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Cruciate ligament  injury/ rupture in dogs

If you’re reading this the chances are your dog has a suspected or confirmed cruciate rupture. I’ll be talking about mine and Lilly’s experience of cruciate ligament rupture in dogs. It’s such a worrying time for us dog owners and watching our beautiful, loyal friends limp around can be heart wrenching. 

So what is the Canine Cranial Cruciate Ligament and what does it do?

The cranial cruciate ligament often written as CrCL in dogs is the same as the “anterior” cruciate ligament (ACL) in humans, I’m sure you will have heard of footballers and athletes injuring this and potentially ending their careers.

 But what exactly is it, well it’s a band of tough fibrous tissue that attaches the femur (thigh bone) to the tibia (shin bone), preventing the tibia from shifting forward in relation to the femur. It also helps to prevent the stifle (knee) joint from over-extending or rotating. 

However, this injury is different in dogs compared to humans. Rather than breaking because of a sudden trauma as is common in humans, a dog’s cruciate ligament has a tendency to degenerate over time a bit like a rope fraying over time with use. This difference in how the injury occurs is also why the treatment differs between humans and dogs. 

There are some breeds of dogs that are predisposed to cruciate injury they include Labradors, Rottweilers, Boxers, West Highland White Terriers and Newfoundlands, though any dog can injure their cruciate. It is highly likely that if your dog injures their cruciate ligament in one leg they will also injure the cruciate in the other leg too. 

Treatments range from non-surgical management to surgical interventions such as the Tibial Tuberosity Advancement (TTA) or Tibial Plateau Leveling Osteotomy (TPLO). Your orthopaedic vet will explain in more detail which option is best for your dog as it varies from case to case and their decision will be based on the evidence they gather from Examinations, X-Rays , CT or MRI, breed, lifestyle and so much more!

Our experience 

On July 6th 2020 Lilly went out with our dog walker, something we’ve done since Lilly was about 18 months old when I worked full time away from home and later to keep her sociable with other dogs . Little did I know that this particular walk would start us on a new journey! 

I was busy working when I received a text from the dog walker saying they were on their way back, but Lilly had hurt her leg and was limping. I went to meet them at the side door and Lilly was completely off her left hind leg, which was unusual. She was also pretty muddy from her walk as it had been raining for a few days prior. First mission was to get her clean, but throughout her shower it was clear that her leg was causing discomfort. Now being off a leg for a little while isn’t an emergency per say, and sometimes these things go away with a little rest. I did, however, record her ‘walking’ around the garden and sent this to a friend who is a vet. She told me to make an appointment the next day and that she thought it may be a cruciate injury.

July 7th, Lilly was still off her leg and I had slept on the sofa downstairs with her. Usually we’d have both been upstairs, in bed. I called the vets and we had an appointment for 3pm. So we went to this appointment and due to covid-19 I had to remain outside whilst the vet examined Lilly. When she returned, the look on her face kinda gave it away, I’m lucky as I have worked with this vet in the past and I know that look usually does not mean great news! The vet graded Lilly’s lameness as severe and prescribed anti-inflammatory meds and said she too thought it was cruciate but that the practice’s orthopaedic surgeon was on annual leave until July 22nd. I wasn’t prepared to wait that long so started looking at alternatives and was recommended, Dr Mark Owen of Ossicle Referrals based at Rowe Referrals in Bristol.

I made contact with my veterinary practice and asked them to refer Lilly to Rowe Referrals, it usually takes 2 working days for contact to be made by the referral practice. So as the end of day 2 was approaching I decided to call to ensure the paperwork had been received. Thankfully it had but I was asked to send a video of Lilly walking to them. I got straight on it and emailed over a video of Lilly not weight bearing on her left hind leg. Within 1hr 18 minutes I was receiving a call back, asking if we could attend on July 22nd this would be to X-ray, examine and if required complete the operation. This was fine for us, but the lady I was talking to said that if there was a cancellation then Mark would like her in sooner, again this was absolutely fine for us as I work from home anyway. 

On Monday 13th July I received the welcome email letting us know the information for our appointment, the Covid-19 procedures in place and what to expect, also included was the paperwork for a direct claim with our insurer. So I set about completing this and sending it all back. Come the afternoon of Tuesday 14th July I received a call asking if I could take Lilly on Wednesday 15th July at 8:30am, as there had been a cancellation!

This was perfect! By this time I’d already been sleeping on the sofa for over a week, Lilly still wasn’t weight bearing and would occasionally toe touch. I’m not going to lie, I know the risks of rupturing the cruciate ligament in the ‘good’ leg are high, so I was very keen to reduce the amount of time Lilly was off her injured leg. 

I had ordered a medical pet suit 4 in 1 top and hind legs to arrive for the initial surgery date of the 22nd, as Lilly has NEVER kept a cone on. You’d put it on and it would be off in minutes no matter what you did, this is something our veterinary practice dealt with themselves when she was spayed! Now there was no chance this was going to arrive in time for Lilly to wear it right from the start so we would just have to wait.

The night of the 14th into the 15th of July was strange, I’d prepared what we needed to take with us as we’d have to leave at 6:15am to get there in time and allow some spare time for traffic. It was a restless night everything went through my mind and I mean everything, I kept waking thinking I’d overslept and we’d missed the appointment! We hadn’t and it was only 20 minutes later than when I last looked at the clock!

