Chelsea DickanAs a dog owner, watching your pup suffer from a long-term injury can be very disheartening. Many injuries and diseases that appear suddenly are equally difficult to deal with, but a long-term health problem’s wear-and-tear on a pooch may be draining emotionally, physically, and monetarily.
Anterior cruciate ligament (ACL) tears in dogs—also referred to as cranial cruciatel ligament (CCL) disease—may present as an injury that worsens over time, a sudden rupture, or a mix of both. Whether the injury appears suddenly or develops gradually, ACL tears impair a dog’s ability to walk and may in some cases be difficult to treat.
Because humans may have a torn ACL treated surgically or non-surgically, you may wonder, can a dog recover from a torn ACL without needing surgery?
In certain cases, dogs may be able to recover from lameness stemming from a partial ACL tear without surgical intervention. However, the likelihood of the dog being able to make a full recovery without surgery depends on several factors including their age, weight, breed, level of exercise, and genetic predisposition.
That said, when dogs do end up needing surgery for an ACL tear, many nonsurgical techniques can aid in the recovery process. Let’s explore the various treatment options for ACL tears in dogs.
A Bit of Background About ACL Injuries in Dogs
Although we may refer to all four of a dog’s limbs as “legs,” these four limbs are similar to humans’ in that the front limbs contain shoulder, elbow, and carpal joints, while the back limbs contain hip, knee, and tarsal joints. ACL injuries affect the rear legs, specifically the connections in the knees.
The knee joint in dogs (known as the “stifle joint”) is analogous to the knee joint in humans. ACL (anterior cruciate ligament) tears affect one of the important ligaments in a person’s knee, while CCL (cranial cruciate ligament) disease affects the “knees” of dogs. CCL disease may involve either a partial or complete tear of the ligament and may also include damage to the meniscus, which provides cushioning between the femur and tibia (leg bones).
In order to reduce confusion throughout this article—and because vets and dog owners alike may not always refer to these injuries as “CCL tears”—these injuries will be referred to within this article as “ACL tears.”
Causes of Canine ACL Injuries
As in humans, ACL tears in dogs may be partial or complete (i.e., the ligament may be fully or only partly severed). Unlike humans, though, canine ACL injuries are not as likely to be attributed to sudden trauma. In many cases, these damages instead occur over time, and a partial ligament tear may eventually become a complete tear.
In addition to the worsening effect time may have on a dog’s ACL tear, factors that may increase the likelihood of your dog experiencing an ACL injury include the dog’s level of exercise, weight, breed, and genetic predispositions.
Human ACL injuries are often associated with sports; for dogs, sports or physically demanding work may also play a contributing role in the worsening of ACL tears.
That said, dogs who are not particularly active are also at risk of developing knee injuries, especially when they are overweight. As in humans, when dogs carry extra weight, their bodies are put under more stress. This can lead to the dog’s ligaments becoming strained or tearing.
The dog’s breed may also play a role in their likelihood of experiencing an ACL tear: certain breeds—including golden retrievers, Labrador retrievers, Rottweilers, and German shepherds—may be more predisposed to develop ACL tears than others. Additionally, pups whose parents had these injuries may be more likely to experience the same.
It is also worth noting that dogs whose ACL has torn in one of their legs are more likely to experience a tear in the other leg, too. On top of that, dogs who have had an ACL tear—whether or it not it has been addressed by surgical or nonsurgical intervention—are likely to experience osteoarthritis at some point, too, which may require pain management.
Symptoms of a Torn Canine ACL
Predictably, symptoms of a dog having a torn ACL primarily revolve around the limb in question.
One telltale sign that a dog has had at least a partial ACL tear is lameness. The dog may not want to place any weight on the affected leg, instead carrying it at an awkward angle. Depending on how severe the injury is, the dog may be more or less willing to walk on the hurt leg.
Another symptom of a torn ACL is the accumulation of fluid or swelling around the knee area. Over time, if the injury is left untreated, it is possible for the knee joint to become thicker or for the hip or thigh muscles to become sensitive or weaker due to overcompensation by those muscles.
Due to the pain and physical complications of an ACL tear, dogs with this type of injury are unlikely to want to walk or run around very much. In some cases, they may be able to walk but are less willing to jump or move up and down inclines, including stairs. Getting up or down may also be difficult for them to do comfortably.
When dogs have both an ACL tear and damage to the meniscus, they may express more signs of pain when moving and their legs may make a clicking sound when in motion.
How is a Dog’s Torn ACL Treated?
In addition to factors including your dog’s weight, age, and other preexisting health problems, the extent of the injury will determine the best course of action. Unfortunately, a torn ACL—whether partially or completely torn—cannot ever be fully reattached; that said, there are many treatments that can help dogs regain mobility, decrease pain, and help prevent or delay further damage.
Treatment options for a dog’s torn ACL include surgical and nonsurgical interventions. In many cases, surgery will be the first step, followed by various nonsurgical methods to reduce pain and encourage healing
There is still a great deal of research to be done to compare the efficacy of surgical and nonsurgical methods in addressing torn ACLs; for now, though, vets know that surgery is generally effective in helping dogs recover from ACL injuries.
Cost of Dog ACL Surgery
If the dog requires surgery, there are a few different surgeries vets may use to treat a torn ACL, and the cost will differ depending on the operation chosen. Additionally, it is important to note that vets do not all charge the same rates and pet insurance may also help mitigate costs.
Surgeries that can help treat a torn ACL include tibial plateau leveling osteotomy (TPLO) and lateral extracapsular suture.
TPLO involves cutting into and adjusting the contact surface of the tibia in order to stabilize the knee and slow arthritis and typically costs $3,500 to $5,000. Larger dogs tend to have better outcomes with this surgery, though there may be a small risk of additional surgery if the bone does not heal correctly.
