Ultimate Guide to Treating Ruptured CCL’s Without Surgery - Part 1

Fewer things strike terror in the heart of a dog owner than seeing your dog first start limping.
— Holistic Dog Mom

In the past week, I’ve stumbled upon posts in numerous Facebook Groups asking about alternative treatment options to surgery for a dog with a ruptured CCL. When I look back at my evolution as an Holistic Dog Mom, my old gal Kahlua’s ruptured CCL was a crossroads for me in seeking alternative treatments.

Kahlua, my double CCL girl


In this series, I’ll share with you:

  1. The 4 Most Common Surgical Options for Ruptured CCLs

  2. 5 Factors to Consider When Determining if Surgery is the Right Option for Your Dog

  3. The Non-Surgical Treatment Options I Used in 2011

  4. The Non-Surgical Treatment Options I Would Use Now

  5. How to Create a Comprehensive Non-Surgical Treatment Plan for Your Dog, and

  6. Can We Prevent CCL Tears Before They Start? A Look at Inflammation in Your Dog


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Stifle Joint

Your dog’s Stifle Joint works similarly to a human’s knee: the femur (thigh) bone meets the tibia and fibula with 2 ligaments (bands of connective tissue) that stabilize the joint.

When there’s a partial or full tear of this Cranial Cruciate Ligament, your dog may start limping, have trouble bearing weight on the affected leg, or begin “toe tapping.”

Photo by Florian Scheuerer / CC BY 2.0


For me, it was the summer of 2011 when Kahlua first started limping. It seemed sudden, but in hindsight she had been acting oddly for a few weeks on our walks - lagging behind or being uncooperative. Since Kahlua was a stubborn gal on her best day, it was difficult to tell if something was wrong. In retrospect, she most likely had a partial tear for a period of time which then became a fully ruptured CCL.

So we ended up at our local vet office where they noticed the classic “drawer sign” in Kahlua — the telltale sign of a torn CCL. We were then referred to a veterinary specialist who wanted to perform surgery.


The 4 Most Common Surgical Options for Ruptured CCL’s

I’ve included links to find our more about each of these techniques from our favorite orthopedic vets at Veterinary Orthopedic Sports Medicine Group.

  1. Extracapsular Stabilization /  Lateral Suture. I think of this as the “old school” surgery. Many general veterinarians can perform this surgery without the need for a referral to a specialist. This surgery is not usually recommended for larger dogs.

  2. TPLO or Tibial Plateau Leveling Osteotomy. Of the people I personally know who have chosen to go the surgical route, this is the most common surgery performed. This actually involves breaking your dog’s tibia bone and inserting a titanium plate.

  3. TTA or Tibial Tuberosity Advancement. Make sure to discuss all potential risks and complications of this technique with your vet.

  4. Tightrope. This is a newer and less invasive technique (does not involve breaking any bones), but also may not be suitable for larger dogs.


My husband & I found ourselves with a huge decision to make. These are the factors we considered in deciding if surgery was the best treatment option for Kahlua.


5 Factors to Consider When Determining if Surgery
is the Right Option for Your Dog

  1. Age & Activity Level.
    Kahlua was a 9-year-old couch potato dog who liked her daily walks and chasing squirrels in the yard. If your dog is a 2-year-old high-drive agility champ, you might make a different decision.

  2. Size & Weight.
    Kahlua was approx. 50 lbs. If your dog is 10 lbs or 120 lbs, you might make a different decision.

  3. Anesthesia.
    Some dogs have health risks that make anesthesia a risk or contraindication. Kahlua always had a bad reaction after coming out of anesthesia. We were never 100% sure if it was the anesthesia itself, or the injection of buprenorphine commonly given for pain, that caused Kahlua’s reaction. It could take up to a week for Kahlua to fully recover and be herself again. She would whine incessantly at all hours of the day & night, pace, seem agitated and unable to settle herself, and generally did not want to snuggle or be comforted - the opposite of her normal self. Any time Kahlua had to be put under anesthesia, it threw her - and our household - into upheaval.

  4. Crate Rest & Recovery.
    The recovery for these surgeries is very intense and dogs have to be on crate rest, usually for weeks. Kahlua had a history of smashing up her face in an attempt to get out of crates. While she never succeeded in breaking out of a crate, she did injure her face on a number of occasions. The idea of crating her for weeks sounded like torture.

    If you do opt for surgery for your dog, make sure to familiarize yourself with the recovery process. You may even want to look up images or videos of post-surgery dogs to prepare yourself.

  5. Money.
    As dog owners, we sometimes feel guilty for considering money as a factor when caring for our dogs. At the time my husband & I were facing these decisions, $5,000+ for a surgery would have been a huge hit on our finances. If we had a 2-year-old dog that was ok with anesthesia and crate rest, we may have been able to find a way to make the money work.

    Another factor to consider is that a high percentage of dogs that rupture their first CCL, will then experience the rupture their other CCL within 2 years.



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