As a dog owner, perhaps one of the hardest things is to see your furry friend in pain.

Unfortunately, a tear or rupture of the cranial cruciate ligament (CCL) just happens to be one of the most common orthopedic injuries in dogs. It’s the number one cause of “hind limb lameness, pain, and subsequent knee arthritis,” according to the American College of Veterinary Surgeons. The injury is similar to a torn anterior cruciate ligament (ACL) in humans.

The CCL or “ACL for dogs” can break down due to a host of factors, including aging of the ligament, obesity, poor physical condition, genetics, skeletal shape and breed. CCL ligaments are only found in the back two legs of a dog.

The American College of Veterinary Surgeons notes that certain dog breeds are more inclined to CCL disease and are prone to CCL tears, which can require surgery. Those breeds include rottweiler, Newfoundland, Staffordshire terrier, mastiff, Akita, Saint Bernard, Chesapeake Bay retriever, and labrador retriever.

How Much Does ACL Surgery for Dogs Cost?

ACL surgery for dogs can cost anywhere between $1,500 to $4,000 or more, says Dr. Alex Schechter, D.V.M., the founder of Burrwood Veterinary in Detroit.

The cost depends on the size of the dog, the seriousness of the injury, the type of surgery that is done and the location of the veterinary clinic, Schechter wrote in an email to Forbes Advisor.

Factors That Affect the Cost of ACL Surgery

There are various factors that can affect the cost of ACL surgery in dogs, including:

• Type of surgery performed. This is one of the most significant factors since there are different types of surgery available: Tibial Plateau Leveling Osteotomy (TPLO), Extracapsular Repair (ECR) and TightRope Repair. Schechter notes that the TPLO procedure is the most expensive due to its complexity and the specialized equipment and surgical expertise required to perform the surgery. The cost of TPLO surgery can range from $3,000 to $8,000 or more depending on the dog’s size, the location of the veterinary clinic and the surgeon’s experience.
• How large the dog is: The size of the dog will determine the amount of medication and anesthesia required for the procedure and follow-up treatment, which will affect the final price of the surgery.
• Severity of the injury: The type of injury or rupture the dog is experiencing will determine the best treatment or type of surgery it needs for proper repair.
• Who performs the surgery: The price will vary depending on whether a general veterinary practitioner performs the surgery in their clinic or a board-certified veterinary surgeon performs the procedure in a surgical facility.

Other Vet Visit Costs

Pet Owners May Encounter Different Types Of Costs At The Vet Including:

• Cataract Surgery For Dogs Cost
• Cherry Eye Surgery For Dogs Cost
• Dental Cleaning For Cats Cost
• Ear Hematoma Surgery For Dogs Cost
• Entropion Surgery For Dogs Cost
• FHO Surgery Cost for Dogs
• Hernia Surgery For Dogs Cost
• Microchip Cost For Dogs
• Neutering Cost For Dogs
• Teeth Cleaning Cost For Dogs
• TPLO Surgery Cost For Dogs
• Tumor Removal For Dogs Cost
• Vaccinations Cost For Dogs
• Vet Visit Cost
• Dog Euthanasia: What Is The Cost Of Saying Goodbye?

What’s Included in the Cost of ACL Surgery for Dogs?

Before you agree to the final price, it’s smart to ask your veterinarian for a quote that breaks down the individual costs of each element of the procedure. Be sure you are clear on what aspects of the procedure will be included in the cost, and what will be considered an extra charge.

In general, most clinics will package costs associated with the surgery into one total price, says Dr. Jacqueline Brister, D.V.M., a veterinary consultant for Embrace Pet Insurance.

“Some surgeons will bundle the entire cost so that pre-anesthetic testing (e.g. x-rays, lab work), intraoperative management and monitoring, the surgery itself, post-operative monitoring and management, as well as initial check-ups are covered in the initial cost,” Brister wrote in an email to Forbes Advisor.

What’s Not Included in the Cost of ACL Surgery for Dogs?

“ACL surgery is a complex, expensive procedure that incurs numerous costs. However, some supplemental expenses are frequently excluded from the surgery’s final price,” says Schechter. “Prescription drugs, medical tools, physical therapy, additional diagnostic exams or imaging and unanticipated medical conditions necessitating more care are a few examples.”

Other things that are not often included in the quoted cost for ACL surgery include:

• Major surgical complications, including infection, implant failure, or delayed bone healing
• Measures to speed recovery, including laser therapy or hyperbaric oxygen therapy
• Pain medications or antibiotics for post-operative care

Is ACL Surgery Required for Dogs with Bad Knees?

There are a number of factors that will determine whether your dog should undergo CCL surgery, including activity levels, size, age, skeletal confirmation and the degree of knee instability.

Dogs that are suffering with a complete or near-complete ligament tear will likely need surgery to have some semblance of a pain-free life.

Unfortunately, 40% to 60% of dogs that have CCL disease in one knee will at some point in the future develop a similar problem in the other knee, according to the American College of Veterinary Surgeons.

While surgery is the best treatment to “permanently control the instability present in the knee joint” it does not actually repair the CCL.

“A torn ACL in dogs can lead to chronic pain, instability and limited mobility if left untreated,” Schechter says. “The affected leg may weaken, and the dog may develop compensatory issues with other limbs or joints. Over time, the persistent stress on the other knee and hip joints can lead to secondary arthritis, which can cause even more pain and further decrease mobility.”

