Three years old, active, sudden hind limb lameness with no accident behind it. A cruciate injury is one possibility, but a limp alone cannot confirm it. Two things I would say before you go any further. First, do not be reassured if he improves on rest and pain medication. In my practice the classic pattern is exactly that: a partial tear settles for a while, then the lameness returns worse, which usually means the rest of the ligament has gone. Improvement with rest does not prove the ligament has healed. Second, ask for both knees to be examined and radiographed, not just the sore one. I have seen the other knee become affected in many of my patients, so I start my exam on the good leg to help the dog relax and establish a baseline. Mention any clicking to your veterinarian; it can be a clue to meniscus injury. On treatment: TPLO is my preferred repair. The right procedure depends on the individual knee, and a brace should be discussed with the treating veterinarian rather than treated as an equivalent repair. And I would not put him on long term cortisone, given what steroids do to cartilage and healing.
ACL Tear in Bulldogs and French Bulldogs INTRODUCTION:
A cranial cruciate ligament tear affects a key stabilizer of your Bulldog’s knee. Owners often use the familiar human term “ACL tear.”
The ligament often weakens gradually before tearing, so owners may notice limping without seeing a fall or twist.
Early diagnosis and appropriate treatment are crucial for optimal recovery and minimizing arthritis development.
Bulldog Knee Joint Four Ligaments
Your bulldog’s knees are supported by four primary ligaments, which are as follows:
- MEDIAL COLLATERAL LIGAMENT
- LATERAL COLLATERAL LIGAMENT
- ANTERIOR CRUCIATE LIGAMENT (ACL)
- POSTERIOR CRUCIATE LIGAMENT
Five Things Bulldog Owners Should Know About ACL Injuries
- ACL injuries are one of the top orthopedic conditions in bulldogs and can happen at any age.
- The ACL is critical for stifle joint stabilization and normal biomechanics.
- TPLO is one surgical option; the choice depends on the knee and the patient.
- Treatment includes weight control and pain management
- Discuss supportive products with your veterinarian: Dr. Kraemer’s Joint and Ligament Care Bundles
Members of this bulldog community prefer prevention over RX
ACL 3-Fold Function
The function of the ACL in bulldogs is threefold:
- TIBIAL THRUST: The first and most significant function is to prevent the forward thrust of the tibia
- INTERNAL ROTATION: Second, the ACL limits the internal rotation of the tibia.
- HYPEREXTENSION: Finally, the anterior cruciate ligament in bulldogs also prevents the hyperextension of the knee joint (stifle).
ACL tear in Bulldog and French Bulldog puppies can happen as early as 6 months of age.
What is The Difference Between Bulldogs ACL and Human ACL?
While canine and human knee anatomies are very similar, the biomechanics are very different
Bulldog and French Bulldog ACL Biomechanics
When comparing the posture and biomechanics of humans and bulldogs, a clear difference emerges, particularly in how we bear weight.
HUMAN ACL BIOMECHANICS:
Humans typically stand with their heels on the ground and their knees relatively straight during weight-bearing activities.
This upright stance aligns the body in a way that distributes weight and force vertically down through the hips, knees, and ankles.
CANINE ACL BIOMECHANICS:
In contrast, bulldogs (like many other four-legged animals) stand with their hocks (equivalent to human ankles) elevated and their knees bent while bearing weight.
This difference in posture means that bulldogs experience different force vectors acting on their knees compared to humans.
The bent knee position in dogs creates a more horizontal force vector, which affects the way stress and strain are distributed across the canine knee, specifically within the stifle joint (the equivalent of the human knee).
Will Strong Muscles Protect The Knee and ACL?
When the CCL is left as the primary defense against shearing forces without the support of strong leg muscles, it is subjected to increased stress and strain. Over time or with sudden, intense pressure, this can lead to injury to the ligament.
If the muscles are not functioning optimally, the CCL is forced to handle excessive loads, making it prone to damage.
This underscores the importance of maintaining strong and healthy leg muscles in bulldogs to support knee health and prevent injuries.
Bulldog Flexed Knee Sloping Anatomy
Unlike humans, bulldog puppies are born with knees that have a natural degree of flexion, reflecting the typical stance of four-legged animals.
