Risk factors for unilateral cranial cruciate ligament rupture diagnosis and for clinical management in dogs under primary veterinary care in the UK.

Vet J. February 2023;292(0):105952.

C Pegram¹, D C Brodbelt², K Diaz-Ordaz³, Y Chang⁴, A Frykfors von Hekkel⁵, D B Church⁶, D G O'Neill⁷

¹ Pathobiology and Population Sciences, The Royal Veterinary College, Hawkshead Lane, North Mymms, Hatfield Herts AL9 7TA, UK. Electronic address: cpegram@rvc.ac.uk.; ² Pathobiology and Population Sciences, The Royal Veterinary College, Hawkshead Lane, North Mymms, Hatfield Herts AL9 7TA, UK.; ³ Department of Statistical Science, University College London, Gower Street, London WC1E 6BT, UK.; ⁴ Comparative Biomedical Sciences, The Royal Veterinary College, Hatfield Herts AL9 7TA, UK.; ⁵ Clinical Science and Services, The Royal Veterinary College, Hawkshead Lane, North Mymms, Hatfield Herts AL9 7TA, UK.; ⁶ Clinical Science and Services, The Royal Veterinary College, Hawkshead Lane, North Mymms, Hatfield Herts AL9 7TA, UK.; ⁷ Pathobiology and Population Sciences, The Royal Veterinary College, Hawkshead Lane, North Mymms, Hatfield Herts AL9 7TA, UK.

Abstract

This study aimed to evaluate demographic risk factors associated with unilateral cranial cruciate ligament (CCL) rupture diagnosis and to explore demographic and clinical risk factors associated with management of unilateral CCL rupture in dogs under primary veterinary care in the UK. A retrospective cohort study design was used. Clinical records were automatically searched and manually verified for incident cases of unilateral CCL rupture during 2019 and additional clinical management information extracted. Multivariable logistic regression modelling was used to evaluate associations between risk factors and: (1) CCL rupture diagnosis; and (2) clinical management (surgical or non-surgical). The analysis included 1000 unilateral CCL rupture cases and a random selection of 500,000 non-cases. After accounting for confounding factors, dogs aged 6 to < 9 years, male neutered and female neutered dogs, insured dogs, and Rottweiler, Bichon Frise, and West Highland White terrier breeds, in particular, had increased odds of unilateral CCL rupture diagnosis. Insured dogs and dogs ≥ 20 kg had increased odds of surgical management, while dogs ≥ 9 years and dogs with one non-orthopaedic comorbidity at diagnosis with CCL rupture had reduced odds. These findings inform identification of at-risk dogs, with Rottweilers and Bichon Frise particularly predisposed. Additionally, they contribute to a greater understanding of the clinical rationales used in primary-care veterinary practices to decide between surgical or non-surgical management of unilateral CCL rupture.

Keywords

Cranial cruciate ligament; Dog; Electronic medical record; Primary-care; VetCompass;

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