Depending on the dog’s overall health and severity of injury, there are non-surgical treatment alternatives, including:

• Restricting activity and providing anti-inflammatories: These alternatives are commonly chosen when surgery can’t be performed for an extenuating circumstance (i.e., financial constraints or concurrent illness). Restricting overall activity and providing pain relief via medication can help provide some comfort.
• Rehabilitation therapy: In the case of a partially torn CCL, some owners have turned to physical therapy with a trained veterinary physical therapist who can help strengthen the muscles and ligaments that support the knee.
• Custom knee braces: Several companies have started making braces for dogs with CCL tears. While they can help stabilize the knee, custom braces don’t necessarily address the pain or eventual tear of the ligament.

Even if a veterinarian recommends ACL surgery, owners can opt to forgo it. Doing so would mean the dog’s life would have to be adapted to living with the condition. Megan Marrs, a dog trainer and founder of the dog care website K9 of Mine, says the surgeon she consulted about her dog’s knees gave her the option of not doing the surgery.

“He said my dog would certainly have limited mobility, but we could use pain meds to ensure that he still had a decent quality of life and manage his situation via medication,” Marrs wrote in an email to Forbes Advisor. “It would mean he couldn’t run and play as he used to, but he could still enjoy other parts of his life.”

Ultimately, Marrs decided her dog was young enough and chose to have the double surgery in order to give her dog full mobility.

What Is Recovery Like for Dogs After ACL Surgery?

To ensure your dog heals properly from surgery, it’s critical to follow all after-care instructions carefully and diligently.

“After surgery, the dog will likely need to rest for several weeks to allow the surgical site to heal,” Schechter says.

Owners will be asked to monitor the dog’s recovery and follow at-home instructions on:

• When to use ice
• When to use heat
• When to give medications
• When to start physical therapy
• How to take them out for potty
• How to confine them

Some of the most critical instructions include:

• Giving all medications exactly as prescribed
• Not allowing your dog to run, walk or jump without a leash or sling until the vet says it’s OK to do so
• Keeping the post-surgical collar on until the vet advises it’s safe to remove it
• Monitoring the surgical site for signs of infection

Does Pet Insurance Cover ACL Surgery for my Dog?

Whether your pet insurance will cover the cost of ACL surgery for your dog will depend entirely on your specific policy coverage.

It is your responsibility as the owner to check your policy and see if ACL surgery is covered.

If you learn that your pet insurance does not cover all or part of the ACL surgery for your dog, there are alternatives to help you cover the cost of the surgery.

Many veterinary clinics offer flexible payment plans that allow you to break the bill into manageable monthly payments spread over a certain amount of time. This is a great option if you don’t have the cash upfront to pay the full cost of the procedure.

If your vet clinic doesn’t offer a payment plan, there’s also the CareCredit credit card, which is designed to be used for medical expenses, including veterinary care expenses.

If you do opt to use CareCredit, you should double check that your veterinary provider accepts the card before applying. The card offers short-term financing options (of $200 or more) with six, 12, 18 or 24 months of no interest—but only if you pay the full amount due by the end of the promotional period. This caveat is essential to take note of; if you don’t pay the amount in full by the time the zero-interest period is over, you’ll be charged interest from the original purchase date. The card’s interest rate at the time of publishing is 26.99%, which means your balance will balloon if you don’t pay it in full by the time the zero-interest period is over.

Another increasingly popular option for funding veterinary bills is crowdfunding on sites such as GoFundMe and Waggle. If you do opt to turn to crowdfunding, you should take note of any service fees charged by the platform. GoFundMe also has a list of 12 charitable sites that will help pet parents pay their vet bills.

Can Knee Injuries Be Prevented?

While some breeds are predisposed to knee issues due to genetics, owners can take proactive steps to prevent more serious knee issues in their dogs.

Owners can help keep your dog’s knees healthy and strong by following these steps:

• Maintain a healthy weight: Schechter notes an overweight dog is more prone to knee problems due to the added strain on the joint. One of the most important things owners can do is ensure their dog is not overfed, isn’t getting too many treats and is getting regular exercise.
• Consider a joint supplement: Joint supplements can be used to help reduce inflammation and pain, improve function and even slow the progression of joint damage. The top recommended joint supplements include glucosamine and chondroitin. You can always ask for your vet’s recommendation.
• Avoid over-exercising your dog: While regular, daily exercise is important to the overall health of your dog, you also want to make sure you’re not overdoing it with the jumping and the agility courses over time.
• Schedule regular vet visits: Not only is it important to have regular vet exams to ensure you’re not blindsided by any health issues, it’s critical you take your dog to the vet at the first sign of a problem. If your dog is limping or refuses to put weight on one of its legs, it’s time to see their vet.

Symptoms of Knee Issues in Dogs

Some of the most common signs of a serious knee issue in your dog include limping, reluctance to bear weight on the affected leg, and a reduced range of motion, says. Schechter.

“The affected leg may also appear swollen or stiff, and the dog may exhibit pain or discomfort when walking, running, or jumping. In some cases, the dog may even develop an abnormal gait, favoring one leg,” Schechter says.

Brister adds that in some instances, veterinarians may suggest a few days of rest and anti-inflammatories to see if there is any improvement.

“But many dogs with ACL tears will continue to limp and show signs of pain. If limping and pain persist, surgery should be considered,” Brister says.