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A Dog Owner's Guide to TPLO Surgery Recovery

by Dr. Pippa Elliott March 01, 2021 6 min read

Dog on a post-surgery walk in the park with a short leash

TPLO surgery is a major procedure. After the specialist surgeon has done their work, it's up to the owner to care for their dog during the long TPLO surgery recovery period. The owner's role is just as important as the surgeon's because and over-active dog could cause implant failure or worse. The guide gives an overview of the typical patient plan for TPLO surgery recovery and how to make this as uneventful as possible.

Quick Recap: TPLO Surgery 101

Before diving into the details of TPLO surgery recovery, let's recap the what and why of this procedure.

What is TPLO Surgery?

TPLO surgery is a surgical method of correcting a damaged cruciate ligament in the knee. The latter is a common problem, which results in severe lameness on a back leg.

TPLO surgery involves cutting the tibia (shin bone) and repositioning the joint surface at a better angle. The bone is held in its new position by metal implants, made up of screws and plates. The beauty of TPLO surgery is the new angle absorbs the impact of the femur (thigh bone) so that the tibia no longer shoots forward relative to it when the dog takes a step.

Why TPLO Surgery?

A ruptured cruciate makes early arthritis of the knee more likely. Correction is important, of which there are several options. TPLO surgery is considered by many surgeons as the gold standard. This is especially true for large dogs because this procedure can cope with the large forces to the knee that happen in an active dog.

TPLO surgery is an advanced procedure and best done by a specialist surgeon. However, once healed the benefits and outcomes tend to be better than alternative procedures, which is why this is such a popular option.

TPLO Surgery Pitfalls

The success of this procedure depends on two things: the surgeon's skill plus an uneventful TPLO surgery recovery period. The major worries during this time are:

  • The implants loosen, bend, or become displaced: This happens if the dog is too active whilst the bone is mending.
  • Infection: This could be a skin infection which causes the surgical wound to break down or a deeper infection which tracks along the implants to infect bone.

Either of these complications could result in the dog needing further surgery, which is often complex and expensive. So the best option is to do things right the first time around during the initial TPLO surgery recovery time, so the dog gets safely back on their paws in the shortest time possible.

TPLO Surgery Recovery: An Overview

After TPLO surgery the dog needs to rest up for around eight weeks while the bone heals. After this, they start a gradual return to normal exercise. Following the rules in these two months is an investment in success: think of it as short term pain for long term gain.

There are three phases of TPLO surgery recovery:

  1. The initial 10 days: The dog needs to get over the anaesthetic and the skin wound heal
  2. 10 days to 8 weeks: Waiting for the bone to heal
  3. Two to six months: Physiotherapy and rebuilding strong muscles.

Let's look at each of these in turn.

The Initial 10 Days

Bone surgery is sore, but vets have wonderful pain relief protocols to help the patient through those first few days. To do this the dog stays at the hospital for a couple of nights, so their pain can be managed with intravenous drugs or pain-relief patches.

Once the surgeon has reviewed their patient and is happy the four-legger can cope at home, the patient is discharged into the care of their owner.

Wound Care

The dog has a long skin incision, on the inside of the knee. This is held together with skin sutures (which are removed after 10-14 days) or intradermal sutures (which dissolve on their own.) This incision must be kept clean.

Most incisions are left uncovered so the air gets to the wound, which discourages infection. The area must be kept clean and dry, which means no licking! Unless the dog is exceptionally well behaved, they must wear a cone-of-shame until the sutures are gone.

Also, provide clean bedding which is soft and spreads the dog's weight, such as Vetbed. The latter is used by vets because it reduces bed sores and wicks wetness away from the dog's skin.

Unless the vet tells you otherwise, leave the wound alone. However, do check it twice a day. Signs of a problem and that you should contact the vet for advice include:

  • Swelling or puffiness beneath the skin incision
  • Redness or heat around the wound
  • A discharge of any type from the incision

Pain Relief

Modern painkillers mean there is no need for the patient to suffer discomfort. Often the dog is discharged home with a combination of pain relief meds for maximum impact. If your dog seems uncomfortable despite this, let the vet know. There are many options for preventing pain.

