CCL Injury in Both Back Legs

It is not unusual for dogs who have a cranial cruciate ligament rupture in one leg to develop one in the other leg. It is a little unusual to have two severe ruptures at the same time, but it does occur, especially in large breed dogs or overweight canines. Generally the signs of this type of injury will manifest itself in the dog with an impaired gait, shaking while walking, and/or dragging the back legs. It is not unusual for veterinarians and pet owners to think that partial paralysis is present or that the severe lameness is due to spinal disc disease because of the severity of the presentation.

Surgical stabilization of the stifle (knee joint) is advocated by most veterinary surgeons when cruciate ligament rupture has occurred in both knees. Despite this, there are not any long-term studies that compare surgical repair to conservative treatment over the lifetime of dogs to show that surgery is actually beneficial when compared to long term comparison with medical treatment alone (i.e. anti inflammatory medications, supplements, CM followed by physical therapy). Conservative management does work, but it is a bit more difficult in the case of a dog with a double CCL injury. There is no need to rush into surgery, despite what your veterinary surgeon may advise. Dogs can do very well for prolonged periods of time doing CM, with smaller dogs and dogs proportionate for weight to size (meaning they are not overweight) often making full recoveries without surgical intervention.

Dogo Argentino with Two Torn CCL

Not surprisingly, surgery is almost always advocated by surgeons . It is likely that surgery does help reduce the amount of arthritis that occurs, but in a long term study of cruciate ligament surgery in dogs in Australia, about 50% still had detectable arthritis in surgically repaired joints and about 10% of dogs were persistently lame despite attempts to surgically stabilize the joint. Tibial plateau leveling osteotomy (TPLO) has become the top choice for surgical CCL repair among many orthopedic veterinarians, and it can be done in both large and small dogs. Supporters of TPLO will say its good choice for the situation in which there is a bilateral cruciate rupture since it seems to be a strong repair procedure, but there are many instances where dogs have done equally as well with either TTA or a traditional repair.

One benefit of doing a traditional extracapsular repair, in addition to saving a few thousand dollars, is that you still have other options for repair if for some reason the traditional repair fails. If you are choosing surgery for a dog with a double CCL rupture, make sure to research each procedure carefully before blindly going along with a procedure you know nothing about. TPLO, TTA and traditional repairs are all very different procedures, and each carry their own set of risks vs. rewards. The best way to find out what is right for your pet is to do as much research as you can and find a veterinarian that is willing to discuss your many options for surgical intervention.

If surgery absolutely isn’t an option, there is a very good chance that in a few weeks, to a few months, you will find that your dog is doing OK without any type of surgical intervention -especially if you can manage the weight loss. There are a number of great resources both on this website and the web with instructions on how to succeed with CM.

57 thoughts on “CCL Injury in Both Back Legs

  1. my Malamute only 3 yrs. old,jumpted over a small fence,and may have twisted her back knee,upon a viewing with no x-ray,vet says she may have torn a ligament in her back knee….and wanted surgery for $1500….not knowing what to do,they gave her a sedative to sleep well,and pain medications…what should I do. to help her ? in time with her age,can it heal….or should I consider surgery to repair her leg…if thats the problem without an X-RAY…..?

  2. Hello,
    Just found this post and was wondering what happened with your dog. Mine just did the same thing and had surgery today to fix it. They thought it was the acl until we took her to her vet and he could tell it was the ligament but did the exray just to be sure. They said without the surgery the bones would just keep rubbing together and this is extremly painful

  3. Our dog had surgery on her right knee last fall, yesterday she injured her left knee, the vet feels it is not worth doing the surgery on her. She is 7 years old part lab part sheppard, and it is breaking my heart thinkng that I will have to put her down…..Vet is coming tommorrow morning at 9am to put her down………..I am sad

  4. Today the vet came to our house and put Oreo out of pain, I feel so bad…..I miss her already….I hope we did the right thing…….it is so hard….when I would come home from work she would be waiting for me……When my wife and I would fall asleep in our bed she would jump up and sleep between us…I miss her and I wish she was still here!!!!!!!!!

