Emma Chandley BVetMed PGCertSAS MRCVS
Introduction
Cruciate disease, commonly known as cranial cruciate ligament (CrCL) disease, is a frequently seen orthopaedic issue that affects our dog's knee joints. This condition can cause significant pain, lameness, and long-term mobility issues if undetected and left untreated. Cruciate disease is especially common in older dogs, and it is important for dog owners—particularly those with senior pets—to understand how to recognise, manage, and prevent it.
What is Cruciate Disease?
Cruciate disease affects the cranial cruciate ligament (CCL) in dogs. This ligament is similar to the anterior cruciate ligament (ACL) in humans. The ligament has the important job of stabilising the knee joint (stifle), preventing excessive movement between the femur and tibia. If the CCL weakens or ruptures, the knee joint becomes unstable, leading to pain, inflammation, lameness, and in severe cases difficulty walking at all.
Cruciate disease can be gradual, developing slowly over time due to ligament degeneration. Alternatively, it can occur suddenly due to trauma or an awkward movement. Dogs suffering from this condition often experience limping, difficulty standing up, reluctance to bear weight on the affected leg, and stiffness - particularly after rest.
Causes and Risk Factors
Several factors can contribute to cruciate ligament injury in dogs, these include:
● Genetics – Some dogs are genetically predisposed to rupture and degeneration of ligaments, making them more prone to cruciate injuries.
● Conformation and Joint Structure – Dogs with poor hind limb conformation may experience uneven pressure on their knee joints, leading to ligament degeneration over time.
● Age and Breed – Middle-aged to older dogs, particularly larger breeds such as Golden Retrievers, Rottweilers, and Labradors, are more susceptible to cruciate disease. However, smaller breeds can also develop this condition.
● Obesity – Excess weight places additional stress on the joints, increasing the risk of ligament damage.
● Activity Levels – While regular exercise is essential, sudden strenuous activity or jumping from high surfaces can increase the risk of injury.
Clinical Signs of Cruciate Disease and Injury
Cruciate disease often presents itself with the following signs:
● Sudden or gradual onset of lameness in one or both hind legs.
● Difficulty getting up, walking, or climbing stairs.
● A stiff or unsteady gait, especially after rest.
● Swelling around the knee joint.
● Sitting with one leg extended to the side instead of tucked underneath.
● A clicking or popping sound from the knee.
If you notice any of these symptoms in your dog, it is essential to seek veterinary attention promptly to prevent further complications.
Diagnosis of Cruciate Disease
A vet will typically diagnose cruciate disease through a combination of:
● Physical Examination – By manipulating the knee joint, your vet will check for instability, pain, and swelling. The “drawer test” and “tibial thrust test” help determine ligament integrity.
● X-Rays (Radiographs) – These may be recommended to assess joint structure, rule out fractures, and check for signs of arthritis.
● Advanced Imaging – In some cases, an MRI or CT scan may be needed to confirm ligament damage.
Treatment Options
The treatment for cruciate disease depends on the severity of the injury, the size of the dog, and overall health.
Non-Surgical Management
For dogs with mild injuries, small breeds, or those unsuitable for surgery, conservative management may be effective. This includes:
● Weight Management – Maintaining an ideal weight reduces strain on the joints and slows down disease progression.
● Restricted Exercise – Short, controlled walks help prevent further injury while keeping muscles active and strong.
● Pain Relief and Anti-Inflammatories – Vets may prescribe NSAIDs (non-steroidal anti-inflammatory drugs) to manage pain and inflammation.
● Physiotherapy and Hydrotherapy – Strengthening surrounding muscles through gentle rehabilitation exercises can improve stability.
● Joint Supplements – Nutritional supplements can help support joint health and reduce inflammation.
Surgical Options
For moderate to severe cases, surgery is often the best solution to restore stability and function to the knee joint. Common surgical techniques include:
● Tibial Plateau Levelling Osteotomy (TPLO) – A surgical procedure that changes the angle of the tibia, reducing the need for the cruciate ligament.
● Tibial Tuberosity Advancement (TTA) – Similar to TPLO, this surgery stabilises the knee by altering the biomechanics of the joint.
● Extracapsular Repair (Lateral Suture Technique) – A method commonly used in small to medium-sized dogs where a synthetic ligament is placed around the outside of the joint to stabilise it.
Post-operative rehabilitation is crucial for a successful recovery. Physiotherapy, controlled exercise, and joint supplements play a vital role in ensuring long-term joint health.
Prevention of Cruciate Injuries
Although cruciate disease cannot always be prevented, the following steps can reduce the risk:
● Keep Your Dog at a Healthy Weight – Reducing excess weight minimises stress on the joints.
● Regular, Low-Impact Exercise – Consistent, moderate exercise strengthens muscles without overloading the ligaments.
● Avoidance of High-Impact Activities – Minimise activities that involve sudden twisting, jumping, or running on slippery surfaces.
● Provide a Balanced Diet – A balanced diet rich in omega-3 fatty acids, collagen, and antioxidants supports joint health.
● Use Supplements – Joint supplements can be beneficial in maintaining joint flexibility and reducing inflammation.
Living with Cruciate Disease
For senior dogs or those with chronic cruciate disease, long-term joint care is essential. Orthopaedic bedding, ramps instead of stairs, and maintaining a stable exercise routine can improve comfort and mobility. Regular vet check-ups help monitor progress and adjust treatment plans as needed.
Additional Support for Senior Dogs
Older dogs with cruciate disease often require extra care to maintain their quality of life. Providing non-slip surfaces in the home, using raised feeding stations, and incorporating gentle stretching exercises can also improve mobility. Acupuncture and laser therapy have been shown to provide some relief and may be useful complementary treatments for managing chronic joint conditions.
Conclusion
Cruciate disease is a common but manageable condition in dogs, particularly in older and larger breeds. Early diagnosis, appropriate treatment, and ongoing joint care can significantly improve a dog's quality of life. Whether through surgery, physiotherapy, or joint supplements, supporting your dog's knee health ensures they remain happy and active for years to come. If you think your dog may have a cruciate injury, consult your vet for a tailored care plan that best suits their needs.
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