This month’s article is by Maja Wichtowski of Tsavo’s Canine Rehabilitation & Fitness Center, Inc. A graduate of Cornell University, Maja has 18 years of extensive experience in Western Veterinary Medicine. Her diverse background includes oncology, orthopedics, internal medicine, dentistry, emergency/critical care, general practice and canine rehabilitation.
We inquired about the most common canine injury, the CCL-Cranial Cruciate Ligament. Regardless if your dog is a sport athlete in Flyball, agility, herding, frisbee, playing at the dog park or a weekend exercise hound it is important to seek medical care with any injury. Maja provides an overview of treatment options for the dog owner when injury unexpectedly occurs.
Maja may be contacted at: Tsavo’s Canine Rehabilitation & Fitness Center, Inc.
Phone 619 846 9531
www.TsavosCanineRehab.com
CCL- Cranial Cruciate Ligament Injury
by Maja Wichtowski
So your dog tore their CCL, now what?
For most, our 4-legged kid’s favorite game is playing ball. All is good until suddenly you hear a scream and your dog returns 3-legged. Is surgery always necessary? What if my dog cannot undergo anesthesia? Is rehabilitation always necessary? We hope to clarify your options.
Typical x-ray of a cruciate tear
Go to Your Vet
If you dog does suddenly become lame, it is imperative that you get them to your veterinarian immediately. Your vet can determine the cause for the lameness. If it is a CCL(cranial cruciate ligament) injury, and it is left untreated, joint degeneration progresses quickly and full recovery becomes less likely. The longer your dog overcompensates with the opposite leg, the more likely that the CCL in that leg will also rupture. Then you have a dog that can’t walk at all!
Basic structures of the knee
Treatment Options
Surgery
If your dog has completely ruptured their CCL, surgery is probably your best bet for a quick recovery and long-term stability. The orthopedic surgeon will determine which surgery is ideal based on your dog’s age, breed, weight, and activity level. The two most popular surgeries are the TPLO (Tibial Plateau Leveling Osteotomy) and the TTA (Tibial Tuberosity Advancement). They both stabilize the joint by changing the joint’s anatomy, and involve the use of titanium implants. There is also Extracapsular Stabilization, which is the least invasive, but usually only used in dogs under 50lbs.
 TPLO |
 TTA |
Immediately following surgery, a combination of NSAIDS (non-steroidal anti-inflammatory), joint supplements, and physical rehabilitation are essential to ensure your pet recovers quickly. Full recovery commonly takes 6-20 weeks, and is dependent on the type of surgery performed, the age and weight of your dog, and how vigilant you are with post-op care.
Non-Surgical Alternatives
If your dog is lucky to have only suffered a partial CCL rupture, or if they are compromised in some way (health or age) that prohibits anesthesia, here are a few options that are available. A custom knee brace is an essential component to recovery if your dog is not undergoing surgery. It will provide stability and allow them to utilize the limb without further damaging the joint. Once you have a brace, stem-cell regenerative therapy or prolotherapy, and physical rehabilitation are the way to go.
Stem Cell Regenerative Therapy requires a minor surgery to harvest the stem cells from your dog’s fat, as well as a repeat anesthesia to inject the harvested and processed cells into the knee the following visit. This therapy uses the same mechanism the body uses to repair itself; with the cells transforming into any kind of cell that is needed. Restricted activity, physical rehabilitation, and brace support, are key post-injection for the best results.
Prolotherapy also uses your dog’s healing mechanism to treat the injury. In this procedure, a solution is injected into the knee directly, causing an inflammatory response which in turn starts the healing process. Your dog will need to be sedated for this procedure, which is usually repeated monthly for 4-6 injections. Post-injection protocol is the same as with stem cell therapy.
The Bottom Line
I hope that we were able to give you a good core understanding of your choices of treatment should your dog ever suffer from this kind of injury. Regardless which route of treatment you and your veterinarian decide on, the benefits of post-op physical rehabilitation shouldn’t be understated. The sooner you start, the sooner your dog can be back on their feet enjoying life pain free. Please feel free to contact us directly if you have any further questions.
Maja Wichtowski, RVT, CCRT
Tsavo’s Canine Rehabilitation & Fitness Center, Inc.
619-846-9531
The Ballistic Racers Flyball Team - San Diego 