When your dog tears its cranial cruciate ligament, that is bad news in itself, but what do you do when your dog ruptures both CCLs at the same time? How do you care for the dog? How do you decide what type of surgery to treat it? How do you afford it? Do you have the surgical procedure on both legs at the same time, or do you do one knee, let it recover, then do the other knee? These are all tough questions, and I’ll be the first to admit, we were a bit overwhelmed when our dog first ruptured her CCL, but hopefully the information here on this page will help out for those rare cases when pets rupture both knee ligaments at the same time.

The first step to take if your dog is diagnosed with 2 torn knee ligaments would be restriction. When I say restriction, I mean putting the dog in some sort of crate or pen that will drastically restrict movement. You don’t want the dog to have room to run and jump as sad as that is to say. While confined, icing the dogs knees can help reduce swelling and inflammation – if your dog will actually let you apply ice.

As the dog is confined, you’ll be left with some more questions to answer – Should we have both knees repaired at the same time, or should we do one, let it recover completely and then do the other. And then the next obvious question that comes after that is, can we afford it? I’ll address these questions together because they can tie directly into one another. We’ll look at these questions considering 2 cases. Case 1 – We get both knees operated on at the same time, and, Case 2 – We get one knee operated on, then wait for it to heal and then get the second knee operated on.

Option 1 – Repair both CCLs at the same time
I’m calling this option 1 because I think that this option will be the all around best option for both the dog and the owner(s). In terms of time commitment, this option will require less time because the knees will be recovering together, rather than waiting for one to recover, then waiting for the other. This option, though drastic, will be less harsh on the dog. With this option, the dog will only be required to be confined for 2-5 months (depending on the type of surgery, the veterinarians recommendations, etc.). This will essentially equate to half of the time as the other option. And the final reason that I think this is the better option is that there is greater potential for savings. If both knees are operated on at the same time, chance are you’ll be able to talk your vet into doing 2 for 1, or at least the second at a 50% discount.

Option 2 – Repair one knee at a time
With this option, you’ll be looking at strict confinement not just once, but twice. This was one of the hardest things when our dog had her knee surgery. There are many things that could come into play when deciding which option is best, age, activity level, attitude, etc, but if you have an active dog, I think that repairing one knee at a time would be absolute torture because it would lengthen the amount of time that the dog is penned up in a confined space. Though the possibility is there, I don’t believe the potential for savings is quite as large in this instance, because by spreading the surgeries out by 3-5 months, you’re in essence taking your dog back for an entirely separate surgery, and the veterinarian will probably want to bill you as such. It’s always worth trying to negotiate the price down a bit, but I would anticipate that the vet would be less willing to cut the price in this instance.

As terrible as this situation would be, it does happen, so I hope that this information helps in making decisions about how to treat a dog who does encounter a dual CCL rupture.

Related Posts

• Our Golden Retriever Bailey and Repairing Both Knees at the Same Time
• Cruciate Ligament in Dogs, Canine Cranial Cruciate Ligament (Crucial)
• Canine Cruciate Brace – Will a Knee Brace Help My Dog?

We live in Southern California, so the beach is a fun and easy way for us to take our dogs out for exercise. We’re able to just walk along the shore and let our dogs run off the leash and do what they want, it’s far more relaxing than having to worry about taking them anywhere on a leash.

So we were out at the beach and our two dogs were our running around doing their own thing. Roxy (our 5 1/2 year old American Pit Bull Terrier) and our pitbull lab mix puppy happy as clams, Roxy digging holes and the puppy running around everywhere as fast as he could possibly go. Seeing Roxy, the puppy go very excited and ran at her, her back legs were set in the sand from digging, and the puppy never slowed down. He crashed right into her at full speed. She came up limping. She’s had slight hip problems in the past, and had a tendancy to limp a bit after our visits to the beach so we took her home, let her rest and decided to see how she was doing the following day.

The next day there was no change in her leg, she was still unable to put any pressure on it, so we took her into the “Doggie ER”. (Side note – if your dog isn’t suffering from a life threatening condition, don’t bother with a Pet Emergency Clinic – you’ll see why). At the pet emergency clinic, they decided to give her X-Rays to see if her ligament was torn – anyone who has ever had any ligament damage or torn ligaments knows that x-rays do not show ligaments, x-rays can only show bones, so having an x-ray was more or less pointless, unless they were checking for broken bones, which they made no mention of. In addition to the cost of X-Rays ($400) our dog had to be sedated, so that the doctor could “aggressively manipulate the joint” to test for instability. You may read negative reviews of manual joint manipulation, but we really didn’t give ourselves any time to research anything online, so we agreed to go ahead with the procedure. The manual joint manipulation allows the doctor (or vet) to check the stifle (knee) joint for “drawer movement”, this is basically any instability in the joint.

After all was said and done, the conclusion at the ER was that our dog had ruptured her Cranial Cruciate Ligament (CCL, equivalent to the ACL in humans) and we were then advised to take our dog to its primary care veterinarian within the next 3 days. At the time, we didn’t have a primary care veterinarian, but we lucked out because we were able to get a surgery scheduled in the place of a canceled appointment.

