How Much Does ACL (CCL) Surgery For Dogs Cost?

ACL, also called CCL, in dogs is the Cranial Cruciate Ligament. This ligament is very much like the ACL, or Anterior Cruciate Ligament, in humans.

In this article, we’ll look at ACL, its available treatments, its causes, and the average cost of surgery to correct the condition. If left untreated, ACL can cause lameness, pain and disability in your dog.

As a dog owner, and with more than 15 years of experience in the pet insurance industry, I’ve seen how critically important timely intervention can be to safeguard your pet’s health and well being.

Symptoms And Diagnosis

The symptoms of an ACL injury ordinarily depend on its severity.

Below are some symptoms that may be observed in a dog with an ACL injury:

• Pain When Walking: Signs of discomfort or pain when walking.
• Stiffness: ACL tears cause dog’s ligaments to retract, limiting the range of motion of the knee joint, especially after resting.
• Limping or Lameness: Walking more slowly than usual or staggering because of the weaker leg. This can range from just a little lameness all the way to being unable to bear any weight on the injured leg.
• Struggles to Jump Up on Furniture or Climb Stairs: Difficulty with activities that require climbing or jumping.
• Presence of the “Drawer Sign”: When the veterinarian holds the dog’s femur in place, the tibia may be pulled forward much like opening a drawer.
• Swelling on the Inside of the Knee: Swelling on the inside of the knee is a common symptom of an ACL injury..
• Difficulty Rising Off the Floor: Struggling to get back up when lying down.

A veterinarian can diagnose ACL injuries through a physical exam along with imaging tests such as X-Rays and ultrasounds.

1. Physical Examination: The veterinarian performs a physical examination, checking for any abnormal popping of the joint, as well as touching and feeling the leg for pain and instability. The dog’s knee might be unusually firm and thick.
2. History of Lameness: The vet will ask for a history of the dog’s lameness.
3. X-Rays: Besides a thorough physical examination, the vet will probably do X-Rays of your dog’s knee to see the extent of the damage and also to rule out other causes of its lameness. X-Rays allow the determination of presence of fluid or arthritis in the joint, too, along with the presence of any small pieces of bone that may have broken off with the ligament when it was ruptured.
4. Cranial Drawer Test: Performed with the dog lying on its side in a relaxed state, the vet holds the dog’s femur steadily in place. If the tibia is able to be pulled forward like a drawer sliding open, this is an indication of a torn ACL. Bear in mind, though, that the lack of a drawer sign doesn’t mean there’s no damage to the ACL.

Causes

There are multiple causes of dog ACL injuries.

• Breed: Some breeds are more prone to ACL injuries.
• Age: Aging of the ligament may cause weakening and degeneration, which makes it susceptible to injury.
• Activity: The ACL may be injured if a dog pivots to make sudden turns when running, twists on their hind legs, or slips on a surface. This usually occurs while suddenly changing direction when running because it places most of the dog’s weight on the knee joint.
• Poor Physical Condition: Dogs that are usually sedentary but get occasional strenuous exercise might have a greater likelihood of developing ACL injuries.
• Neutering: Numerous studies have shown that a small percentage of males, especially very large breeds, that are neutered before one year old sustained ACL injuries later on in life. This applies to females, too.
• Obesity: The excess weight of obese dogs can wear on the joint over time, causing the ACL to develop weakness and degeneration. This means that overweight dogs are at much higher risk of tearing an ACL.
• Other Knee Problems: Dogs that have other knee problems, such as a luxating patella, for example, might be predisposed to rupturing an ACL.

Treatment

Treatment options for ACL injuries may include surgical as well as non-surgical methods:

Non-Surgical Treatments for ACL:

Treatment for ACL  injuries in dogs may differ based on the severity.

Here are some common non-surgical treatment options:

• Pain Management: Pain control or anti-inflammatories can offer your dog comfort as they heal.
• Rest: Strict rest is often recommended to avoid further injury to the area.
• Physical Therapy: Physical therapy can strengthen the muscles and improve the dog’s recovery.
• Laser Therapy or Acupuncture: These treatments can improve circulation and promote healing.
• Weight Management: Managing the dog’s weight can help reduce stress on the joint.
• Orthopedic Braces: These can help stabilize the leg.
• Joint Supplements: Supplements like glucosamine can help protect your dog’s joints.

Surgical Treatments:

In some cases, surgery may be necessary for ACL injuries. The type of surgery is dependent on the dog’s age, size, and severity of the injury.

