TPLO Post Operative Care

Bilateral TPLO Post-Operative Instructions

Tibial Plateau Leveling Osteotomy (TPLO)

Thank you for trusting Anicira with the care of your pet. Please remember that your pet has had an orthopedic surgery and needs appropriate care to properly recover. We hope your pet has as smooth of a recovery as possible, with high comfort and low stress. We are available by phone or e-mail, Monday-Friday 7a-5p, to ensure that all your questions are answered during this time. However, if your pet appears to be in distress and requires immediate attention, please contact Anicira Veterinary Center or your local veterinary emergency clinic.

IV BANDAGE

Your pet may have a small bandage or wrap on the leg where an IV catheter was placed.  If your pet is discharged with this bandage in place, please REMOVE this bandage within 2 hours of arriving home.   This bandage may have been removed prior to your pet leaving the hospital.  

DIET

Please decrease the amount of calories that your pet eats daily especially during the confinement period.  We recommend that pets with orthopedic disease maintain a body condition score of 4-5 on the Nestle Purina Body Condition System.  

MEDICATIONS

Your pet will be sent home with medications to help keep them comfortable. Your technician will go over your pet’s medications at the time of discharge.

INCISION CARE

Monitor the incision for redness, discharge or swelling. Mild bruising or swelling along or below the incision can appear within the first few days of surgery. Application of a cool compress (for example, an ice pack wrapped in a small towel) for 5 minutes at a time, 3 to 5 times daily can be helpful to reduce the bruising or swelling. If the bruising/swelling is prolonged or seems severe, please contact Anicira Veterinary Center or the nearest emergency clinic.  Your pet must NOT lick or chew at the incision.  Any licking of the incision may delay skin healing or even cause failure of the repaired incision. An Elizabethan collar should be worn at all times until the incision is healed and sutures are removed. An E-collar is in place to prevent licking and chewing.  This must be in place at all times.  Your pet CAN eat and drink with the E-collar in place.  

There may be swelling near the stifle/knee or around the hock/ankle.  This swelling is usually self-limiting and resolves in 7-10 days.  

FOLLOW UP

  • Please recheck with Anicira Veterinary Center in 10-14 days for suture/staple removal. 
  • Please recheck with Anicira Veterinary Center in 8 weeks for radiographs and a recheck to assess bone healing. If the bone at the osteotomy site has healed, your pet may be released from our care.  If the bone at the osteotomy site is not healed, we recommend continued confinement and a 12 week post-op recheck with radiographs.  
  • Please recheck with Anicira Veterinary Center in 12 weeks for the second x-rays.

COMPLICATIONS

Complications are unusual but can be serious.  Complications can include infection in the immediate post-op period or even years after surgery, failure of the metal implants, patellar tendonitis, meniscal disease, continued lameness, worsening of arthritis, breaking of the tibia, non-union, delayed union and others.  

ACTIVITY

You have received these instructions and a link to review at home care but we also request that you download a free rehab guide for TPLO from TopDogHealth.com as an additional resource. Please note, gated off areas and small room confinement are NOT ALLOWED.  Crate or kennel confinement is REQUIRED.  Short leashed walks in the heel position are allowed.  

It is imperative that you closely follow the strict confinement and activity restrictions to help prevent serious complications that may require a second surgery.  A more complete description follows: 

Weeks 1 and 2 (the first 2 weeks post-op): 

Activity should be confined while in the house, with no running, jumping, playing, or use of stairs. A crate or kennel should be used for activity confinement. When you are home and your pet is being closely supervised, your pet can spend time with you in a confined room with carpeting to avoid slipping, and with no furniture that would encourage jumping. There should be no walks during this time, other than brief leash-walks only to allow for urination/defecation. Range-of-motion (ROM) physical therapy should be performed 3 times daily, with each session lasting 5 minutes. This passive motion of the joint will aid in decreasing joint inflammation and will encourage the act of weightbearing on the limb. To perform passive ROM therapy, place one hand at the level of the foot, and place the other hand on the leg above the knee. Gently flex and extend the knee through its normal range of motion. If your pet appears painful during the therapy, then lessen the degree of flexion and extension as needed to allow for greater comfort. 

Weeks 3 and 4: 

As long as your pet appears comfortable, we will start short leash walks. If there is excessive bruising/swelling, or you have other concerns, please contact us before starting activity. Leash walks should be started to encourage weightbearing on the operated limb. On a level surface, 5- minute slow leash walks should be performed 3-5 times daily. Keep in mind that these walks are meant as light physical therapy, and they are not meant as exercise. 

Weeks 5 and 6: 

Continue with walks, 3-5 times daily, but increase the duration to 10 minutes per walk. If all is going well, the walks can be somewhat faster during week 6. At the end of week 6: Radiographs should be taken by Anicira Veterinary Center. As long as healing is progressing well, inhouse restrictions (including stair use) can be lifted. At this time, the limp should be fairly subtle. 

Weeks 7 and 8: 

Continue with walks, 3-5 times daily, increasing the duration to 15 minutes per walk. The walks can gradually increase in speed, and gentle hills can be added. 

Weeks 9-14: 

Continue with walks, 3-5 times daily, increasing the duration to 30 – 45 minutes per walk. The walks can gradually increase in speed, and gentle hills can be added. 

At the end of week 12 – 14: Radiographs should be taken by Anicira Veterinary Center. Excessive activity (playing with other dogs, full-speed running) should be avoided for another month. Gradually increase to normal activity. If the limp worsens, then activity should be decreased for a few days until limb use improves. The lameness should be gone by the end of week 14. Please contact Anicira Veterinary Center if lameness persists. Thank you for entrusting your pet to our care. We look forward to hearing from you as the post-operative recovery progresses

Please contact Anicira, your primary care veterinarian, or an emergency clinic if any of the following occur:

  • Pale gums
  • Discharge or bleeding from the incision
  • Severe pain, depression or weakness
  • Vomiting or Diarrhea
  • Discharge or bleeding from incision
  • Labored breathing
  • Decreased appetite for more than 24 hours
  • Lethargy lasting more than 24 hours