treating the tear: treatment options for cruciate tears
Your vet has just told you that your dog has torn his cruciate ligament, a part of his knee (stifle) joint, located on his rear legs. Now it’s time to discuss treatment options.
But first – you’ll notice that in the example above, I said “your dog,” instead of “your pet.” The reason is simply that cruciate tears are a much more common injury for dogs. Cats can tear their cruciate ligaments too, but it occurs very infrequently, nearly always as a result of extreme trauma. Cats typically do pretty well with strict rest and pain control, whereas treatments for dogs can vary from surgery to stem cell therapy – which is where a Petplan pet insurance policy can come in very handy!
In dogs, the cruciate often tears due to trauma that occurs during high-impact activities, and dogs with pre-existing joint abnormalities such a luxating knee caps (patellas) or arthritis are more at risk for tears. In dogs there is also frequently a degenerative process of the ligament that makes it more prone to tearing.
Signs that your dog might have torn his cruciate are typically toe touching or non-weight-bearing lameness, and pain and swelling of the stifle joint, so if you suspect a tear, bring him to the vet right away.
Treatment recommendations in dogs are typically based on your pet’s age, weight and other complicating factors. With a cruciate rupture, the size of your dog does play a large role in deciding which treatment option may have the best chance of success.
Small dogs, those under 16 pounds, have a much greater chance of a good recovery without surgical intervention. About a quarter of these little dogs will do well with anti-inflammatory medication, STRICT rest and any necessary weight loss. In these small dogs, it is perfectly reasonable to try this conservative approach for four to six weeks. If your petite pooch’s comfort hasn’t vastly improved by the end of this time period, then surgery may need to be pursued.
Dogs over 16 pounds generally require surgical intervention to have a good outcome. Conservative management has not been found to be very effective for these larger pets. There are several surgical procedures that can be used to repair a ruptured cruciate ligament, including suture techniques that stabilize the joint from the outside. There are several different suture techniques, and together they have about an 85% success rate. For larger dogs (those over 50 pounds), another surgical procedure called a Tibial Plateau Leveling Osteotomy (TPLO) generally has the best outcome, but it also has a higher risk of complications due to the use of an implant and the complexity of the surgery.
There are other less popular, non-surgical management strategies besides rest and anti-inflammatories, consisting mainly of stifle braces and stem cell therapy. I have never used a stifle brace, but it appears that the general consensus is that they are costly, generally ineffective and not practical for long-term use. Stem cell therapy is still in its infancy as a treatment option for cruciate injuries. There is some evidence that it may be useful in arthritic conditions, but it is doubtful that stem cell therapy will be the full answer for a cruciate tear, since once the ligament is torn, the joint needs to be restabilized via a surgical procedure. Ultimately, your veterinarian will advise you on which course of treatment is the best for your individual pet.
Regardless of how it happened, pet parents of any pet that has torn his or her cruciate should do a few things to help to keep their joints healthy. The most crucial is keeping these pets lean, since excess weight puts undue stress on any joint and makes them more prone to injury. Low-impact exercise such as walking and swimming is ideal for dogs whose joints are more prone to injury. Joint supplements or diets that contain chondroitin sulfate or glucosamines may help to prevent further damage to injured joints. Talk to your veterinarian about further steps you can take to protect your dog’s knees.