Ruptured anterior cruciate ligament (ACL) in dogs

Certain breeds are more prone to ACL problems

One of the fastest growing and expensive to treat orthopedic epidemics seen in dogs today is the increasing numbers of dogs (and to a much lesser extent, cats) diagnosed with either complete or partial anterior cruciate ligament tear of the stifle, or knee joint of an animal. When I was in veterinary school back from 1987 through 1991, this was only a rare cause of lameness in dogs, mainly being seen in a few breeds, particularly the Rottweiler. However, both the incidence of this condition and the variety of breeds affected has grown tremendously in recent years. The history may include mild to moderate off and on hind leg lameness that has been sometimes present for weeks or months, or a sudden 3 legged lameness in those pets with a complete tear.

Varying degrees of stiffness can be seen after exercise or rest. Many of these pets are often tested for Lyme disease, and in fact Lyme disease is often significantly overdiagnosed as a cause of lameness in dogs. Most of these pets are middle-aged larger breed dogs such as Mastiffs, St. Bernards, Bulldogs, Labrador Retrievers, Akitas, and Rottweilers. However, any sized breed can be affected. While there is an intense search as to a genetic cause for this big increase in the incidence of this condition, there is also some who feel that an immune-mediated disease, where the pet’s own immune system destroys the ligamentous structures of the stifle could also be involved.

In my opinion, various nutritional factors and over vaccination may be playing roles here. Unfortunately, up to 50% of dogs who tear one curiae ligament or ACL, are at some point in the future also going to have the other stifle affected. An ACL rupture is often diagnosed by your vet palpating excessive laxity in the knee/stifle known as a positive “drawer” sign. However, in some partial cases this can sometimes be difficult to elicit. Many pets need to be sedated and have appropriate x-rays taken, as well as even some having joint taps to assess the joint fluid, as well as sometimes exploration of the joint to definitively diagnose those sometimes elusive and vague cases.

If your pet is diagnosed with this condition, there are various surgical techniques available from the expensive TPO procedure to many others, but this will vary depending upon the particular surgeon. Even when surgically corrected, some degree of degenerative joint disease and joint thickening often develops at some point in the future. I have seen lighter and smaller breeds with partial tears often return to normal function with rest, prescription nonsteroidal anti-inflammatory medications, and joint supplements, regaining adequate use and function of the affected limb over time and patience.

With the breeds especially prone to tearing this ligament, I always recommend a good natural diet such as Azmira, Wysong, or even a proper homemade diet following a balanced recipe. I will sometimes supplement these pets with extra vitamin C in the form of Ester-C to strengthen the collagen of the connective tissue of the body from doses as low as 500 mg up to a few grams once to twice daily, depending upon the size of the pet. I also love using antioxidants as well to natural help prevent and reduce inflammation such as Proanthozone, as well as Yucca Intensive by Azmira. Glucosamine/MSM derivatives including Super Joint Enhancer or Glyco-Flex by VetriScience also may help enhance the health of the joints in general.

In those pets where I suspect partial tears or to help facilitate recovery from surgery, I will often recommend pet physical therapy, an emerging area of veterinary medicine that increasing numbers of veterinarians are being trained in. Hopefully by keeping the body healthy through good diet and nutritional supplementation, we can help keep our pets’ joints and ligaments healthy and strong. While there are no guaranteed preventative steps an animal guardian can take, in my practice I try and promote good diet and nutritional supplements to help keep the joints strong and healthy, and hopefully lessening the likelihood of this common and painful orthopedic condition.

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70 Comments

  1. Dr. Michael Dym, VMD veterinarianJuly 15, 2014 at 4:06 pm

    No defined criteria or time limits involved with choosing surgery, although longer surgery put off, there is more scar tissue and chronic inflammation that occurs in joint that may make surgery a bit more tricky. Also consider gemmotherapies, which I have had great results with in some of these. Learn more about these on line. Ones I have found helpful for this are Common Birch, Wild Woodvine, and Mountain Pine….

  2. My 5 yr old St. Bernard will be the ‘Tightrope’ procedure done on her left hind leg. Are there any supplements I should be giving her after? I’m thinking of glucosamine, msm, chondroitin, HA. Possibly – boswellia and also amalaki powder (which is a natural form of vitamin C)She is not overweight at all and is fed a balanced homemade diet.

  3. Dr. Michael Dym, VMD veterinarianOctober 14, 2014 at 3:54 pm

    Hi Michelle. They all sound like great products. My favorite glucosamine/MSM supplement is called Glycoflex III, which you can get from 1800petmeds. As for Bosswellia, the supplement Dev Cor Mobility by Vetri Science is my favorite along those lines.

