How to Manage a Dog After ACL Surgery

Within a period of one year, my dog had two surgeries: Both surgeries due to complete tears of the ACL, a major ligament of the rear leg. Our ACL injury journey is well documented on this blog, but this is our first “what’s life like” a year or more out from the ACL surgery blog post.

If your dog has ever injured his or her anterior cruciate ligament or has experienced a muscle, ligament, tendon, or joint injury, you know that post injury care is imperative.

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Some dogs are more prone to ACL tears than others

Quick Review/Primer: What Is An ACL Injury?

A ligament connects bone. It is connective or fibrous tissue that is located at a joint. In a dog, the cranial cruciate ligament, sometimes called the anterior cruciate ligament (ACL/CCL), is located in the rear legs. It connects the thigh bone with the lower leg bone. You can imagine how important this ligament is to a joint.

Our dog tore BOTH of his ACLs: The first one as a partial tear in 2013 that progressed to a full tear and the second one in 2014. The first time we tried conservative measures including rest, cold laser therapy, and even a custom made brace for his leg.

The anterior cruciate is a ligament that is commonly damaged. The board certified surgeon who performed the two surgeries on my dog says that more than half of his patients have this injury. Some dogs are more prone to ACL injury than others. However, ANY dog at any age of any breed, lineage, or mutt can tear the anterior cruciate ligament.

According to Michigan Animal Hospital, statistically, 35-40 percent of the dogs will suffer rupture of the cruciate ligament in the opposite leg.  It is probable that the underlying arthritic change that lead to the first rupture has already started in the opposite leg.

For a complete overview and more details of our journey, you can read the Everything Guide to Dog ACL Injuries .

The everything guide to dog ACL injuries

Preventing ACL Injuries in Dogs

Most articles online talk about what a ligament rupture in a dog is and what to do when it happens.

I get asked if there is anything I would do differently in our journey with two ACL tears in our dog, Dexter. Well, yes, some things.

Reputable studies are showing over and over that neutering a dog too early can increase his chance of rupturing/tearing the ACL. A puppy is still growing at 6 months of age. We had our dog neutered right around that point. I mean, it’s what we are told, and so we do it. When we know better, we do better, as the saying goes. I would still neuter my dog, but I would do it at a little over a year of age if I could rewind and do things over again. I’d let the joints and ligaments reach their growth potential. Maybe then, he wouldn’t increase his chances of injuring or rupturing his ligaments. Maybe he still would, but well, I’d rather err on the side of prevention.

Side note: Our dog’s littermate brother also tore both of his ACLs within a year. He was neutered before one year of age, too.

Some dogs are more prone to ACL injuries and tears, and it’s not just my opinion: Science and studies and all that jazz. One of the pioneers in the field of veterinary medicine, Dr. Jean Dodds, writes, “(In a) study of large breed dogs with ACL rupture found early-age neutering…to cause an excessive angle to the tibial plateau.”

She is not alone. There are studies galore posted here and there online about early age neutering from reputable sources. We are pro neutering and spaying but at the right time.

I am grateful for trying conservative measures, but with an active dog and knowing as much as I do about the pain and an ACL tear’s propensity to advance from partial to full tear, I’d go for the surgical repair upon diagnosis.

Dog ACL custom brace

If you have a dog who is older, has other health conditions preventing surgery, or you simply cannot afford the surgery, then conservative management of the ACL tear is to be considered. I do know a few folks who have opted to manage their dog’s on again-off again ACL tears. Each dog’s journey is unique and no two dogs, like people, are alike.

If you opt for a brace for the ACL injury, 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. Thus, My Pet’s Brace, where we visited, had a custom fitting, but they also work with veterinarians out of state, too.

Braces DO NOT heal the knee. They only help a dog walk better. When visiting our dog’s orthopedic surgeon, he asked to see the custom brace that was made for Dexter. Of the thousands of patients on which he performed surgery, no one ever tried a custom brace first.

There is no 100 percent guarantee you can prevent a ligament injury in your dog. Life doesn’t hold guarantees in that way. You can, however, keep your dog in shape, and follow the advice below so that your dog’s joints, bones, and connective tissues (ligaments and tendons) stay healthy.

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.

