Three ways to keep your dog’s knee ligaments healthy and avoid surgery
Imagine your dog playing in the park having fun with his canine friends when out of nowhere you hear a yelp and your best friend is hopping back to you on three legs with questions in his eyes. What's happening? Why am I in pain? Your heart sinks and your vet later tells you your dog suffered a cranial cruciate ligament (CCL) injury.
Unfortunately, this scenario is way too common. Most people think injuries are just bad luck. However, this is true only in a few cases. My goal is to explain why you have a lot of control in protecting your dog against cranial cruciate ligament and knee injuries in general.
WHAT IS THE CRANIAL CRUCIATE LIGAMENT?
The cranial cruciate ligament is located in the knee joint and it prevents the femur, the thigh bone and the tibia (the bone below the knee), from sliding back and forth when dogs walk. It’s one of the most vulnerable areas of the hind leg, if not the whole body.
There are two cruciate ligaments in dogs’ knees and their anatomy is actually quite similar to humans.
So let me take a little detour and share a human story with you.
THE STORY OF JENNA
My friend Jenna is in her forties and has an ACL (Anterior Cruciate Ligament) injury, the equivalent of a CCL injury in dogs. The hardest part of this injury is she can't take her dog for walks, which is one of her favorite things to do.
No one told Jenna a cruciate ligament injury is usually months or years in the making before it snaps.
The first problem is Jenna exercised infrequently and the burst of activity would be too intense and her weakened body, tissues and ligaments would suffer from small injuries that compounded over time.
When it came to diet, she believed she was eating healthy. However, she’d eat croissants, toast, cereal and other carb-laden foods for breakfast. It wasn’t unusual for Jenna to have barbecued ribs with fries for lunch. For dinner, she often ate salad washed down with a few glasses of wine.
All this made Jenna carry more weight, making her more prone to injuries, core instability and back pain. In fact, her lower back pain was sometimes so severe she couldn’t get out of bed.
She also wasn’t taking supplements to provide the essential building blocks that make muscles and ligaments strong.
Jenna also loves eating fish and tuna, which are high in mercury, and rice, which is high in arsenic. High toxin levels can cause muscle tightness and inflammation, which can increase the stress on joints and ligaments.
Jenna wasn’t aware her lumbar spine is vital to the energy flow and tissue strength in the knees and that her lower back pain was connected to her digestion being out of balance.
Jenna couldn’t gather the willpower to make healthier choices and one day she turned to say hi to a friend and that was enough for the cruciate ligament in her left leg to snap.
I use Jenna's story instead of a case involving a dog because it’s my experience that describing the human reality may make it easier for you to understand what precedes a CCL tear in dogs.
PREVENTING CRUCIATE LIGAMENT INJURY IN YOUR DOG
I’m not going into detail about surgical methods of repairing CCL injuries in dogs because you can find that information in many online articles. The surgery itself is relatively routine. If it’s performed by an experienced surgeon and with the necessary rehabilitation, most dogs will return to a reasonable level of function.
However, no matter how well the surgery is done, a repaired knee can never be compared to healthy joint stability. When the CCL tears, there are also the inevitable consequences of arthritis, back misalignment and a possible CCL tear in the other leg.
This clearly means protecting your dog's knee joints from injury should be your goal and priority.
Many people believe a CCL injury is simply the result of bad luck and genetics. It's my opinion that the risk can be greatly reduced if you follow these steps to protect your dog's knees.
Feeding food that has plenty of building blocks for tendons, muscles and joints is essential. I’ve seen dogs from the same litter fed kibble while others were fed a raw or home-cooked diet. The difference in bone, joint and ligament strength is staggering. A healthy, species-appropriate raw meat based diet is the key to strong connective tissues, including joints and ligaments.
Unfortunately, soil overuse, monoculture and nutrient depletion affect our food and as a result, deficiencies are way too common. It’s no coincidence that dogs with cruciate tears are often nutrient depleted. I recommend supplementing your dog’s diet with a multivitamin and mineral supplements that are sourced from whole foods, not synthetic, as well as a safe and mercury-free source of Omega-3 fatty acids.
Some of my colleagues believe CCL tears happen due to poor knee joint angulation that is too open, but I don't consider that as important as food.
Exercise is a double-edged sword. Too much exercise can weaken otherwise healthy connective tissues and joints. Jumping, ball chasing, sudden braking and jarring can cause repeated trauma that never heals completely. Too little exercise leads to weakening due to lack of stimulation and tissue blood perfusion (the circulation of blood through the body tissue).
You’ll also want to avoid the all-too-common weekend warrior dog syndrome. Many dogs laze around all week while their owners work and then they go wild and crazy on the weekends. Lack of exercise followed by an excess of activity is the perfect combo for injuries, so try to keep your dog exercised regularly, even on weekdays.
Excessive tone in the thigh muscle also causes stress on knees. The quadriceps muscles can become excessively toned due to intensive exercises such as jumping, sprinting or walking on the hind feet. This creates increased stress on the knee (or the stifle joint as it’s called in dogs). Make sure your dog gets a wide variety of different exercise to keep muscle development even throughout their body.
Keeping nails properly trimmed is important because long nails can cause changes in the knee angulation and increase the chances of slipping and injuring the knee.
Healthy spine = healthy knees
This one deserves a separate chapter.
Over my years in veterinary practice, I’ve noticed many dogs start with overexertion, sprains or injuries to their lumbar spine long before they injure their CCL. Such dogs may have an arched back and sometimes show signs of spondylosis (a spinal form of arthritis). Other dogs just have spastic muscles along the spine.
The main point to remember is that the blood, nerve and energy flow to both hind legs come from the fourth and sometimes third lumbar vertebrae to the second sacral vertebra. As soon as the muscles of this region tighten or get injured, the blood vessels, nerve and energy channels to the hind leg get pinched. You can imagine a garden hose that gets pinched and the flow of water to the plants decreases.
The blood vessels and nerves originating in the lumbar-sacral region can be compared to little watering hoses that need to pass through the muscles. When they’re injured, weak and spastic, the hind leg muscles, connective tissue and ligaments in the hind end weaken.
I have yet to come across a person or a dog with a cruciate or a ligament injury that doesn’t have some form of lumbar or sacral pain.
You can provide balanced exercise, strengthen your dog’s core and work with an experienced chiropractor, physical therapist or osteopathic practitioner to keep your dog structurally healthy.
© Dr. Peter Dobias, DVM