Cruciate Ligament Rupture

[Airedaler]

Touch wood, I've never had a dog with a cruciate ligament rupture but it does seem to be very common.

I came across the following article.

http://tinyurl.com/n6vey3e

My recent experience with totally different ailment being treated by an holistic Vet rather than my conventional (very competent) Vet has led me to realise that too often we treat the symptom not the problem as is the suggestion in this article.

Would be interested to know what others think.

[superminty]

Very interesting article and one I will chat to my vet about. I opted for non-surgical repair when my 9 year old was diagnosed with a torn cruciate and she has had three really good years now with no lameness. I'm always keen to avoid surgery where possible.

[korbin13]

The article comes across, to me anyway, as don't spend your money on surgery, spend your money on my cure (plugging his upcoming course). Nothing wrong with that I suppose but the reader needs to keep this in mind.

My JRT x (deceased) had cruciate issues and didn't need surgery, just management as recommended by the vet.

My mastiff x has had two TPLO surgeries. First one I tried the conservative management pathway but after three months she still couldn't put her full weight on the leg, second leg, I just went straight to surgery.

Both my dogs ruptured their cruciates while sprinting. They haven't just developed. Possibly it was genetic, who would know?

Like most things in this world, individual cases should be treated differently.

[Erny]

I have a lot of respect for Dr Jean Dodds. I spoke with her a long time ago and do believe there is a connection between thyroid issues and cruciate break-downs. That this article is suggesting a connection between cruciate break-downs and auto-immune issues makes sense to me, as thyroid issues + auto-immune issues are also often hand-in-hand.

I think there's much in the thoughts behind that article that would do well to be taken into account.

[Erny]

Very interesting article and one I will chat to my vet about. I opted for non-surgical repair when my 9 year old was diagnosed with a torn cruciate and she has had three really good years now with no lameness. I'm always keen to avoid surgery where possible.

That's fantastic, Superminty!

[curly]

Very interesting. I bred a dog who just had the expensive surgery. She has great conformation and great hips, so it wasn't an inherited weakness (and none of her generations of relatives have had this injury). I'd say she injured the leg 'cause she's large, active and very unfit and undermuscled.

Funny thing, she's been on antibiotics, anti-this and anti-that for some time. Her ears are yeasty, her skin is oily and she's shedding huge amounts of coat (this is a poodle!). Clearly the drugs are really messing up her system.

[superminty]

Very interesting article and one I will chat to my vet about. I opted for non-surgical repair when my 9 year old was diagnosed with a torn cruciate and she has had three really good years now with no lameness. I'm always keen to avoid surgery where possible.

That's fantastic, Superminty!

I agree! Another thing my vet recommends is limited, if any, use of NSAIDs - which is referenced in the article.

[westiemum]

Very interesting. I bred a dog who just had the expensive surgery. She has great conformation and great hips, so it wasn't an inherited weakness (and none of her generations of relatives have had this injury). I'd say she injured the leg 'cause she's large, active and very unfit and undermuscled.

Funny thing, she's been on antibiotics, anti-this and anti-that for some time. Her ears are yeasty, her skin is oily and she's shedding huge amounts of coat (this is a poodle!). Clearly the drugs are really messing up her system.

My Mac has had three ACL repairs - the first six months after I got him as a six year old fresh out of a cage/run at a notorious puppy farm. He blew it running across an oval with some other dogs, having the time of his life. My vet commented that his back leg musculature was very underdeveloped - and I think it was caused by living most of his early life in a cage. He went onto blow the other one a couple of years later and had to have 2 further surgeries when the first one failed and the back leg angle had to be re-aligned along with the ACL repair. So while I'm sure there are auto-immune causes I suspect there are other environmental causes as well.

