While surgery is usually recommended by veterinarians for ligament injuries, it may not be necessary for all dogs. The most common ligament injury is a tear of the ACL, or ruptured anterior cruciate ligament in the knee. Especially if your dog is elderly, overweight or a large breed, ask the veterinarian if alternatives to ligament surgery are possible. Untreated ACL ruptures may lead to arthritis.
In older dogs or those with other medical issues, confinement and rest for a period of up to three months can be a surgical alternative. This method is unsuitable for highly active dogs, as the dog must be confined to a small area with no stairs or furniture to jump on or off. The veterinarian may prescribe non-steroidal anti-inflammatories (NSAIDS) or buffered aspirin to ease pain. Over-the-counter supplements such as MSM and glucosamine may also be given. Depending on the individual dog, limited amounts of daily walking may be permitted.
Prolotherapy is non-surgical treatment for a rupture of the cruciate ligament. While used for decades in humans, it has only recently become common in veterinary practice. Also known as sclerosing therapy or proliferative therapy, treatments usually take several sessions done at three-week intervals. "Prolotherapy in Dogs" explains that during each session, the joint is shaved and then disinfected with a surgical scrub. Multiple injections are then carefully placed in the ligaments and joint capsule. The injected agent acts to thicken the ligament, similar to scar tissue. Dogs are usually sedated but not anaesthetised for the procedure. Prolotherapy is suitable for any body joint.
Instead of surgery, some dogs with partial ligament tears may benefit from physiotherapy along with non-surgical conservative management of their injury. The conservative management includes rest and taking a "wait and see" approach. Excess weight strains the joints, so overweight dogs must go on a diet. Therapies include low-impact swimming, massage, leg braces, acupuncture, acupressure and chiropractic treatment. Ultrasound therapy is also used in canine ligament injuries. According to veterinarian Babette Gladstein, ultrasound therapy sends high-energy sound waves into the ligaments. As they absorb the ultrasound waves, they are converted to heat, so ultrasound therapy is similar to heat therapy.