Preventing a CCL Rupture, What are the warning signs part 2

In the last Learn & Go we discussed the first 2 warning signs of a CCL rupture, today we talk about 4 more. The last one may be the most important and one you are not aware of.

First, we start with posture. Dogs with reduced angulation in the rear limbs, are more likely to tear their cruciate ligament. In our video, Dr. Laurie quickly and easily explains how to tell if the dog has straight or angulated rear limbs. She also describes the posture of dogs whose hips, knees, or hocks are painful and what that leads to.

The next two Warning Signs are seen in the patellas. Hand stack the dog so that the metatarsal bones are perpendicular to the ground. Measure the distance from the line of the metatarsal bones to the greater trochanter. More distance means more angulation. Moderation is the key. Akitas are known for having a straight rear. Labrador Retrievers are often moderately angled, and German Shepherd Dogs are one of the most, if not the most, angulated breeds.

Dr. Laurie also describes the posture of dogs whose hips, knees, or hocks are painful and what that leads to. Continued compression on the same spot on the cartilage is uncomfortable. The dog may straighten their rear legs moving the pressure to a new spot making the joint more comfortable. Unfortunately, this often leads to back pain. In the video we have pictures to show exactly what to look for. Knowing this, we can work with the dog and watch their flexion come back as our treatments make them more comfortable. As their rear limbs regain normal position, the pressure on their backs is reduced.

Sloppy, or puppy sitting, with weight on to one hip can either cause abnormal biomechanics leading to a CCL tear, or can be a warning sign of discomfort in the stifle. This is often a sign, long before a limp is evident . Weight shifting off of one rear limb on to the other is an obvious sign that something is painful, but shifting the weight forward is often overlooked. Dr. Laurie shows you an easy way to determine if the dog is shifting their weight forward.

In the video, Dr. Laurie also shares a special test that she uses to detect subtle changes in weight bearing, a simple test you don’t want to miss.

The next two Warning Signs are seen in the patella. Being able to evaluate the patella is key. Patella Alta and Patella Baja are normal variations. Dr. Laurie explains these variations and why they are important. Next, she demonstrates two tests that check for patella luxation. If the patellar tendon is no longer at the front of the stifle, there may be more instability allowing excess pressure on the cruciate ligament, and potentially increased damage..

The next test is the patella motion test. Motion in one direction, but not another, may indicate scar tissue pulling the patella into the femur, causing inflammation. If we don’t fix this, it doesn’t matter what else we do, we are fighting an uphill battle.

Last but not least, many veterinarians assess the stifle using the anterior drawer and cranial tibial thrust tests. Both tests are looking for abnormal motion. Another, more subtle sign, using these same tests is to assess for discomfort. This can only be seen if the tests are performed slowly. There may not be motion yet, since in some of these cases, a few but not all, of the fibers are still intact. In those cases there may be discomfort from the torn fibers. These torn fibers can be a cause of acute inflammation. Treating the dog early, when there is only pain and inflammation, and not waiting until there are other, more obvious signs, can be the difference between having a dog that doesn’t need surgery and one that does.