Unfortunately, cruciate ligament disease is the most common cause of hind limb lameness in dogs. The knee is a bit of a problem joint in dogs, as it is in footballers and netballers. Long term wear and tear of high speed stops and turns, chasing a ball, or running up and down the fence line with the next door neighbours’ pet can all increase the risk of your dog rupturing cruciate ligament.
Cruciate disease presents in two main forms.
1. Sudden lameness on one leg. This lameness is very obvious and very painful, usually resulting in a hopping gait without weight bearing on the affected leg.
2. Chronic weakening of the ligament causes increased lameness and discomfort over a period of time.
Cruciate disease causes terrible changes within the joint when not addressed, including knee pain and lameness, excess joint fluid, arthritis and damage to the meniscus ( a cartilage pad within the knee joint).
Signs of cruciate disease include:
Lameness (limping) on the hind leg/legs
Reluctance to walk or exercise
“Toe Touching” at rest
Muscle wastage on the affected leg due to misuse
Yelping or whimpering when moving on the leg
During a clinical examination, your veterinarian will feel your dog's knee for any cruciate ligament instability. If there is any suspicion of cruciate disease, your vet will recommend performing x-rays under a sedation or general anaesthetic to assess the knee. X-rays are used to confirm that there are no other problems, to assess the degree of arthritic change and to plan surgical options.
Surgery to fix the joint is the recommended treatment in the majority of cases. The joint is surgically explored , the damaged ligament is removed, the meniscus is assessed and the joint is stabilised.
There are two main techniques used:
A Triple Tibial Osteotomy (TTO) is the preferred technique. This involves three
separate incisions into the bone below the knee (the tibia), allowing the bone to be reshaped, plated and screwed into a different position remove the need for a cruciate ligament. The TTO procedure gives the strongest likelihood of return to normal athletic function. It is a procedure which requires a high level of specialist training to perform. Dr Sue Gibbons (BVSc FACVSc) is available by appointment to perform this procedure at our clinic.
The De Angelis technique involves placement of an artificial ligament outside of the joint capsule to function like a new ligament. This technique is more suitable for smaller pets or where financial constraints exclude the TTO option. Several of these procedures are performed monthly.
There are additional treatments which are used in conjunction with surgical intervention to give the best results to your pet. Anti-inflammatory pain relief helps reduce pain and inflammation of the joint and surgical site. Injectable and oral anti-arthritic agents maximise joint healing and assist in treating arthritic changes. Post operative physiotherapy and gentle exercise can help your dog regain function as soon as possible.
Is surgery the only option?
In short, yes. Although a dog suffering from cruciate disease may appear to be weight bearing once rested, they will deteriorate quickly as joint degeneration occurs over time. Timely surgery can not stop all arthritic changes, but can certainly prolong joint health.
The veterinarians at The Bloomin’ Vet are experienced in the diagnosis and successful treatment of cruciate injuries. It is important to catch this disease early before the inflicted joint damage becomes severe, so it is recommended that an appointment is made with us if you notice any hind limb lameness.
Why are dogs knees so prone to injury?
Unlike an elbow joint, the knee strictly relies on two fragile ligaments connecting the thigh bone (femur), to the shinbone (tibia). As there are no bony connections, this renders the knee relatively unstable. The cranial and caudal cruciate ligaments criss-cross over within the joint, ensuring that the bones can only move within a limited area. As these ligaments provide joint stability, if one or both are partially or completely torn, the two main leg bones will move independently of each other. This causes tissue damage, inflammation, pain and lameness.
Interesting points about Cruciate Ligament Disease
Cruciate disease in giant breeds happens on average, at a much younger age due to the increased joint forces in heavier dogs. This also holds true for overweight and obese young dogs being more prone to cruciate disease.
In small breeds, cruciate disease tends to appear at an older age.
Middle aged desexed female dogs are slightly more prone.
Breeds with bendy looking legs from behind (Staffy, Maltese, Shih tzu, Jack Russell) put inappropriate forces on the knee due to their conformation which make them more prone to this disease also.