Just as humans can tear an ACL—a specific type of knee injury—your dog can injure their ACL through gradual wear and tear. An ACL tear can be very painful, and surgery is often required to fix the ligament.
As of 2023, ACL surgery for dogs can cost about $1,500 to $10,000, and dogs who injure one ACL often injure the other. As a result, it’s important to make sure that you’re financially prepared just in case your dog ever does tear their ACL.
What’s an ACL?
The anterior cruciate ligament (ACL) and posterior cruciate ligament (PCL) are cruciate ligaments of the human knee joint. The ACL connects the femur and tibia bones at the front of the knee, while the PCL connects them at the back of the knee. Together, they provide stability and support to the knee during movement and physical activities.
Dogs don’t technically have an ACL or PCL, but they have an equivalent, called cranial cruciate ligament disease (aka CrCLD, CCLD, or CCL), that does the same thing in their hind legs.
Just like humans can tear their ACL by lifting weights or playing football, dogs can also tear their cranial cruciate ligament, resulting in a very painful condition that may require surgery to fix it.
But for the sake of this article, we’ll refer to a dog’s cranial cruciate ligament as what most pet parents colloquially call it—their ACL.
How do dogs injure their ACL?
Dogs, especially highly active dogs, can cover lots of ground (and rounds of fetch) each day. All of that movement puts stress on their joints. That wear and tear can gradually weaken the ligaments in your dog’s knee, increasing their chance of ACL injuries. It’s highly unlikely that one squirrel chase that got a little too wild will be the cause of a dog’s ACL injury.
Obese and aging dogs are also at an increased risk of an ACL injury, and genetics can also play a role, leaving certain dogs more predisposed to ACL injuries than others.
If a dog injures the ACL in one leg, the dog will be more likely to injure the ACL in their other leg in the future. This could potentially happen after your dog has already had surgery in one leg, since the other leg holds more weight and is under more strain during the recovery process (but it’s more likely from the underlying condition). That situation could lead to your dog needing not one, but two expensive surgeries.
How can I help my dog prevent an ACL injury?
Fortunately, there are several ways that you can help to prevent an ACL injury:
- Keep your dog at a healthy weight. Obesity in dogs can increase their chance of injuring an ACL, so ensure your dog gets regular exercise—not the occasional, excessive play session—and consider feeding a lower-calorie food if your dog needs to lose a few pounds.
- Consider joint supplements. Joint supplements can support your dog’s orthopedic health.
- Use pet stairs or ramps. Avoid situations where your dog has to jump down off the couch or out of your vehicle. Set up pet stairs or a ramp so your dog can simply step—or glide—down, reducing the risk of a traumatic injury.
- Carefully choose your play areas. When it’s playtime, make sure that your dog has a flat, even surface without any ruts or holes where they could catch a leg. Fill in any holes in your yard and keep the area free of debris.
- Maximize traction. If you have slick tile or hardwood floors in your home, put down stair runners or rugs to give your dog extra grip and help to prevent slips and falls.
What are some signs that my dog might have an ACL injury?
Several signs can indicate that your dog may have an ACL injury:
- Limping or unexplained lameness
- Avoiding putting weight on a leg
- Walking on tip-toes
- Swelling in the knee
- Clicking sounds in the knee joint
- Difficulty jumping or getting up from a sitting position
- Unusual lethargy
- Muscle atrophy in one or multiple legs
If you notice any of these signs, then be sure to call your vet right away and restrict your dog’s movement. It’s possible for dogs to simply strain a cruciate, and if you catch this injury early, your vet may be able to help keep your dog from actually tearing the ligament. Catching a smaller cruciate tear earlier on can also give you a chance to limit your dog’s movement so your dog doesn’t make the tear larger.
How do vets diagnose a dog’s ACL injury?
To diagnose an ACL injury, your vet will start by performing a physical exam and palpating your dog’s knee. Your vet may be able to make the diagnosis based on that examination alone, but x-rays or a sedated orthopedic exam can also provide more detailed information about the size and severity of the tear.
Your vet might refer you to a board certified veterinary surgeon to determine the diagnosis and discuss treatment options.
How much does ACL surgery cost for a dog?
ACL/CCL surgery for a dog can cost roughly $1,500 to $10,000. The exact cost of the surgery will vary depending on your dog’s exact injury and the type of surgery needed, your dog’s size, which can affect the amount of medications they need, and even your location and the veterinary hospital that you choose.
Depending on your dog’s diagnosis, your vet might recommend one of three available ACL surgical options:
- Extracapsular suture stabilization: Starting from $1,500 to $3,500, this surgery involves using a high grade, sterile suture to stabilize the knee joint. The suture line may break down over time, but scar tissue will help keep the joint stabilized.
- Tibial plateau leveling osteotomy (TPLO): Prices typically start from $2,000 to $10,000. During this procedure, the tibia is cut and rotated to create a sliding motion, and a bone plate is used to stabilize the joint. It can help to prevent arthritis and blocks the knee from sliding forward to prevent future injury.
- Tibial tuberosity advancement (TTA): Starts from roughly $3,500 to $6,500. Like the TPLO surgery, this surgery cuts and rotates the tibia, but is less invasive.
You will need to consider not only the costs, but also the pros and cons of each procedure—which are best to consult with your vet or the veterinary surgeon—when deciding what is right for your dog.
Every vet clinic sets their own surgery prices, so you may be able to save money by comparing quotes from several clinics before deciding where to bring your dog for surgery, and which procedure your dog has.
Veterinary surgeons tend to charge higher rates than a smaller veterinary clinic, but depending on your dog’s injury, your vet may feel that you will get the best results by bringing your dog to a veterinary surgeon.
