CCL tears, or “cranial cruciate ligament” tears, can occur slowly over time or be abrupt. With this in mind, the symptoms and indicators below may start showing all of a sudden, or they may develop slowly. This is a tear or rupture to your dog’s cranial cruciate ligament and is similar to an ACL tear in humans.
We’ve had two dogs that have had CCL tears and subsequent TPLO surgery, and another we are getting ready to go through it with at this very moment. Aside from that, we’ve been lucky not to have more, given the number of dogs we have had over the years.
What we have found, though, is that some symptoms tend to point very clearly to the need for TPLO surgery, and some that are a bit hard to distinguish.
If it happens suddenly, the limp will be sudden, and the pain level will be high for a few days but will taper off a bit. Obviously, the quicker you can get the dog to the vet, the better.
Larger dogs are more prone to CCL damage than smaller ones, and some breeds are actually predisposed to it, such as Rottweilers, Labradors, Akitas, Newfoundlands, Saint Bernards, and others.
CCL symptoms and indicators
Hind leg dragging / toe-touching
This is the most common and visible sign of a dog with a ruptured or torn CCL and would most likely benefit from TPLO surgery.
This may manifest early as a limp, so watch for a limp as well.
Difficulty in getting up from the floor
If your dog is struggling to get up, this may indicate an issue.
Watch closely to see the real struggle and if it comes when putting weight on the rear legs.
This may be an issue with the CCL.
Decreased activity level
If an otherwise active dog suddenly shows less interest in fetching that stick or catching that frisbee, it may be because it hurts him to do so, so he opts out.
Rocket, the girl we are prepping for TPLO at this time, is a dog who has earned her name.
Super fast, very active.
She has less enthusiasm for activities these days, and this is one of the things we noticed that drove us to take a closer look.
Difficulty getting into or out of a car or truck
Again, our dog, Rocket, was notoriously active and would jump into the back of our SUV or through an open door. She won’t now, so this may be another area to watch if you have gas-happy pups as we do.
Cranial cruciate ligament tear or rupture diagnosis
Gait observation
Your vet will be able to tell a lot just by watching your dog walk or run. Gait analysis is an interesting study, and several methods can be used. The most common is simply via visual observation of the gait. Interesting information is available about canine gait analysis.
Drawer test
Every vet is trained to recognize the symptoms of a torn CCL, and they can quickly perform what is called the “drawer test.”
In almost all cases, this can be done without sedation or any visible signs of pain. In extreme cases, sedation may be required.
To perform the test, the vet will hold the top of your dog’s leg still (the femur) while manipulating the bottom of the leg (tibia and fibula).
The vet is looking to see if the lower portion of the leg can move forward while the femur is held in place, like a drawer closing.
Often you’ll see a range of motion here of maybe half an inch or less. Importantly, there should be no movement at all.
Any movement indicates a torn or ruptured CCL.
The drawer test is an excellent first step and provides an accurate diagnosis in most cases. To be sure, though, x-rays will most likely be needed.
Here’s a good video of a vet doing (and explaining) the drawer test.
X-rays
If the drawer test indicates a torn or ruptured CCL, the next step will be x-rays.
This is where you start counting the money the entire TPLO costs.
Your vet may want x-rays to ensure the most accurate diagnosis, but if your pup is heading into TPLO surgery, you can be certain the surgeon will require them.
The surgeon will use the X-rays to determine the proper angles that need to be set during the surgery. To determine success, there will also be follow-up x-rays after the surgery and then again probably eight weeks later, near the end of the TPLO recovery.
CCL tear or rupture symptoms – conclusion
The best approach is to keep an eye on your pup for any new behavior or, importantly, lack of desire to play or be active.
I know of people who intentionally reduce their dog’s activity to prevent CCL tears.
Often, they experience them anyway.
I’m of the mindset that I let my dogs be dogs and face the consequences when they arrive. In over 20 years of rescuing dogs (and letting them play as much as they want), we’ve had two TPLOs to contend with. Maybe we’ve been lucky.
Watch for hind leg dragging, as this was what tipped us off both times. You may catch it earlier as a developing limp.
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