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CCL or ACL Tears

How to get your dog back on 4-legs, out of pain and back to life, with or without ACL surgery.

5 Things Any Dog Owner Should Know Before They Decide on ACL Surgery

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Want to chat more about how Pawsitively Fit can help your dog who has suffered a CCL tear? Fill out this form and let’s chat!

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CCL or ACL tears are THE MOST common orthopedic injury in a dog and THE MOST common injury we treat at Pawsitively Fit! Pain meds and crate rest alone won’t help your dog get better.

What causes a CCL tear?

There are two causes of CCL (cranial cruciate ligament) tears – trauma and degeneration.

  • Trauma – this is what is often thought of when a cruciate ligament tear occurs. A dog is running fast, or changing direction when they might “yelp!” and suddenly be on 3-legs, holding up one of their back legs. It is very painful for a dog.
  • Degeneration – this type of cruciate ligament tear is more chronic and occurs over a longer length of time. An owner would often report periods of lameness which a dog recovers from. Often, there will be an event in which the dog suddenly seemed to get a lot worse and not recover the same as they had in the past. Usually, this is an older dog.

What are the signs and symptoms of a CCL tear?

Dog with CCL tear
  • If it is a sudden tear, often a dog will cry out suddenly during activity and be holding up a back leg
  • Back leg lameness (can be on and off or consistent)
  • Reluctance to do normal activities like walks, stairs, get up onto furniture
  • Swelling around the knee (which may sink down to the ankle because of gravity)
  • Sitting with the injured leg out straight and refusal to sit squarely
  • Resistance to an owner trying to bend and straighten the knee

Does this sound like you?

Many owners turn to their vet for treatment advice. After a cruciate ligament tear is confirmed they are given a brace, pain medications and usually a surgeon’s recommendation is that surgical treatment is the only way to recovery. Many owners are scared, feeling helpless and like they’ve let their dog down. Does your dog really need surgery and is that the only road to recovery?! 

In the mean time, your routine is likely changing. Maybe those walks you used to rely on at the end of the day to destress after work, that also allowed you to be social with the neighbors, are disappearing.  Months go by with no recovery, and your dog is still in pain. Maybe you are fearful that if you go out and leave your dog at home, they might slip and fall and hurt themselves more. You’re torn and don’t know where to turn.

Dog with torn CCL

Is this how you feel?

😥Worried that your dog is going to continue to get worse and that they are going to hurt themselves more, especially the other leg?

😥Worried that you can’t tell how much pain your dog is actually in?

😥Worried that you don’t know how to help them with the pain and that that feeling is only going to grow over time?

😥Frustrated that no other recovery or treatment method has been suggested for you other than pain meds, cruciate ligament surgery and keeping your dog quiet?

😥Scared that you are going to lose your companion because you aren’t doing everything for them that you can, even though no one has told you what else to do?

Indy after surgery for CCL repair

If your dog has been diagnosed with a CCL tear here’s what you should know:

✔ A CCL tear is the MOST COMMON musculoskeletal injury in dogs. Up to 50% of dogs who tear one side, will tear the other

✔ Pain meds are beneficial for helping to manage your dog’s knee pain, but they don’t always help your dog get around better. In other words, pain medications alone will not help your dog gain back the muscle, stability and flexibility they had before the injury

✔ While ACL surgery is usually the first suggestion made by a vet for many dogs, it is not necessarily the only option. At the very least, it is one option. But many owners choose to get a second opinion or not to pursue surgery because of the cost, their conservative beliefs or the health or age of their dog.

✔ The longer a dog is struggling with a CCL tear without getting help, the more they will compensate and use their bodies differently, causing aches and pains in places other than just their joints.

What can I do to help my dog feel better?

👍Make a decision about getting help. Depending on how much your dog is struggling, they may not have time to wait. Or, if you do wait, things could continue to get worse.

