Published: 01 Feb 2023 | Last Updated: 23 Feb 2023 11:37:43

A new study from the Royal Veterinary College (RVC) explores the reasons for cranial cruciate ligament (CCL) rupture in dogs in the UK, as well as the factors influencing how it is managed clinically. The research also identifies which breeds are most at risk of CCL, with this list including popular breeds such as Rottweilers, Bichon Frise and West Highland White Terriers.

Cranial cruciate ligament rupture in the knee may be most commonly known for its major impact on the lives of footballers such as Alan Shearer or Roy Keane, but it is also a common and serious problem for dogs. Most cases in dogs are characterised by gradual degeneration of the cruciate ligament, often resulting in sudden onset pain and lameness. The findings from this new RVC research will help owners and vets to identify dogs at most risk of CCL rupture and it also highlights the clinical rationales used in first opinion veterinary practice to decide between surgery or not for the injury.

Led by the RVC’s VetCompass Programme, the study included 1,000 CCL rupture cases and a random selection of 500,000 other dogs without CCL injury. The research found that the breeds at most risk of CCL rupture, compared with crossbreeds, were Rottweiler (x 3.66 times risk), Bichon Frise (x 2.09), West Highland White Terrier (x 1.80) and Golden Retriever (x 1.69). Conversely, the breeds with the lowest risk were Cockapoo (x 0.26), Chihuahua (x 0.31), Shih-tzu (x 0.41) and German Shepherd Dog (x 0.43).

Treating CCL often involves deciding between surgical and non-surgical management. However, until now, the factors affecting this choice of clinical management of CCL rupture have not been epidemiologically analysed. The findings from this study show that insured dogs and dogs weighing over 20 kg were more likely to receive surgical management, while dogs older than 9 years and those with another major clinical problem at the time of diagnosis with CCL rupture were less likely to receive surgical management.

Additional key findings include:

  • The average age at first diagnosis of CCL rupture was 7.4 years, showing CCL rupture as mainly a disease of middle aged and older dogs.
  • Dogs aged 6 to < 9 years had the greatest risk (x 3.24) of CCL rupture diagnosis compared with dogs < 3 years.
  • Neutered females (x 1.46) and neutered males (x 1.42) were more likely to be diagnosed than entire females.
  • Dogs weighing more than 30kg (x 2.19) and insured (x 2.79) were most likely to have surgery.
  • Dogs over 12 years (x 0.26) and with a comorbidity (x 0.38) were least likely to have surgery.

Camilla Pegram, VetCompass PhD student at the RVC and lead author of the paper, said:

This study has used the power of “big data” to robustly address the risk factors for cruciate ligament rupture diagnosis and management in dogs. The factors affecting the decision to surgically or non-surgically treat dogs with cruciate rupture are now clearer, with future work underway to address the clinical outcomes of this decision.”

Dr Dan O’Neill, Associate Professor in Companion Animal Epidemiology at the RVC and co-author of the paper, said:

After centuries of reshaping by mankind, dogs now come in over 800 distinct and recognisable breeds that each has its own unique pattern of health and disease. This new study helps owners of breeds such as Rottweiler, Bichon Frise and West Highland White Terrier to understand that sudden lameness in a hindleg could indicate a ruptured cruciate ligament that needs urgent veterinary care. VetCompass studies are empowering owners to understand their dog’s health better than ever before.”

Dr Anna Frykfors von Hekkel, Lecturer in Small Animal Surgery at the RVC and co-author of the paper, said:

“This study helps to confirm suspicions we have held in the clinic, with recognition of breeds such as the West Highland White Terrier and Rottweiler being at increased risk of developing CCL disease. It offers a valuable insight into how these patients are managed in general practice and factors that might influence that challenging decision.”

Paula Boyden, Veterinary Director at Dogs Trust, said:

“As well as providing practical solutions to canine welfare problems happening right now, Dogs Trust invests in securing better dog welfare for years to come through the work of our Canine Welfare Grants (CWG) programme. Over the years, the CWG projects have had far reaching impacts on dog welfare and we are delighted that the Royal Veterinary College VetCompass Programme continues to provide such fascinating insights into important areas of canine wellbeing. The findings of the latest study will be extremely useful in helping to identify those dogs most at risk of CCL rupture and provide clinical rationales for deciding whether surgery is the best course of action."

Notes to Editors

The paper is available from The Vet Journal at DOI: 10.1016/j.tvjl.2023.105952

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About the RVC

  • The Royal Veterinary College (RVC) is the UK's largest and longest established independent veterinary school and is a Member Institution of the University of London.
  • It is one of the few veterinary schools in the world that hold accreditations from the RCVS in the UK (with reciprocal recognition from the AVBC for Australasia, the VCI for Ireland and the SAVC for South Africa), the EAEVE in the EU, and the AVMA in the USA and Canada.
  • The RVC is ranked as the top veterinary school in the world in line with the QS World University Rankings by subject, 2021.
  • The RVC offers undergraduate and postgraduate programmes in veterinary medicine, veterinary nursing and biological sciences.  
  • The RVC is a research led institution with 88% of its research rated as internationally excellent or world class in the Research Excellence Framework 2021.
  • The RVC provides animal owners and the veterinary profession with access to expert veterinary care and advice through its teaching hospitals and first opinion practices in London and Hertfordshire.

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