This inherent flexion in the knee joint, combined with the natural sloping anatomy of the knee, results in a state where in contrast to humans the bulldog anterior cruciate ligament (ACL) is consistently under tension.
To illustrate this biomechanical concept, consider two parked cars: one situated on a flat street and the other on a steep slope.
What is The Car Brakes ACL Model?
The human knee can be thought of like a car parked on level ground. When the car isn’t moving, the brakes aren’t working hard because nothing is pushing it to roll.
In the same way, when a person is resting or not placing stress on the knee, the ACL may be relatively relaxed, as there are no forces trying to shift the joint out of position.
BULLDOG CAR BRAKES ACL MODEL:
Conversely, a car parked on a steep slope is subjected to constant gravitational force pulling it downhill, placing continuous stress on the braking system to prevent motion.
In a similar manner, bulldog puppies naturally maintain their knees in a flexed position, creating a biomechanical “slope” in which the anterior cruciate ligament (ACL) is under near-constant load. Unlike the intermittent loading seen in humans, this conformation results in persistent ligament tension, analogous to the sustained braking force required to keep a car stationary on an incline.
This continuous ACL tension reflects the inherent biomechanical demands placed on the stifle joint of quadrupeds (particularly in breeds such as bulldogs) and highlights the unique considerations required when evaluating, preventing, and managing knee pathology in these animals.
ACL (Anterior Cruciate Ligament) Humans Versus Dogs
HUMANS: In people, the top of the shin bone (called the tibial plateau) is almost flat. Because of this, the ACL in the knee is not under constant strain during normal walking or standing.
Most ACL injuries in humans happen suddenly, usually during sports or accidents that involve twisting, jumping, or a hard landing.
These are traumatic injuries, not problems that develop slowly over time.
BULLDOGS: bulldogs are built very differently. The top of their shin bone has a steep slope, which naturally puts ongoing pressure on the ACL every time they stand, walk, or run.
- the ACL in bulldogs is always working, even during normal activity
- Injury usually happens gradually, not from one big accident
- The ligament slowly weakens over time until it finally tears
This is why many bulldog owners don’t see a single injury moment, the limp often appears “out of nowhere.”
Because bulldogs have a naturally sloped shin bone, a forward force is created in the knee every time they stand or walk. This force, called cranial tibial thrust (often referred to as “ACL draw”), pushes the shin bone forward.
The ACL acts like a seatbelt, preventing this forward movement and keeping the knee stable. Over time, the constant strain on the ACL can cause it to weaken and tear.
What are the Symptoms of ACL Tear in Bulldogs and French Bulldogs?
Common symptoms are
- Limp: Limping: often worse after activity
- Atrophy: Muscle Disuse Atrophy
- Inactivity
- Difficulty rising
- Abnormal gait
Why ACL Injuries Are Painful?
1. Instability and inflammation: A damaged ligament allows abnormal knee movement. This strains the surrounding tissues and can contribute to pain, inflammation and cartilage damage.
2. Meniscus Injury: The meniscus, a cartilage cushion in the knee, is then forced to absorb extra stress and may tear.
Meniscal tear is often accompanied by a “click” that can be heard when your bulldog walks.
A clicking knee may indicate meniscus damage and needs veterinary assessment.
Will My Bulldog Limp if The ACL is Injured?
Bulldogs with an ACL tear usually develop a limp.
When a meniscal tear is also present, the pain is often much more severe.
In these cases, bulldogs may only touch their toes to the ground or completely refuse to put weight on the injured leg.
Four Care Priorities for Bulldogs at Risk of ACL Injury
- Weight control: Keeping your dog at an ideal weight reduces stress on the joints, particularly the knees, and lowers the risk of injury.
- Strengthening Exercises: Incorporate conditioning exercises that strengthen the muscles around the knee, such as controlled uphill walking.
- Avoid High-Risk Activities: Limit activities that involve sharp turns, sudden stops, or jumping.
- Joint supplements: ask your veterinarian whether a joint supplement fits the care plan. Do not rely on supplements to prevent a tear or stabilize an injured knee.
1. Does Overweight Increase The Chances of ACL Tears?
Maintaining your bulldog puppy’s fitness and ensuring they stay toned and lean is essential for promoting optimal musculoskeletal health and reducing the risk of ACL injuries.