  5. Steve…I am so sorry about Oreo. I can’t believe the vet would want to put her down, but I don’t know all the facts. My Marvin is 10 and he ruptured his right knee 2 years ago. The vet advised a wait and see approach. This was surprising because it’s a state of the art clinic. Marvin’s knee healed great with no signs of arthritis, but last week, his left knee ruptured. We are doing the wait and see again. He needs to lose 20 lbs. The vet is hoping to manage his weight and we should be fine.

    1. Jennifer,

      That’s great news about your Marvin. If you don’t mind, I’m looking for more details on Marvins recovery. I have a 7 YO golden retriever with a ruptured CCL. I am using the conservative approach. We are in month 3 and doing great. The only concern I have is that after a good workout and a nap, she will limp for a few steps. The limp is pretty bad for 5-10 steps after she’s had some down time. Did you experience the same?

      Thanks for any insight.

    2. Thanks for your input.

      My lab Brew 107 lbs down from 118 has now torn both ACLs he can barely walk. Can’t climb stairs to go sleep with us. He turns 5 in Jan. I also know he has a severe heart murmur. He’s. It a candidate for any surgery.


      1. hi Just reading through this and wondered what you ended up doing? my golden just ruptured both of hers and is scheduled for surgery monday.

  6. Jennifer — Are both ruptures a total tear? How big is Oreo? With the first one, how long was it that you had to keep him inactive and see an improvement? How long before somewhat normal activity was allowed? Any information would be appreciated.

  7. My dog has just had a TPLO op and we were told he probably has a tear in his right rear leg now. He is only one week post op now and we know a long way to go yet but we don’t fancy repeating this plus the cost £3,300 so far.
    Is there another way with avoiding surgery, he is an (nearly)8yr old Golden Retriever.

  8. We do American Pit Bull rescue. One of the dogs we rescued, who came to us with a broken front leg, which we had repaired (but she still limped on it) came up lame in her two back legs. A vet visit confirmed that she had ruptured both cruciates. We currently have 13 dogs; two of whom have gone through single cruciate rupture repairs. I can’t imagine how they could repair both legs at the same time. Reading this article opened my eyes to the option of not having to put her through surgery…I’m going to do more research on this. Thank you for the article.

    1. Hi my dog got both back legs done at same time TPLO Operation following all after care instructions over 3 months my dog is now pain free and fully mobile ,she is a large breed cross Rotty . it was very hard but worth it .

      1. Hi, can you tell me how your dog is doing now? I have a Cane Corso scheduled for both legs in two weeks and I’m pretty nervous.

        1. I have an Australian Shepherd who tore his rear right ACL 4 months ago. He is 6 1/2 years old. After many consultations and research, it was determined that the best option (to prevent future arthritis and lameness) was surgery. He had surgery and did great. As is common after a torn ACL, he now has torn the ACL in his other leg. In lieu of waiting and increasing odds of lameness in the future, he is undergoing ACL reconstruction in the second leg. After much research and discussions with veterinarians, I can honestly advise and encourage those who have a dog with an ACL tear to have it repaired. Not to repair surgically will leave your dog at a high risk for complete lameness in the future. As for cost concerns, I consulted with 2 orthopedic surgeons. One quoted $4000-$6000, the other (highly recommended) charged $1000. Needless to say, I chose the $1000 and he did great. I anticipate excellent results as before and I’m comforted knowing that his long term prognosis is excellent compared to dogs who do not have surgical repair.

          1. Hi, I am curious to know where you are located and which Vet you saw that only charged you $1000. The Vet I consulted with wants $3,000 to repair one leg. He is a Cairin Terrier (small dog). I can’t afford $3,000 so I was curious to know where your Vet is located that charged $1,000.

          2. The vet who did both ACL reconstructions is in Kentucky. But if you ask arounf- there are some vets that don’t charge thousands of dollars but still do a great job. Elk Creek Animal Clinic, Dr. Alex Shelley.

      2. I have a rottie too. Can you pleaseee give details on how u helped your rottie poop? Last year he tore his right ACL and yesterday the left one. Since I didn’t repair it he can’t seem to be stable to go poop. I’m so lost and heart broken

      3. How did ypu even manage her to go potty without being able to bear weight being she is a very large labradinger just blew his and he is only 6 weeks.postop from the other

      4. Hi my dog has torn his in both legs and we’re trying med management now. how hard was recovery with two legs having surgery? How did you get them out and about to use the bathroom etc?