  4. This is great! Thanks for sharing. Ever since my older dog Ralphie tore his acl I have been researching everything about acl tears. I really don’t want to put him through surgery since he is an older dog so I got him an a-trac brace from woundwear. It seems to be working well and I hope the brace can heal him so he can run around again! 🙂

  5. Hello, I have a 1 1/2 year old blue heeler/ black lab cross! She was 3 legged for a while due to her back leg hock popping from left to right! I took her to the vet a few months ago and she gave me pain meds, anti-inflammatory and antibiotics! I had my dog on complete bed rest and after a while she was able to walk around the block without going 3 legged..! So I assumed that it was just a sprain, and she was better! Her hock wasn’t popping and she seemed fine! But today I noticed she is going 3 legged “part-time” and her hock is popping left to right, I wanted to know how can you tell if it is a complete ACL tear or if it is partial…! and if that is what you think it is..?? I have been giving her joint supplement pills everyday since she first started doing it about a month and a half ago, because I thought it would help..! But I’m scared that she will need surgery because I could not afford it anytime soon… but I don’t want her to suffer! so do you have any ideas on what I could do…. I am willing to try anything.!! please help me… thanks

  6. Dr. Michael Dym, VMD veterinarianDecember 25, 2014 at 9:44 am

    Complete tears of ACL’s can be sometimes difficult to diagnose without direct surgical exploration, but usually the diagnosis of a torn ACL, etc is made on physical exam and manipulation of the stifle joint by a competent vet. She may have had a partial tear initially that became more complete with time. I would get second opinion from different vet in your area. Anti inflammatories and joint supplements can help as well as rest, in addition to asking about laser therapy, as well as even some vets now using special types of braces for these dogs, instead of surgery. I also like supplements known as gemmotherapies, which you can read about on line to help these dogs. The ones I would recommend are Common Birch, Black currant, and Wild Woodvine.

  7. I have a 7 year old, 30 lb Australian shepherd mix who has completely torn her ACL. What is the best recommendation for a dog this size? My vet seemed pretty confident surgery is the only way and a TPLO is best. Any help, thoughts, suggestions about the different types of surgeries or treatments would be greatly appreciated!
    Thanks!

  8. Jonathan Van LingeMarch 14, 2015 at 10:32 am

    I have an 8 year old corgi who had a fully torn ccl in 2012 surgically repaired. Now she is favoring the opposite leg, she toe touches and put some weight on it. Took her to the vet and he said there is movement but it doesn’t feel totally torn. She had been put on kennel restriction for two weeks and 75 mg of rimadyl daily (1/2 tablet every 12 he’s). Since her 2012 surgery she’s been taking cosequinn, vitamin e, and fish oil daily. Are there other supplements that may help or be better?

  9. Dr. Michael Dym, VMD veterinarianMarch 18, 2015 at 12:41 pm

    I would try Tumeric at dose of 10 mg per pound twice daily. Also consider antioxidants like proanthozone from 1800petmeds, as well as gemmotherapies, which you can read more about at http://www.thepetwhisperer.com

  10. Dr. Michael Dym, VMD veterinarianMarch 18, 2015 at 1:41 pm

    Surgery is probably your best option and consultation with a veterinary orthopedic surgeon.

  11. I am confused! You are recommending so many different supplements to help with ACL tears…. which one is the most effective and can some be used with others? You have recommended several supplements/meds to treat one dog but does this mean they should all be taken or to choose just one?
    My dog is about ten years old, weighs 60lbs and has a torn ACL. She was on a pain/anti-inflammatory prescribed by the vet but when I ran out I did not renew the prescription thinking that a pain med might encourage her to use the injured leg more. I am restricting her movements as best I can. It has now been seven weeks and I see no improvement at all… she is still walking on three legs all the time.

  12. How many ligaplex should I give my 70lb put a day for his torn acl?

  13. Hello , I have a four year old female boxer mix who I believe has a full ACL tear . What supplements ? There are so many out there and I am a little overwhelmed . Thank you so much 🙂

  14. Hi Dr. Dym, I have a 5-year-old 100 pound Rottie mix who was just diagnosed with an ACL partial tear. He can still go up & down stairs and can run after the mailman but doesn’t jump up on the bed anymore. I’ve seen him lift that back leg sometimes like he’s trying to take weight off it. I haven’t heard him whimper so I don’t think he’s in pain and our vet said that too. The vet gave us a prescription for Rimadyl 100 mg and my dog will receive the last pill today. I’d like to start him on supplements and read all the comments above with your suggestions. I wrote down “super joint enhancer”, omega 3 fatty acids like “Nordic naturals omega 3”, “proanthozone”, “Ligaplex II”, “yucca intensive”, and “Canine Health” by Life Vantage. I don’t want to over supplement my dog so I’m wondering if you could recommend the best two or three supplements for my dog with his unique circumstances, unless you think he would really benefit from all the supplements listed above? Thanks for your advice and time.