Inactive bulldogs are more likely to have weaker muscular support and poorer muscle function, which are crucial for stabilizing and “protecting” the ACL from excessive stress and strain.
Furthermore, bulldog obesity exacerbates the load placed on the knees, intensifying the daily wear and tear experienced by the ACL.
2. Where Do Joint Supplements Fit?
Review the following products with your veterinarian alongside weight management, activity and treatment. Follow the current labels; these products do not replace diagnosis or repair a torn ligament:
- Dr. Kraemer’s V4B Bully Total Joint for Advance Formula, review the formula and label directions
- Dr. Kraemer’s V4B Bully Comfort Aid Formula helps manage pain and discomfort
- Dr. Kraemer’s V4B Bulldog Fish Oil Joint-Immune- Skin. to help reduce inflammation
- Dr. Kraemer’s V4B Arthritis Pain and Ache Basic Bundle
How To Manage ACL Tears in Bulldogs?
Management of ACL requires a multimodal approach that may include:
- Drugs :
- NSAIDs (nonsteroidal anti-inflammatories)
- Analgesics: for pain
- Physiotherapy
- Regenerative Therapy: stem cell therapy, PRP, Laser, Peptides
- Therapeutic Supplements: Joint support, comfort, anti-inflammatory
- Surgery: TPLO
ACL Tear in Bulldogs and French Bulldogs SURGERY REPAIR:
Bulldog and French Bulldog ACL tear surgery goals are to stabilize the knee joint and do so early to minimize DJD (Degenerative Joint Disease, Bulldog Arthritis).
Various repair methods have been employed, categorized into static repairs aiming to mimic the function of your bulldog’s ACL, and dynamic repairs which modify knee biomechanics to mitigate the necessity for a functioning ACL.
1. BULLDOG ACL TEAR STATIC SURGICAL REPAIR:
Static repairs include
- intracapsular grafting techniques
- Extracapsular lateral suture techniques
- tight rope
- fibular head advancement
2. BULLDOG ACL TEAR DYNAMIC SURGICAL REPAIR:
Dynamic repairs involve the neutralization of cranial tibial thrust (or cranial drawer) as the primary goal. The two current dynamic repair techniques addressing the underlying biomechanical instability in a canine ACL tear are the
- Tibial plateau leveling osteotomy (TPLO)
- Tibial tuberosity advancement (TTA).
The TPLO which changes the angle of the tibial plateau, has been popular for over a decade and is considered the gold standard for bulldogs.
The TTA is a technique that changes the relationship between the patellar tendon and the tibial plateau angle via an osteotomy (bone cut).
#1. ACL TEAR SURGEON EXPERIENCE TIP:
First, you should know that not just any veterinarian can perform either of these procedures. To truly master these surgical techniques, extensive training is required.
#2. ACL TEAR SURGEON PREFERRED TECHNIQUE TIP:
Even within the veterinary profession, there remains ongoing debate regarding the most optimal surgical procedure for ACL repair in bulldogs. Different veterinary surgeons may advocate for varying techniques, leading to diverse opinions and preferences. It’s common for surgeons to favor a particular method based on their training, experience, and personal biases.
However, it’s important to recognize that both static and dynamic repair methods can be effective when performed by skilled and experienced surgeons. Ultimately, the success of the surgery often depends more on the surgeon’s proficiency and expertise in executing their chosen technique with precision than on the specific method itself.
TPLO (Tibial Plateau Leveling Osteotomy) is my preferred surgical choice for ACL tears in bulldogs and is considered the gold standard by most orthopedic surgeons.
ACL Tear in Bulldogs STEM CELL THERAPY
For many of our ACL-injured patients, we combine regenerative medicine with traditional medicine and surgery
stem cell therapy is a state-of-the-art treatment that we often combine with surgery. In addition, other joints and medical conditions can be treated simultaneously. Last, as an additional benefit, we almost always cryobank some pet stem cells for future medical and surgical needs.
Can I Treat ACL Tear With Stem Cell Therapy Instead of Surgery?
I’m frequently asked about the effectiveness of stem cell therapy as a noninvasive alternative to ACL tear surgery repair.
