Advances in the Canine Cranial Cruciate Ligament, 2nd edition

Rehabilitation for Dogs with Cruciate Ligament Rupture 347

Figure 42.5 A Labrador Retriever with bilateral partial
cruciate ligament rupture is flexing his pelvic limbs and
spine and extending his neck to shift his center of gravity
forward. The dog predominantly bears weight on his
thoracic limbs. Changes in posture in dogs with bilateral
cruciate ligament rupture are common.

offers an opportunity to further sensitize own-

ers to the importance of controlled activity

and provide ambulation assistance. Activity is

increased based on tissue healing time frames

and the patient’s clinical status.

Rehabilitation strategies

Rehabilitation options for dogs with CR include

cold and heat therapy, neuromuscular electri-

cal stimulation, manual therapy (massage, pas-

sive range of motion, stretching, joint mobi-

lizations), therapeutic exercises, and ambula-

tion assistance (Table 42.1).

Cold can be delivered by use of a cold pack

or compression sleeve (Drygaset al. 2011). Cold

therapy has been shown to be effective for

pain management in the postoperative period

(Andersonet al. 2016). Neuromuscular elec-

trical stimulation is used to promote muscle

mass (Johnsonet al. 1997), particularly when

Table 42.1Rehabilitation considerations after cruciate ligament rupture stabilization.

Recovery

phase Option∗ Purposes Candidates

Acute

(day 0 to 3)

Cold therapy Pain relief

Edema reduction

Dogs with tissue trauma

Massage Edema reduction and pain

relief

Dogs with severe tissue trauma or

pain

Passive range of motion Edema reduction

Avoid loss of joint motion

Dogs at risk for joint motion loss

Weight-shifting exercise Avoid onset of limb disuse Non weight-bearing limbs

Subacute

(day 4 to 21)

Manual stretching Increase joint motion Patients lacking stifle extension or

flexion

Strengthening exercises Decrease loss of muscle mass

Avoid limb disuse

Increase proprioception

All patients

Working, sporting dogs

Dogs with limited mobility

Proprioceptive exercises Increase proprioception and

balance

All patients

Working, sporting dogs

Dogs with limited limb use

Neuromuscular electrical

stimulation

Increase muscle strength Patients with decreased quadriceps

control and lacking muscle mass

Chronic

(after day 21)

Strengthening and

proprioceptive exercises

Normalize motor control

Normalize muscle mass

Normalize posture

Recover fitness

Return to client goals

Return to competition

All patients

Patients with decreased quadriceps

control and lacking muscle mass

Working, sporting dogs

∗The therapeutic plan is based on patient’s clinical presentation, the time frame of tissue healing, and client goals.