  15. Hi Kim. thank you for your question. These are all excellent supplements that you ask about. I would probably start with Proanthozone, Super Joint enhancer, and Nordic Naturals Pet Omega 3 from 1800petmeds. I have also found that supplementing with the spice Tumeric or Curcumen(main ingredient in Tumeric) at dose of 500 mg twice daily also can help as natural anti inflammatory for body, especially the joints. You also might want to consider working with a good, classical, constitutional homeopath, as many of these issues are genetic and constitutional in Rottis and are often due to an autoimmune/immune mediated, gradual and slow destruction of the ACL and meniscus of the stifle, which very often will eventually completely tear, even with good supplements. Over 50% of affected dogs, will often tear their other side as well. To learn more about homeopathy, see the booklet on the website http://www.beyondflatearth.com as well as the info on my website http://www.doctordym.com Many homeopathic vets do offer phone consultations.

  16. I have a 65 lb, belgian Shepherd , a month ago she had surgery {Ant.Cruciate Repair Large} now I walk her not to far, and even when I don”t she is limping, it cost me 1,500 dollars , now she is still limping, .The vet examed the lower part of the left leg where the surgery was done, by pressing in on it ,but it didn”t bother her , when the vet moved up to the side above where the surgery was, she was hurting , when xrays were taken there was nothing wrong with her hips, they were fine, so the vet told me it must be a nerve, but she really didnt no. my dog is 5 years old, and she is on 5 pain pills a day, I don”t no what to do, she needed the surgery , now she seems worse and nobody has answers.

  17. Hi MAureen. Best to get second opinion from another veterinary orthopedic specialist in your area, or a veterinary neurologist if needed, if a proper diagnosis is needed and your current vet is stumped. I would also make sure on good joint supplement like super joint enhancer and yucca intensive by azmira from 1800petmeds.

  18. Antoinette AdamsJuly 7, 2017 at 10:58 am

    Hi Dr. Dym

    I have a 2 yr old South African Boerboel he has a partial acl tear. Koli is currently doing hydrotherapy and cold laser therapy once a week. He was diagnosed with this a little over a month ago. Koli weighed in at 160 lbs and just last Saturday he is now 163.5 lbs. my concern is the weight gain which can prolong the healing process its really hard dealing with this situation. so my question is what else can I do to manage the weight gain and something to really help with rebuilding the ligaments around the knee?

    thanks
    Antoinette

  19. HI Antoinette. I would put him on some good joint supplements like Glycoflex III from 1800petmeds, as well as good fish oil like Nordic Naturals Pet Omega 3 fatty acid from 1800petmeds. Also can use antioxidant proanthozone and Yucca intensive. Low potency Rhus Tox and Ruta Graveolens homeopathic remedy at 6c potency twice daily for a few weeks can also help.

  20. Hi Dr. Dym,
    I have a cocker spaniel 10 years old, who the vet diagnosed him with ruptured anterior cranial cruciate ligament. He immediately put him on Carprofen 75mg one table daily. He took blood test before giving him the medication to check his liver function. He was fine. Today I did a second blood check after two weeks to check his levels, to make sure that the medication is working and does not have a bad reaction from it. Waiting to see his blood results second time. It happened one month ago.The vet examined his leg and diagnosed him without taking the x-rays. He told me that the x-rays are not helpful unless I’m doing the surgery. I do not know if he has a partial rupture or a total rupture. The dog is not not putting the full weight on the posterior left leg. He puts the leg down but most of the time when he walks he keeps it up. The vet suggested that the best option is the TPLO surgery. He also mentioned that the other natural treatments like acupuncture or prolotherapy may stabilize the leg but not to the full extent. My concern with the surgery is the 3-4 months recovery period, and the fact that even with the surgery later on he can develop arthritis on that leg, etc.
    I looked online at the ortho-pets braces coupled with rehabilitation therapy. Not sure what is the best treatment for him, and would like your advice if possible.
    I very much appreciated.
    Thanks,
    Daniela

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