The Everything Guide to Dog ACL Injuries

acl injury

I say this is the everything guide to dog ACL injuries because what you are about to read, see, and links included represent years of actual experience with this issue x2 and a variety of treatment modalities with eventual surgeries.

I know all too well about canine knee injuries: In the past two years, my dog has ruptured both ACLs (anterior cruciate ligaments) in his legs. After trying conservative management, including a custom orthotic knee brace, cold laser therapy, limited mobility aka rest, and anti-inflammmatories, surgery was still required: Times two.

My dog, Dexter, had ACL surgery utilizing extracapsular suture technique on his left leg in 2013 and on his right leg in 2014 . There is a high likelihood that if a dog tears an ACL, the other leg will be affected within one to years following. It sucks, I know.

If you’ve arrived at this article it is likely that your dog:

  1. Tore his or her ACL and you are looking for options other than surgery;
  2. You are curious and never heard of an ACL brace for dogs;

The ACL (aka CCL) is a ligament that is commonly damaged. In fact, the surgeon who performed the two surgeries on my dog says that more than half of his patients have this injury. In fact, some dogs are more prone to ACL injury than others. However, ANY dog at any age of any breed, lineage, or mutt can tear an ACL.

Living With an ACL Tear

If I had to do it all over again, I would still try the conservative approach first since on his first injury, as my dog’s first ACL tear was partial. I am glad I tried, but I now know that most partial ACL tears progress to full. A partial tear of the anterior cruciate ligament is a diagnosis a lot of dog parents receive. This means that the entire ligament is not torn and has not yet fully ruptured.

It is likely, but not certain, that the ligament will progress to a full tear. I have encountered dog moms and dads who tell me their dog lives comfortably with a partial tear of the ACL. Any joint that is compromised is prone to develop arthritis. Living with a partial tear does have limitations: At any time, it can progress to a full tear and then surgery is most likely required. Scar tissue can take the place of the damaged ligament, but it will come at a cost: Arthritis, pain, and/or limited mobility.

ACL tear

For Dogs Who Can’t Have Surgery

Not all dogs are surgical candidates for a variety of reasons: Cost of surgery, other health conditions, age and risk of anesthesia, etc. In addition, there are many types of ACL repairs. Smaller dogs tend to have an extracapsular repair done while bigger dogs with bigger bones may require TPLO surgery.

For dogs who are not undergoing surgery for one reason or another, stabilizing the knee is of utmost importance. ACL tears that are not treated at all are at very high risk for developing degenerative arthritis. Imagine the ligament is a rubber band. If you snap that rubber band in half, the knee can no longer keep stable.

knees

Like humans, dogs routinely injure the anterior or Cranial Cruciate Ligament (CCL aka ACL) in their knees. Since the CCL prevents subluxation of the knee joint, maintaining its integrity is of primary concern. Since ligaments connect bones, when a tear in the ligament occurs, the stability is no longer there. A stable knee means a stable joint and scar tissue can then take the place of the tear. Ligaments cannot regenerate themselves, so scar tissue formation is crucial. Here’s a good piece from Colorado State University Veterinary Teaching Hospital about ACL tears and repairs.

 

dog brace
Dexter in the moments after trying the brace for the first time.

 

Braces for Dogs

An ACL tear takes months to heal and many more months before dog parents should engage the dog in their normal activities so as to not have a recurrence or re-injury. During that time, you want scar tissue to form for the reasons noted above. In order for scar tissue to replace the torn area, the knee joint must be stable. Stability comes with: Rest or a stabilizing device, such as a brace.

Yes, they make braces for dogs. Not all products are created equal, and this holds true when it comes to products designed to create comfort and stabilize the knee when a dog has an ACL tear or rupture.

I discovered a small business within driving distance of my home called My Pet’s Brace. They provide orthotic devices for dogs that require bracing to support hip, stifle, hock and paw injuries in the hind legs and shoulder, elbow and carpal injuries in the front legs.