How to help your dog after ACL surgery

Arthritis Prevention and Leg Care After ACL Surgery

To understand why arthritis develops because of an ACL injury or tear, you need to understand this process. In simple terms, imagine the ACL as a rubber band. That rubber band holds two things together. If you slightly rip that rubber band, those two “things”— in this case, the femur and tibia — are not as stable. They move and shift, and when that rubber band fully tears, as is the case with many ACL injuries, suddenly you have nothing to connect them. You have bone rubbing on bone. Ouch. The femur and tibia, bones of the leg, now move back and forth across each other. That tough band of tissue, the cruciate ligament, is not there to support them. A stable kneecap, the patella, needs the ACL to be strong and not torn so that the femur and tibia have proper support. When joint cartilage wears down, in addition to causing pain to the dog, arthritis sets in.

And wait, there’s more: That abnormal motion of the tibia and femur rubbing on each other can damage the menisci in the leg. The menisci is the cartilage pad, or as our dog’s surgeon called it, the “shock absorbers.” When the bones rub together due to the tear of the ACL, the bone cuts into that shock pad (menisci) and severe arthritis ensues.

Anatomy of a dog knee

The reason why some dog parents choose to rest a partial tear of the ACL in a dog is so that scar tissue can build up in the tear. At any time, that tear, even with scar tissue forming, can progress. Even if it heals, it can re-tear. You also have arthritis to deal with as a result. One misconception I’ve encountered in these years of getting to know the anatomy of a dog’s leg is this statement: “My dog isn’t active so I don’t need to have surgery on his or her ACL tear.”

A dog does not need to be super active to damage a ligament. A dog can pivot, step off a curb, pounce, or any number of motions that can cause a ligament to tear.

I wanted my dog to have stability. He has it with his surgically repaired ligaments. Incidentally, there are several types of surgeries for dogs with ACL tears. Seek a board certified orthopedic surgeon and discuss the best option(s) for your dog. Based on his size and our surgeon’s recommendation, our dog had a lateral suture repair on both legs.

How Is Our Dog Years After Double ACL Repair?

Here is Dexter then with his limp, right after getting his cast:

And here is Dexter now:

Does he ever limp or hobble at the age of 8? No, knock on wood.

He does have some arthritis but it is controlled and would have been much worse without the surgery. Some dogs never return pre-injury athletic state because of that initial injury to their leg. Other dogs recover and excel. Each dog is different.

He gets daily walks, play sessions indoors, massages courtesy his dog mom, and if need be, I would consider cold laser therapy. We keep his weight to a healthy number and his veterinarian and orthopedic surgeon are thrilled with his progress.

Controlling and Slowing Arthritis in Dogs

  1. Something to coat the joints and slow the process of arthritis while providing comfort to the dog. We are not getting paid to tell you this, it’s just what has worked for us: A daily dose of Cosequin Advanced Strengthcrushed up, and sprinkled in my dog’s food. We used this with our previous dog and started around age 3 to prevent any future joint issues. She never had a limp or issue and she lived to nearly 15 years of age. Not all glucosamine and chondroitin supplements are created the same. For our dog’s weight, he gets a half a tablet a day. Now and then, we bump up to a full tablet if we know Dexter will be exercising more, rain is expected, and so on.
  2. Organic coconut oil on his food: Once daily. Karen Becker of HealthyPets.com explains coconut oil for dogs best. It also benefits the coat, the body at large, and even for food sensitivity or allergy flares in some cases. We use this with the early meal of the day.
  3. Omega-3 Pet Soft Gels: Omega-3 fatty acids EPA and DHA are important fatty acids for humans and their dog and cat companions because they cannot be made in the body. Nordic Naturals has a soft gel that we use, again punctured and mixed in with the supper meal daily. The omega-3 fatty acids (EPA and DHA) found in fish oil support things like joint health, heart health, skin and coat, immune system, and more.

Read more below about vitamins and supplements for dogs here and what to watch out for, how to determine what your dog needs, and how much is too much.

CLICK THIS: The Reality of Dog Vitamins and Supplements

dog vitamins

Products and Suggestions to Make the ACL Journey Easier

There are several things we used, continue to use, and would recommend exploring in the event your dog injures his ACL.  Many of these products can be used for dogs in general and/or for other types of injuries or situations as well:

Cover Me By Tui: The cone of shame need not bring a dog’s spirits down. I know my dog would be more upset and depressed in wearing an Elizabethan collar than the actual surgical recovery itself. So I looked into other options, and low and behold: There are viable lick preventative measures that are available for pet parents who want an E-collar alternative. Granted, some dogs will figure out how to get through garments and bandages, so I wanted something easy to use, safe for my dog, and that would not dampen his spirits. Enter the Cover Me by Tui from Tulane’s Closet.  Don’t want a piece of doggy apparel?

dog pajamas

CLICK THIS: Dog Alternatives for the Cone of Shame

Dog Stroller: Depending on the size of your dog, consider a pet stroller. I purchased the Pet Gear No-Zip Jogger Pet Stroller, with great wheels and able to accommodate a dog up to 70 pounds. I want my dog to feel like we are not neglecting the outside world and his presence in it. So we packed up the stroller and take short but much-needed walks in it. He loved it.

