This is often a complex question as there are many different presentations of a torn cruciate ligament. A veterinarian will use a test called a drawer sign to evaluate the degree of the movement in the joint as a method of determining if there is a partially torn ligament or a completely torn ligament. If you imagine the cruciate ligament as being made of 100 fibres (strings) and in some cases, all 100 are torn and now there is a lot of instability/excess movement in the joint.

If we are not pursuing surgery it is asking the body to create a significant amount of scar tissue/ fibrosis around the joint to create stability. The instability will contribute to long term arthritis, muscle wasting and pain as the cartilage is worn away. Dogs walk with their knees in a flexed position naturally and this bent-knee position will cause the tibia/shin bone to move forward without a cruciate ligament in place and this will create swelling, inflammation and pain. This scenario will be amplified in a large breed active dog. Surgery will often have the best results in the above example.

We also know that dogs with a torn cruciate can have a secondary tear of the cushion in the knee called the meniscus. A torn meniscus would be addressed at the time of surgery as the meniscal tear has no way of healing itself and also contributes to a poor outcome without surgery. The challenge is there is always a group of dogs who have only partially torn their cruciate ligament and the degree of instability is not as great. Imagine in this case that only 25 of the fibres are missing and the degree of instability is not as severe but another dog could have 75 fibres missing. These cases are often best discussed with your veterinarian.

There are some dogs that may not be candidates for surgery due to age, underlying conditions or cost concerns. Your veterinarian will evaluate the degree of instability, activity level and age of your pet. If there is a clicking sound in the knee it would increase the suspicion of a meniscal tear and surgery is often the better plan of action. A rehabilitation veterinarian can also be beneficial in answering this question as there is no one plan for all dogs. If surgery is not the route that your dog is pursuing our home exercise program that is supported by our rehabilitation facility is recommended. We would still want to maximize the mobility of your pet and the function of the limb.

Our home exercise program is a week-by-week program designed by Dr. Tina McGrath with the online support of instructional videos. The home exercise booklet is downloaded from the website for you to print with instructions for the 12-week recovery program. This is the perfect guide for those that have received surgery and are pursuing rehabilitation at home or those that have not pursued surgery. We believe that a rehabilitation facility with a certified rehabilitation therapist is your best option to maximize your pet’s recovery but this is not always available or feasible in every case. If a pet has a reduced range of motion post-surgery this has been linked to more arthritis in the future. An inability to regain muscle mass post-surgery will decrease stability and create pain in other muscle groups in the spine and front limbs due to overuse of other muscle groups to compensate.

Arthritis is progressive so the answer is that there is likely going to be more arthritis due to continual instability in the joint. We do not know how quickly arthritis will progress but the size and weight of the dog are often factors. Managing your pet’s weight is critical during this process as obesity will play a role in speeding up the progression of arthritis. Feeding a high protein low carbohydrate diet that is well supplemented with omega-three fatty acids has proven to reduce the speed of arthritis. Science diet Metabolic and Mobility diet from your veterinarian is a diet that meets these criteria. We also recommend a joint supplement that contains anti-inflammatory ingredients such as omega threes, green-lipped mussel and Boswellia.

There is a percentage of pets that will try a conservative route and then decide to pursue a surgical route. A home exercise program for those dogs pursuing a conservative route should be implemented to help pets have more successful outcomes. We believe our home exercise program with video support will assist clients in feeling confident in their ability to perform exercises and care for their dog.

There is likely a genetic predisposition for the cruciate ligament to tear in certain dogs but there are things that can be implemented to try to reduce the risk of this occurring. There are some studies that support the idea of neutering dogs later than one year of age. This allows testosterone/estrogen to aid in the closure of growth plates and this appears to reduce the risk of anterior cruciate rupture.

We cannot alter genetics but we can reduce the risk of injury by maintaining a healthy lifestyle for you and your pet. Regular exercise is an important part of weight management for dogs and obesity is a source of inflammation within the body. Chronic inflammation and additional weight on the joints is going to add to the risk of arthritis. Exercise is meant to be at a consistent level daily for dogs to encourage muscle building, range of motion of joints and the ability of dogs to build endurance. Controlled slow leash walking on various surfaces and over curbs and hills can be an excellent way to create a healthy fit dog. Controlled walking upstairs can also help dogs build hind end strength which is critical for stability around the stifle. The dogs that have participated in our home exercise program for their first ACL rupture can use the program to maintain fitness for life and hopefully avoid the subsequent rupture of the second ACL. Depending on the studies, there is a 40-45% chance of the other ACL tearing.

We often recommend using a lavender based bed spray MM “be calm” to help create a sense of relaxation in your pet. You can increase the number of times per day that you massage your pet as the MM “Be Calm” lavender massage oil scent will then be connected to positive feelings. The reduction of cortisol that occurs with a sense of calmness is going to be beneficial in the healing process. You can also look to food puzzles and filling a Kong toy to give your pet some mental stimulation. We recommend that you do not use a bowl to feed your pet during the recovery process and to use a Kong as the delivery method for meals.