Effect of Cranial Cruciate Ligament Treatment on Canine Life Expectancy

In the literature

Boge GS, Engdahl K, Bergström A, et al. Disease-related and overall survival in dogs with cranial cruciate ligament disease, a historical cohort study. Prev Vet Med. 2020;181:105057.

The Research …

Cranial cruciate ligament (CCL) disease is one of the most common orthopedic conditions in dogs and the leading cause of canine pelvic limb lameness.¹

Surgical management of CCL disease has been shown to be the most effective treatment for returning the affected leg to function and limiting progression of stifle osteoarthritis. There are several procedures to treat this disorder, with osteotomy and extracapsular techniques being commonly used. Conservative management, which can include any combination of rest, NSAIDs, physical therapy, nutraceuticals, and intra-articular stifle injections, is an alternative option.

This historical cohort study evaluated the effect of treatment method (ie, conservative vs surgical management) and multiple risk factors (eg, body weight) on the survival of dogs with CCL disease (n = 333). Most veterinary studies on orthopedic conditions in dogs focus outcome measures on degree of lameness, return to function, and complication rate; this study, however, specifically evaluated the effect of treatment on life expectancy.

Models in this study revealed improved survival in surgically treated dogs as compared with dogs managed conservatively. In addition, factors shown to negatively affect survival included increasing age, increasing body weight, and having other orthopedic conditions.

Some important factors were not accounted for. Meniscal tears occur in a large portion of dogs with CCL disease and can be a source of pain and lameness. In this study, many patients treated surgically most likely had a meniscal injury treated at the time of surgery; however, joint exploration was rarely performed in dogs managed conservatively, so meniscal injury could be considered a confounding factor. In addition, increasing body weight was found to negatively affect survival, although smaller dogs generally tend to have a longer lifespan than larger dogs.

Findings regarding how CCL disease can affect survival rate in dogs can help clinicians make decisions regarding treatment recommendations for these patients.

… The Takeaways

Key pearls to put into practice:

• CCL disease may affect life expectancy in dogs.

• Patient factors (eg, age, body weight, presence of orthopedic and nonorthopedic comorbidities) should be considered when selecting a treatment method for CCL disease in dogs.

• Surgical treatment often results in the most favorable long-term outcome for dogs with CCL disease.