Is Surgery the Only Option?

It didn’t take long to figure out why Sophie was limping. On the previous day, the active

six-year-old Labrador Retriever had been chasing a ball when she suddenly let out a yelp

and began limping on her rear leg. When I examined her knee, I immediately knew that she

had torn her ACL, or anterior cruciate ligament. When I told Sophie’s “mom” that surgery

was the best option to ensure that her dog could return to normal mobility, she was

shocked to learn that the procedure would cost $2,500 $to 4,000.

Unless you’ve had a dog with an ACL injury, you may not be aware that it’s by far the most

common orthopedic injury of dogs. The ligament is found inside the knee joint and is

responsible for maintaining front to back stability of the knee. When the ligament is

completely torn, the dog will not be able to put its full weight on the leg. Frequently, the

ligament tears without any obvious trauma in dogs that are overweight or that have

genetically poor conformation of their knees. Because the ends of a completely torn

ligament inside the knee do not reattach on their own, surgery is frequently recommended

to stabilize the joint and allow normal use of the leg.

Not every dog with an ACL injury needs surgery, however. Dogs weighing less than 30

pounds usually do well without surgery because they don’t bear as much weight on the

affected leg. A nonsurgical option for ACL injuries in larger dogs is to have a custom knee

brace made for the dog. I have two cases where the clients have opted to use a brace

instead of surgery, and the dogs are able to walk quite well. It also appears that if used

properly, these braces may allow the dog’s knee to tighten up adequately over six to 12

months, eventually getting to the point where they no longer need the brace.

Some dogs’ ACL injuries result in only partial ligament tears. Frequently these animals are

sent to surgery because many veterinarians believe that the damaged ligament has poor

blood supply and won’t heal, eventually tearing completely. I have found that this is not

always true, and that a partially torn ACL can indeed heal completely with a combination of

acupuncture, herbal and nutritional support. These treatments bring more blood supply and

nutrients to the damaged ligament and allow it to heal.

Another important issue to consider is if a dog injures the ACL on one knee, the other knee

frequently suffers the same fate. This is because the same contributing factors generally

affect both knees. Certainly obesity and poor conformation play a role, but other factors are

just as important. A recent study done at the UC Davis School of Veterinary Medicine

showed a significant increase in the incidence of ACL injuries (and hip dysplasia) in

Golden Retrievers that were spayed or neutered at or before six months of age, compared

to dogs that were altered later. It appears that hormones produced in the ovaries and

testicles are important for proper bone and ligament growth. This is one of many reasons I

recommend waiting until dogs are fully grown before being neutered or spayed. I’ve also

seen a connection between poor quality dog foods and ACL injuries. I believe that proper

nutrition is definitely one of the most important factors in the prevention and treatment of

ACL injuries.

Hopefully your pet will never end up like Sophie, but if your dog is someday faced with an

ACL injury, remember that there are options other than surgery. And as to the prevention of

these injuries, I recommend waiting until your dog is fully grown before neutering or

spaying. I also recommend a high quality, nutrient dense low carbohydrate diet to guard

against obesity and optimize the strength of the ligament and tendons.

Dr. Judkins is the owner of Animalkind Holistic Veterinary Clinic in Jacksonville, Oregon