Signs that a dog may be uncomfortable include:

  • Whining or crying
  • Restlessness
  • Not being able to sleep
  • Lip licking
  • A tense facial expression
  • Out of character grumpiness or growling
  • Lack of appetite

If you suspect your pet is in pain, let the vet know.

Rest and Recuperation

During these early days the metal implants take all of the dog's weight and can become damaged or displaced. To prevent this happening rest plays a crucial role.

Small dogs should be confined to a comfortable crate, with larger dogs kept in a small room with a non-slip floor. Rest means rest, with no walks and no jumping or using stairs. Small dogs should be carried out to the toilet, and kept on the lead to stop them running after squirrels!

Larger dogs should be assisted out on the lead, perhaps with a sling under their belly to help them down steps.

Moving On: 10 Days to Eight Weeks

Once the skin incision has healed, it's time to wait for the bone to fuse together. This takes six to eight weeks on average. At the end of this time the dog has postoperative x-rays taken, to assess how well the bone has knitted together.

So what are the do's and don'ts during this period of TPLO surgery recovery?

Dos and Don'ts

  • DO take things easy, when walks are allowed these are short, slow, and on the lead
  • DON'T allow jumping, twisting, or turning. This means NO stairs, jumping on furniture, chasing toys, or playing tug.
  • DO follow the vet's instructions about lead walks
  • DON'T leave the dog unsupervised with free access to the house. Instead, keep them restricted to the crate (small dogs) or small room (large dogs)
  • DO contact the vet if the dog takes a turn for the worse

Short Lead Walks

Most TPLO surgery recovery plans allow for short lead walks during this time.

A typical plan is:

  • Weeks 1 - 4: Three to four times a day, a five-minute potter round the yard. This is also a chance for the dog to toilet.
  • Weeks 5 - 8: As above but its OK to potter for 10 minutes at a time.

That's it! Plain and simple, less is more when it comes to an uneventful recovery.

Making Strides: Two to Six Months

Yeah! The two-month state-of-healing radiographs show the bone is healing well. What next?

After all that rest the dog has lost a lot of muscle bulk. An important part of TPLO surgery recovery is a gradual return to activity, which allows the dog's fitness and muscle strength to build back up and support the knee.

This period of physiotherapy is often supervised by a veterinary physiotherapist, who gives the owner exercises to do with their dog. Some lucky dogs have hydrotherapy sessions, which allow them to swim in warm water without taking weight on their joints.

At home, it's best to keep the dog on the lead, to avoid a sudden explosive take-off when the dog spots a squirrel (which is often how the cruciate gets damaged in the first place.)

The trick is to go for gentle lead walks, starting at five minutes, two times a day. Stick with this for two weeks, and then increase the amount of time by five minutes. Carry on with these ten minutes walk for two weeks, then add on another five minutes.

You get the idea, add on five minutes every two weeks providing the dog is coping and not lame.

Successful TPLO surgery recovery takes a lot of commitment, but the rewards are worth it. During those weeks of rest, take comfort in knowing the pay off is a happy dog that can run to their heart's content.

Dr. Pippa Elliott
Dr. Pippa Elliott

Dr. Elliott graduated from the University of Glasgow, UK, with a Bachelor of Veterinary Medicine and Surgery. She has over three decades of experience working in companion animal practice and is the designated veterinarian for the Cats Protection rescue center, Harrow. In addition to hands-on work in the clinic, Dr. Elliott is an editor for small animal, veterinary textbooks from Improve International. She also writes a regular newsletter piece for the Webinar Vet and contributed to The Veterinary Times. Dr. Elliott is also qualified as an Official Veterinarian to oversee the export of animal products abroad.