Related Posts

• Surgical Options for Torn/Ruptured Cranial Cruciate Ligament (Cranial Crucial Ligament)
• Diagnosis – How We Determined Our Dog Had A Torn/Ruptured Cranial Cruciate Ligament (CCL)
• Diagnosing a Torn/Ruptured Cranial Cruciate Ligament in Dogs

The cranial cruciate ligament in dogs provides stability to the knee (stifle) joint. Any strain, tearing or rupture of the cranial cruciate ligament can, and will, result in knee (stifle) instability. A strained cranial cruciate ligament can, in many cases, be repaired or heal itself without surgery. Strains should be treated with conservative management. Tears and ruptures of the cranial cruciate ligament require more drastic treatments such as orthopedic surgery. When it comes to surgical repair of the CCL, there are multiple CCL surgery options available and it is always best to consult with your veterinarian prior to deciding which option is best for your dog.

The necessity of the cranial crucial ligament (CCL) can be compared to the necessity of the anterior cruciate ligament (ACL) that is found in humans. While there are people who have bypassed having surgery with a torn ACL, their knees are typically less stable for the remainder of their lives and their activity has to be severly limited. The same holds true for canines – should a torn or ruptured CCL be left untreated, the dog will survive, but may display lameness in the limb with the torn ligament, and the dogs activity level will not be the same as that of what it was prior to damaging the ligament.

Related Posts

• Surgical Options for Torn/Ruptured Cranial Cruciate Ligament (Cranial Crucial Ligament)
• Tightrope Surgery in the Treatment of a Dogs Torn Cranial Cruciate Ligament
• Diagnosing a Torn/Ruptured Cranial Cruciate Ligament in Dogs

When it comes to caring for our pets, we all want the best possible option, however, most veterinarians will have a single method that they prefer to perform, thus leaving you to find another vet if you do not agree with having a specific CCL surgery. Prior to committing your dog to a surgery, you’re going to want to find out what option your veterinarian will perform, the recovery time, what percent of normal activity level will the dog return to when fully recovered, etc. Of all the surgery options, I’d say that any would be better than going without the surgery (see my post on my friend who did not get the surgery for his dog), but in the end, the choice is going to be up to you – the dog owner. Without the surgery, your dog will have an unstable stifle (knee) joint, and will probably show lameness terminally.

Cranial Cruciate Ligament (CCL) Surgery Options

• Traditional Repair – Lateral Fabellar Technique
  This technique is typically recommended for smaller dogs (we went with this option on our 60lb pit bull). With this technique, a monofilament nylon cord of about 80-100lb tensile strength is passed from the lateral fabella to the tibial crest, in what was explained to me as a figure 8 pattern, basically wrapping the knee joint to eliminate and prevent joint instability (drawer movement). Scar tissue will, over time, develop around the joint, which will further stabilize the joint, but will also begin to restrict range of motion.
• Tibial Plateau Leveling Osteotomy (TPLO)
  The TPLO CCL repair technique is generally recommended for larger breeds of dogs, as well as active dogs, such as agility dogs. This technique is also thought to cause less degenerative arthritis around the stifle joing. Key things to note about the TPLO surgery are a quicker recovery time, better range of motion, less arthritis and a return to athletic (working) activity levels. TPLO surgery involves cutting the bone and slightly rotating it before re-attaching it with a plate. By rotating the top of the bone, less pressure is put on the joint.
• Tibial Tuberosity Advancement (TTA)
  This is a new, less invasive option to the TPLO surgery, but will not be an option for all dogs. Since this surgical option is less invasive, it allows for a quicker recovery time. TTA also puts a cut in the tibial bone, however it shaves off the front of the bone and extends it with a spacer. Also like the TPLO surgery, the TTA option depends on the angle of the stifle joint and is not recommended for dogs with a steep angle in the stifle.
• Tightrope Surgery (Tight Rope Surgery) (Updated June, 2009)
  Tightrope surgery is a very new procedure that is based on a similar procedure performed in human ankles. It is far less invasive and is performed through small incisions in the skin, and woven through small holes drilled in the bones of the stifle joint. Tightrope surgery is an arthroscopic procedure and thus far seems to have very positive results.

As you can probably tell, each option has advantages and disadvantages, and all options should be discussed with your veterinarian after x-rays are taken of your dogs knee joint.

Related Posts

• Cruciate Ligament in Dogs, Canine Cranial Cruciate Ligament (Crucial)
• Diagnosis – How We Determined Our Dog Had A Torn/Ruptured Cranial Cruciate Ligament (CCL)
• Diagnosing a Torn/Ruptured Cranial Cruciate Ligament in Dogs

TPLO, or tibial plateau leveling osteotomy, is a common surgery performed on dogs to stabilize the stifle (knee) joint after a tear or rupture in the cranial cruciate ligament (CCL) (can be compared to the anterior cruciate ligament (ACL) in humans). Normally, the cranial cruciate ligament (CCL) prevents backward-forward movement of the stifle joint. When it tears/ruptures, the stifle joint becomes unstable and the dog suffers lack of mobility, lameness or loss of use and is subject to chronic and progressive arthritis in the stifle if untreated.

In a TPLO procedure, the tibial plateau, the portion of the tibia adjoining the stifle (knee), is cut and rotated so that its slope changes to approximately 5 degrees from the horizontal plane, forever changing the biomechanics of the dogs movement. This prevents the femur from sliding down the slope of the plateau. It is rumored that TPLO surgery generally results in faster recovery times compared to other procedures to stabilize the knee joint. Most dogs (over 90%) are expected to regain a very active and athletic lifestyle with no post-operative complications and without the need for any pain relieving medication.

Related Posts

• TPLO vs. TTA vs. Lateral Fabellar Traditional Technique – Cranial Cruciate Ligament Repair
• Cost of TPLO Surgery – Cost to Repair Torn Cruciate Ligament in Dogs
• Surgical Options for Torn/Ruptured Cranial Cruciate Ligament (Cranial Crucial Ligament)