Dealing with Cruciate
Ligament Injuries in Labrador Retrievers
(As seen in the Purina Labrador Retriever Update January 05)
Chances are your Labrador Retriever may have experienced a ruptured cranial
cruciate ligament (CCL). It’s the most common orthopedic injury seen by
veterinarians and is exceedingly common in Labradors, says one expert.
Kurt Schulz, D.V.M., M.S., DACVS, associate professor of surgical and radiological
sciences at the University of California-Davis School of Veterinary Medicine,
says, “Labradors tend to be active dogs that take part in a wide-range
of sports. CCL tears are very common in Labs. This may be due in part to a genetic
disposition and a tendency for less active dogs to get overweight. Unfortunately,
there is no known way of preventing CCL injuries, because we don’t know
the underlying cause. Controlling body weight is the single most important step
an owner can take to minimize the risk of this problem. Moderate activity and
fitness are beneficial.”
A dog’s CCL is similar to the anterior cruciate ligament (ACL) in humans.
Located in a dog’s stifle (knee joint), the CCL plays a key role in stabilizing
the femur (thigh bone) on the tibia (shin bone) and allowing a dog to bear weight
on his or her leg. “When the CCL tears, the two bones are destabilized
and the dog becomes lame,” Schulz says. “Unless the injury is treated
fairly quickly with surgery, painful arthritis will likely set in.”
“Sometimes a dog can tear its CCL either partially or completely as a
result of a traumatic injury like twisting or wrenching the knee,” Schulz
says. “But the ligament can also slowly stretch and tear over time, resulting
in a chronic, insidious injury. When that happens, a dog might limp for a while
but regain use of the leg until the complete tear occurs and the dog is no longer
able to put weight on the leg.”
Determining CCL Ruptures
If your dog starts to limp, you should take him to the veterinarian immediately,
Schulz recommends. “Early treatment is important to stave off cartilage
damage, which leads to arthritis,” he says. “Since a cruciate tear
doesn’t show up on radiographs, in the vast majority of cases we don’t
X-ray.”
Instead, your veterinarian will likely evaluate the way your dog is walking
and palpate his legs, feeling the knees carefully for any slipping, Schulz says.
“Your veterinarian will flex the knee to see whether the top of the tibia
can be pulled forward abnormally, like a drawer, indicating a CCL tear. Your
veterinarian may also pull the affected leg out to the side checking for instability,”
he says.
A partial cruciate tear doesn’t necessarily result in instability. “If
a portion of the ligament is intact, the veterinarian may not feel the instability,”
Schulz says. “In that case, it is helpful for a veterinarian to view the
ligament either through surgery or arthroscopy, a procedure in which a small
camera is attached to a scope, for diagnosis of a cruciate problem. For a definite
diagnosis, it is important for a veterinarian to either feel or see that the
CCL is torn.”
During an initial examination, a veterinarian should base treatment and recovery
recommendations on an individual dog, says Denis Marcellin-Little, D.E.D.V.,
associate professor of orthopedic surgery at North Carolina University College
of Veterinary Medicine. “A dog’s fitness level, the extent of the
injury, the level of pain, and the functioning of the joint all factor into
the decision. Surgery is important, but what happens before and after surgery
will be important as well.”
Surgical Options
Surgery to stabilize the knee is usually the treatment of choice for dogs over
20 pounds, Schulz says. There are several types of surgery, and the best choice
will vary for an individual dog. Surgery may range from $600 to $3,000. Surgical
techniques used to repair CCL tears include:
Surgical Recovery
Surgical
Tips from a Breeder |
The good news
about surgery for CCL ruptures is that it is frequently curative, meaning a
dog can go back to normal use of his leg. The bad news is that the surgical
recovery takes from six to 14 weeks, and a dog must be quiet and controlled
during this time. Recovery depends on the body condition and age
of the dog and the surgical procedure performed.
Though it may be difficult to keep an active dog quiet for six weeks or more,
it is crucial, says Schulz, noting that consequences of noncompliance are serious.
“Allowing a dog to be active during surgical recovery can lead to complete
surgical failure, as well as infection,” he says. “And if surgery
fails,
a second operation may be necessary. There should be no running, jumping, falling
or slipping during recovery.”
Breeder Laura Michaels of Flint, Mich., was concerned about surgical recovery
when her 4-year-old Labrador, “Darby,” required a CCL repair in
2001. “I was frantic about the diagnosis and the thought of trying to
keep her quiet so long,” she recalls. “With six other dogs in the
house, I didn’t think I could do it.”
Michaels, who breeds under Woodhaven Labradors, participates in agility with
her dogs. She thought she noticed a misstep when Darby was practicing weave
poles, then later that night noticed Darby was tentatively putting weight on
the leg. A visit to the veterinarian confirmed the diagnosis. “Darby had
TPLO surgery, and the recovery was swift and complete,” Michaels says.
Physical Therapy
Post-surgical physical therapy and rehabilitation are key in a dog’s ability
to regain full function of the knee joint, which is especially important for
working Labradors. “Professional physical therapy can be extremely helpful,
but there is an additional cost,” Schulz says.
“We recommend physical therapy at different intensity levels, depending
on factors like a dog’s fitness level and age,” says Marcellin-Little.
“It is far from being a cookbook approach. While physical therapy can
be beneficial, any activity your dog receives post-surgery should be coordinated
with your veterinarian.”
Future Injuries & Prevention
Unfortunately, once a dog has had a cruciate injury in one knee, it’s
not unusual for him to have the same problem in the other knee. About 30 percent
of dogs that have surgery in one knee will require in the other, Schulz says.
In addition, a CCL tear can lead to injury of the meniscus, the two cartilage
cushions that sit inside the knee and serve as shock absorbers when a dog walks.
“If the meniscus tears, it can very painful for the dog and must be treated
surgically,” Schulz says. “About 50 percent of completely torn cruciate
ligaments lead to meniscal injury. When the meniscus is torn, the knee will
make a characteristic popping sound when the dog is walking.”
Since there is no known way of preventing a CCL injury, veterinarians speculate
on prevention. “While it is believed there may be a genetic connection
in CCL tears, the exact connection isn’t known,” Schulz says. “It
is likely in the future we will identify characteristics to avoid in breeding.”
In the meantime, it is thought that carrying excess weight may place a dog at
increased risk of CCL injuries. “It makes sense that overweight dogs are
at a greater risk for CCL tears,” says Marcellin-Little, adding that it
has not been scientifically proven. “The most important thing owners can
do is to watch their dogs closely for limping or reluctance to bear weight on
their leg. The sooner a CCL injury is discovered, the better.”
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