Canine stroller for Dexter

GingerLead Dog Support: I so wish I had this when my dog was recovering from surgery. This company  provides rear support harnesses for aging, disabled or recovering dogs struggling with their mobility or balance. Helps dogs with weak hind legs walk. Since the dog has limited mobility per doctor’s orders postoperatively, this would have helped us at the curb for walks.

GingerLead for dogs

CLICK THIS: How to Entertain a Dog After Surgery

Best wishes to you and your pooch. In an effort to help guide you and your dog, here is our complete listing of links to help guide you through ACL surgery, options, and our journey:

The Everything Guide to Dog ACL Injuries

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

Alternatives to the Dog E-Collar

Note: This post contains affiliate links from Share a Sale and Amazon, meaning if you click on a link above and then make a purchase, Fidose of Reality will receive a small commission with no extra cost to you. You help us keep the site up and running and in exchange, you get to shop for items you love. Wags!






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  1. Great tips for those in this situation. It makes me sad to think about someone not knowing how to handle it the right way.

  2. What a sweetie! My dog actually broke his leg as a puppy and he had to have surgery too. It was truly awful, and it was hard for several months. It is good to see recovery though!

  3. How cute is your dog in that stroller! 🙂 So good to know that they actually do this kind of surgery in dogs. Thanks a lot for all the great info.

  4. That’s interesting that they told you to wait longer to neuter him. I would’ve done it earlier than that, too, so that is good to know. We rescued our dog when he was about a year old, so I don’t know how young he was when he was neutered. You just wouldn’t connect the two, but the explanation makes sense! Great post, thank you!

  5. I wish I knew this when Victor went for his surgery. His leg didn’t recover well. He is incredibly high energy (especially two years ago) and keeping him calm was next to impossible. The vet also gave him pain killers that caused hyperactivity in some dogs (I didn’t know this at the time) so that didn’t help. I underestimated how long his leg will take to heal and well, it didn’t heal well. He still lifts is occasionally after an active day.

    1. Our beagle Diesel also had both legs done and he also lifts one rear leg occasionally especially when the weather is cold and he takes a longer walk or runs about a bit too much.

  6. Our old lab has discovered the fountain of youth since we got him and he lost about 20 lbs. Managing a dogs weight is a big part of preventing ACL tears also, I suspect.

  7. I will never forget the sounds of my dog Chucky yelping after breaking his leg jumping from the motorhome door when we got home. I am glad he recovered well.

  8. Knock on wood we haven’t had any tears with Ruby. She is kind of a couch potato, but as you pointed out, it can still happen with less active dogs. I am a big believer in coconut oil. Ruby gets a bit in her food and seems to help all kinds of things.

  9. Valuable resource for anyone with a dog. So glad that Dexter is doing well now. I think my dog would love a stroller, just because ❤

  10. When Jasmine was diagnosed with partial tears in both knees, we really wanted to solve it without surgery. We considered CM very hard but felt that with her activity level it wasn’t likely to work. We decided to try regenerative medicine but by the time we were able to get to that (other emergency and surgery unrelated to the knees), the ligament on one of the legs got fully busted. We opted for the suture repair. Jasmine had that done on both knees, combined with stem cell therapy and we were happy with the results.

    With Cookie, having partial tears also, we decided to give regenerative medicine a chance once again. We did PRP and so far so good *knock on wood. Should Cookie need surgery at some point in the future, we’d really like to be able to go with the new “hinge technique”, Simitri Stable in Stride. So far, the implant for Cookie’s size dog is still in working. So we’re holding off with full off-leash activity just to have this option open.

  11. Glad your dog was able to recover from ACL injuries. I love the pet stroller and may have to pick one up for my dog Buddy even though he doesn’t have an ACL injury.

