In this episode, Dr. Kristin Kirkby Shaw and Dr. Hannah Capon discuss cranial cruciate ligament (CCL) disease in dogs, a common and significant issue affecting many breeds. Kristin shares her recent experiences returning to clinical practice and emphasizes the importance of early detection and intervention in managing CCL injuries. They explore the terminology, diagnosis, and treatment options for CCL disease, with a particular focus on its connection to arthritis. The conversation also touches on the challenges of managing arthritis in dogs and the need for a deeper understanding among pet owners and veterinarians alike.

Key Takeaways:

1. CCL Disease and Its Prevalence:

• CCL disease is a common condition in dogs, particularly affecting breeds like Labradors, Rottweilers, and Golden Retrievers. Unlike humans, where ACL injuries are often traumatic, CCL issues in dogs typically develop gradually due to ligament degeneration.

2. Terminology Clarification:

• Understanding the various terms related to CCL disease is important for dog owners. The CCL in dogs is analogous to the ACL in humans, and the “stifle” refers to the dog’s knee joint. Familiarity with these terms helps in better communication with veterinarians.

3. Link Between CCL Disease and Arthritis:

• CCL Disease often begins with synovitis, or inflammation in the joint that starts to weaken the CCL and is essentially early arthritis. As the CCL weakens and instability develops in the stifle, arthritis progresses. Surgery to stabilize the stifle helps reduce arthritis, but long term even dogs that have surgery should be monitored for OA pain.

4. Diagnosis and Early Indicators:

• Early signs of CCL disease in dogs include subtle changes in gait, occasional lameness that is worse after exercise but improves with rest, sitting off to the side on their hip rather than symmetrically, and difficulty rising or jumping. CCL disease is often mistaken for hip arthritis or “general arthritis.” It is important that CCL disease is diagnosed because the treatment recommendations for CCL disease are different than arthritis in other joints.

5. Treatment Options and Challenges:

• Surgical interventions that stabilize the stifle joint, such as the TPLO (Tibial Plateau Leveling Osteotomy), are considered the first line treatment recommendation for CCL disease. TPLO is very effective at returning dogs to an active lifestyle, but it is very important to discuss the pros and cons of surgery with your surgeon. Managing post-operative care and long-term arthritis requires a comprehensive approach that considers the dog’s overall health, lifestyle, and the owner’s resources. If surgery is not pursued, arthritis will be need to be more aggressively managed.

6. Monitoring Sitting Posture:

• Teaching dogs to sit symmetrically from a young age can help in detecting changes in posture that may indicate underlying issues. If a dog starts sitting unevenly, it may be a sign of discomfort or joint problems that need veterinary attention.

7. Incorporating Rehab and Proprioception:

• Integrating rehabilitation or prehabilitation into surgical care plans is helpful. Proprioception exercises, which improve balance and body awareness, are simple yet effective for recovery and preventing further injuries. These exercises can be easily incorporated into daily routines despite their complex-sounding name.

Further links:

https://www.vetmed.wisc.edu/lab/corl/canine-genetic-testing/

https://caninearthritis.org/article/ccl-surgical-and-non-surgical-options-overview/

https://caninearthritis.org/article/ccl-non-surgical/

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