November 22, 2017

CCL (Cruciate ligament) issues

A common injury in dogs is Cranial Cruciate Ligament issues where the ligament in the knee (stifle) ruptures or partially tears. This ligament provides stability to the knee when standing on the leg. When the ligament is damaged the dog will be lame and in pain and some will not put the leg down much at all. This problem is often treated with an operation but some can be treated with conservative treatment (physiotherapy rehabilitation and hydro treadmill). Any operation is best followed up by post- op physio rehabilitation.

This is one of the most common conditions we work with in dogs both after the operation or conservatively without an operation. Before conservative treatment can start we need to assess the dog to see how suitable they are – this depends on degree of injury, whether meds are controlling the swelling and pain, the size and weight of the dog and any other medical conditions they may have. article on conservative management for CCL injury

There are a few different ways that a vet can operate on this area and all benefit significantly with physiotherapy within the first week after the operation. One of the least invasive operations is called Lateral Suture but only some dogs will be suitable for this type of operation. The lateral suture stabilises the joint while muscles close to the joint are strengthened to support the joint. The suture will likely eventually break so it is important that the muscle strength is in place for the joint before the suture breaks – hence physio and hydro asap. The other ways are a called osteotomy (TTA/TPLO/MMP, etc) – which means the tibia (shin) bone is cut and parts moved to change the angle of the joint so that the joint does the work of the ligament. Physio after this type of operation encourages the dog to use the leg correctly to promote bone healing and muscle strengthening and reduce the pressure on the other leg which iis already at risk of cruciate injury..

It is common for the dog to rupture the CCL in the other leg within 12 to 18month however over the years we have observed that most of the dogs we treat immediately post op with a full physio program have not gone on and ruptured the other leg’s CCL ligament.

If your vet has not mentioned physiotherapy or only thinks it is suitable after a number of weeks please ask them to call me so I can discuss the options. Or call me yourself and we can chat and then I can call your vet. Vets do worry we may “manipulate” joints or exercise the dog when they have prescribed rest – BUT this is not what we do after cruciate operations/tears. We do rehabilitation work that promotes healing and promotes the most comfortable return to four-legged function for your dog.

We treat many dogs small and large with cruciate issues and many local vets refer to me directly after they have operated.
Here are what some of my previous clients have said:
Riley – Rehab after a CCL operation
dog pilates Riley is an energetic young pointer who had an operation to repair a cruciate ligament tear in his hind leg – known as a CCL repair. He had Physiotherpay rehabilitation in the weeks after his operation which meant he recovered well. He now uses his operated leg as normal, has no limp and is running around on his walk. His owner wrote: ‘I really appreciated all your help with Riley, I would have been a little lost without physio and not known where to start.’ Yasmin
Tilly – 6 yr old energetic Lab – post CCL repair physio rehab.

Tilly hTillyad an operation to repair her ligament in her hind leg and her vet recommended post-op physiotherapy from a week after the operation. She is an energetic lady and her home had tiled and wooden floors which are a risk of slipping which would cause the repair to break.

Her owner, Peter said that he was happy she received physiotherapy and that the good range of therapies to benefitted her as well as a cheerful and professional service.

Pip thank you cardPip – post op CCL repair. Pip is a great character and an energetic chap who lets everyone know when there are visitors by running to the door. He had to have an operation on his knee after his cruciate ligament ruptured. His physio rehabilitation started with ten days of his operation. His owners for very diligent at doing his fun but therapeutic homework to help him use the leg correctly which is the best way to get it to strengthen up again and not put strain on the other leg.

His owners sent this lovely thank you note with a picture of Pip. from Dave and Carol.