Post-TPLO Recovery

Healing begins here.

Quick Recovery

Many dogs will feel good in a relatively short time after surgery, but it is important to remember that it takes 8 weeks for the bone to heal. So, if they over-do it during this time period, they are more likely to have a complication. Healing may take longer in geriatric pets, pets that have had long-standing severe lameness & muscle loss, or those with other systemic health conditions. Physical rehabilitation therapy can improve the speed and extent of the recovery process following TPLO surgery.

Medications

Non-steroidal anti-inflammatory drugs (NSAIDs): Most pets will be sent home with a 2 week course of an NSAID, such as carprofen or meloxicam. This class of medications helps to reduce inflammation at the surgical site and also act as a pain reliever.
Gabapentin: This medication provides pain relief through a different mechanism than NSAIDs and may cause sedation. It is usually prescribed for 2 weeks as well.

Trazodone: This medication will help keep your pet calm and quiet during the recovery process and will make it easier for both you and your pet to adhere to the exercise restrictions. This medication may be needed for the full recovery period!
Antibiotics: Occasionally, antibiotics are prescribed postoperatively in an effort to minimize the risk of surgical site infection.

Non-steroidal anti-inflammatory drugs (NSAIDs): Most pets will be sent home with a 2 week course of an NSAID, such as carprofen or meloxicam. This class of medications helps to reduce inflammation at the surgical site and also act as a pain reliever.
Gabapentin: This medication provides pain relief through a different mechanism than NSAIDs and may cause sedation. It is usually prescribed for 2 weeks as well.
Trazodone: This medication will help keep your pet calm and quiet during the recovery process and will make it easier for both you and your pet to adhere to the exercise restrictions. This medication may be needed for the full recovery period!
Antibiotics: Occasionally, antibiotics are prescribed postoperatively in an effort to minimize the risk of surgical site infection.

Recheck Appointments

It is extremely important that you keep all recheck appointments so your pet’s healing can be monitored, and any concerns can be identified early.. Your first recheck appointment with Midwest Veterinary Specialists will occur 10 to 14 days postoperatively so we can evaluate limb function, the incision and remove any skin sutures or staples. A second recheck will occur eight weeks after surgery, when we will evaluate your pet’s recovery, take X-rays to assess bone healing, and let you know if it is safe for your dog to gradually return to normal activity. Additional rechecks that may be needed if lameness re-occurs or your pet fails to improve.

Open Positions

Exercise Restriction and Rehabilitation

Your pet’s activity needs to be severely restricted until there is radiographic evidence of bone healing, which typically takes around 8 weeks. He must remain in a small area (6x6 feet) with good footing or in a kennel when he is not directly supervised. He should not have free roam of your home. Running, jumping of any kind, playing, stair climbing, and uncontrolled off-leash activity are strictly prohibited until instructed otherwise to reduce the risk of delayed healing or implant failure. He should be extra careful when walking on slippery surfaces such as tile, linoleum, or wood floors during this period of recovery. Please follow the instructions for activity outlined below:

Exercise restriction is important and physical rehabilitation is extremely beneficial during the recovery process.

Week 1-2

Leash walks for urination and defecation purposes only – no longer than 5 minutes each up to four times a day. All leash walks should be slow enough to encourage your pet to place his foot with each step. Please use a sling, towel, or Help-em-Up Harness for support when walking on slick surfaces or if stairs must be used to go outside.

Weeks 3+

In addition to leash walks to urinate and defecate, 2-3 additional leash walks are allowed. Please start these leash walks with 5 minutes of “active walking” and gradually increase the length of the leash walk by 5 minutes each week up until the 8 week recheck. “Active walking” time means actual walking time, not “stopping and sniffing time.” All other restrictions apply. If at any point your pet begins to demonstrate signs of lameness, soreness, or becomes uncomfortable following walks, please decrease duration or frequency of the walks.

Excessive activity may result in implant failure, delayed bone healing and other healing complications. If your pet suddenly stops using the leg, or seems painful, please contact Midwest Veterinary Specialists for recommendations.

Recovery Weeks 1 & 2

E-Collar

For the first 2 weeks after surgery, it is imperative that your pet not lick or chew at the surgical incision, as this can cause infection or the incision to open up.

A well fitted Elizabethian collar (E-collar) can be used to help prevent him from licking at the incision and should be used until the incision has healed and any sutures or staples are removed. Your pet may find it easier to eat and drink without the E-collar and you may remove it for these activities. However, please keep in mind that it only takes a few seconds for a motivated dog to cause a lot of damage to their surgical site, so please monitor them carefully.