Below are some common types of surgery performed for ACL injuries in dogs:

1. TightRope® Procedure: This is an extracapsular repair using a strong suture material that provides stability to the affected joint.
2. Tibial Plateau Leveling Osteotomy or TPLO: Changes the angle of the tibia so that the femur doesn’t slide backward, which stabilizes the knee joint.
3. Tibial Tuberosity Advancement or TTA: Changes the dynamics of the knee, making the cranial cruciate ligament no longer necessary for stability.
4. Lateral Fabello Tibial Surgery  or LFS: A common surgery for dogs with a ruptured ACL.
5. Extracapsular Lateral Suture Stabilization or ELSS: The oldest surgical correction for cruciate ligament injury in dogs. The joint is stabilized outside the joint capsule, placing a special type of suture material outside the joint to mimic the functionality of the dog’s cranial cruciate ligament.

How Much Does ACL Surgery Cost?

The cost of ACL surgery for dogs, also known as CCL, can differ greatly depending on a variety of  factors, such as the location of the veterinary clinic, type of surgery, size and breed of the dog,  and extent of the injury.

The average cost of ACL surgery for dogs ranges from $750 to $8,000.But, this procedure usually averages between $2,000 to $4,000 per knee. The cost may be higher for more difficult cases or for surgeries done at specialty clinics.

What Is Included In The Surgery Cost?

The cost of ACL surgery for dogs usually includes various components:

• Pre-Op Exams: Includes an initial consultation and diagnostic tests needed to confirm the diagnosis and plan the appropriate surgery.
• Post-Op Care: Includes follow-up visits to check on the dog’s recovery after surgery.
• Surgical fees: The cost of the surgery, which can vary according to the type of procedure.
• Medication: Pain medications for pain management or antibiotics for infection prevention are normally included.
• Anesthesia: The cost of anesthesia is generally included in the cost of the surgery. The amount of anesthesia required depends on the dog’s size.
• Hospitalization: The dog might need to be hospitalized for monitoring after the surgery.
• Physical therapy: Some dogs will need physical therapy after surgery to regain their mobility and strength.

Real-World Examples Of ACL Surgery Costs

1. VCA Animal Hospitals: Costs range from $1,000 to $6,000 for the procedure itself. More complex cases or those requiring specialized care may be higher​, while less difficult cases might be lower.
2. Lemonade Pet Insurance: Lemonade Pet Insurance has a reimbursement percentage of either 70%, 80% or 90%. So, your cost would depend on which percentage plan you selected.
3. A-Z Animals: A-Z Animals states a typical cost of between $1,000 and $5,000, noting that the total cost price might vary depending on several factors such as breed, age, overall health and severity of the ACL injury.

What Factors Affect The Cost Of ACL Surgery?

The cost of ACL surgery varies depending on several factors. Having a working knowledge of these factors can help you anticipate expenses and be better able to  make informed decisions about your pet’s care. Here are some factors involved:

1. Severity of the Injury: The severity of the ACL injury can affect the cost, since more severe injuries may require more complicated surgical procedures.
2. Type of Surgery: The surgical procedure the vet recommends can affect the cost.
3. Size of Dog: Larger breeds are more prone to ACL injuries and may need more rehab time.
4. Surgeon’s Experience and Reputation: More experienced surgeons or those with a high reputation for dog ACL surgery may charge more.
5. Location: The region or city where the ACL surgery is done can greatly impact the cost because of higher or lower costs and fees.

Does Pet Insurance Cover ACL Surgery?

Generally speaking, yes, most pet insurance providers do cover ACL surgery. Here are some things to keep in mind:

1. Pre-existing Conditions: If ACL treatment/surgery is covered can depend on whether or not your insurance has coverage for pre-existing conditions.
2. Waiting Periods and Exclusions: ACL issues in dogs may be subject to a longer waiting period as well as stricter exclusions than other conditions due to being  expensive to treat.

Hereditary And Congenital Conditions

Numerous comprehensive pet insurance policies provide coverage for hereditary along with congenital conditions, including ACL. For instance, Lemonade Pet Insurance ordinarily covers the cost of ACL surgery, minus deductibles and co-insurance, provided that the policy was in place before the dog had symptoms​.

MetLife Pet Insurance covers ACL surgery, too, under its policies that include hereditary conditions, and advises pet owners to check for exclusions related to pre-existing conditions​​.

ACL injuries injuries in dogs can have a hereditary component. It has been found that these injuries have a polygenetic architecture with a moderate heritability factor. This means that multiple genes can contribute to the risk of ACL injuries, and that these particular genes may be passed down from parent to offspring.

