One of the biggest growing and expensive to treat orthopedic epidemics seen in dogs today is the increasing numbers of dogs (and to a much lesser extent of 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, as you read in a previous blog. 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 of 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, Be Well, 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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One Comment
Hello, Suggestions/advice very appreciated — My 2 1/2 yr. old Aust. Shepherd has completely torn ACL back knee. The other is partially torn. Ortho vet suggesting surgery in partially torn knee first, waiting a bit, then doing completely torn knee. What is your opinion on doing the worst knee first , with hope that partially torn knee heals with rest. Money is an issue. Price for surgery $1600 per knee for nylon thread (I think this is called Extracapsular Stabilization). Dog weighs 70 lbs. Thank you.
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Dr. Michael Dym, VMD veterinarian Reply:
May 19th, 2010 at 10:45 pm
I have seen many dogs with partially torn cruciate ligaments heal with rest and ant inflammatories along with use of joint supplements. So I think that would be fine approach to repair the completely torn knee only to start. Even the best surgeons acknowledge that dogs WILL develop degenerative joint disease even in surgically repaired ACL’s. The supplements I would use long term include super joint enhancer, omega 3 fatty acids like nordic naturals omega 3, the antioxidant proanthozone, all which you can get from 1800petmeds. I would also look into the supplement Ligaplex II from company called Standard process, which is wonderful for strengthening ligaments when used over time.
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