Generally, I advise against it as it doesn’t address the underlying biomechanical issues.
However, I often recommend and perform stem cell therapy in conjunction with surgery to enhance healing, improve range of motion, and mitigate osteoarthritis.
Stem cell treatment should not be presented as a proven way to prevent a tear in the opposite knee.
How Cryobanking Stem Cells May help Prevent and Treat ACL Injuries?
Furthermore, we typically preserve some of our clients’ stem cells through cryobanking for potential future medical and surgical needs. It’s worth noting that many reputable pet insurance companies now cover stem cell therapy for pets, offering an additional option for financial support in these cases.
In contrast to surgery, stem cell therapy can provide pain relief for multiple injuries at once with minimal anesthesia and minimal post-surgery downtime, all at a relatively low cost. Plus, the stem cells can be cryobanked for additional future treatments.
Are Peptides Like TB-500 Can Benefit Bulldogs With ACL Injuries?
Peptides such as TB-500 (a synthetic derivative of thymosin beta-4) and BPC-157 (Body Protection Compound-157) are short chains of amino acids with researched potential for promoting
- tissue repair
- reducing inflammation
- modulating immune responses
- and supporting healing processes.
These compounds mimic or derive from peptides that occur naturally in the body, including in pets.
Synthetic versions are typically administered via injection, though some preclinical studies suggest oral administration may be viable in certain cases due to BPC-157’s stability.
While preliminary research and anecdotal reports indicate possible benefits for conditions involving tissue damage such as anterior cruciate ligament (ACL) injuries in dogs these peptides are still pending regulatory approval for veterinary therapeutics and obtaining them from a legitimate approved compounding pharmacies can be challenging (in some states more than others)
Always consult a licensed veterinarian for evidence-based treatment options.
Is Non-Surgical ACL Treatment a Good Option?
When surgery is not feasible, ask your veterinarian for an individualized plan for comfort, activity and follow-up. Stem cells do not correct the unstable mechanics of a torn cruciate ligament. In cases where surgery is not feasible or preferred by the owner due to factors like
- advanced age
- anesthesia risks
- cost
- prolonged post-op confinement
- extended recovery time
Additionally, for dogs with multiple orthopedic issues alongside the ACL tear, such as
- elbow dysplasia
- hip problems
- arthritic hocks
In cases where surgical repair of only one problem may not be the most effective approach, stem cell therapy can offer pain relief for multiple injuries simultaneously. This treatment option comes with the benefits of minimal anesthesia and post-surgery downtime, along with a relatively low cost.
Moreover, stem cell therapy provides the advantage of cryobanking, enabling the preservation of stem cells for potential future treatments. This flexibility and versatility make stem cell therapy an appealing option for certain situations where surgery may not be the optimal solution.
What Are the Chances of an ACL Tear in the Other Knee?
In my practice, I have observed that about half of these Bulldogs develop a tear in the other knee within a year. This is a practice observation, not a prediction for every dog; both knees need monitoring.
BULLDOG AND FRENCH BULLDOG TPLO ACL TEAR REPAIR
The philosophy behind TPLO (Tibial Plateau Leveling Osteotomy) surgery is to completely change the dynamics of the dog’s knee so that the torn ligament becomes irrelevant to the knee’s stability.
TPLO repair is our preferred surgical repair method.
The TPLO completely alters the dynamics of the knee by neutralizing the effect of the forward tibial thrust. Once the tibia is cut and rotated, the femur can no longer slide backward, and the knee is immediately stabilized.
Menisci injuries in bulldogs are also corrected during the surgery.
1. BULLDOG TPLO SURGEON
Choosing between TPLO and TTA depends on the degree of the tibial slope, the tibial plateau, and the health of the patella and patella ligament. The dog’s general anatomy, degree of osteoarthritis, and age should all be taken into account.
But most important is the surgeon’s experience with the elected procedure.
2. TPLO SURGERY COST
The cost of TPLO surgery in dogs varies depending on the region and who is performing the surgery.
TPLO vs. STATIC REPAIR
The bulldog puppy’s tibial slope and resulting sliding action are why most orthopedic veterinary surgeons have abandoned old-style static replacement procedures in favor of dynamic ones like TPLO and TTA.