[curly]

Yesterday's vet check up was very interesting. He pulled up the x-rays and drew lines and angles everywhere, demonstrating the action and effectiveness of the joint. Good to see the actual mechanics of the joint. In essence, when this big, bouncy, unfit dog bounced once too often (probably landing in a pothole), without decent muscle to support her, the itty bitty ligament tore. She's now going swimming every day to get some movement and muscle back. BTW, poodle are rubbish at swimming!

Also, it seems the most common type of dogs with ACL injuries are overweight and under active. Anyone surprised?

Edited April 5, 2014 by curly

[Jumabaar]

Another take on this using a human example

In the past it was deemed bad luck if a footballer did an ACL. There were no significant differences in the joint mechanics and other factors were ruled out.

Recently studies that have done more investigation have shown that there is a significant relationship between footballers who have sore backs/, and a poor proprioception (knowing where their body is in space, and how to keep it there) and them damaging their ACL.

Now its impossible for us at this point in time to do this type of study in dogs- but every dog that has a damaged CCL (cranial cruciate ligament which is the equivalent to the human ACL) has had a tight back. This is however after the injury so its impossible to know if this is because of the injury or it was there before. And of course the dogs that do come and see us for physio rarely go on have a CCL injury.

Inflammation is certainly a big part of the picture- and is another reason why the dogs we see don't develop tears because we are very proactive in treating inflammation!

Also any number of pot holes won't matter if the body is working at 10% It is because the muscles that support the joint are not working effectively that allow these injuries (and they can stop working because of inflammation). Swimming is great at cardiovascular exercise and flexibility, but rubbish at helping these supportive muscles to get back to working because they only function against gravity and under bodyweight. Wading is much more effective at rehab than actual swimming.

Sporting dogs quite often get CCL injuries. And fat can actually produce lots of pro- inflammatory substances.

Lots of interesting factors and it is interesting having both a Veterinary perspective and now slowly adding in a physiotherapists perspective.

[Erny]

I agree with Jumabaar - there are more things than meets the eye to cruciate injuries. Diet, thyroid (which in itself can be genetic but also influenced by diet), as well as lack of attention to core muscle exercise can all contribute to this injury. We tend to be reactive to cruciate injuries, dealing with the symptom, rather than focusing a bit more on being pro-active and working to protect the cruciate ligament and reducing the likelihood of occurrence.

[Blackdogs]

Interesting about the link between thyroid issues and cruciate disease. Some studies have linked early desexing to thyroid issues and cruciate disease but not linked them.

[Erny]

It makes sense to me when I think about it. If the thyroid is not functioning as well as it should and given its support nurtures just about every organ in the body, then it is comprehensible that the muscles and ligaments in the body may also be at risk of not receiving the right nutrition for optimum upkeep and I would expect that this would be likely to show up more commonly in the main ligament/ligament fibres as these are the ones taking the most stress and strain in the normal course of the dog's physical actions. It would not surprise me that there is a link between early desexing > thyroid > cruciate either. Everything is intrinsically linked and it all really starts with nutrition balances to the body - diet and/or hormone based.

Just my thoughts.

[Jumabaar]

I agree with Jumabaar - there are more things than meets the eye to cruciate injuries. Diet, thyroid (which in itself can be genetic but also influenced by diet), as well as lack of attention to core muscle exercise can all contribute to this injury. We tend to be reactive to cruciate injuries, dealing with the symptom, rather than focusing a bit more on being pro-active and working to protect the cruciate ligament and reducing the likelihood of occurrence.

Being pro-active is really hard to get people to understand!!

If only all clients were as wonderful as DOLers :)

[Guest Clover]

Yesterday's vet check up was very interesting. He pulled up the x-rays and drew lines and angles everywhere, demonstrating the action and effectiveness of the joint. Good to see the actual mechanics of the joint. In essence, when this big, bouncy, unfit dog bounced once too often (probably landing in a pothole), without decent muscle to support her, the itty bitty ligament tore. She's now going swimming every day to get some movement and muscle back. BTW, poodle are rubbish at swimming!

Also, it seems the most common type of dogs with ACL injuries are overweight and under active. Anyone surprised?