Much of their primary clientele in dogs deals with ligament ruptures and tears. After a thorough examination and assessing Dexter’s somewhat limpy gait, a stifle brace was recommended. The brace would be worn for 6 to 9 months during “active waking hours,” which for a then 4-year-old Cocker Spaniel is quite often. The brace cost $625 for a dog of Dexter’s size, which is a worthwhile investment. If surgery is necessary, ranges average between $1,800 and $2,500 (or more) – depending on where you live and nature of the operation required.

Incidentally, in the thousands of operations the orthopedic surgeon performs locally each year, I was the first person ever to have a dog try the custom brace. He even asked me to bring the brace in and show him, which he in turn, showed his colleagues.

Not All Braces Are Created Equal

I have since learned that not all braces are created equal. A custom brace is most effective because, like a custom brace for a person, it conforms to the exact specifications of your dog’s anatomy. Not all knees, legs or dogs are the size same and with the same structures. Two Cocker Spaniels, for example, side by side, still do not have the same anatomical measurements.

There are a variety of non-custom braces available, but none could guarantee the precise custom molding to my dog’s knee as that from a facility that makes them with your dog’s specifications in mind.

The folks at the orthotic center actually casted my dog’s leg and the brace was built from that. It is important to understand the process that goes into crafting a custom device for your dog versus purchasing one that is designed for most any dog to wear. I realize there are cheaper options available, but I wanted the security and peace of mind that my dog’s anatomy and healing would be best served by a device actually designed for him, with precision accuracy and a staff willing to help me before, during, and after…plus followup appointments.

dog ACL brace
Dexter at an appointment for his ACL brace fitting.

Custom Knee Brace Step by Step

The four steps in the simple process of creating a custom device for your pet are: 1) taking a cast of the leg or other body part, 2) fabricating or building the device, 3) fitting the device on the dog and, 4) modifications and adjustments, if necessary. (Steps 3 and 4 are usually accomplished at the same time.)

It sounds more complicated than it actually is, so here’s a visual and video guide of what happens, and in our case, for a custom stifle joint for ACL stability:

You and your dog’s veterinarian discuss options and if it is determined that a leg brace would best serve your dog, find a brace business that actually can see and touch your dog for custom molding. If there is not a clinic near you to do this, many times a kit is sent to the veterinarian and they perform the casting, then return it for custom molding to the orthotic manufacturers.

We opted to drive to the facility for the process. After meeting with the folks at My Pet’s Brace, the process began. My biggest concerns were pain during the process and if my dog would adjust to the end product. There was no pain, the process was easy, and Dexter adjusted to the brace in about 60 seconds. It takes most dogs a day or so (or less) to adjust, so we were very fortunate.

The entire process took about five minutes to actually take an exact replica of Dexter’s stifle area. This is best left up to the experts, and the business we dealt with works with veterinarians all over the country. They send the kit to your vet’s office, your vet can do the casting and then send it back to them for custom creation.  Spending the time necessary to take a good cast in the proper final alignment is critical in obtaining a well-fitting functional device.

Here are some images of the actual process that occurs once the client leaves and the casting begins:

dog brace

From moulding to casting to sizing, many steps occur to make a custom orthotic stifle for a dog.

Post Brace

My dog wore the brace for 90 days, except for sleeping or while lounging around in the house. Though the brace did help to stabilize the knee, his light running with it on did more to put stress on the already fragile ACL and snap, one day it just gave out. Once the ACL fully ruptured, this meant bone on bone contact. You can read about the first ACL surgery with pictures and more here.  At this point, surgery was required and we’ve outlined the entire process below.

Round Two

In June of 2013, Dexter’s ACL in the other leg tore from a simple running movement at the park, just as the experts predict may happen. The same doctor, same surgery, and same recovery process ensued.

dog_knee
This is the moment Dexter was released from the hospital in August of 2013. Notice the leg.

