Note: This is a guest post from Jana over at Dawg Business. Check out her blog for more on dog ACL injuries and dog health information.
If you have a large breed dog, you will hear about hip dysplasia, but the odds that someone will talk to you about ACL injuries are quite low. The first time we heard the words was after our dog blew her knee.
There are at least three reasons why you should learn about ACL injuries in dogs.
1. There are things you can do to minimize the risk.
2. Knowing the signs of an ACL injury will prevent delays in diagnosis and treatment. That is important because a knee with a torn ACL becomes unstable and serious arthritis sets in very quickly.
3. You might be presented with a single treatment option. While it might be the best one, it is important to be aware of all options before making any decisions regarding your dog’s health.
A torn ACL is the most common knee injury in dogs
So what is an ACL injury?
ACL is short for anterior cruciate ligament. It is also referred to as CCL (cranial cruciate ligament).
If you take a look at the anatomy of the stifle (dog’s knee), you will see that there is no ball and socket like in a hip joint. One bone is virtually sitting on top of the other, held in place by connective tissue. The two crossing cruciate ligaments are holding the bones in place and play a vital role in providing stability of the joint. Because of the anatomy of the knee, the ligaments have to withstand a lot of stress and that’s what makes them most vulnerable to injury.
Once the ligament gets torn or stretched, the stability of the knee is lost. This results in lameness, pain and onset of arthritis.
When your dog presents with a sudden onset of hind leg lameness that is not improving, you should suspect an ACL injury and have your dog checked by a veterinarian as soon as possible. The degree of lameness will depend on the degree of ligament damage. Your dog might start favoring the leg, putting weight only partially (tip-toeing) or not putting weight on the affected leg at all.
Treatment for ACL injuries in dogs
A knee with a damaged crucial ligament will not get better on its own. Your options will depend on the degree of the injury (partial tear, stretched ligament or fully torn ligament), age of your dog and anatomic aspects of your dog’s knee.
There are nonsurgical treatments, such as braces, regenerative stem cell therapy or prolotherapy. If you have an older dog that wouldn’t do well with surgery, braces or prolotherapy might be your best option.
However, if you have a young, healthy dog, a surgical solution gives your dog the best chance of returning to his active life. The most popular knee surgeries today are TPLO (tibial plateau leveling osteotomy) and TTA (tibial tuberosity advancement). Both these surgeries stabilize the knee by altering the bone anatomy.
An older and less invasive type of ACL surgery is extracapsular repair. There are a number of factors that will determine whether an extracapsular repair is an option for your dog. While most experts deem this surgery unsuitable for large breed dogs, there is evidence to the contrary. However, following strict post-op regime is crucial for the success of this type of repair.
How do I prevent my dog from having an ACL injury?
The most important preventative measure to prevent ligament injuries in dogs is weight control. People still don’t seem to realize this, but obesity in dogs is a serious health risk. Not only does obesity increases risk of injuries and degenerative joint disease, it is a contributing factor to a number of other conditions, including heart problems, diabetes and even cancer.
Exercise will not only help keep the weight down, but it will also build strong muscles. Strong muscles help stabilize the joint and prevent injuries. Leash walks on even, flat surfaces are a good way to help the dog build muscle. Swimming is another great exercise. Be careful when your dog is taking part in activities that involve quick starts, stops, jumps and turns such as agility or Frisbee. With any sport, there is a risk of injury and dogs should slowly work into activities and receive proper training and conditioning.
Underlying conditions such as hypothyroidism and structural abnormalities affecting the knee such as a luxating patella also increase the risk of ACL injuries.
Has your dog ever injured his or her knee or other joint?
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My little ten pound Timmy got what the vet called “quarterback knee.” He said that the scar tissue as it heeled on a dog that young and small would be stronger than the knee had been.
I was reluctant to believe him, but a week later he was gingerly walking on it and two weeks later there was no sign of any injury.
Wow, that’s great that it healed so well!
My 8 year old heeler mix had this ACL injury. His back leg would be so painful to walk on. I hoped to have surgery, so i tried a less envasive method that has changed his life! i ordered it from a place called muttkneebrace.com. It was about $200, and it was all customized just for him. The website gave me directions on what and how and where to measure, and I sent it in, and even talked with the lady who made it. She helped figure out how to properly position the brace, and no surgery was required!