In a lateral extracapsular suture, a suture is placed under the skin around the outside of the knee joint; this surgery typically costs $1,200 to $1,500. The goal of this surgery is to encourage scar tissue to form around the suture, which provides additional support to the knee. Larger, younger, and more active dogs are more likely to experience complications with this surgery; additionally, this procedure is not as effective in slowing the development of arthritis.
Whether or not you are able to afford surgery for your dog, because these injuries worsen when not addressed, it is important to see a veterinarian as soon as possible if your dog is suffering from symptoms of a torn ACL.
Nonsurgical Treatments for a Dog’s Torn ACL
In some situations, surgery may either not be an option or may not be feasible for dog owners to pursue, perhaps due to the cost of surgery or the dog’s age or preexisting conditions.
In general, dogs who are on the smaller side—both in breed and in weight (under 30 pounds)—are more likely to be able to recover with less invasive treatment methods than larger dogs. Even so, you should consult with a vet before beginning an at-home regimen, since improper care for this type of injury may lead to worsening rather than healing.
Sometimes nonsurgical treatment options are initially pursued, but then surgery ends up still being needed because the dog does not recover as expected. If your vet determines that the injury to your dog’s ACL would best be treated non-surgically or by surgery followed by nonsurgical interventions, here are a few treatments they may suggest:
Rest, Inflammation Reduction, and Pain Management
One of the most important means of encouraging healing in dogs with ACL injuries is through the limitation of physical activity. While the injury may not fully heal through rest alone, it is a key component of both post-surgery care and nonsurgical treatment.
Though it is not a way to cure an ACL tear, pain management through medication or other means (including icing, which can help soothe pain and lower inflammation) is vital when a dog of any size has an ACL injury.
Inflammation of the knee is common in ACL injuries and can also contribute to leg pain. Depending on how severe your dog’s injury is, the vet may suggest different means of reducing inflammation and pain, including NSAIDs, glucosamine supplements, acupuncture, or laser therapy.
Weight Loss
As previously mentioned, overweight dogs are at an increased risk of tearing their ACLs. Although overweight dogs who undergo ACL surgery with subsequent nonsurgical support tend to have better outcomes than those who recover solely through nonsurgical means, both groups have better outcomes overall when they also lose weight.
Canine Physical Therapy
If your dog receives surgery for an ACL tear, it is likely that the vet will want your dog to also undergo physical therapy after the operation. In instances of nonsurgical partial ACL tear management, vets may also suggest physical therapy, though your dog may need an extended period of rest before this can begin.
In some cases (such as hydrotherapy), the physical therapy will need to take place in the vet’s office; however, your vet will likely teach you how to help your dog perform certain physical therapy exercises at home.
Although you may be able to look up some exercises online, it is important that you know how to do them correctly before starting them so that you do not accidentally cause further damage to your dog’s leg.
Canine ACL Brace
Because ACL injuries in dogs are different than those that affect humans, support measures that are helpful for humans—including the use of a brace—may not be as effective for dogs. Even so, for some dogs, a brace may be a good means of providing support to an injured knee and may help improve the dog’s ability to walk. In addition to braces found online, vets can also help you find custom-fit orthotics.
Generally, a stiffer brace will be more helpful than a softer brace, and it is likely that the dog will need to continue wearing the brace indefinitely. For some older dogs or very sickly dogs, though, this may be a better option than invasive surgery.
How Long Does Recovery Take for a Dog with a Torn ACL?
The length of recovery depends on whether or not the ACL tear has been addressed though surgery, surgery and follow-up with nonsurgical interventions, or solely nonsurgical interventions. Generally, the best outcomes occur when surgery is followed by rest, physical therapy, and (when indicated) weight loss.
If you are treating your dog’s torn ACL without surgery, it is important that you know that the process can take a much longer time—potentially months—compared with recovery after surgery.
Nonsurgical recovery may also indirectly incur extra costs such as the cost of physical therapy; additionally, it is likely that someone (you, a family member, neighbor, or a dog-sitter) will need to keep a close eye on the dog throughout the recovery process.
Your vet can provide solid, evidence-based advice to help you determine which treatment option would be best to address your pup’s injury. If you know about the different ways an ACL tear can be treated, you may feel more empowered when the time comes to make treatment decisions.
Frequently Asked Questions
Q: What Happens if I Don’t Pursue Treatment for My Dog’s Torn ACL?
A: If your dog has an untreated partially torn ACL, there is a chance the ligament could completely tear, which will lead to greater pain and loss of mobility. Also, even if your dog is able to recuperate from a torn ACL without surgery, once a dog has one torn ACL, the likelihood of the ACL in the other knee tearing is increased. For these reasons, it is important to have your dog visit a vet and have their injury monitored, even if you don’t decide to pursue surgery.
Q: What if I Can’t Afford Surgery for My Dog’s ACL Tear?
A: While most of us are willing to do anything for our pup’s health, the economic realities of veterinary care can interfere with that goal. In many cases, the best health options are simply not affordable for dog owners. While many vets offer payment plans, this option often isn’t feasible either.
If you determine that you are unable to pay for the surgery, talk to your vet about proceeding with other non-surgical treatments. But most importantly, don’t feel guilty about it! Care for your pet in the best way you are able to, and appreciate how lucky you are to have them in your life. Your dog knows nothing about treatment options and finances, and will love you just as much regardless.
Q: When Should a Dog with a Torn ACL Be Put Down?
A: Because ACL injuries tend to worsen over time rather than appearing suddenly, when it becomes evident that your dog has an ACL injury, there will likely still be plenty of treatment options to address the injury that may help you extend your dog’s life. Your vet will be able to help you keep track of signs that your dog is not doing well, and will be able to provide direction about when it may be appropriate to put your dog to sleep.