Costs

The costs vary from vet to vet, surgeon to surgeon, and city to city. Here’s a breakdown of some of the costs we incurred:

Custom orthotic brace for left stifle:  $625

Six cold laser therapy treatments: $250

Extracapsular surgery with same-day release from veterinary hospital: $2,000

My dog’s love and devotion coupled with good health: Priceless.

I should note that we have had Veterinary Pet Insurance for about 20 years and we have had nothing but success with them on the Major Medical Plan with additional coverage. About 90 percent of all of the above was covered under our policy, which has a very reasonable cost per month.

News Bullhorn Megaphone Important Alert AnnouncementHaving an ACL injury can be tricky, for both the dog and the pet parent who must restrict activity without creating a withdrawn dog who has no clue why he or she is not allowed to run and pla. However, there are options available and the links below will guide you through. If your dog has suffered an ACL injury, let us know your experiences, too.

Further Reading: Helpful Links to Guide You Through ACL Surgery and Options:

Diary of a Dog Undergoing Laser Treatment: Entry One

A Non-Surgical Approach to My Dog’s ACL Tear: Brace Time

How a Stifle Brace Saved My Dog from ACL Surgery

Ninety Day Update of ACL Conservative Management

Surgery for Dog ACL Injury: The Saga Continues

How to Entertain a Dog After Surgery

What to Do When Your Dog is Having Surgery

The Road from Dog ACL Injury to Recovery: Step by Step

Dog ACL Surgery Six Weeks Later

Dog ACL Injury Saga Continues

Dog ACL Surgery The Second Time Around

Dog Entertains Cows After Surgery

Some Dogs are More Prone to ACL Tears Than Others

Note: We were not compensated for any of the information included. We cannot guarantee same results and we are not veterinarians. Please always check with your dog’s veterinarian.with any medical issues or concerns.

Comments

  1. Thank you for such an in-depth look at Dexter’s ACL injuries and treatment. Haley had a stretched ACL injury a few years ago and it’s always in the back of my mind that she could re-injure or tear it. It was interesting to learn that the development of scar tissue is a good thing when there’s a tear to take the place of the torn ligament. I never would have guessed that. Also, the information about the brace was really helpful. I hope it doesn’t happen, but I feel so much more prepared now if Haley ever tears her ACL. Thanks!

  2. Wow! Great info. I also have VPI for our three dogs so was happy to see you comment that they helped offset some of the cost of treatment. Thanks for such a thorough article.

  3. Yep, we know all about busted knees too. Never actually tried the brace, though considered and researched it. Decided for surgery. Hopefully Cookie’s and JD’s knees will hold up through their entire lives.

  4. This is extremely helpful thanks Carol. Finn has a luxating patella on his right rear leg so we are set for a similar experience some time in the future.
    Am sharing to the WherePetsAreFound.com Community across all social media, thanks,
    Annette x

  5. It amazes how our dogs can have so many similar injuries and illnesses that we can get too. I am sorry you and Dexter had to go through this not one but twice with his ACL. I am glad he is doing better now. Thank you for writing this informative article for other pet parents to read when dealing with ACL injuries to their dogs.

  6. Dexter is a cutie! So glad he’s all healed now. This is a VERY informative post and I’m going to recommend to all my dog owning friends that they check out your blog.

  7. I admit I know nothing about ACL injuries because I’ve never had experience with it first hand (crosses fingers). It’s nice to know someone with such expertise!

  8. What an interesting and informative blog post, thank you! I love seeing how much detail you put into your writing, this is going to help a lot of pet owners down the road. It also helps that Dexter is seriously adorable! 🙂

  9. That injury seem so painful. Poor Dexter! I’m glad that he has you for a mom, Carol. Not everyone would have the patience and persistence to properly care for such a complicated injury.