Interesting. I’m glad your dog is feeling better and that the brace helped. It some cases, surgery is necessary to get rid of pain.
I just purchased a MuttKnee Brace as I was trying to figure out what to do with our 12 year old yellow lab mix with a blown ACL…miniature horse bandages, vetwrap, I was finding nothing except expensive prescription or veterinarian required casts needed for measurement. Then I stumbled on MuttKnee and I look forward to it’s arrival for our poor boy. The injury happened 3 days ago and it’s killing us watching him hobble around. Definitely a life altering experience…I’m glad someone is making braces out of something other than hard metal, plastic and strapping. Will update when it arrives!
I hope it works well and takes away most of his discomfort. Let me know how it goes!
Leah,
Please update us on your experience with muttkneebrace. My 10 year old 90 lb. coonhound/lab mix developed an ACL injury about five weeks ago. Keeping him inactive and Glucosamine-Chondroitin supplements is helping a some but I fear won’t be enough. But $2000 plus for surgery that might be risky at his age doesn’t appeal to me either. I’m inclined to try muttkneebrace so let me know how it works out. Thanks!
I am curious as well. I hope it works for you coonhound mix so that he can begin to feel at least a little better.
Our Lab Divot has just had 2 surgeries on the same knee. She went down in March or April our vet attempted the fishing line to mimic the ligament. He didn’t do it well and she had swelling after the surgery, weeks after when I would take her for her therapy walk she would be in pain and not progressing.
The Vet went back in to position the line differently so it wouldn’t cause the pain and swelling. She had had that 2nd surgery a month or so ago and isn’t really improving. My wife and I are trying to figure out where to go next. Divot had the TPLO surgery 6 years ago and now I see just how that operation left her, now that the TPLO’d knee is the “good” one. She is at maybe 65-70% on the TPLO knee and 40% or so on the more recent one. We are at a point where we don’t know what to do or who to trust. We started her back on Rimadyl (spelling?) and she responds well with it, but I’ve heard that Rymidal is not good to have a dog on for very long. Is the next step and MRI? Do they have those for dogs? CT scans, are they as good. I have to bury myself in the internet and try to learn something about these things so we can make a rational decision.
Right now a third surgery doesn’t strike me as rational. Great website.
Ned
Thanks for your comment, and I hope your dog is feeling better soon. I’m going to ask Jana to answer your questions because she has more experience and knowledge on this than I do.
Hi Ned.
Can you please be more specific as to which type of surgery was done? “Fishing line” is used in extracapsular repair. But there is another, similar surgery, called tightrope, which is a lot like that but different enough. Personally I could see complications as more likely with the tightrope than with the traditional extracapsular repair.
Also neither of these two really mimic the ligament, that is a different type of surgery all together. They do stabilize the joint until it can heal and stabilize itself with scar tissue.
The healing process with these is rather long, but there definitely shouldn’t be any swelling weeks after surgery.
It IS possible that sometimes the line can irritate muscle or other tissues and cause pain … doesn’t seem that common in the recovery period, more commonly this can happen after the post-op period. In fact that is the most likely cause of lameness AFTER the joint had healed. In those cases it is resolved by removing the no longer needed suture via arthroscopy.
Clearly at this time the suture is needed there to stabilize the knee.
Rimadyl will help with pain, but it won’t fix the problem if there is one. Was it confirmed that there is no infection going on in that joint?
Here is what I would do:
1) find out precisely which type of surgery was done and how
(e.g. such notes could look like this: “std, 100 lb extracapsular repair of ccl on l stifle, crimp, one loop from medial and one fron lateral one hole tibia and under patel lig.. jt very good rom and no drawer at closure”
2) get a second opinion.
Once you find out what exactly is causing the problem then you can address it. Yes, they do have MRI for dogs, but if you find a good surgeon to provide second opinion, he’ll also guide you through further diagnostics and what needs to be done to fix it.
Thanks for your help on this, Jana!
Don’t buy the mutkneebrace. Its a waste of money and totally useless.
Rest and recuperation is the best medicine.
Keep you dog from jumping and puting stress on the knee. Slowly reintroduce short walks.
The knee will get stronger over time.
Don’t waste your mony on poorly made gimicks.
Thanks, Jason. What if it’s used with everything you said above?