👍Get your dog moving. Your dog should be encouraged to start to use their injured leg again gradually overtime. Working with a canine rehab specialist can help ensure that your dog is doing the RIGHT exercises to avoid setbacks and maximize their potential

👍Keep them on a leash. Now that the main ligament that stabilizes the knee is damaged, your dog is at increased risk of further injuring that leg or injuring the other leg. They should not be allowed to run and jump right now.

👍Get real, quality rehab for your dog. Rehabilitation can help your dog recover and is important whether or not your dog has surgery. At Pawsitively Fit, we have seen countless dogs with CCL tears, both without surgery or after repair. Yes, it is entirely possible for a dog to undergo a cranial cruciate ligament treatment that does not include just surgery! 

The good news is Pawsitively Fit can help your dog after an ACL tear!

How does Pawsitively Fit help?

🐾We spend the time to examine your dog from nose to tail, top to bottom to determine what their exact needs are. Yes, they have hurt their knee, but the knee functions as part of the whole body.

🐾We empower YOU, the dog owner, by explaining to you WHAT we find, and what that means for your dog and how that impacts their treatment.

🐾Our initial focus is on getting them moving again to help decrease their pain.

🐾Next, we focus on increasing their strength to KEEP THEM MOVING, through exercise.

🐾Lastly, we progress those exercises to maximize their gains!

🐾Our client’s dogs recover faster, with fewer setbacks and less risk of a CCL tear on the other side, allowing them to continue to do the things they love to do with their owners for many years to come!

Meet Karma!

Karma is a 6 year old Rottweiler cross. She moved to Ontario to be with her current owners and had injured her ACL / CCL about 6 months prior. Her owners decided that surgery wasn’t the option for them.

When we first met her, Karma was barely using her right hind leg and had lost a lot of muscle. Her owners were invested though. With rehab, including exercises, hands-on therapies and laser therapy, Karma was able to regain full use of her right hind leg. She now enjoys playing with her dog siblings, running and being a big lap dog up on the couch (where she can get up to herself!).

In the above video, Karma is showing of her hind leg strength and her body awareness! She even exceeded our expectations!

Why owners chose not pursue knee surgery

There are many reasons why an owner may choose not to have surgery for a CCL tear. Some of these reasons include:

Cost. Surgery for CCL tears are expensive (anywhere from 4k and up!). This can be prohibitive for a lot of owners. Some owners are also hesitant as surgery does not guarantee a positive outcome after all the money has been spent.

Age of the dog. Older dogs are not precluded from having surgery. However, many older dogs do have more health issues which may increase the risks of surgery. Again, many owners are often hesitant to submit their older dog to surgery for risk of negative outcomes or not feeling the financial costs of surgery are justified for an older dog.

Health of the dog. If a vet determines your dog’s health is too poor to perform surgery this option will not be given.

Weight. Dogs who are carrying excess weight might be deemed poor surgical candidates and also not be offered surgery.

Owner’s beliefs. This can take many forms. One example are owners who do not believe in putting their dog through the stress of surgery.

How Does a dog’s torn ligament heal without surgery?

The goals of rehabilitation without surgery are to allow time for scar tissue to develop to stabilize the knee joint as well as strengthening the muscles around the knee joint. Scar tissue and muscle will help to stabilize the knee with a torn ACL / CCL ligament. You can also check out a blog post we wrote on the topic.

non surgical CCL rehab

Which dogs with cruciate ligament tears should be prioritized for surgical treatment?

There are two main reasons why a conservative approach might not be the best choice for your dog:

Meniscus tear. The meniscus is a piece of cartilage that provides cushion in the knee joint. There are two menisci in each knee joint. When the meniscus is torn (occurring in up to 80% of CCL tears), it can be very painful for a dog and impede successful rehab with surgery. Often a flap of cartilage gets caught when the knee is bending and straightening. (At Pawsitively Fit, if we find a dog with a CCL tear also has a meniscal tear, we will suggest the owner reconsider surgery).

Lack of patience and commitment. Non-surgical healing from a CCL tear is slow. The dog needs to be kept on-leash, confined and prevented from running. If they are allowed to be too active too soon, the risk of further injury to the knee joint (including a meniscus tear increases) as well as risk of injury to the other knee joint.