Keep in mind that most vets will require payment at the time of your dog’s surgery. If you aren’t able to pay for your dog’s surgery costs in cash, you may need to explore other options, like a credit card.
Pet insurance can also help to cover the cost of your dog’s vet care needs (which we’ll discuss a little later), giving you peace of mind that you can pay for your dog’s care.
Does my dog need surgery to heal a torn ACL, or are there alternative treatments?
Unfortunately, your pup’s torn ACL can’t be fully repaired without surgery. But in some cases, you may be able to try some alternative treatments to improve your fur fam’s quality of life without surgery.
Smaller dogs who weigh less than 30 pounds may be able to reduce or resolve limping in the case of partial ACL tears through crate rest. Staying in a crate restricts your dog’s motion, allowing scar tissue to form in the area, but it won’t heal the ligament. Your dog will need to remain quiet in a crate for up to six weeks, so this may not be the best option for a highly energetic pup.
Your vet might recommend a knee brace to help support your dog’s knee joint and potentially improve their quality of life, but it won’t heal the ligament. Knee braces must be customized to your dog’s leg, and they can cost $1,000 or more. Your dog will need to wear the knee brace consistently.
Rest, meds, and physical therapy
A combination of rest, medications, and even physical therapy are some of the ways you can help manage your dog’s pain and improve their well-being when they have an injured ACL—depending on the severity of the condition. You will need to play an active role in limiting your dog’s activity and making sure that your pup gets plenty of rest. Your vet may prescribe anti-inflammatory and pain medications, and may also recommend physical therapy sessions. A physical therapist can work with your dog during the sessions and may give you exercises to do with your dog at home to help keep them comfortable.
Your vet or vet surgeon may recommend surgery or medical therapy first before trying these treatment methods.
What’s included in the costs of ACL surgery for dogs?
While the total cost of ACL surgery can seem high, it probably includes many more items than you would imagine. Most ACL surgery quotes include all of the essentials that your dog may need before, during, and after surgery:
- IV fluids, antibiotics, and pain medication
- The surgical procedure
- Surgical supplies and sutures
- Plates and screws
- Antibiotics and pain medication for you to take home
- An e-collar for you to take home
- Overnight hospitalization
Many practices will include additional services that your dog will need, like a re-check appointment two weeks post-surgery, and a set of x-rays eight weeks after the surgery. Read your quote carefully to determine what’s included in the cost, and ask your vet about any additional potential expenses that aren’t included in the quote.
How can I help my dog fully recover after ACL surgery?
The best way to help your dog fully recover from ACL surgery is to follow your vet’s care instructions. After surgery, your vet will probably require that your dog rest for several weeks before gradually returning to activity. Your vet may recommend crate rest for the first 10 to 14 days that your dog is home, which will allow the surgical incision to heal. Your dog’s crate should be large enough for them to turn around in, but no larger. You can make the crate more comfortable by adding a pet bed or blanket.
During the initial few days that your dog is home, they should gradually return to putting weight on the leg. You will need to monitor your dog for issues like increased swelling, redness around the incision site, or unwillingness to put weight on the leg after 48 hours. Call your vet if you notice any of these issues. You should give any antibiotics and pain medication as your vet prescribes.
It’s also important to keep your dog from chewing or licking at the sutures. Your vet will probably send you home with an e-collar, and your dog will need to wear it so that they don’t irritate the site or tear out the sutures.
After keeping your pooch heavily restricted for about eight weeks, you can likely gradually get your dog moving again over the course of two to three months, but closely follow your vet’s directions. You may be able to slowly introduce leash walks at home, and your vet may also show you some range of motion exercises to do with your dog at home. It’s important to keep your dog from running, jumping, climbing stairs, playing fetch, or doing other highly active movements.
Depending on your dog’s tear and surgical procedure, your vet might recommend taking your pup to physical therapy sessions. You will also need to make sure that you take your dog into the vet for all of the follow-up appointments, including follow-up x-rays to monitor healing.
Will pet insurance cover the costs of my dog’s ACL surgery?
Paying for an unexpected ACL surgery can be stressful, but covering your dog with pet insurance can give you the peace of mind of knowing that you have a financial plan in place. Pet insurance can help to cover the costs of your dog’s ACL surgery, but there are some limitations.
Lemonade Pet, for example, has a six-month cruciate ligament event waiting period. That means that if you buy a Lemonade Pet policy and your pet develops a cruciate ligament injury before six months have passed, that injury would be considered a pre-existing condition, even if it’s the result of an accident.
That said, if your pet develops a cruciate ligament injury more than six months after you purchase a policy, your Lemonade pet insurance policy can help cover the costs of the diagnostics, surgeries, and medications related to the injury. Keep in mind that you will need to include the vet visit add-on if you want your policy to cover follow-ups, and you will need a physical therapy add-on to cover vet-recommended physical therapy.
Remember that you’ll need to pay the full vet bill upfront, and your reimbursement for a covered claim won’t include your insurance plan’s deductible or co-insurance.
Preparing for your dog’s ACL surgery
Hopefully your dog never needs ACL surgery, but it’s helpful to be prepared, just in case. Consider getting pet insurance for your dog, and putting money into a savings account that you’ll use just for emergency vet bills. Taking steps to help prevent an ACL injury, like keeping your dog at a healthy weight, can help, too, and will hopefully avoid your dog ever needing surgery.
A few quick words, because we <3 our lawyers: This post is general in nature, and any statement in it doesn’t alter the terms, conditions, exclusions, or limitations of policies issued by Lemonade, which differ according to your state of residence. You’re encouraged to discuss your specific circumstances with your own professional advisors. The purpose of this post is merely to provide you with info and insights you can use to make such discussions more productive! Naturally, all comments by, or references to, third parties represent their own views, and Lemonade assumes no responsibility for them. Coverage may not be available in all states.