I don’t think it will help at all.
The reason is a dogs hind leg is very awkward shape. It it impossible to get a snug fitting brace around the knee with the few minor measurements you are asked to provide.
Whats more the dogs leg changes shape depending on the position of the leg during a normal walking gate. You need a very snug fitting and very pliable brace to keep a reasonable pressure around the knee. The mutneebrace is neither. It appears to be made out of scuba diving wetsuit type material. Not very pliable and impossible to get a constant snug fit around the knee.
It seems very uncomfortable for the dog and irritates his inner groin area. Most of the pressure is arond the muscles instead of the knee. In my opinion this will make the knee worse as it will not allow proper circulation and hinder the muscle from strengthening.
Its heart breaking to see your once active dog slowed down by a bad ACL so the guilt drives us to spend money by trying anything that promises to help. Fortunately I am lucky enough to be able to afford to try a few different things but I would hate to think that someone who can’t afford it would waste their money on what is a fairly useless item.
I don’t think surgery offers anything but pain and discomfort for the dog. In the end the knee will be right back where you started, probably worse and damaged forever.
Given time, proper diet and rest the knee will get better although it will never recover fully and you will always need to avoid the dog jumping, running too hard, or twisting the knee.
The dog will need to be massaged, pampered, loved and hugged often for ever after. Something my dog does not seem to mind at all.
Have you tried this brace? It is neoprene which is the same material used for human knee braces and the measurements requested are quite detailed. There are videos showing use with and without it and the improvement seems significant. I have not tried it but I am not sure how you know it is useless.
Gita,
I haven’t used the brace for any of my dogs. I have heard many, many people say the brace didn’t help at all, though. In my opinion, it would be worth a shot in addition to the obvious rest, strengthening, stretching, good diet and so on.
Thanks for the feedback, Jason.
I don’t know what I think about surgery for a dog’s torn ACL. Each individual case is different, as is each owner’s financial situation. I have known quite a number of dogs with torn ACLs, and of course the vets always push the surgery without looking into other options. Not everyone thinks to get a second opinion or to try the approach of rest, a good diet and time.
From my experience with my own golden retriever several years back, we went with the surgery, did not receive much info on rehabilitation after the surgery and my dog’s knee never recovered fully. The surgery did seem to relieve the majority of her pain, but I still don’t know if it was worth it to put her through that or not.
Oh btw. I just read your bio as I didn’t realize this was a personal blog. (I just found this page directly by accident and didn’t go to the home page. sorry)
How does a girl from North Dakota get interested in Rugby. I ‘m from Australia and it is almost a religion here.
I didn’t even know Rugby was played in the USA except for maybe a few expat’s from Aus, NZ or UK.
Take care.
Rugby is not big here, but most of the larger colleges have a club team and more and more smaller colleges and high schools also offer rugby. My high school had the first girls rugby team in Minnesota. Now there are at least a dozen girls high school teams in Minnesota. I’ve been hooked ever since I was 14. I started a club team at my little college in Moorhead, Minn., which is right on the border of North Dakota where I live now. There are no adult teams in my immediate area, unfortunately. I’d have to start my own team, and believe me, I’ve thought about it.
Hi Lindsay, your experience with surgery is very typical. I am yet to hear of a single successful surgery where the dog recovered fully. It seems those that can simply say the surgery did not work are the lucky ones. Most are horror stories such as Ned’s on this forum who after 2 surgeries and several thousand dollars the knee is worse than where it started.
Jan’s is absolutely correct when she say’s the scar tissue will build up over time and strengthen the knee, especially in younger dogs who tend to heal faster. That is exactly what I found after doing lots of research and talking to a vet who practices natural therapies. (much to the annoyance of her peers) Surgery should not even be considered for older dogs as they may never recover from the pain and discomfort, and after many months may become depressed and pretty much lose the will to live.
My dog weakened his both ACL’s from tearing down the stairs every time the doorbell rang then slip sliding on the polished wooden floor. Finally he tore it completely and was limping badly for several weeks but after a few months rest (and a carpet rug at the bottom of the stairs) his knee is almost as good as new. (though he will still aggravate it sometimes if I let him get too excited).
Good luck and hope you are all well.
Take care.
I am also yet to hear of a dog ACL surgery that was completely successful.