      5. Could you tell me what kind of surgery? Also, how was rehab? How did you get dog in and out? How did you keep dog quiet?
        Thank you
        TJ Pugliese

      6. May I ask how your dog functioned after the surgery without either leg, specifically going outside to go to the bathroom. Our lab is on week 6 of TPLO and just tore her other last night. So fearful that shifting all her weight to her newly fused knee with cause issues.

  9. My dog has 2 ruptured ACL’s. Requiring 2 TPLO surgeries. at the cost of $6,000.00. She is lame on her left side. The left blew last week causing her to be lame on the left. After xrays, vet said her rt. knee must have ruptured awhile back because there are signs of arthritis in that one. She is not even 2 yrs. old and I only take her on long walks. She was playing inthe backyard when this happend. I cannot affor this surgery. I am a single woaman on permanent disability and living on a fixed income. She is my baby and a sweetheart. I would do anything for her , but I just cant afford so much $ all at once. Does anyone know of where or who I might contact for financial help??? Also if anyone knows of who to contact for knee braces, and meds, like rimadyl, antibiotics, and pain meds for her. If anyone or anyplace can donate such things I might be able to get the surgery sooner rather than later. She is beginning to get very depressed. I dont like to keep her on all these meds, but she is in extreme pain, and her energy level is usuallly HIGH. I dont want her to damge herself more. Please contact me @ ASAP. She needs surgery NOW.. Thank You Nikki & Gabby

    1. We just had acl surgery on our 5 yr old dog. We went through . We have 1 year to pay it off with no interest. Hope this helps.

    2. Ask the vet about Equine Adequan. It prevents the deterioration of cartilage and in some cases rebuilds cartilage. Three vets at Auburn told me to put my dogs on it. I’ve had four dogs (Two last year)have lateral suture surgery. The first one was a 150 lb lab/dane rescue. All four have been big dogs. The first two were perfect. Last year my two current dogs chased a deer and tore their CCL. After talking with the head surgeon at Miss ST I could not go with the bone altering TPLO or TTA. We went with the lateral suture again. Perfect except one dog stretched the suture, had to have a 2nd surgery to remove the filament, then a third surgery to replace the filament and remove his meniscus. He then stretched that one. His leg WAS a mess, lost all muscle mass. Went to a friends pool and did water exercises and put him on ADEQUAN. He barely limps today and runs full out on a limited basis. He is going to be arthritic but I believe he’s going. To be ok. His brother also had two surgeries but he never lost his muscle mass and he’s ok. Lateral suture surgery runs about $750 here, if something happens there is a repair, when you alter the bone and something happens there’s little you can do.

    3. Put her on Equine Adequan, there is NO side effect. Three vets at Auburn recommended this drug. It prevents cartilage loss and in some cases rebuilds the cartilage.
      I have gone thru eight ACL surgeries with my two big dogs (85 & 78 lbs). They have had the lateral suture surgery ($750) and repairs ($200-$400). They are both fine now but they both went thru multiple repairs.

    4. My three large dogs have all had the Lateral suture surgery and have done fine. With this surgery there is the option of REPAIR !!! With TPLO or TTA once you alter the bone, there’s no repair option. P,ease check this out. And with Lateral Suture surgery the cost here is $725.

  10. I have a Golden Retriever , who at 6yo had a tumor on her rearend that was cancer. We had the recommended surgery and even did chemo x 8 rounds. A lot, 5K , of money later, we also found out that she tore her right acl. It was a no brainer at the time to not fix it b/c we were dealing with recovery from the cancer. 2 years later, she is still here, 8 1/2 and in remission we’ll call it, and now tore the other acl while playing in the snow a couple months ago. I am so torn whether to do the surgery or not to fix the fresh new acl tear. Not sure how long she’ll live overall with or without the surgery. My vet recommends the surgery of course but is also understanding if I don’t want to do it due to her circumstances. She’s gained 4 lbs in 4 weeks just by laying around and no exercise b/c she’s just limiting her activity I’m guessing b/c of the pain. I know that she needs to lose weight, as she is now 80 wopping lbs. Any advice ???? I’m leaning toward no surgery.