  12. As always, so much great information in your post Carol! I always share your health posts, they’re such a great resource. Poor Dexter, he went through a lot with two ACL tears in a short timeframe, you’d never know if looking at him now! He’s such a happy, active dog. It’s interesting about the spay/neuter reference. My Husky was spayed at 6 months, I would have done it sooner but a paperwork error led us to believe the breeder had already spayed her (we thought that seemed odd). Now I’m glad we didn’t spay her so early, I’m learning more about spaying dogs too early. It’s hard to know what the optimal time is to spay/neuter. Different Vets have different recommendations; some say 6 months, some say as long as 1 and a half years for a giant breed. Sharing.
    Love & Biscuits,
    Dogs Luv Us and We Luv Them

  13. I had no idea that ACL problems were that common in dogs! That is a very high prevalence. I didn’t know there was a correlation between neutering a dog too early and the ACL either. I’m glad that Dexter has done so well recovering from his ACL rupture. He has the best set of pup parents anywhere to get through something traumatic like that.

  14. Wow! I never connected early neutering with ligament and joint problems. Our breeder recommended we wait until the girls were at least 6 months of age because the silver shaded Persians mature later.

  15. Wonderful information on this topic! My Doberman (who died in 2014) had torn ligaments (both knees, one year apart) and the surgery was horrible :(! But I was surprised how strong a dog can be! If people went through this kind of surgery, we wouldn’t be able to walk for weeks or even months!! But due to her injuries, she has arthritis in her knee joints, bad! Really really bad :(! Anyway, she is in a better place now <3! Thank you for sharing!! Great info, as always!!!!

  16. I damaged my ACL, PCL and MCL in different accidents over the years and have horrible arthritis in both knees so I sympathise with Dex. Painful. I am glad you were able to do the surgery and rehab. I am trying regenerative and diet now. I wish that GingerLead had been available and I had known more for my Cookie as she had hip and arthritis issues her last 12 months (she was a large lab but was very healthy until 13). Kilo the Pug was neutered at 2 right before I got him so that may help and gets Glucosamine and Chondroitin and fish oil. I have to watch his little legs as he jumps like a bandit so is bound to have an injury.

  17. I had no idea early neutering would make a difference – interesting! Poor Dexter went through a lot. I’m glad he has mended thanks to your dedicated research and care. I will definitely share – thank you.

  18. Thank you Carol and Dexter for sharing this journey with us! What a scary and expensive ordeal Reading stories just like this is exactly why I decided to finally get pet insurance! Also, I with I would have know about . GingerLead Dog Sling prior to BlogPaws my grandma needed this really bad for her dog after her strokes!

  19. My springer spanial.,10 yrs old in May. Has torn ACL,needs surgery with a plate being inserted over knee,has some arthritis in knee also..well this may seem like a silly question but I’m concerned,with no wt bearing,how will he poop?..My Jackieboy will not poop on leash.,well wouldn’t so far. Should I buy a sling to try and hold him.,he s 78 lbs,I’m worried also as to get him out we have to walk around deck down 3 steps to get on the ground..any thoughts.I need to get this right so he heals well

    1. Hi there Nanci – I was concerned about that, too. Dogs are very resilient and they figure it out. There is a product you can try in recovery called Ginger Lead Dog Sling. Let us know how it goes.

      1. Thank you Carol.Surgery is April 3rd..I am ordering the ginger lead sling this week. ,as we also have alot stairs up deck to get into house . That was concerning me too…,getting him in and out. Appreciate your blog and a,ll the information .I want to make sure we do everything we can for a healthy recovery.Will write back after surgery.

  20. Thank you for sharing all your useful tips. We’re getting ready to schedule my sweet boys CCL surgery soon. His name is Sebastian; Sebastian Samuel when he’s in big trouble! He is half Black Lab and Half Golden Retriever. We had a second opinion done with a manual manipulation by an excellent vet many of our friends see regularly here in Anchorage.

    The good news is that they will do the x-rays the day of surgery so we don’t have to put him under anesthesia twice. It has been just over two weeks since he first injured himself and that leg isn’t improving, in fact, I think it might getting worse since it trimbles constantly when he put pressure on it. Of course, we inconviently live in a two-story house where the main living area is on the second floor. Poor Bugs, can’t get up the stairs easily without me lifting his hinny up. Thankfully, he learned quickly that stairs hurt and he is less insistent about following us up. I will allow him to come up every few days making one trip up and one down but that is it. We’re in training right now for completely being locked down after surgery.

