Health & Medical

Cranial Cruciate Ligament Disease: Breeds at High Risk, Symptoms, Treatment Options

Cranial Cruciate Ligament Disease | Vanillapup

The Cranial Cruciate Ligament disease is a very common problem in dogs. Find out more about this condition, such as symptoms, diagnosis, and treatments.

The Cranial Cruciate Ligament (CCL) disease is a very common problem in dogs. Just scroll through established online community groups and we would probably see dog owners sharing experiences with this condition.

Dealing with CCL tears or ruptures may be traumatising for most dog owners but with proper treatment and care, there will be a significant improvement.

Curious Black Labrador | Vanillapup

What is Cranial Cruciate Ligament Disease?

The CCLs are the main stabilisers of the knee joints (stifles) in the back legs. It connects the femur (thighbone) to the tibia (shin bone).

In between these two bones, there are two cartilagenous paddings called the meniscus for shock absorption and load bearing. It can get damaged due to an injured CCL.

While “rupture” and “tear” may sound like a sudden injury, the American College of Veterinary Surgeons (ACVS) found that the vast majority of affected dogs suffered instead from a gradual deterioration of the CCL over a period of months or years.


“A torn CCL may cause the dog to start limping suddenly, often after some form of exertion, such as jumping off a sofa,” explains Dr. Eugene Lin (BVSc), founder of The Animal Ark Veterinary Group.

“Depending on the severity of the condition, the dog may display signs of mild lameness or be unable to bear weight on the affected limb, causing her to stand on just 3 legs. There would also usually be a painful swelling at the middle or inner part of the knee joint.”

Breeds at high risk

Large breed dogs, such as Golden Retrievers, Labradors and Rottweilers may be more susceptible to CCL injury. However, Dr. Lin has seen an increased number of small breed patients, such as Malteses, Shih Tzus and Chihuahuas, suffering from the same condition.

From my experience, Westies seem to be prone to this disease as well. Hence, it can be fair to say that CCL injury can happen to breeds of all sizes and ages.

Perhaps the only way to reduce the likelihood of developing a CCL rupture is to keep your dog’s weight in check. According to Dr. Lin, obese dogs are also more likely to develop CCL rupture as extra weight accelerates progressive damage to the ligament.

“Current literature has also established that 40-60% of dogs who have CCL disease in one knee would develop it in the other knee over time.” adds Dr. Koh Cher Ling (BVSc), Associate Veterinarian at Landon Veterinary Specialists.


Diagnosis includes assessing the dog’s medical history, conducting a physical and gait examination, and taking good quality radiographs.

“Radiographs helps the diagnosis by detecting the presence of joint effusion (fluid accumulation in the joint). They are also able to help your veterinarian determine the presence and degree of arthritis and take measurements for surgical planning”, says Dr. Koh.

Non-surgical treatment

In smaller and lighter animals, Dr. Lin shares that veterinarians may recommend conservative treatments through prescribing anti-inflammatories.

With strict rest, most of these animals would become ambulatory again in a few weeks. Unfortunately, without surgery, the knee joint will continue to undergo degenerative changes.

Surgical treatment options

Cranial Cruciate Ligament Surgery | Vanillapup

According to Dr. Koh, the majority of dogs with CCL will require surgery. This is especially so when the lameness persists due to damaged meniscus or when both knees suffer from the condition.

The goal of surgery is to create a stable knee to bear weight, relieve pain, and slow down the development of knee arthritis. 

Surgical options and techniques are categorised into two groups: 


Osteotomy-based techniques

Osteotomies balance out the opposing thrust forces exerted by the femur and the tibia during weight bearing through implants to create a stable knee in the absence of the ligament. 


Suture-based techniques: 

This category of techniques uses an inert suture placed outside of the knee joint (extra-articular) to mimic the stability provided by the ligament.

It would typically take 5 – 8 weeks for the wound of healthy dogs to heal and fuse.


Happy Border Collie | Vanillapup

Cranial Cruciate Ligament surgeries can cost between one to two thousand dollars to over SGD5,000, based on estimations from Dr. Lin and Dr. Koh.

Since its launch, Happy Tails Pet Insurance has received several claims for Cranial Cruciate Ligament rupture with varying bill amounts.

“The largest bill amounted to over SGD8,000 in total (including room & board and surgical costs), out of which more than SGD6,000 was paid out to the satisfied policyholder. She submitted the claim 7 months after purchasing the policy for her then 3-year-old Maltese,” says a representative from the Happy Tails team.

Insuring your pets early can help to alleviate the financial burden associated with surgical treatments like this, and allow prompt treatment.

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Full disclosure: This post is sponsored by Happy Tails Pet Insurance.

Disclaimer: This post is not a contract of insurance. Full details of the terms, conditions and exclusions of this insurance can be found in the policy wording on our website at You should consider the policy wording in full before making any decision to purchase Happy Tails Pet Insurance. Happy Tails is arranged by Aon Singapore Pte Ltd and underwritten by MSIG Insurance (Singapore) Pte. Ltd. © 2016 Aon Singapore Pte Ltd, Co Reg No. 198301525W. All Rights Reserved.

Photo credit: Thomas Hawk via / CC BY-NCthepeachpeddler via / CC BY-SA and ynaka29 via / CC BY-NC-ND

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Latte is the happy Westie behind Vanillapup, a website for dog lovers. Discover latest products and services, dog-friendly hangouts, helpful tips and advice, and exclusive perks.
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