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.
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.