Among the many alternative therapies for a CCL injury is one you may or may not have heard of: prolotherapy. Prolotherapy (“prolo” is short for proliferation) is an injection technique used to stimulate the growth of healthy connective tissue to help strengthen torn or weakened ligaments and tendons and eliminate chronic pain. Prolotherapy has been used successfully on humans for over 30 years, and is also performed on dogs, cats, horses, and other animals. Read on to learn more about prolotherapy and if it might be a treatment option for your dog.
Not all dogs are candidates for prolotherapy. It is most appropriate for:
- Dogs with injury or tears in one or both CCLs. Prolotherapy can protect the cruciate ligament in
the non-surgical leg from rupture in cases where one ligament has already been repaired
- Dogs with chronic osteoarthritis pain that involves one or more joints
- Geriatric dogs with chronic arthritis or joint pain that are not candidates for surgery
- Post-surgical dogs with genetic orthopedic disease (hip, shoulder, and elbow dysplasia) and chronic lameness and pain
- Performance dogs (agility, working dogs) with ligament or tendon injuries
- Dogs that are sensitive or have adverse reactions to conventional pain medications (i.e. Rimadyl)
How It Works
A solution is injected into the affected ligament(s) and acts as an irritant, which triggers
inflammation and in turn helps stimulate the healing process through the growth of new tissue. The solution most veterinarians use for injection is a combination of dextrose, lidocaine or procaine, and vitamin B12. The area may be inflamed and/or sore for 1-2 days following injection. The treated tissue then moves into the repair phase, starting several days and up to six weeks following injection. Once the healing period is complete, the patient can be re-evaluated for joint laxity and pain and, if necessary, the treatment is repeated. It is thought that maximum tendon and ligament strength is achieved within a year after prolotherapy has been completed.
Prolotherapy treatments generally take around 20-45 minutes, depending on the condition of your dog and the number of ligaments being treated. The procedure is mild to moderately painful; light sedation is sometimes used. The number of treatments needed varies depending on several factors including your dog’s size, age, severity of the condition, and response to the treatment.
Dogs slowly improve between prolotherapy sessions. It is recommended to leash walk dogs for 24-48 hours following treatment. While your dog might look and feel much better after treatment, it is important not to let them over-exert themselves. Movement must still be restricted during the healing period until your vet recommends increasing exercise. Over time, the pain will lessen, joints will become more stable, and muscles will become stronger. Prolotherapy is a progressive build-up of healthy tissue, therefore rehabilitation and recovery is naturally progressive as well.
According to Journal of Prolotherapy, at least four veterinarians with published case studies for dogs and cats claim 80-90% success rates in correcting CCL tears with prolotherapy. There are minimal risks and mild side effects associated with the treatment. These include: minimal bruising or swelling at the injection site, very low infection rates, and short healing time (compared to surgery). Of course, be sure to discuss your options with your vet, and if you decide to pursue prolotherapy treatment for your dog, be sure it is performed by a licensed veterinarian trained in prolotherapy.