    1. Cut her food in half and supplement with no salt green beans…great way to lose weight. Both me dogs have knee surgeries this year so I know what you’re going through !

  11. Steve, I am so terribly sorry for your loss! My 9 year old Aussie blew out her right rear CCL a week and a half ago. She was sched. for surg. tomorrow morning. Last night she was following me, (we’ve been apart about 2 weeks in her entire life), and slipped on the stair and just fell to the floor screaming in pain. Our vet, who is about 1 minute away, doesn’t do any more emergency stuff, you have to go to a special clinic about 30 mins. away, (all the vets in our area are part of that now), so we did that and left her overnight so they could manage her pain. I picked her up at 7:30 this am and took her into my Vet. He just called and told me that she has destroyed her left rear CCL as well and it’s actually worse than her right one is. He is calling his professor who was part of developing a special treatment that involves moving bone and installing a metal plate. My Vet knows that Kilee has arthritis, (Rimydal for over a year), and we live in a split level house, so stairs to get in, and out…lot’s of stairs. She weighs 65 lbs. I tore my right rotator cuff and left knee out so carrying her is impossible for me. I wondered if anyone else here has had a situation similar to mine? I’m waiting for my Vet to call me with his professors prognosis. This is the hardest thing ever and all I’m doing is crying. ugh.
    Thanks folks.

    1. I have a 65 pound dog that tore up his left knee 2 months ago. This morning, he got away from me and it looks like he tore up the right one. I too live in a split level house with lots of stairs and can’t carry him up and down. I have a dog ramp in the process of being finished, but he wouldn’t even try it today. Made it down the stairs, but I couldn’t get him back in the house. After about a half hour, he made it to the garage. He’s never slept anywhere but my bedroom. I can’t afford the surgery. The diagnosis alone almost sent me into bankruptcy. My vet told me that it is common (about 60%) for dogs that tear up one, will tear up the other. I am interested in what the vet tells you and that is why I am replying….That and to just commiserate with you. There are dog braces that cost a mint of money and dogs seem to get around just fine. I would explore that option before surgery in my case. I did see a video today of a man that has used an elbow brace for people with some good luck. I tried it, but it was just too small for him and kept sliding off. I might return it and try a small sized knee brace with stabilizers. Just something to consider. Best of luck to you and your girl.

  12. Hi Betsy.I have a 3 year old wire haired pointer that has had both legs repaired TPLO,the left went first( at 1 year old ) with meniscal damage the right went 1 week after recovery .$6,000, now at 3 the meniscal has gone in the left.You will be chasing hope with an bunch of money,I am, because I love my dog, and it’s money i need, .the trouble is with this type of injury you fix one problem then wait for the next.Good luck Betsy my heart feels for you.Frank from australia

  13. I just wanted to let you all know that a reader submitted their story about a Bilateral Tightrope surgery – choosing to do both legs at the same time. I only have information back from her on the first day after surgery, but am anxious to see how it goes.

    Seems like a pretty daunting prospect to me, but she raises some good points about only having to go through everything surrounding the surgery once – the resting period, rehab, operation, etc. You can see her post here if you’re curious –

    Have any of the rest of you done a CCL repair on both knees at the same time?

  14. Oh, so sad. I ended up losing my girl. She just couldn’t have survived the surgeries. We have a tri-level home. She was put to sleep the day after I wrote that note.
    We just got our new little Aussie boy, Ed, 3 months ago. He was a rescue..we’re his 5th home in his one year of life. He has been such a challenge, but he is worth it and we love him. Thanks for all the feedback. God bless you all!!

  15. […] CCL Injury in Both Back Legs | Dog Knee and Leg Injury, Canine … Surgical and non-surgical options to repair a ccl injury in both legs. […]

  16. hi ,i hve a 5yr old rottie who has had a cruciate op 3yrs ago ,although she seems much better on that leg now she still has problems after along walk unfortunatly her other leg has gone now and im wondering if she has the op on this leg is the other one going to b strong enough to support her through her rehabilitation she is 49kg so quite a heavy dog any advice wud b appreciated as i wud hve to get a looan to get her the operation and want to make sure having the opp is the right decision many thanks

  17. Dear Chris and others,

    After your dog has recovered from a torn CCL (whether you did surgery or not) you are not supposed to expect that they can go on long walks or do any major workouts, as one person said. The knee will never perform as it used to, only to a max of 85%, so the walks and activities must be cut in half (that’s the recommendation). In other words, if your dog used to walk 2 miles, he should only now be walking 1 mile. And if your dog used to do any activities that involved twisty movements (like frisbee) then this is now out of the question or he can easily re-injure. And if there is any limping after an activity it means this was too much. Please be careful people!!!