    I love the idea of a post surgery sleeve although the company you shared doesn’t appear to have one for hind legs. Maybe I can make something for him to use. He loathes cones and the inflatable collar. However, I keep the inflatable one out whenever “No Licks” are allowed. Usually, he listens quite well when I say no No Licks followed by inspecting the spots that are bugging him. Even when Sebastian was neutured we didn’t use a cone. Knowing myself how stitches can and do itch, when I caught him licking I’d use a little neospirin and lightly scratch around the are where stitches were. It always calmed him. Hopefully all of those tricks will work following surgery on his knee.

    Thanks again for sharing so much helpful information.

  21. Ugh! We are 4 days post-op for CCL surgery #2. The first was four years ago, so I’m thankful our little guy didn’t have to go through a second surgery soon after the first.

    Thanks for this great article! Since it has been so long I’ve had to re-educate myself about all things ACL. Our little guy was neutered at 4-5 months shortly after his testicles dropped (we’re not certain of his age but that’s our best estimate of how old he was when our vet said we needed to have it done). Boy, if I could have a do over for that week – I would have waited to do the neuter).

    1. I am with you, Cathi. I wish I waited to neuter my dog until he was maybe 2. Another one of dog’s littermates torn an ACL, too – and he was neutered at 6 months as well. We wish your little guy a smooth recovery!

  22. My dog is having the TPLO surgery next week and I just ordered a GingerLead. I also bought a Comfy Cone. Thank you for the information you have provided. I am a nervous wreck about this surgery and reading your blog has helped me.

    1. You are going to get through. I hate leaving them and it is upsetting, I know. My dog is hospitalized right now. Good idea on the GingerLead and Comfy Cone. Did they say how long your dog would be hospitalized? Would love an update, Clarice, as you re able. Thanks a bunch for your kind words.

  23. Thanks for the great information based on your experiences. I thought I would share my experience with you all as well. I have a 5 year old husky who just underwent Tibial Wedge Osteotomy surgery in December on his right leg. At the time of the surgery I was told that he will require surgery on his left as it is also ruptured. I have since come across a site tiggerpoz.com that provides a wealth of information on ACL injuries and alternatives to surgery. I would recommend everyone visit this site prior to booking your dog for surgery. I am going to try the posh dog knee brace on his left knee to see if it is able to heal without the need for surgery. The success rate is extremely high and the best part is not having to put my dog through another surgery. The brace is not cheap but a fraction of the cost of surgery and a whole lot better for my dog. I think it is important that we all make informed decisions when it comes to our beloved fur babies and not just taking the advice from our vets. I wish I had taken more time to research than jumping right into the surgery. Happy reading!

    1. Healing hugs to your husky. I tried conservative treatment for my dog at first, and I am glad I did. Ultimately the partial tear went full and then a year later, the same thing. I am glad we did the surgery but we had the fishing line type. Thanks for coming by.

      1. Hi, thanks for posting all this valuable info. Our high-energy black lab was just diagnosed with a ACL tear in her left rear knee. She is 4.5 years and has so much energy that she can’t stop running, it’s so hard to keep her down. We took her to UC Davis Vet Hospital and they recommend the TPLO surgery, which cuts the bone below the joint to adjust it to a more level plane, then screws a plate on it. I think because our dog is large and very active, the suture was not a good option, and the vet said it may not hold up under pressure. There was a third option too, a newer one, but they don’t do this one. Wonder if you had all these options. Finally, your article states that the surgery repaired the ligament, but I think this may be a mistake because none of the surgery options actually repair the ligament, they just adjust or stabilize the joint. I asked why they cannot surgically reattach/reconnect the ligament, like they do in humans, but they said that technology is not available for dogs. Too bad.

  24. Hi there just received a diagnosis on my 10 mos. Johnson American bulldog if your not familiar with this breed they have a mastiff body so you see 1 problem his size he’s 77 lbs and still growing. I am watching how weight of course. Both his knees have this problem but I think it’s a birth defect he has not been injured. He also has hip dysplasia on one side. The breed has extreme pain tolerance and I have touched gently his hind and he growled this has happened 6 x or so. They need his growth plates to close befor they could even do it. Honest and hat do you think about doing this to a dog ? What has his
    Life been like since you did surgery as far as pain. I’m guessing he just had the 1 knee and also a smaller breed.. please be honest we live with 4 cats a yorkie chickens grandkids and lots of action at home. It’s an active house.

    1. My dog really improved big time after his ACL surgeries. He is an active Cocker Spaniel and his recovery both times was uneventful. Your dog will need to rest in recovery and also do rehab.

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