Linebackers and Ligaments

By Dr. Anndrea Kapke
www.olivebranchvet.com
olivebranchvet@gmail.com


You may have heard of the common football player’s injury of “blowing your knee out.” It is also called an anterior cruciate ligament (ACL) rupture. This injury happens to dogs and cats too, but it is called a cranial cruciate ligament (CCL) rupture in animals.
Lou is a one year old Bulldog whose breed physique makes him look like a defensive lineman. He is a short, sturdy 70 pound guy. This June, shortly after his first birthday, his owners, Joe and Barb Hunt noticed he was having trouble standing up. They thought at first that his left hip was bothering him. A veterinary physical examination and x-rays showed that his hip was fine, but possibly his knee was bothering him. Rest was recommended. Lou improved, but in mid-July, he was limping on his left rear leg again. This is a common pattern for CCL injuries.
There are two cruciate ligaments in the knee joint of humans, dogs, and cats that cross the horizontal surface of the joint like an “X”. The CCL has the job of keeping the knee from being hyperextended. CCL injuries may occur when an animal suddenly turns the leg when the foot is planted, or suddenly steps into a hole when running. CCL ruptures most often occur in young, active dogs like Lou, and in middle-aged, overweight dogs. As animals age, the fibers in the cruciate ligaments begin to weaken. Fat dogs put too much weight on the weakened ligaments, causing them to rupture. Cats may also suffer CCL ruptures, but it is less common.
A dog who partially or completely tears a CCL may go suddenly lame. The limping may improve over the next few weeks to a month and then come back again. Veterinarians work to determine if the rear leg lameness is caused by a hip problem or a knee problem. A common test for CCL rupture is called a cranial drawer test. The vet moves the long bones of the dog’s leg and the knee really shouldn’t be able to move forward like a dresser drawer. X-rays are also taken.
How this injury is treated depends on the patient. Cats and dogs weighing 30 pounds or less may heal with what is called “conservative treatment.” This means six to eight weeks of rest, restriction of activity to short leash walks to go to the bathroom, weight loss if needed, medication for pain and inflammation, and sometimes, physical therapy.
Dogs that weigh more than 30 pounds do better with surgical repair of the knee. There are several different types of surgeries that can be done, depending on the specifics of the pet’s injury and the veterinarian’s preference. In Lou’s case, we referred him to a veterinary orthopedic surgeon on the northside of Indianapolis because of potential complications due to his young age and breed. Regardless of the type of surgery done, 90 percent of canine CCL surgery patients have successful outcomes. CCL surgery repair usually costs between $1,500 to $3,500 per knee. Whether surgical repair is done or not, there will be some arthritic damage in the knee as a result of the injury. Also, it is important to know that forty to sixty percent of dogs that rupture one CCL, will rupture the CCL in the other knee within the next one to two years.
After knee surgery, dogs will be restricted to leash walking for 6-8 weeks and will need physical therapy. Barb Hunt said, “Post surgery care has taken a lot of discipline on our parts, we have changed our schedule at times and made sacrifices in order to be available to Lou so he recovers 100 percent after the surgery.”