the pain of early season injuries to cruciate ligaments (within the knee) to help their team to a championship. Their story is ongoing, one we may hear more about on Home Page Sports. But we are here to talk about creatures that move on four legs. Dogs don’t play football — well, ok, maybe some do — but whether they’re playing hard or lounging on the sidelines, our dogs can and do sustain knee injuries.

The most common cause of lameness in a dog’s hind leg is injury or damage to a ligament in the knee. In people, this ligament is known as the Anterior Cruciate Ligament. In dogs, the ligament is the Cranial Cruciate Ligament. Although they have different names, these are considered same ligament—the differing terminology is simply because dogs walk on four legs while we walk upright on two.

Though commonly seen in larger, middle aged dogs that are overweight and not overly active, cruciate ligament injury can occur at any age, in any breed, of any size, of any activity level and even occurs in cats. The lameness often first appears as something minor to the owner, who may think that the dog just ‘overdid it’ playing that day, or perhaps slipped on the floor. The unique structure of this very important part of the knee joint allows the ligament to undergo some damage early on and still function to support the knee.

Partial or incomplete tears to the cruciate ligament will often result in some mild lameness. This first episode of lameness is often dismissed as just a sprain. Any insult to the ligament weakens it and destabilizes the knee. Left untreated, joint instability often leads to degenerative arthritis that begins in as little as a few weeks. This arthritis can occur at any age.

Prompt, thorough evaluation of any dog that comes up even mildly lame in the rear leg is the critical first step to managing cruciate ligament injuries and slowing the development of function — altering and eventually debilitating — arthritis in the injured dog’s knee. As drastic as it may seem, surgical intervention to repair even partially torn cruciate ligaments is beneficial to returning the dog to more normal activity and function.

Since our pets vary so much in age, size, weight, temperament, activity level and lifestyle, choosing a repair method needs to consider all of these factors and then take into account what is the best fit for the individual patient and his/her family.

Numerous surgical procedures have been developed and used over the years to repair the cruciate in dogs and no single procedure is considered the “best.” There are two main types of surgical repair for cruciate ligaments in dogs. One type of repair replaces the damaged ligament with some form of artificial suture material. The second type of procedure adjusts the geometry of the knee (the anatomy is altered) to stabilize the joint by removing the need for the cruciate ligament altogether. Though no surgery can return the knee to “like new” status after the cruciate ligament is torn or damaged, permitting the dog to run, play, walk, and live its life on a knee that is functional and as pain-free as possible is the goal.

Once a professional diagnosis of cruciate ligament injury is made or considered likely, surgical options should be considered. This is true for any age, breed or type of dog. There are many reasons why surgery may not be the best for a particular animal, so a complete evaluation and thorough discussion with your veterinarian is essential. Should surgery be agreed upon, remember that not all general practice veterinarians will perform surgical correction and often will prefer to send the dog and his/her owner to a veterinarian or veterinary hospital where the procedure can be performed. If you are unsure that your dog needs or will benefit from knee surgery, take the time to get a second opinion. Geometry altering procedures require a skilled veterinary surgeon—usually one with board certification.

If you can’t manage the travel of repeated visits to a large referral surgery hospital remember some board certified surgeons, like Dr. Kathy Collins, DVM, will travel to perform the procedure at a hospital that can provide appropriate follow-up after care and rehabilitation.

Surgical repair by any method is a big event in the life of you and your dog. Skilled nursing and medical care are necessary not only to safely deliver anesthesia and control pain during and immediately after surgery, they are essential to achieving a successful long-term outcome. The healing and rehabilitation period following any knee surgery is 4-6 months. Important considerations following any knee surgery should include medical management of pain, physical therapy and activity level control, and nutrition, including weight control for some dogs.

Getting the lame dog with a cruciate ligament injury up and moving again without pain and restrictions requires a team. That team is comprised of you the pet’s owner and family working together with skilled caring veterinarians and veterinary nurses.

Summary:
• Early veterinary examination and diagnosis when your dog starts limping.
• Surgical correction is often recommended and necessary, even if the ligament is not completely torn.
• A caring team that includes the owner, the veterinarian, and supporting professionals working together is crucial to a successful outcome.

Together we can get your dog moving again.

For more information on Dr. Kathy Collins and her qualifications visit her website:

http://www.vetsurgicalspecialist.com/

The American College of Veterinary Surgeons has a good review of this subject so if you want to learn more go to:

https://www.acvs.org/small-animal/cranial-cruciate-ligament-disease

Please visit our web site and if you signup and register you’ll be able to search several well written articles on cruciate injuries and surgical repair:

http://pvvc.net/pet-health-resources/pet-health-articles/articles/?rid=8525

If you have questions or comments on this episode of ‘Creature Care’ just email me at creaturecare@pvvc.net