Just as humans can tear an ACL—a specific type of knee injury—your dog can injure their cranial cruciate ligament (CCL) through gradual wear and tear. This injury is very painful and can affect your dog’s ability to walk comfortably.
A Tibial Plateau Leveling Osteotomy (TPLO) surgery is one of the most common types of ACL surgery for dogs that can help to relieve that pain and treat the injury. As of 2024, TPLO surgery for dogs can cost roughly $6,000 to $10,000 per leg.
Hopefully your dog never needs TPLO surgery, but it’s important to be familiar with the signs of this ligament disease and treatment options so you can be mentally (and financially) prepared, just in case.
What’s an ACL?
In order to understand your dog’s injury, we first have to describe the ACL, which is a part of a human’s knee joint. Buckle up, we’re going to hit a few acronyms.
The anterior cruciate ligament (ACL) and posterior cruciate ligament (PCL) are cruciate ligaments of your own 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 the cranial cruciate ligament (aka 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 CCL, resulting in a very painful condition that may require surgery to fix it.
How do dogs injure their CCL?
The CCL helps to stabilize a dog’s knee in their hind leg, just like a human’s anterior cruciate ligament (ACL) stabilizes their knee. The CCL prevents the tibia (your dog’s shin bone) from shifting forward along the femur, or thigh bone.
The knee joint is a hinge joint, so the CCL plays an important role in letting the joint move back and forth without allowing it to move from side to side, and also preventing the shin from moving forward independent of the thigh bone.
If the CCL tears or ruptures, it no longer stabilizes the knee. Since the top of the tibia is sloped, the femur can scrape across the tibia without the support that the CCL normally provides.
It’s very painful when that happens, and your dog may limp and have trouble moving around.
Some things to keep in mind:
- As your dog ages and their joints undergo wear and tear, their CCL can gradually weaken, increasing the chance of a tear. Arthritis can contribute to that gradual weakening, too.
- Older dogs are more likely to injure their CCL than younger dogs. Dogs who are obese may also be at increased risk of injury.
- Dogs who have torn a CCL in one leg have an increased risk of injuring the CCL in their other leg.
- A torn CCL might require TPLO surgery, which we’ll discuss in just a sec.
What are some signs that my dog might have torn their CCL?
If you know the signs of a torn CCL, you may be able to recognize the injury early on and possibly keep it from getting worse. Your dog’s symptoms may be initially mild, but if you notice any of these signs, it’s important to get your dog to a vet and restrict their activity until the appointment:
- Swelling around your dog’s knee
- Limping and lameness
- Unwillingness to put weight on the leg
- Holding the leg up off the ground
- Stiff or unsteady walking
- Stiffness when getting up after lying down
- Difficulty standing up after sitting or lying down
- Pain around the knee
How can I keep my dog from tearing their CCL?
While you can’t completely guarantee that your dog won’t tear or rupture a CCL, there are several ways to reduce the chances of that happening.
Give your dog daily exercise
When your dog stays fit, their muscles stay strong and are better able to support their joints. Focus on giving your dog daily exercise to help maintain that muscle strength.
Maintain a healthy weight
If your dog is overweight, their joints are under increased stress when they run or play. Focus on keeping your dog at a healthy weight and helping an overweight dog to safely lose some weight.
If you need help, your vet might be able to make recommendations that can help with your dog’s weight loss.
Consider your dog’s fitness level
If you’re planning an unusually long hike or want to try a new sport, like agility, with your dog, it’s important to make sure your dog is fit enough. With busy schedules, it’s easy to try to pack in lots of activities on your day off, but suddenly changing your dog’s exercise routine can increase their chances of a CCL injury.
Instead, try to give your dog exercise that’s the same intensity and duration each day. You can gradually start improving your dog’s fitness if you want to work toward a goal like a long hike.
What is TPLO surgery for dogs?
TPLO surgery is a common treatment for dogs who have torn their CCL. The procedure helps to stabilize your dog’s knee joint so the femur no longer scrapes against the tibia.
During the surgery, your dog will be put under general anesthesia. Then, a veterinary surgeon will use a saw to make a curved cut through the top of the tibia called an osteotomy.
The surgeon will separate a piece of the tibia, changing the angle of how the tibia and femur meet. That new angle helps to stabilize the femur on top of the tibia. With the tibia reshaped, the surgeon will install a metal bone plate and screws on the tibia to hold the piece of cut bone in place.
In time, the dog’s body will grow new bone, connecting the cut piece of tibia onto the rest of the bone.
