What Is Cruciate Disease in Dogs?
The cruciates are a pair of ligaments in your dog's knee joint. Your dog has a cranial cruciate ligament (CrCL) and a caudal cruciate ligament (CdCL). These two ligaments work together to provide stability in your dog's knee joint and allow for it to function as a hinge, bending and straightening.The CrCL also helps prevent the knee joint over extending or rotating abnormally.
The cranial cruciate ligament (CrCL) is the one that is most commonly affected when a dog suffers from cruciate ligament disease. In health the CrCL stabilises the two long bones that form the knee joint, the femur (thigh bone) and the tibia (shin bone), preventing the tibia from sliding forwards in relation to the femur. When the CrCL is partially or completely ruptured, the tibia can slide relative the the femur and the knee joint becomes unstable. This instability leads to pain but also longer term joint damage which will result in the development of osteoarthritis.
What Causes Cruciate Ligament Disease in Dogs?
Many pet parents find themselves asking, what causes cruciate ligament rupture in dogs? Cruciate ligament injuries in dogs can occur suddenly (traumatic injury) or over time (degenerative damage). Trauma, such as a sudden twist or turn while running or during sporting activities, can lead to acute ruptures of the ligament. On the other hand CrCL damage can be caused by the gradual weakening of the ligament (like a fraying rope) due to factors like age, genetics, obesity or repeated low grade trauma to the joint. Initially this ligament becomes progressively weakened or partially torn and the signs at this stage tend to be mild. With continued use however the condition will get worse, eventually leading to complete rupture. Often this occurs at the time of an explosive activity like chasing a squirrel or jumping so the cause appears to be traumatic but actually the ligament was already weakened to begin with. In the vast majority of dogs cruiciate ligament damage is due to gradual degeneration. Unlike dogs, In humans, cruciate ligament injury is most commonly purely traumatic (often a result of skiing or other sporting activities). This is why the treatment recommendations can differ between human and veterinary patients.
Larger breeds, such as Labrador Retrievers, Rottweilers, and St. Bernards, are more susceptible to this condition, but small dogs can be affected too. Obesity also predisposes dogs to cruciate injury. Dogs that have ruptured one cruciate ligament are also predisposed to rupturing the cranial cruciate ligament on the other knee (this is unfortunately very common).
What Are The Symptoms of Cruciate Ligament Injury
Are you asking yourself, how do I know if my dog has cruciate damage? If your dog develops a CrCL injury, the most common sign is sudden lameness or limping in the hindlimb.
Other clinical signs may include:
- Stiffness
- Reduced range of motion
- Difficulty rising
- An altered gait
- Muscle loss in the affected leg.
- Sitting with the affected leg to the side
- Toe touching or non-weight bearing lameness
Cruciate ligament rupture is painful for dogs. It is important to understand that a dog in pain will rarely ever whimper, yelp or cry out.
How Do Vets Diagnose Cruciate Ligament Injury In Dogs?
Veterinarians typically diagnose CrCL injuries through a combination of physical examination, palpation of the knee joint, and imaging tests such as X-rays. Often it is necessary to manipulate the knee joint while your dog is sedated or under anaesthetic to confirm instability in the joint. In some cases, advanced imaging like MRI or CT scans may be required to assess the extent of the injury.
How is Cruciate Ligament Disease in Dogs Treated?
Many people wonder, will my dogs cruciate ligament heal itself? Or can a dogs cruciate ligament heal without surgery. The answer to this question is no. The cranial cruciate ligament in dogs will not repair itself if it has been ruptured. Neither surgery nor conservative management options look to repair the damaged ligament (except in very specific cases). Instead they both focus on improving the stability of your dogs knee joint by different methods.
Treatment options for cranial cruciate ligament rupture in dogs include:
- Surgery: A number of different surgical techniques are available including procedures such as:
- Those that render the ligament unnecessary by reshaping the joint surface of the tibia (shin) bone.
- Tibial Plateau Levelling Osteotomy
- Tibial Tuberosity Advancement
- Ligament replacement surgery
- Outside of the joint for example a Lateral Fabella Suture
- Inside the joint: These procedures are rarely successful.
- Outside of the joint for example a Lateral Fabella Suture
- Those that render the ligament unnecessary by reshaping the joint surface of the tibia (shin) bone.
- Conservative Management: see more information below.
Surgery currently provides the most reliable recovery from a cruciate ligament rupture in dogs.
Is Cruciate Ligament Surgery in Dogs Always Necessary?
Sadly all dogs that have a cruciate ligament injury will go on to develop osteoarthritis in their affected knee joint. Surgery can help to slow this progression by improving the stability of the knee joint and a well performed surgery, with very careful aftercare is the most reliable route for recovery from a cruciate rupture. This is especially true of larger breed dogs. Recovery time from surgery is in the order of around 6-12 weeks.
For dogs who cannot under surgery, for health reasons that preclude a general anaesthetic for example, conservative management of a cruciate rupture can be attempted. Recovery from cruciate rupture by conservative management takes between 9-12months and while limited published data exists, success rates for conservative management are described at around the 67% mark. Dogs that do not respond to conservative management may still need to go for a surgical repair to regain leg function. It should be understood that in larger dogs, typically those over 15kg, have a poor chance of becoming clinically normal with conservative management. Although smaller breed dogs and cats have a better chance of successful conservative management, improvement in signs can take months and may never be complete.
Whether a dog is suitable for conservative management will depend on factors such as patient behaviour and owner commitment. It should not be seen as the "cheaper" or "easier" route as considerable input from a veterinary rehabilitation professional can be hugely beneficial, conservative programmes can be intensive for owners to follow and around a third of cases may still need surgical intervention even with perfect conservative management at home.
Prevention and Management
While some risk factors like genetics and age are unavoidable, maintaining a healthy weight, ensuring regular exercise, and avoiding excessive high-impact activities can help reduce the likelihood of CrCL injuries. For dogs already diagnosed with CrCL disease, a comprehensive rehabilitation programme can help improve strength and mobility following surgery, enhancing recovery and quality of life. We can also aid in conservative rehabilitation programmes if your dog is not a surgical candidate.
Rehabilitation Following on From Cruciate Disease
Rehabilitation can be enormously beneficial for dogs with cruciate disease, whether they undergo surgery or follow a conservative management approach. After procedures like TPLO, rehabilitation helps restore joint function, improve muscle strength, and reduce pain, leading to a faster and more complete recovery. Techniques such as controlled exercises, hydrotherapy, and therapeutic massage aid in regaining mobility while minimising complications like muscle atrophy or compensatory injuries. For dogs managed conservatively, rehab supports joint stability, enhances muscle support, and reduces inflammation, helping to maintain quality of life and slow disease progression. A structured rehab plan tailored to each dog's needs optimises long-term mobility and comfort.
If you suspect your dog is showing signs of a cruciate ligament injury, it’s important to consult your vet as soon as possible. Early intervention can significantly improve outcomes. Following veterinary diagnosis whether surgery or conservative management has been recommended we at Pawsitive Relief can help your furry friend regain their mobility and comfort.