  18. My dog is facing acl surgury. In a next week I have a split level ranch and am not sure how recovery will go her other back keg will need it too.. any tips on prep or recovery?

  19. Our husky had double ACL ruptures. 1 with a complete ACL tear. Hated it for her, she was absolutely miserable. We chose not to do the surgery due to lack of available experienced professionals in our area and our dogs history with surgery. It’s an expensive and physically/mentally taxing ordeal either way you go. It took three vet visits to get a proper diagnosis. We put her on a strict diet, restricted movement and iced her knees for the first few days after the second one went out, she was also on a opioid and anti-inflammatory pain meds schedule for about a month. We used a dog chair, hip sling, joint suppliments and patience to rehabilitate her. The dog wheelchair was expensive but a godsend. I don’t regret our decision.

    1. Hi Sarah
      Our Rueger had his first TPLO about 6 weeks ago. He is 9 yo and was healing well but nowhere near 100%. He got away from me, dragging me until the leash came off my wrist. Halfway to telling that squirrel what’s up, he collapsed and was just screaming in pain. We really don’t have another $6000, even though this risk was very well known to us. He was using his right leg mostly during the healing and rehab of the left TPLO. Now, he’s 3-legging it and only putting weight on the already repaired leg. I’m petrified that he will re-tear the “surgically altered new repair.” He cannot really even walk and he is in so much pain, even with doggie Norco and trazadone. We refuse to euthanize, just don’t know what else to do.
      We did try stem cells on his.initial tear and they actually worked! But then he got away from the dog sitter and re-damaged the progress the stem cells had made. We definitely want to start with stem cells again he’s just in so much pain I feel helpless!
      Thank you!

    2. Hi Sarah how is your husky now? My Lab/Shep is now 13 years old and tore both her rear acls. Her right one blew out 2 weeks ago and then her left one went out a week later. Drs don’t want to preform surgery on her because of her age. She is absolutely miserable and I’m running out of options. I did by a wheelchair which is not going well and I’m waiting in some braces to come in through the mail. I feel like I’m being selfish by putting her through this ordeal instead of taking her out of misery. Is there light at the end of the tunnel please let me know 🙂

  20. That is fantastic news. I had a similar situation with my golden. I initiated the same restrictions (3-6) months and therapy as if she had the surgery with fantastic results. My only option, at that time, was the TPLO surgery which is horribly invasive.

  21. My 150 lb malamute has torn both of his hind leg acls. What would be the best brace for his size and for having 2 tears

  22. Help our 5 yr old 75 lb doodle has had two set backs. He had lateral surgery Jan 6, tore his meniscus Jan 15. Went to MS State for surgery to clean out the knee on Jan 27. Then on Feb 16 had lateral suture repair surgery. He had a pronounced limp after this and his knee is twice the size with scar tissue. Six weeks later his jumped over his enclosure and is in pain. Vet can feel some draw movement in his knee but feels it might be his spine to cause so much pain. At night he doesn’t want to lay down. Question, his 2nd surgery at MS State was a partial meniscectomy, could he have torn what meniscus he has left when he recently jumped. He’s in the same kind of pain. I can’t bear the thought of putting him through a 4th surgery.

  23. My 6 year old gsd, storm, tore both rear knees a week ago today. She’s undergoing treatment for impa at same time so risk is too high for surgery-and they want $8k I’m having braces made and have no choice but conservative treatment. It’s going to be a long hard road since she is non weight bearing 🙁 Pray for us.

    1. Have you heard of laser therapy, I heard it works and is a good alternative to non steroids. And I have both of my boys on Equine Adequin. It’s great !!! NO side effects!!!

