Dog Knee Surgery & CCL Ligament Repair » Diagnosis

Diagnosis – How We Determined Our Dog Had A Torn/Ruptured Cranial Cruciate Ligament (CCL)

Kenneth — Wed, 30 Sep 2009 19:38:24 +0000

As with ACL tears in humans, CCL tears in dogs can be sudden and very noticeable, or they can develop slowly over time. When a person injures their knee and suffers a torn ACL, it is normally going to be very painful and the joint will feel very unstable and in most cases, will not be able to be used. The same will hold true for dogs when they injure their CCL. When our dog tore her CCL, she immediately stopped bearing weight on the leg.

Our dogs CCL was torn while at the beach, our other dog was playing and ran into her at full speed while she had her feet set in the sand and was digging. The impact caused an awkward twisting of her rear leg that was planted in the sand and it caused the CCL to give way. After the impact, she immediately held her leg up and began hopping/skipping and only using one rear leg.

This was an extreme situation, and it was obvious when it happened that our dog had suffered some sort of an injury. Whenever anything like this happens, the dog should be taken to the vet immediately, though I’m not sure I’d recommend the emergency vet anymore. If you’re unable to get your dog into the vet within a few days from the injury, the emergency vet may be your best option, but chances are, they’ll have you take your dog to your primary car veterinarian.

There will be cases where the injury slowly develops over time, and ligament will eventually give way, tearing/rupturing partially or completely. In this circumstance, you may notice your dog limping on occasion (not all the time), probably particularly after heavy activity, strenuous activity or prolonged activity. Some breeds of dogs have knee joints that aren’t physiologically great at bearing weight, and any of the above mentioned conditions can aggravate the CCL, and over time it can eventually deteriorate enough to the point where the ligament gives way. In this case, you’ll want to take your pet to the vet to get an opinion as you begin to notice the symptoms – limping, stiffness, sluggishness, less playful, etc. As the owner, you’ll know when your dog isn’t acting normally. If your dog is developing a slowly forming knee injury, it can often be treated by conservative management, weight management, and sometimes even change in diet. Your veterinarian will be able to give you treatment options and recommendations, but hopefully seeing the signs early will be able to prevent a full tear or rupture of the CCL.

Diagnosing a Cranial Cruciate Ligament (CCL) Injury

Kenneth — Mon, 22 Jun 2009 04:52:21 +0000

The stifle (knee) joint in dogs, is very similar to the knee joint in humans, in that there are ligaments that run through the joint providing stability, and just like in humans, there can be many varying degrees of injuries in the stifle joint which makes it very important to have it properly diagnosed prior to rushing into surgery or treatment.

The injury could be something that happened suddenly as the result of a stressful event, or the injury could develop over time through normal “wear and tear”. Injuries that develop over time can be the result of many different factors, overuse, incorrect stifle joint angle, high impact activities, and many other things can contribute to cranial cruciate ligament injuries that develop over time. Ligament injuries that happen suddenly can be caused by jumping and landing awkwardly, twisting wierd on the leg, or being run into by another dog.

For the injury that happens suddenly, the dog will immediately stop bearing weight on the leg. Every dogs reaction will be different, as all dogs have different pain threshholds, but you as the owner will definitely be able to recognize that your dog has a problem. In stifle injuries that develop over time, the symptoms may not be so obvious, but they will still be noticeable. In slowly developing injuiries, the dog may limp occasionally, sit awkwardly (sloppy sit – sitting on the side, rather than on its legs), etc.

In both of these situations, it becomes necessary to have the injury diagnosed, and this is where things can get a little bit tricky. When consulting most vets and clinics, there will typically be multiple diagnosis methods available, each of which will be the preference of the practicing veterinarian. These are the typical diagnosis options for the stifle joint:

X-Ray
One recommended course of action will typically be an x-ray. The problem with an x-ray is that ligaments cannot be seen on x-rays (which I’ve learned through injuries of my own). X-rays basically serve one purpose, and that is to see if there are any broken, dislocated or misplaced bones.
Manual Joint Manipulation
Another course of diagnosis is manual manipulation of the joint in which the veterinarian checks for “drawer movement”. Drawer movement is the lamens term for instability in the joint, and comes from the fact that the knee joint will slide back and forth, like a drawer, if there is ligament damage because the ligaments won’t be there to hold the bones in place. Dogs will almost have to be sedated in order to test for “drawer movement” as it would be very painful for the dog to be awake during the procedure.
MRI
A common option in human injuries, having an MRI done is not as feasible for our pets, though it would quickly and easily be able to tell us whether there was a torn or ruptured ligament in the knee. The reason that MRI’s aren’t necessarily available for dogs is that the equipment is very expensive, and the cost of the procedure is highly expensive as well.

Of the above diagnosis options, an x-ray is usually recommended to check that there are no broken bones, and once that is verified, the veterinarian will check for drawer movement to determine if there is ligament damage. I’ve heard stories, and read stories of misdiagnosis online, and I’ll try to address that in another post, as this post will strictly focus on diagnosising cranial cruciate ligament injuries.

In a perfect world, we’d all be able to get MRI’s for our dogs if there was any question that they had a CCL injury, however, it’s not a perfect world, so we use the methods that are available to us. Thus, manual joint manipulation is one of the more common diagnosis techniqes, and with it, we have its drawbacks. The biggest drawback of manual manipulation to check for “drawer movement” is the possibility of furthering the injury. The injury can be worsened by any/all of the following:

Sedation – as mentioned above, the vet will often sedate the dog in order to be able to manipulate the leg without the dog “fighting” it. This can result in over-torquing the joint.
Rough exam – twisting of the joint

These factors can actually lead to injuries to other parts of the joint as there are multiple muscles, ligaments and tendons running through the knee. You may wish to be present durin the manipulation of the knee joint so that you can read your dogs reaction to the twisting.

Conclusion

I understand that all of the above isn’t necessarily great news if your looking for answers about your dogs recent injury, but I’m just trying to provide as much information as possible to allow you to make an informed decision on the treatment of your dog. If I had known a fraction of what I know now, I may have gone an entirely different route at the time of our dogs injury, but on the same note, I’m very glad that we went the surgical route as our dog has been doing great since her recovery. If you haven’t already, make sure you read our story.

Diagnosing a Torn/Ruptured Cranial Cruciate Ligament in Dogs

Kenneth — Sun, 22 Jun 2008 17:03:11 +0000

When our dog tore her CCL, she imediately came up lame and was unable to put any weight or pressure on her right hind leg. She had minor hip problems previously, so at first we thought that she just overdid it while playing at the beach, so we took her home, gave her some MetaCam and let her rest overnight. When nothing had changed the next day (Sunday), we decided to take her to the pet Emergency Room.

At the ER, they told us that to diagnose the problem with her knee they were going to have to do 2 things:

Take x-rays of the stifle (knee) joint to make sure that there is no bone damage and/or arthritis.
Manipulate the joint while the dog is sedated to check for instability (drawer movement)

So we left our dog at the emergency clinic so that they could sedate and diagnose her injury, and when we next heard back from them, they told us that she most likely has a torn cranial cruciate ligament (CCL; misspelling: cranial crucial ligament) and that we should take her to her primary care veterinarian to discuss repair options.

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