Cranial Cruciate Ligament Rupture
"Honey Bee is limping again. What should we do?" "Oh, give her a couple of aspirin, and she'll walk it off."
So here you are, sitting in your veterinarian's office because Honey Bee has not improved. You may have also noticed the slight eye twitch the vet/assistant/technician has developed while you recounted the tale of the mysterious limp.
Lameness is one of the most common veterinary sick visits that we see. There are many reasons for Bee may have begun limping, and knowing what to tell your vet staff will make the process much easier (and hopefully cheaper) for you. A medial luxating patella, soft tissue injury, arthritis, and fractures are other significant causes of limping I will eventually cover. So part one: cranial cruciate ligament rupture.
The two most important lessons from these articles:
You should never, ever use online resources as a means to attempt to diagnose or treat any disease.
Do not give your pet medication without consulting a veterinarian first.
Do not. Give your pet. Medication. Without consulting. A veterinarian first.
Worst case scenario, you could seriously injure your pet or delay treatment. In the best-case scenario, we will judge you. Heavily. Now, on to Bee and her limp.
An animal's cranial cruciate ligament (CCL) is equivalent to the anterior cruciate ligaments (ACL) in humans. Animals have cranial (towards the head) and caudal (towards the rear). Humans have anterior (front) and posterior (rear)—the CCL/ACL's role in stabilizing the knee by attaching the femur to the tibia. So, if you play a game of soccer and plant your leg down, someone hits you from the side. Femur moves to the side, tibia stays where it is, knee gives up, and you and your parents' bank account screams (sorry, mom and dad).
That scenario is unlikely for Honey Bee unless she is secretly Air Bud. However, the idea is the same and especially true if Bee carries a little more weight than she should. Often, our patients have been rough housing or chasing after a squirrel. Giving a detailed history to your veterinarian can help narrow down the next steps.
Cranial Cruciate Ligament runs from the back of the femur to the front of the tibia.
Diagnostics - When the CCL ruptures, the knee becomes unstable and shifts, unlike a healthy knee. An injured animal in a strange place with an area that hurts when touched is not ideal, and the patient may be placed under sedation. Veterinarians can manipulate the knee and feel for instability in some cases. An X-ray also allows us to rule out other causes of injury, such as fractures. Every veterinarian will do things differently but with the same goal. Using the history, you tell us will guide our diagnostics and treatment recommendations to make your pet feel better.
Treatment - Bee has undergone the necessary diagnostic steps, and the veterinarian has determined her CCL is ruptured; now what? Your two basic options are surgery or no surgery. Surgical correction involves altering bone to stabilize the knee or using a high-strength suture to simulate a CCL. Non-surgical consists of managing the pain with long-term medication. Managing this way is not usually recommended as reinjury and arthritis are common. This post is already too long, so I won't discuss the procedures. Your vet can guide recommendations based on your pet's age, size, and underlying history.
Keeping your pet at a healthy weight is extremely important. Many pets will injure the other knee once one CCL is damaged, especially if they are overweight. Like with people, activity restriction will be the most critical part of recovery for nearly any injury. We can also use medications to help reduce inflammation and pain. However, many of these medications do not play nicely with each other. Mixing pain meds can cause severe gastrointestinal issues, so always let your vet know if you give medications at home, especially over-the-counter medications.
Prevention - The best way to prevent CCL rupture is to keep your pets at a healthy weight (see nutrition post). Calling your vet when you first notice limping is also essential. Yes, many cases heal independently, but your vet's office can document the call and offer advice. This goes for any illness or questions you may have. By keeping Honey Bee's weight down, not giving over-the-counter medications, getting her to the vet promptly, and following activity restriction recommendations, her owners gave her a shot at the best outcome. Which is, the Bee's Knees.
For more information on CCL rupture from Veterinary Partner : Ruptured Cranial Cruciate Ligaments in Dogs