Again, this is in sharp contrast to human orthopedics, where replacement with a biological graft is the standard.
ACL Tear in Bulldogs TIPS & WARNINGS:
Below are selected ACL injury tips & warnings, courtesy of Dr. Kraemer
#1 ACL RADIOGRAPH TIP:
Radiographs are very helpful in diagnosing bulldogs’ ACL tears and ruptures. In some instances, the radiograph will catch the joint in this slipped or drawn position. Other common radiographic findings are joint effusion (fluid) and evidence of osteoarthritis.
#2 BULLDOG ACL RUPTURE TIP
In my practice, the typical presentation of an ACL injury involves a bulldog that is experiencing sudden hind limb lameness, which may improve initially with pain management medication and rest.
However, there’s often a subsequent worsening of lameness, indicating a potential re-injury or full rupture of the ACL. This pattern suggests that the dog may have initially suffered a partial tear that temporarily improved with rest but ultimately led to further injury.
#3 ACL INJURY AND HYPEREXTENSION TEST TIP:
The majority of bulldogs with an ACL rupture or partial tear exhibit pain when the tibial thrust maneuver is performed or when the stifle joint is placed in hyperextension. These actions exacerbate discomfort and are indicative of instability and potential damage to the ACL.
#4 BULLDOG ACL TIBIAL NOTCH TIP:
It is my conclusion that the bulldog’s knee’s tibial femoral space is different than that of other breeds. This finding has been confirmed by my orthopedic surgeon, Dr. Paul Cechner, Diplomate A.C.V.S. who has been operating on a dog’s knees for over 40 years and on my bulldog patient’s knees for a decade.
We’ve noticed a narrowing of the tibial femoral space (notch) in bulldogs, particularly on the inner part of the joint where the ACL attaches. This reduced space leaves minimal room for the ligament to move, potentially increasing the risk of wear and tear and raising the likelihood of rupture or partial tears in the ACL.
#5 BULLDOG ACL MEDIAL BUTTRESS TIP:
Some bulldogs form a bump on the inner aspect of their knee, which is a fibrotic response to stifle instability.
#6 BULLDOG ACL PAIN & LAMENESS TIP:
Pain and lameness associated with bulldog ACL injuries stem from the instability of the stifle joint and the resulting inflammation. When the ACL is torn, the stretching of the joint capsule sets off a chain reaction of events.
This includes cartilage degradation and the development of degenerative joint disease, collectively contributing to the discomfort and impaired mobility experienced by the bulldog.
#7 BULLDOG MENISCUS TIP:
Frequently, the pain experienced by your bulldog intensifies when the medial meniscus is compressed beneath the medial femoral condyle. This occurs as a result of the forward movement of the tibia and the backward sliding of the femur during cranial tibial thrust.
#8 BULLDOG ACL TEAR TESTING TIP:
Bulldogs and other dogs with a CrCL injury and subtle lameness may display characteristic signs in their gait and posture. You may notice a shortened stride and a slightly extended stifle on the affected limb. Conversely, the normal limb may appear to bear more weight and land harder on the ground.
Observing how the dog sits can also provide valuable clues. Dogs with a CrCL injury may sit with the affected leg extended and positioned outward to the side. This specific sitting posture is referred to as the “positive seat test” and can indicate discomfort or instability in the knee joint.
#9 BULLDOG ACL INNER ROTATION TIP:
In addition to its role in forward thrust, the ACL in bulldogs also functions to prevent the inner rotation of the tibia. This rotational constraint is particularly crucial given the unique anatomical characteristics of bulldogs, which predispose them to ACL tears.
#10 BULLDOG ACL RUPTURE TIBIAL LOAD TIP:
Nearly all bulldogs exhibit some degree of hip dysplasia and/or medial patella luxation, both of which impact the function of various muscle groups in the hind limbs.
These conditions affect muscles such as the quadriceps, gastrocnemius (calf), and hamstrings, causing them to shorten and contract. Consequently, this muscular imbalance further exacerbates the inward load on the tibia, contributing to the predisposition for ACL tears in bulldogs
#11 ACL TEAR PRP TIP:
In addition to stem cell therapy, many of my patients, including dogs and cats undergoing orthopedic surgical procedures, also receive PRP (Platelet Rich Plasma) during surgery. This involves the direct injection of PRP into their joints. Ask about the additional cost, evidence, expected benefit and follow-up for your dog before adding PRP to the treatment plan.