Hi there! I happened upon this doing research for my GSD’s ACL tear. She’s three and a half, in very good shape, and I’m hoping to avoid surgery at all costs. Especially after some of the research I’ve done so far. I don’t think I can cite one person who’s glad they did it. I’m currently focusing my search on braces and rest/confinement coupled with supplements. The two braces I’ve narrowed down to are from Muttknee and Woundwear. After reading Jason’s review of the Muttknee brace, I’m a little discouraged as the reviews I found elsewhere of the Woundwear were fairly comparable. Anyone here have experiences with the Woundwear brace, or even another company that I maybe haven’t come across yet? I don’t have all the money in the world, but am willing to do what it takes to help my girl. But I’m not a fan of surgery in general, no matter what the cost is. I would REALLY like to avoid that, for her sake and mine. Anyone have any experiences, stories, or feedback on either braces or just recuperation…..have at it. And thank you in advance from a fellow dog owner/lover.
Amanda and Gretl
Well I am in agreement with you and would avoid the surgery as well. One of my dog walking customers tore his ACL back in May and the vet immediately recommended surgery. Instead of going through with this, his owners decided to just give it some time, let their dog rest and go for some walks to help with strengthening and stretching and to just see if he could recover on his own. He has been doing just fine.
I have no experience with knee braces for dogs. I have only heard a few reviews and none have been especially positive.
I feel like I am not being very helpful so maybe someone else will chime in!
I got the MuttKnee Brace for my 13 year old Akita….What a disappointment! I was so excited once it finally came..It took forever it seemed. The owner makes them and wouldn’t contact me for weeks. When I would finally hear back through e-mail she kept saying she was behind. So, I got it about five weeks late. Anyway, wow, what a joke… Like the post above said… It is so ill fitting, you are scared to death you are going to do more harm just trying to get it on..It took 3 adults to try to figure out how the thing is suppossed to go on him..I still don’t think we got it on right. My Akita was so stressed by this time that all he wanted to do was lay down. They have to stand up the whole time you are trying to put in on. It was so weird like post above so snug you can hardly get it on and then it bags out around the knee. I e-mailed and told the owner how disappointed I was, that was over a year ago; never heard a peep back. These folks need a suit filed against them. Do not but Muttknee Brace, it is junk!
Wow. Thank you so much for sharing your experience with this brace! Sorry to hear this product is such a joke!
I have a dog-friend with a very recently damaged ligament. After vet consults and personal research coupled with advice from well-informed friends, I am choosing the more conservative treatment approach of enforced confinement, temporary use of Previcox, and time. I did find a different brace some of you might want to investigate. Kind of pricey and I do not know any users or results. But it’s called the A-TraC Dynamic Brace. I think the producers require tibial length per radiology for custom fitting. Good luck to us all!
Thanks so much for the info, Donna. It’s nice to know there are options. I hope the dog you are referring to gets better soon!
My dog ASpen is a pyrenees. She is 17 years old and just suffered a torn ACL. The vet said at her age surgery is not an option. She is a fighter but I am at a loss. We are on pain meds and she is taking it easy. Please ,any suggestions would be greatly appreciated. She is otherwise in great health .
Poor girl. I am sorry to hear that your dog is hurt. I think you are doing the right thing. Plenty of rest and pain medicine. Has the vet suggested what to do for exercise? I would think that stretching and short walks to strengthen the knee would help. But I am not a vet.
@Sarah (above)
Sorry you had such bad luck with the muttkneebrace folks. I have a 2 year old Argentine Dogo and we recently had ACL surgery performed by a very skilled ortho surgeon. Recovery with rest and stretching has not been sufficient.
My wife and I hated to see her continue to sit and wag her tail while wanting to play with other dogs at the park, however the pain was still too much for her.
We shelled out the $260 (for the duel knee version) and put it on her… a few days later, she was back in the game! She hasn’t played this well or had this much fun for a year. The Muttkneebrace worked AMAZING. I can’t stress to folks in this thread how much this “gimmick” changed our girl’s life.
Don’t slam a brace if you haven’t used it. Jason.