  10. Wow, what an ordeal for your poor baby. I’m sorry you two have had to go through all of this. It is incredibly difficult to see your baby sick or injured. I’m really glad that he is better now, though, and it’s really amazing that your insurance picked up most of the cost!

  11. So much great information – luckily this is something I haven’t had any first hand experience with. Now I certainly know where to look if it comes up with any of my friends’ pets. That’s amazing that they make the brace that way; I guess I hadn’t considered how custom ones were made before. Good to know Dex is all healed up now.

  12. This is a fantastic article – thanks so much for such a detailed write-up of an important health issue for our canine friends! I’m sharing b/c this info is so important!

  13. Oh poor Dex, what an ordeal for a little dog to go through – and a worried dogmom too! This is such great information, definitely sharing. Thanks for such a thorough report.

  14. I’m sorry that happened to Dexter! We just got a puppy and would hate for an injury like this to happen to him. Glad you were able to find something to help him though. He’s lucky to have you.

  15. I’ve seen a lot of these in the past few years. Just from friends dogs at the park, to a few pups that boarded at the kennel I worked at, and now one of my own dogs! Its not a fun process!

  16. This is an AMAZING post. I often think about this with how active Charlie is. Bookmarking and saving for the future ( I hope I wont need it). I am so glad that Dex is doing so well.

  17. Very informative blog! I’ve been going through it for an hour or so now because our 2 year old German Shep hurt her knee and we’re in the beginning stages of what we believe is an ACL tear. In October we took her out to play fetch, she slipped on the wet leaves but continued on, we didn’t think much of it. Then a few days later she began to whine while going up the stairs (we live on the third floor of a three family house).

    She just had the X-Ray done actually today and the vet couldn’t find anything visibly wrong on it. But she still whines (screams practically ugh) when going up the stairs. She can walk just fine, run a bit but no stairs. Which makes it VERY problematic for us to take her out, she’s been apartment bound for at least two months. Thankfully we have a small porch where she can go out and potty.

    Long story short, I’d love to try the brace at first but do you have any idea how she would be able to handle stairs with the brace?

    • So an ACL tear will not often show on xray. Can the vet do a drawer test? This is pretty definitive for ACL tear. Also I would recommend seeing a specialist. The brace was great for a while and a great option for dogs who can’t have the surgery. In your German’s case, she may need TPLO procedure. I would definitely seek a board certified specialist in the surgery. Unfortunately, a dog with a brace has mobility but should not do stairs. You want the leg stable so that scar tissue can form if a tear exists. It is so hard to keep active dogs still. Keep me posted on how your dog does. I am very curious, okay? I appreciate knowing that these resources have helped.

  18. I was told by our vet that for my Zola’s torn ACL, the best thing to do was to restrict her activity as much as possible during 8 weeks, and see if there was any improvement. We also bought her a custom knee brace from Ortocanis.com to help stabilize her knee while she recovered. If she showed improvement it meant that her knee was healing on its own and that she probably could do fine without surgery. It was definitely tough to not be able to go on walks or play with her for such a long time, but in the end it was definitely worth it! We made sure to buy her an orthopedic bed and put it on the ground, and keep her in an enclosed area every time we left home so that she wouldn’t be jumping on and off any of the sofas or beds or going up and down the stairs. She was already 10 years old when this happened and a year later she’s doing great! I really believe that for both people and dogs, avoiding surgery whenever possible is the best option.

    • I am so happy to hear that the brace worked for you and it has provided the needed stability. Though that isn’t always the outcome for every dog, you are proof that it can and does help. Way to go!

    • Dogs sure can be expensive sometimes.. but boy is the love they give worth it! I’m recently going through a similar situation but the tear is partial so we’re also going to try avoiding surgery. I’m going to look into the Ortocanis dog knee brace you mentioned.. it’d be great to find an alternative that works without having to shell out hundreds and hundreds of dollars (don’t get me wrong, if I have to I will but first I want to learn more about some of these promising alternatives!) Crossing our fingers….

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