#12 ACL STRESS INJURY TIP:
A bulldog puppy suffering from an ACL injury might have just a subtle limp that turned into a sudden acute non-weight-bearing lameness.
However, unlike humans, the injury is rarely of a purely traumatic etiology.
#13 BULLDOG ACL PARTIAL TEAR TIP:
Partial ACL tears in bulldog puppies are not uncommon, and only one portion of the ligament can experience a complete tear. Because ACL injuries tend to be degenerative, a considerable number of bulldogs with partial tears will eventually progress to a full tear of the ligament
#14 ACL LASER THERAPY TIP
All my orthopedic surgeries, including Bulldog ACL tears, are treated post-op with class 4 cold laser therapy to reduce pain and enhance healing.
#15 ACL tPEMT TIP
All our bulldog ACL surgeries and other orthopedic surgeries are sent home post-op with pain management medication (NSAID and other analgesics). In many cases, we also send our post-op surgical cases, such as the Bulldog TPLO for ACL tear with PEMT loop a safe device that enhances healing, reduces inflammation, and improves pain control.
#1 BULLDOG ACL OSTEOARTHRITIS WARNING:
When left untreated, ACL injuries in dogs invariably result in progressive osteoarthritis, which is a lifelong, debilitating, and chronically painful condition.
Additionally, untreated ACL injuries often cause uneven weight-bearing, leading to overcompensation by other legs and joints. This overcompensation places increased stress on the contralateral knee, raising the likelihood of additional injuries and potentially resulting in an ACL tear on the opposite knee.
#2 ACL TEAR BRACES WARNING:
The anatomy and biomechanics of the bulldog and French bulldog stifle differ significantly from those of humans, leading to misconceptions among pet owners. Non-surgical treatments for bulldog ACL tears are often ineffective due to the chronic biomechanical stress unique to these breeds.
A custom brace may be considered in selected cases. Discuss fit, skin checks, comfort and the limits of support with your veterinarian; it is not a substitute for an examination or a surgical consultation.
#3 ACL LIMPING WARNING:
Bulldog CrCL (Cranial Cruciate Ligament) injuries should be considered and investigated in cases of hind-limb lameness. Affected dogs may present with various degrees of lameness, likely due to the multifaceted nature of the condition.
Your bulldog puppy may exhibit non-weight-bearing, partial weight-bearing, or occasionally non-ambulatory behavior as a result of this injury.
#4 ACL HYPEREXTENSION WARNING:
Some bulldogs may display mild and chronic lameness, indicating a partial CrCL (Cranial Cruciate Ligament) rupture. In these cases, there may be minimal joint swelling (effusion), and radiographs may not show signs of osteoarthritis. While these dogs may not exhibit the cranial drawer sign, they will likely experience discomfort and pain during the tibial thrust maneuver.
This discomfort is often caused by the compression of the inner menisci when the stifle joint is placed in hyperextension.
#5 ACL OTHER PROBLEMS WARNING:
Less commonly, some bulldogs may present with acute non-ambulatory symptoms, such as difficulty rising or shifting leg lameness. Unfortunately, these cases are occasionally misdiagnosed as neurological conditions like disc disease, or bulldog malformation. Adding to the complexity, these patients may also have concurrent conditions such as hip dysplasia, degenerative joint disease (DJD), and lumbosacral disease.
Distinguishing between a CrCL tear and bulldog back disease requires a thorough orthopedic and neurological examination to accurately diagnose the underlying issue.
#6 ACL RADIOGRAPH WARNING:
When examining a French Bulldog for potential ACL injuries, it’s crucial to assess both legs and conduct radiographs, as the opposite side may also be affected due to compensatory mechanisms. To ease the examination process, I typically start with the “good” leg, allowing the bulldog to relax and establish baseline responses
A palpable or audible click may indicate a meniscal tear.