As an alternative to an E-collar, you may consider a barrier to the surgical site with the LickSleeve. This device is like a leg warmer that can prevent your pet from damaging or contaminating the surgical site. +

Passive range of motion exercises

Passive range of motion (PROM) exercises help maintain muscle and joint function during the recovery period. Gentle flexion and extension of the operated limb can be done 2-3 times daily to improve range of motion of the stifle joint. Support just above the stifle (knee) and at his hock and gently flex the leg up to the body and then extend the limb first straight down in a standing position and then back behind him to extend the hip. Hold each position 3-5 seconds and repeat the exercise 10-15 times. It is important to gently support the knee to prevent twisting or rotation of the limb. This may take a second person to relax him in the front end, but this should not be painful. These exercises may also be performed with your pet laying down. +

Ice and heat therapy

Altering the temperature of the surgical site can have therapeutic benefits. Cold therapy will decrease inflammation and swelling, while improving comfort and the ability to perform rehabilitation exercises. Warm Therapy improves blood flow to the surgical area, loosens up the soft tissues, and can help reduce swelling.

Ice
Please ice the surgical area for 10-15 minutes, 3-4 times daily the first three to five days after surgery.

At Midwest Veterinary Specialists, we will provide you with a reusable gel pack but you could also use crushed ice in a Ziploc bag or bags of frozen peas.
Wrap the Ice pack around as much of the stifle as possible.
Please use a thin towel between the gel pack and your pet’s skin. A thick towel may prevent adequate cooling of the tissues.

Heat
After 3-5 days of icing, you may apply a warm pack to the stifle for 10-15 minutes, 3-4 times daily.

The gel pack provided by Midwest Veterinary Specialists that was used for icing can also be used as a heat pack. Alternatively, a warm washcloth *in a plastic bag* may be used on any residual swelling or bruising to aid in the reduction of swelling, bruising, and to increase circulation.
Test the heat pack on the back of your wrist first—if it is too hot for your skin, it is too hot for your dog.
Wrap the heat pack with a thin cloth and apply to your dog’s stifle.

Recovery Weeks 3 & 4

The following adjustments are made during weeks three and four:

Increase leash walks by 5 minutes sessions each week.
PROM can be reduced in frequency
Continue ice therapy as needed if your pet seems sore after walking or exercise.
We recommend scheduling an appointment with our Rehabilitation Service at Midwest Veterinary Specialists around this time point. Based on your pet’s progress, additional exercises may be recommended including:
- Walking your dog in a large figure-eight pattern
- Having your dog step slowly on and off of a curb in an S-pattern
- Walking on gentle inclines
- Weight shifting: When your dog is standing, gently nudge the hips from side to side
- Sit-to-stand: Similar to squats, have your dog nearly sit down and then stand up
- Leg lifts: When your dog is standing, lift one of the non-surgical legs off the ground at a time for 10 to 15 seconds. Underwater treadmill therapy may begin at this time.
- Continue to restrict all off-leash activity.

Recovery Weeks 3 & 4

The following adjustments are made during weeks three and four:

Increase leash walks by 5 minutes sessions each week.
PROM can be reduced in frequency
Continue ice therapy as needed if your pet seems sore after walking or exercise.
We recommend scheduling an appointment with our Rehabilitation Service at Midwest Veterinary Specialists around this time point. Based on your pet’s progress, additional exercises may be recommended including:
- Walking your dog in a large figure-eight pattern
- Having your dog step slowly on and off of a curb in an S-pattern
- Walking on gentle inclines
- Weight shifting: When your dog is standing, gently nudge the hips from side to side
- Sit-to-stand: Similar to squats, have your dog nearly sit down and then stand up
- Leg lifts: When your dog is standing, lift one of the non-surgical legs off the ground at a time for 10 to 15 seconds. Underwater treadmill therapy may begin at this time.
- Continue to restrict all off-leash activity.

Recovery Weeks 5-8

The following adjustments are made during weeks five through eight:

Increase leash walks by 5 minutes sessions each week.
Discontinue ice and heat therapy.
Continue performing the previously described exercises.
Underwater treadmill therapy can be continued.
Swimming in our custom Swimex therapy pool may begin at this time.
Continue to restrict all off-leash activity.

Recovery Weeks 8-12

We will evaluate your dog’s recovery and take X-rays eight weeks after surgery to assess healing after TPLO surgery. Assuming healing is on schedule, you can gradually return your dog to normal activity using these guidelines:

Continue to gradually increase the duration of your dog’s walks.
Gradually introduce off-leash activity. We recommend taking your pet for a longer walk on a leash before the first time he is allowed off leash to minimize the chance of over-doing it.

Open Positions