Not the case all the time. Older dogs with muscle loss, running on the sand is quite common, ball chasing, jumping off the couch.

I have noticed a lot of flyball dogs suffering this injury. But not actually doing flyball, just every day to day life.

I would love to do a study on older flyball dogs and retiree's.

We are going on about 18 months with no surgery with my guy and he is doing quite well, getting old but still gets around fine.

Eta: jumbaar & erny

Edited April 7, 2014 by Clover

[ness]

Its interesting to read about the relationship between sore backs and cruciates. For what its worth my girl who did rupture her cruciate has never had issues with a sore back. She also had good proprioception. I don't think there was much I could have done differently to reduce the risk of her having it rupture. She was also only at the local chiro vet 2 months before she did it and had a totally clean report card. Just goes to show you can be careful and still not totally avoid the problem.

[Jumabaar]

Yesterday's vet check up was very interesting. He pulled up the x-rays and drew lines and angles everywhere, demonstrating the action and effectiveness of the joint. Good to see the actual mechanics of the joint. In essence, when this big, bouncy, unfit dog bounced once too often (probably landing in a pothole), without decent muscle to support her, the itty bitty ligament tore. She's now going swimming every day to get some movement and muscle back. BTW, poodle are rubbish at swimming!

Also, it seems the most common type of dogs with ACL injuries are overweight and under active. Anyone surprised?

Not the case all the time. Older dogs with muscle loss, running on the sand is quite common, ball chasing, jumping off the couch.

I have noticed a lot of flyball dogs suffering this injury. But not actually doing flyball, just every day to day life.

I would love to do a study on older flyball dogs and retiree's.

We are going on about 18 months with no surgery with my guy and he is doing quite well, getting old but still gets around fine.

Eta: jumbaar & erny

I am actually hoping to try and do some information collection for flyball first and then other sports. So far in a very small data set I have noticed that the flyball dogs tend to have CCL injuries opposite to their turning side. And as you said it is rarely when they are actually doing sport. This links to what we saw when we recently ran a conditioning class for flyball dogs where they could do some exercises to a very high level, and other exercises they all struggled to do at all. Which indicates that we should be doing much more to keep our sporting dogs strong and healthy.

The dogs have come up with so many ways to try and 'cheat' in the exercises to make it easier and not use the correct muscles (where we then have to out think them to make them use the right muscles!) and this is what they dog to be able to just keep going with life. After 7 weeks the dogs are now actually choosing to use the right muscles without us having to come up with modifications to bias the correct muscles because once they have strengthened them they are actually finding it easier to use the right muscles than the wrong ones. But without that training they would never have gone back to using the correct muscles because the incorrect muscles were the easiest solution- stronger and 'kinda sorta worked ok'. And when this is happening the mechanics in the joints change, and the forces on muscles change and injury (even a minor one) is a matter of when not if. Which means that the dog then adjusts and uses more of the wrong muscles to just continue on.

There have been a few surveys overseas for agility that are interesting and we are hoping to run another course to see if the areas where dogs have been found most likely to injury themselves correlates to their deficiencies as well as the flyball dogs.

There are so many factors and the more I dig the more questions I have!! Its exciting to think about doing it- just a matter of actually doing it.

Also Ness- what we look at is quite different to a chiro, and when i say sore it might never have actually been painful. It might just mean that they are relying on hip flexors rather than the muscles that should support the back. This can be caused by any injury anywhere in the body due which results in compensation. It is part of the whole picture.

But I also agree that there is always the 'perfect storm' which nothing will prevent.

[ness]

I should have said the dog with known stifle issues has however shown significant soreness in through her back as a comparison but agree you can never prevent everything. I suspect in my girls case knowing how many close relatives (littermates/half sisters etc) had cruciate issues at a younger age then she did that it probably helped delay the issue and don't doubt age was a factor and she probably wasn't as well muscled as she would have been in her prime.