When my alarm finally did go off, it was get up and go time! I had prepared everything other than the cooler bag for Lilly’s food. Thankfully the staff at  Rowe were more than happy to continue feeding Lilly her raw food, whilst she was with them. Other veterinary hospitals I had looked at would not allow this, which really put me off using them. Just before heading off I popped Lilly’s meals into the cooler bag with an ice block for the journey ahead.

Lilly in the car in way to Rowe
In the car on our way to the veterinary hospital

For our journey I had put Lilly’s Zippy bed which she has had since she was a puppy into the back of the car. Normally Lilly would be in a crate but, if I’m honest there’s just no way I could have gotten her in and out of it again safely without hurting her. Thankfully Lilly simply laid in her bed for the journey to Rowe and was really well behaved. We arrived there for around 8:10am so I phoned through to let them know we were there and ask if there was a toilet we could use. Thankfully there was but we’d be required to wear a mask and gloves, which wasn’t an issue at all as I’d made reusable masks with a filter pocket that we’d taken with us. I complete the paperwork required and signed the authorisation for radiographs, examination, nerve block and the TTA or TPLO procedure if it was required. The estimated cost for the surgery and follow up xrays were clearly listed. 

I attached the vets slip lead and removed Lilly’s harness and collar before lifting her out of the car, handing over her food and saying my goodbyes. We were advised that the vet would call us around lunch time to discuss the examination findings, x-ray results and discuss next steps. Lilly went with the nurse without issue. She did look back a few times but was otherwise ok. 

The drive home felt so strange driving from England back into Wales knowing my girl wasn’t with us. 

When we got home I set about putting up Lilly’s XL crate, which she again had as a puppy. I gave it a good clean and went to get her amazing Tuffies bed to go in the crate. The Tuffies bed has a futon mattress which is super supportive and gives the bed its weight. I also purchased with the Tuffies Wipe Clean bed a couple of stunningly soft and snuggly thick fleece covers. I grabbed a blanket that we usually use on the bed to cover the top of the crate to make it more of a den and placed a vet bed right outside the crate. 

Lilly in her crate
Lilly in her crate post op, with her Tuffies bed inside and vet bed outside.

When the phone rang it was Dr Mark Owen, explaining his findings. It was as we expected a Canine Cruciate Ligament injury, she had failed the draw test, was severely lame and the x-rays showed osteophytes and typical signs of cruciate injury. However, her right leg, nothing abnormal was detected which was fantastic news!

Mark asked how much I knew about this type of injury, and Lilly’s activity levels. I explained I had experience in a veterinary practice and that I had studied Forensic Anthropology (osteology is massive in this degree). I know a lot of the terminology and have a good understanding of the procedures and complications etc, along with bone regrowth and having titanium plates in my face I know the risks of plates and screws and management of arthritis post op long term.

Lilly is pretty active, we walk the local mountains and 4-6 miles is a fairly good average for us. With that information Mark confirmed he would be going ahead with the TTA procedure. We had a good conversation and was advised that I’d get a call again between 5pm and 7pm once Lilly had come round from the anaesthetic.

The wait was hard, anaesthetic isn’t without risk and it’s not exactly a straightforward surgery either. However, true to his word Dr Mark Owen called me again at 5:42pm to say all had gone well and that it was a complete rupture of the cruciate, however the meniscus (the cushion between the joints) was intact, which was great news. He also said that Lilly was awake and doing well and that I could call through the night if I wanted to, which was great. I did call around 9:30pm just to make sure she was ok before going to bed myself and thankfully she was. The nurse I spoke to said that she had been to the toilet and had eaten since the last call! This really put my mind at rest.

Around 7:41am the on duty vet called to update me on how Lilly had been through the night. Thankfully she had been great, she’d moved around using the left hind leg and had had a comfortable night. The vet arranged with us to collect Lilly at 1pm so we’d leave home at around 11am to get there in time. When we arrived I had an authorisation form to fill in for the direct claim and had to pay a fee for Rowe to deal with this and also pay the standard insurance excess, all of which we were aware of anyway. 

When Lilly was brought out she was walking on all fours, an occasional limp from the back left but hey that’s to be expected! She wasn’t even 24 hours post op yet! She had a dressing over the incision and a buster collar and her blue XL comfy cone too. I was so pleased to see her wiggly Labrador butt heading our way! The clipping of her fur goes from just above the hip, down to just below the start of the hock and inside the groin area, it was pretty darn neat and no clipper burn! 

I lifted Lilly into the back of the car, put her collar and lead on and gave back the vets slip lead. I was handed a really comprehensive discharge information pack along with more metacam to see us through. The appointment was made for the follow up x-rays on the 1st September.

On our way home from Rowe
on our way home

The Journey home was a little bumpy, more because of the roads than Lilly to be honest, though she did get a little car sick on the way which did land on me but that wasn’t a problem. As soon as we got home it was straight into the crate to start our road recovery. I sat down and read every word of the discharge paperwork whilst Lilly slept. I highly recommend you do the same, anything that you’re unsure about, please phone your vet and get it clarified. 

I also recommend if you’re on Facebook joining Canine Cruciate Recovery (TPLO, CM etc.) the group members are mainly in the USA but there are members from all over the world. They are a fantastic support group  and all have been in the same position you are! 

Conclusion

So there you have it, the start of our journey from injury to recovery from canine cruciate ligament injury. I hope you’ve found this post helpful in some way.

I will be writing about my must have items for canine cruciate injury recovery and also questions to ask your vet prior to surgery. I’ll also continue to write about our journey to recovery so please subscribe to the newsletter to know when I release new blog posts.