  24. My two boys (75 and 85 lb) tore their left CCL last year chasing deer. I’ve used the lateral suture before successfully so we went with that procedure again. The 85 lb boxer pointer mix did great (his other leg was three years ago. The 75 lb poodle griffon was not a good patient. He stretched the suture, had to surgically remove to and then do a repair surgery and he stretched that one. He is on Adequan and is doing good. He slightly favors the leg but is still able to run a limited distance. I did ALOT of research on the TPLO and TTA. Once you alter the bone there’s no going back. And there is a occurrence of osteosarcoma with the TPLO. I would rather have a dog that limps than a dog that loses his leg. The bone altering surgeries were not worth the risk.

  25. I have a 75 lb pit bull who was lame in his right hind leg early June. Took him to the vet & they thought it was luxating patella. He was sent home w/pain meds & a re-check in 2 weeks. 4 days later he was lame in his left leg & hardly able to walk. (I was hoping it was just from the strain of using that leg). But I’m back to the vet for x-rays and it turned out he tore the CCL in both legs. He had a bilateral TPLO done three days ago and he’s already doing great. The vet was surprised that the day of his surgery he was walking on his own when they took him out to go to the bathroom. He has to wear the cone and go back to the vet for a check14 days. We also cut back on some of his food because he is a bit overweight and that was probably one of the issues that caused it. And I’m happy with his progress and I’m glad I got them both done at the same time. But it was very very expensive

    1. Im so glad that worked out for you. Because of my dogs age the vets did not want to do any surgery on her torn knees. I had to keep her in confinement for about a month and bought a waist lift to help support her knees when she walks. Its been 6 months and the scar tissue has healed and my dog now walks with no issues 🙂 check it out it may help yours as well.

      1. If my dog was older I would have tried the conservative approach. Because he’s only three and weighs 74 pounds we didn’t think that was a viable option for him. He actually has this length of that sent them home with one. Glad to hear your pups doing better

  26. My 8 year old springer spaniel has experienced severe arthritis in his right front elbow for about 3 years and has been on rimadyl and adequan for pain/inflammation. In December he completely tore the ACL on his right rear leg, forcing him to bear weight on his arthritic front leg. We chose conservative therapy over surgery and his recovery had been very slow going. Two days ago he completely tore the ACL on his left rear leg and can barely walk as he’s basically down to 1 good leg. I was told because of his bum front leg he isn’t a candidate for a wheelchair or surgery and that the most humane thing would be to put him to sleep. We went to a second vet for another opinion and were told the same thing. I’m struggling with this decision; I understand he’ll likely never be able to walk for more than 5-10 minute at a time but what I don’t know is if that’s something he can happily live with and I have no way to confirm how much pain/discomfort he’s in. I’m just not sure ending his life is the right choice.

    1. My vet recently repaired the two back legs of a dog with a lateral suture at the same time. The dog is well and running around today. The owner bought a small pool and did hydrotherapy until the legs were strong enough. I talk with my vet about these issue all the time since my two 80 pound dogs had FIVE knee surgeries on their same legs within two months of one another. Here in TN the surgeries were only $700 for the initial surgery and $350 for the 3 repairs.

    2. When my dog tore both is CCLs (same week – I posted above). He couldn’t walk, even with two good front legs. He would take two steps, then lay down. The rimadyl was helping, but not much. When they added Tramadol, it made a tremendous difference. In fact, he was walking great on both legs that I was second guessing having the surgery. However, because he was only 3, I didn’t want to keep him on the pain meds for a long time. Since your dog is older, that may be an option. Also, try putting him on Cosequin DS. That does wonders for arthritis.

  27. Hi there, my 12 year old Maltese (20lbs) tore his left ACL about 4 weeks ago. When we took him to the vet, she thought it was most likely arthritis. However, two days after, he was just running and yelped and cried, and all of a sudden he couldn’t stand or walk. We took him to the vet the next day and another vet said it was most likely torn ligaments. After x-rays, he confirmed that Bobo did indeed tear both his ACLs and recommended TPLO surgery. I want to go forward with the surgery, but my husband is concerned that because Bobo is a small and old dog, surgery may be too much for him. Does anyone have a similar experience or any advice? Thanks, Anita.

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