Returning to normal length, leashed walks can take up to approximately 4-6 months

Returning to running/free-play can take up to 9-12 months.

Can a brace help heal the injury with or without surgery?

If you ask 10 vets about braces for CCL tears, chances are you will get 10 slightly different answers. There isn’t good research to back up the use of knee braces in dogs like there are in humans after ACL tears.

In general, a brace can help with the healing process. The role of the brace is to externally stabilize the knee joint. This is beneficial for dogs who either are not going to have surgery or to provide an extra layer or protecting for the dog who does have surgery while the surgical site heals.

There are a few things that any owner that is considering a brace should be aware of:

1. Not all dogs are going to tolerate wearing a brace! Most owners intuitively know if there dog is going to be willing to wear a brace. Yes, there will be some getting used to it, but a brace doesn’t work if it isn’t worn.

2. It should be custom made! There is no negotiation here. Dog’s vary in size and shape more than any other species on the planet. We DO NOT recommend purchasing a prefabricated brace off of the internet. Save your money!! Instead, look for a company or orthotist who has experience creating custom braces for other dogs and take a look at testimonials.

3. It’s best combined with rehabilitation, whether your dog has surgery or not. This is only going to help your dog build back muscle and help to stabilize the joint.

4. If your dog has had a meniscus tear, start with surgery. These are painful injuries that don’t get better without surgery.

Popular companies to get knee braces from are Hero Braces and Orthopets.

My Vet told me there is a 50% chance the other knee will tear. How do I prevent this?

This is a stat that is thrown around a lot and it’s difficult to find the source of this statistic. And while we may not know the exact risk, it definitely is a risk. There are several things that an owner can do to prevent a CCL tear on the other knee.

1. Increase the strength, balance and body awareness of your dog’s hind end. This is best done with a specific exercise program that progresses as your dog improves. We recommend working with a canine rehab therapist.

2. Warm-up your dog before doing any sort of physical activity.

3. Keep your dog at a healthy weight. Too many extra pounds can increase the stress on the knee ligaments.

4. Avoid overdoing high intensity, high impact activities as these increase the risk of a tear.

READY TO TALK ABOUT HOW PAWSITIVELY FIT CAN HELP YOUR DOG? FILL OUT THIS FORM AND WE WILL GET IN TOUCH WITH YOU!

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Success Stories

Chances are we’ve helped a dog with problems just like yours. We are all good dog owners, sometimes we just need a little help.

“I completely and totally recommend Shauna of Pawsitively Fit, Kingston for canine physiotherapy and rehab. She worked with our golden retriever before and after TPLO surgery with wonderful results. Shauna was firm but gentle while working with our Tess enabling her to reach the desired results. She loves dogs and both our dogs adore her. Shauna is a lovely, caring person and a true professional. Thank you Shauna for everything you did for Tess.”

Picture of TessDot P, Tess's Owner

“Highly recommend Shauna Slobodian, the animal physiotherapist and owner.  She visited our home the last few months following our dog, Jagger’s knee surgery.  It was great to have her come to our home rather than the worry and stress of loading him into our vehicle to take to her for treatment. Shauna is very knowledgeable and helped guide us through exercises to aid in Jagger’s recovery.  We are happy to report that the surgeon has given him the go ahead to resume normal activities, albeit, at a slow pace.  Thank you, Shauna. Jagger wouldn’t be where he is without you!”

JaggerKaren M, Jagger's Owner

“We engaged Shauna’ s physiotherapy services to help with our 8 month old dog’s recovery from orthopaedic knee surgery. Shauna was extremely professional and knowledgeable about dog behaviour, injury recovery and strengthening exercises. She even provided detailed written updates to our Vet. We would unhesitatingly recommend her and call upon her again if our dog needed physio treatment after surgery or injury. Thank you Shauna, you made a world of difference!”

Picture of MillieLeslie D, Millie's Owner