Until that bone grows, though, the metal plate and screws are all that’s stabilizing that joint, so it’s extra important to carefully follow your vet’s instructions to keep your dog calm and quiet during the surgery recovery.
Some dogs that have a minor tear and weigh less than 30 pounds might be able to reduce limping through crate rest and pain management, without surgery.
But for most dogs, surgery will often be the best treatment option.
How much does TPLO surgery cost for a dog?
The cost of TPLO surgery can range from $6,000 to $10,000 per knee. This is a complicated operation that should be performed by a board-certified veterinary surgeon.
Will pet insurance cover the costs of my dog’s TPLO surgery?
A Lemonade pet insurance policy can help to cover the costs of your dog’s TPLO surgery, minus your deductible and co-insurance, giving you the peace of mind of knowing that you’ll be able to afford the care your dog needs.
While pet insurance can help to pay for surgery and other expenses, like x-rays, there are some limitations to keep in mind.
Your pet won’t be covered for medical expenses that occur before your policy’s waiting period ends. For example, if you buy a Lemonade Pet policy and your dog sustains a cruciate ligament injury during your waiting period, which varies depending on your state, the injury would be considered a pre-existing condition and would be excluded from your coverage.
But let’s say your dog develops a cruciate ligament injury more than six months after you purchased a policy. In that case, your policy can help to cover costs including diagnostics, surgeries, and medications that are related to the injury. If you want your policy to cover follow-ups with your vet, then you will need to add the vet visit add-on. And if you want to be eligible for reimbursement on vet-recommended physical therapy, then you’ll need to include the physical therapy add-on on your policy.
What to expect with TPLO surgery for dogs
Diagnosis
To diagnose your dog, your vet visit will start with a physical examination. They may also take x-rays of your dog’s knee. An x-ray won’t show a torn CCL, but your vet can look for changes in the joint that could indicate a torn cruciate, and help rule out any other potential injuries to the knee joint.
The vet might also use a sedated orthopedic exam to provide more detailed information about the size and severity of the tear.
Choosing the right treatment
Once your dog is diagnosed with a torn or ruptured CCL, your vet will recommend an appropriate treatment, like surgery. If you have a small dog with a minor tear, you can discuss whether limiting your dog’s movement or other alternative treatments might be an option to manage your dog’s pain instead of surgery.
The procedure
If your dog will undergo surgery to repair their CCL, It’s important to limit your dog’s activity until the surgery, which can help to keep the injury from worsening.
You will need to drop your dog off on the day of the surgery. The veterinary surgeon will perform some pre-surgical bloodwork to make sure your dog is healthy enough for the procedure.
During the surgery, your dog will be placed under general anesthesia, and will be carefully monitored. Your dog will likely receive an antibiotic shot and pain medication.
Post-op
After the surgery, the vet will monitor your dog’s recovery from anesthesia and will tell you when you can pick them up. They might keep them overnight for additional monitoring.
When your dog comes home, they will probably have an e-collar to keep them from licking their surgical site.
Recovery
The recovery period can take up to about four months. During the recovery, you will need to bring your dog in for check-up appointments so your vet can monitor the healing. Your vet might also recommend physical therapy sessions to support your dog’s healing.
It’s very important that you carefully follow your vet’s instructions during the recovery period.
- Week one: Your dog cannot run, jump, or play, or they could reinjure their leg. Your dog will need to be on crate rest or stay in a small room or on a leash to keep them quiet. It’s likely that your dog will be in some pain during this time, so you’ll need to give the pain medication as your vet prescribes. You will also need to support your dog with a sling when they initially get up and move around.
- Week two to four: Your dog will be able to gradually start using their leg again. It’s still important to limit your dog’s activity, and your vet might recommend that your dog begin physical therapy during this time.
- Week five to eight: Your dog will start to use the leg more and more. You can gradually start to increase your dog’s activity, and your vet can give you some advice on how to do this safely.
- Month two to four: Your pup can gradually return to their regular pre-injury activity level. Be careful not to let your dog do too much, too soon, since it’s still possible for them to reinjure their leg.
Preparing for the costs of TPLO surgery
Surgery can give your pooch the best chance of recovery if they tear their CCL, but it can be costly to pay for an unexpected TPLO surgery—not to mention if it’s on both knees.
Investing in a pet insurance policy early in your dog’s life can help you to prepare, just in case, and be able to get your best friend the treatment they need without worrying about how to afford it. At Lemonade Pet, you can buy your pooch a policy as soon as they turn two months old.
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.