A new genetic test has been developed at the University of Wisconsin–Madison School of Veterinary Medicine that determines susceptibility to ACL injuries. The screening test is the first of its kind in pets, and requires just a cheek swab that an owner can collect at home, or a small blood sample.

Pre-Existing Conditions

Pet insurance policies don’t typically cover pre-existing conditions. If your pet has been diagnosed with ACL before you take out the policy, or shows symptoms of ACL during the waiting period, the surgery probably will not be covered​​.

How Can I Save Money On ACL Surgery?

Saving money on ACL surgery for your dog can be achieved through several strategies.

First, consider getting pet insurance that covers hereditary and congenital conditions, as this can significantly offset the cost. Many comprehensive pet insurance plans will cover the surgery after deductibles and co-insurance, potentially saving you hundreds to thousands of dollars. It’s important to enroll your pet in insurance early to avoid issues with pre-existing condition exclusions.

Another way to save is by exploring financing options or payment plans offered by veterinary clinics. Some clinics offer interest-free payment plans or financing options that can help you manage the cost over time. Additionally, look for veterinary schools that might offer discounted rates for procedures performed by supervised students.

What Breeds Are Typically Affected By ACL?

Certain dog breeds are more susceptible to developing ACL due to genetic predispositions and anatomical features. The breeds most commonly associated with ACL include:

• Poodles
• Bichon Frises
• German Shepherds
• Rottweilers
• Mastiffs
• Akitas
• Bernards
• American Staffordshire Terriers

Sporting Breeds

These sporting breeds are often susceptible to ACL due to genetic factors:

• Labrador Retrievers
• Golden Retrievers
• Chesapeake Bay Retrievers
• Newfoundlands

Other Affected Breeds

While the above categories cover many of the commonly affected breeds, other breeds can also develop ACL, including:

• Boxers
• Chow Chows

Please keep in mind, though, that any breed of dog can have ACL problems.

Is Surgery Required For ACL?

Not always, no. Sometimes surgery might not be necessary. In some cases, more conservative management might be effective. This is especially true for smaller breed dogs or those with less severe ACL injuries.

If surgery is out of budget or too risky because of a dog’s age or overall health condition, a leg brace might help your dog to heal correctly as well as quickly. Resting the affected leg can help, too.

What Happens If ACL Is Left Untreated?

Here are some of the problems that may occur if ACL is left untreated:

• Instability: Without surgery, the body tries to stabilize the wobbly knee with scar tissue. Unfortunately, this is hardly ever strong enough to keep the knee stable.
• Limited Range of Motion: This scar tissue limits the range of motion. The more scar tissue, the stiffer the joint — the dog cannot bend or extend the knee all the way.
• Pain: Dogs with a torn ACL are typically in pain. Over time, pain may decrease to some degree, but it still hurts, especially once arthritis sets in.
• Exercise Intolerance: It’s tough to run around with a sore knee, which leads to exercise intolerance as the conditions above worsen.
• Muscle Atrophy: Not using the leg leads to various degrees of muscle loss.
• Arthritis: The older the injury, the more arthritis we see in the joint. Arthritis is a life-long condition and there is no cure for it1.

How Can I Prevent ACL?

It isn’t possible to entirely prevent ACL injuries, unfortunately. But there are some things you can do to be proactive about helping your dog avoid them:

• Regular Exercise: Regular exercise may help with bone, strengthening, muscle, along with connective tissue development.
• Warm Up Before Exercise: Dogs, like humans, need to warm up before strenuous activities. This may help to prevent ACL and other injuries.
• Avoid Strenuous Activities: Avoid activities that may cause your dog to twist its knee, like jumping off of something high, running and turning quickly, or stepping in a hole.
• Beware the “Weekend Warrior Syndrome”: If your dog is basically a couch potato through the week, don’t let it engage in intense physical activity on the weekend. This sudden change in activity can increase the risk of injury.
• Maintain a Healthy Weight: Overweight dogs are more prone to ACL injuries because of the extra pressure on the knee ligament.
• Breed Awareness: If you own a breed that is genetically predisposed to ACL injury, be vigilant about monitoring its ACL health. Being aware of the risks means you can do all you can to prevent the problem.

While the steps shown above can help reduce the risk of ACL injuries, you should note that because of the genetic nature of the condition, it can’t be totally  prevented. If your dog shows symptoms of ACL, you should consult a vet right away.