Sarah, you have legitimate reason to complain as you tried it. All I can say, is for some dogs, perhaps it cannot replace surgery, and I sorry that was the case for your dog. As for mine, It worked wonders… I guess nothing is 100% successful, not even for treatment of humans. – I think I’m more upset that they did not get back with you when you complained, I find it hard to swallow as I had a very good experience with them, but I do believe you. You’re one of those rare instances that happen with any product, and I feel very bad for your furry family member. I hope you’ve found another solution that worked!
For those reading this, and cannot afford to spend 2 – 3 thousand on surgery, I highly recommend giving the muttkneebrace a shot. Worst case scenario, is you are out $200 – $260, and are back to square one. Medium case scenario, is your dog’s quality of life is improved, even if not fully recovered, and if you end up like me, your dog will be back to their old self. I love the duel version of the mutt brace, and don’t know what I would have done without it. (actually I do know… I would have paid another 2,000 on surgerys.
I take the brace off when she is not at the dog park or being “super” active. When she’s just around the house, or outside chilling out, I don’t use the brace because I want her knee and body to do strength and healing on it’s own. I use the brace only when she is going to be ramped up at full speed, lots of starts, stops and rolling.
Good luck to everyone regardless what you end up doing. Our furry family members are people too (for me anyway) and I wish the best to you!
- Heath
Thanks for sharing your experience. I am glad to hear your dog is feeling better!
Our 6 yr. old loveable labradoodle tore his CCL a few weeks ago nad has been hobbling around since. We have been to our wonderful vet several ti tmes. TPLO was the said to be the best option, but at $3000 and my hubby’s recent job loss we just couldn’t do it. we talked about extracapsular and tightrope.but aftwr researching all the surgeries, we don’t feel really great about any surgery even if we could afford it. Our vet has been very supportive and we now have him on cartrophen in jections, metacam, glucosamine hcl, msm and a little devil’s claw. We mentioned the muttknee brace to her and she calles the canine rehab specialist to find out about braces. She recommended “pawsability.com” here in Canada who makes very customized braces that are more rigid. we are investigatine this option, and the option of some physio too. We have purchaes a muttknee brace fully aware that it might not work, but the lower cost was worth the risk…at least we are not out $3000 which may also be unsuccessful. Our vet said that tightrope has just recently become improved whereas there used to be a higher risk of infection. Extracapsular or the fishing line job is not generally recommendes i large breeds. Our doggie was in great health, ideal weight and well-exercised so it is sad to see him laid up. Does anyone know if swimming would be a good rehab activity for this type of injury? I forgot to ask our vet that question. I’ll let you know muttknee brace works out.
I know many dogs with knee injuries in our area have done hydrotherapy. They swim in a controlled setting in a small tub. Basically like a pool treadmill. Asking about swimming would be a good question for your vet.
I understand why you didn’t go the surgery route. My own dog thankfully has never had a serious injury, however he does get very stiff and sore sometimes when he plays too much fetch. If he were to tear his ACL I’m not sure I would do the surgery either. It would have to depend on the exact situation.
Hi,
My 9 y. o. Golden Retriever had TPLO ACL reconstructive surgery in June 2011. She recovered completely and has full use of her right hind leg. Unfortunately, she tore her left one in Oct. 2011. We then opted on the “conservative” route by resting the left leg for 6 weeks. She is now 10 years old and is able to go on 1-2 mile walks daily, albeit at a slower speed than 2 years ago, but still enjoys her walks. I would definitely recommend the surgery, assuming you can afford it (we paid $4K total including hospital, surgery, anesthesia, etc.) knowing that these dogs have a greater than 50/50 chance of tearing the other ACL. We decided not to have surgery on the left one because we didn’t want the dog to endure yet another surgery, rehab, etc as the entire process aged her quite a bit. We only decided on surgery with the first ACL tear knowing the dog could not get along with 2 torn ACL’s. We are happy with our decisions so far.
Susan,
9 times out of 10 usually when one leg goes, the other one does after! I know its so hard on our pups! We went the surgery route for the first leg. I did research after surgery for post treatments and I found the woundwear atrac dynamic brace. It was developed for cruiciate ligament tears but also used for post surgery. Well when the other leg went out, we used the atrac brace as the way to heal. It was great! I suggest everyone to look at bracing their dog instead of surgery and look at woundwear!
Lizzy
OH! There are a ton of videos of people using woundwear braces on youtube. That helped me research and decide!
Lizzy