Pet 411: What You Should Know about Cranial Cruciate Ligament Disease

Dogs can be amazing athletes, running and jumping with such enthusiasm. But just like human athletes, this high-impact activity can lead to injuries. One of the most common causes of limping we see at BluePearl is rupture of the cranial cruciate ligament (CCL), comparable to a human’s anterior cruciate ligament (ACL).

One of our Pet 411 readers contacted me because his 12-year-old dog suffered damage to his CCL and he’s wondering about the best treatment options. Since CCL surgery is typically handled by our skilled BluePearl surgeons, I reached out to my colleague Dr. Amanda Conkling, who is board-certified in veterinary surgery, to get her input on the best course of action for our reader. Here’s what she had to say:

The CCL joins the thigh bone or femur to the  tibia or shin bone at the knee joint. This ligament plays an important role in stabilizing the knee joint and giving it flexibility.

In our canine friends, CCL rupture is actually a very complex degenerative process. CCL rupture can affect virtually any breed of dog, but among the most susceptible are Labrador retrievers, Newfoundlands, golden retrievers, German shepherds and Rottweilers. There are also certain factors that make dogs more at risk for injury, including being overweight, being physically inactive followed by a sudden burst of activity, being a male dog who was neutered before five months of age, having a conformational abnormality in the hind legs or having had a ruptured CCL in the opposite knee within the last two years.

It’s typically fairly easy to identify signs of CCL injury. Dogs will limp or show lameness in one or both hind legs and may avoid using one leg. They may also have difficulty getting up after resting and may have swelling around the knee joint. If you notice any of these signs, it’s important to take your dog to the veterinarian as soon as possible. The diagnosis of a ruptured CCL can be confirmed by a thorough orthopedic exam of your pet.

Fortunately, we’ve made a lot of progress in the diagnosis and treatment of these injuries. Surgery can stabilize the knee joint and the expectation for a full recovery is good. Types of surgeries typically performed to address a torn ACL are techniques called TTA or TPLO. In both of these, a portion of the tibia is cut and realigned to change the angle of the knee. This is intended to help stabilize the joint.

For the reader who is wondering how to proceed with a 12-year-old dog, a lot depends on your dog’s overall health, degree of arthritis and mobility.  Smaller dogs may be able to avoid surgery with rest, physical rehabilitation and pain medications. For larger breeds, surgery is commonly the best option to restore joint stability and mobility. There are a lot of factors to consider, so have a conversation with your veterinarian. He or she can help you make the decision that is best for your dog.

Lifestyle changes should always be considered to promote a healthy weight, regular low-impact activities and joint supplements.

Thank you so much to Dr. Conkling for her input! And for those of you in the Grand Rapids area, Dr. Conkling will be appearing on WZZM’s Pet Peeves on Nov. 30 to discuss all things related to CCL surgery.   We’ll be sure to post a link to the segment on BluePearl’s Facebook page.

As we enter the holiday season, I hope you have a wonderful and joyous time with all of your family members – those with two legs and with four!

Have a question about your pet that you’d like answered? Write to Dr. Cathy Meeks at She’d love to hear from you, and your letter may be picked for an upcoming Pet 411 column.