#7 ACL TEAR DRAW SIGN WARNING:
If a cranial drawer sign is not palpated in a bulldog suspected of having a CrCL injury, it’s important to consider re-evaluating the cranial drawer under sedation. This step is necessary because the bulldog may be resisting palpation due to muscle tension or significant fibrosis that has stabilized the stifle joint. Additionally, the absence of a drawer sign in a bulldog’s knee could be attributed to a partial ligament tear, with the remaining intact ligament resisting gross displacement.
Sedation allows for a more accurate assessment by relaxing the muscles and minimizing resistance during the examination.
#8 ACL AND MPL WARNING:
Many bulldogs experience MPL(medial/inner patella luxation) either before or alongside ACL injuries. These two conditions can be interconnected because patients with MPL often exhibit medial rotation of the tibial crest. This rotation places continuous tension on the ACL, which is believed to predispose bulldogs to ACL tearing. Therefore, the presence of MPL can contribute to the development or exacerbation of ACL injuries in bulldogs.
Additionally, bulldog puppies diagnosed with MPL may experience persistent osteoarthritis in their stifles. This ongoing condition can create an enzymatic environment that contributes to the deterioration of the ACL over time.
Moreover, the rupture of the ACL tends to worsen the severity of patellar luxation. This is primarily because the loss of constraint on the inward rotation of the tibia and the cranial displacement of the tibia during weight-bearing exacerbate the condition. Consequently, this movement alters the insertion point of the patellar tendon, causing the patella to be “lifted” out of the trochlear groove and facilitating luxation
#9 ACUTE BILATERAL ACL RUPTURE WARNING:
Acute bilateral ACL ruptures (i.e., both ACL tears at once) are rare, but when present, they are erroneously diagnosed as a neurological condition, such as degenerative myelopathy or herniation of an intervertebral disc. A bulldog with acute bilateral ACL rupture will have great difficulty rising and may appear to have hind limb paresis.
#10 BULLDOG ACL STEROIDS WARNING:
I don’t recommend treating bulldog ACL injuries with long-term cortisone due to the steroid effects on cartilage and healing, as well as other adverse effects it’s known for.
Insider tip
Watch how your bulldog sits. A dog with a cruciate injury tends to sit with the bad leg extended and swung out to the side rather than tucked underneath. That is the positive seat test, and you can do it at home from the sofa.
The other thing I look at is stride. On the affected side you see a shortened stride and a slightly extended stifle, while the good leg lands harder and carries more. Owners usually notice the limp. Almost nobody notices the sit, and the sit shows up earlier.
One more, for the vets and for owners asking the right question: if the drawer sign is absent but you still suspect a cruciate, re-check it under sedation. A tense bulldog, or one who has laid down enough fibrosis to stabilize the joint, will hide it while awake.
Why did my bulldog tear his ACL with no accident?
What does the ACL actually do?
What is that clicking noise?
He seems better after a few days rest. Is he healing?
Will a brace work instead of surgery?
TPLO or TTA?
Can stem cells replace surgery?
Veterinary Care and Supportive Products
Any hind limb lameness in a bulldog earns a proper orthopedic and neurological examination, because a cruciate tear, a luxating patella, hip disease and back disease can all look alike from across the room, and they are occasionally mistaken for each other. Ask for both knees to be assessed. No supplement repairs a torn ligament. Ask your veterinarian whether supplements belong in the care plan and which label directions apply to your Bulldog.
The Orthopedics Vital Bundle
More Help from Dr. Kraemer
An ACL tear rarely travels alone. These are the conditions I check alongside it:
- Medial patella luxation (MPL)
- Hip dysplasia in Bulldogs and French Bulldogs
- Bulldog arthritis and arthritic pain
- IVDD and disc disease in Bulldogs
- Stem cell therapy for dogs and cats
- Class 4 cold laser therapy
About the Author
Roy Kraemer, DVM, is a veterinarian with extensive clinical experience caring for Bulldogs and French Bulldogs. His educational work emphasizes breed specific biomechanics, accurate diagnosis before treatment, surgeon experience over surgical fashion, and protecting the second knee.
Trusted By Vets ~ Recommended by Owners ~ Approved by Bulldogs
References
- American College of Veterinary Surgeons: Cranial Cruciate Ligament Disease
- Merck Veterinary Manual. Cruciate Ligament Rupture in Small Animals
- American Animal Hospital Association. 2022 AAHA Pain Management Guidelines for Dogs and Cats
