TPLO Frequently Asked QuestionsWe've got answers below.
Can you work with my veterinarian?
Do we work directly with you or with our regular veterinarian?
What if I don’t have a veterinarian?
We are interested in finding out more and/or scheduling – now what?
What are your hours?
Is ACL or CCL surgery a time-sensitive procedure? What happens if I wait?
My dog has ruptured both ACL’s – can we do surgery on both legs at once?
We know that approximately half of all patients who tear one ACL will go on to tear the other, and it is not uncommon to examine patients that have ruptured both ligaments at the time of diagnosis. Performing surgery on both knees at once means your pet goes through one anesthetic episode, one surgery, one period of hospitalization, and one rehabilitation period. It is also more economical to perform both surgeries at once. However, it is known that increased duration of anesthesia time and surgical time can increase the risk of surgical complications, specifically infection. In addition, if surgery is performed on both limbs at once, then your pet literally doesn’t have a good leg to stand on in the immediate post-operative recovery. However, if surgery is performed on only one knee, and the other is affected by a cruciate tear, then once the surgical limb is feeling better than the injured limb (which may be only days following surgery), then more weight is born by the surgical limb, and thus there is more stress on that implant. With surgery done on both limbs at once, stress on the implants may be minimized assuming weight bearing is symmetrical.
Though older literature advised steering clear of performing bilateral TPLO’s, with recent advances in implant technology the most recent peer-reviewed literature on the subject has shown no difference in the complication rate when performing single session bilateral TPLO’s over staged TPLO’s.
How long does TPLO surgery take?
Will my pet experience any pain?
Patients typically receive a combination of pre-, intra-, and post-operative injectable pain medications (morphine, hydromorphone, etc). In addition, epidural or local anesthetic blocks are often given to help reduce pain. Finally, patients will also be sent home with oral pain management and anti-inflammatory medications.
Does my dog need x-rays before surgery?
Does my dog need blood work prior to surgery?
Can my dog eat and drink the day of surgery?
What do I need to bring to the hospital?
Should my pet’s activity be restricted prior to surgery?
My pet’s surgery is coming up soon and I still have questions. Should I just wait until the day of surgery to have these answered?
Where does my pet stay the night of surgery?
What happens if there are complications after surgery?
My dog hasn’t pooped since surgery – what’s going on?
Why won’t my dog eat since surgery?
My pet is vomiting after surgery – what should I do?
What do I do if my dog is in pain?
Does my dog really need to wear this ridiculous cone of shame?
Why is my dog still limping after TPLO surgery?
In most cases, persistent lameness following TPLO is associated with post-surgical inflammation, soft tissue associated pain, or pain within the joint secondary to damage caused by the cruciate ligament injury (severe cartilage disease or arthritis). Other potential causes of lameness following TPLO include meniscal injuries and infection.
Rare causes of lameness could include implant failure, fibular fracture, or fracture of the patella (knee cap).
Can a dog re-tear the CCL after TPLO surgery?
However, whether your pet has a partial or a complete tear of the CCL during TPLO surgery — and whether the remainder of the ligament is left intact or it is completely removed — further need for the CCL and additional procedures would be highly unlikely.
What are the potential complications?
As with any procedure, there are always potential risks with surgery.
- Anesthesia – Anesthetic complications are very rare. Hospitals typically provide extensive anesthetic monitoring including EKG, blood pressure, pulse oximetry, end-tidal CO2 measurements, heart rate, and respiratory rate.
- Implant failure – When implant failure happens, the plate or screws could bend or break following surgery. Implant failure is very rare because TPLO plate designs and locking screw technology significantly reduce the risk.
- Infection – Post-operative TPLO infections may occur in approximately 5-10% of patients. Owners can prevent infection by preventing the licking or biting of the incision site. Antibiotics can help treat surgical site infections.
- Post-operative meniscal injuries – The risk of post-operative meniscal injury is approximately 10%. The patient may need additional surgery, or their surgeon could recommend rest, anti-inflammatories, and joint supplements.
Other uncommon complications include fibular fracture, patellar fracture, implant-associated discomfort, and osteosarcoma.
How long will it take until my dog can walk after TPLO surgery?
How much activity should my pet have after surgery?
The first 4 weeks of recovery are most critical to your pet’s outcome. Your pet may go outside 3-5 times daily for 5 minutes at a time, on leash, for elimination purposes only.
After 4 weeks, if your pet is doing well, you may gradually start increasing the length of walks by 5 minutes/walk/week – in other words, week 5 your pet may go on ~10 minute walks on leash, week 6 ~15 minute walks, etc. By 8 weeks your pet can be up to two 20-30 minute walks per day, ALWAYS ON LEASH, with a couple shorter leash walks for elimination purposes.
These regular walks are critical for maintaining muscle mass and range of motion in the joint. In addition, weight bearing is beneficial for bone healing.
What sort of other rehabilitation should be performed after surgery?
If you would like to pursue professional rehabilitation or if your pet is not returning to the level of activity desired, rehab options include:
Should we ice or heat pack following surgery?
After 3-4 days, you may begin heat packing the incision site. You may use a heat pack purchased from a pharmacy for this purpose, or you can fill a tube sock with rice and then heat it in the microwave. Remember, if it is too hot for your skin, its too hot for your pet. Heating can be performed for 15 minutes at a time, 3-4 times a day. This helps to reduce swelling and can also be performed prior to passive range of motion therapy.
If at any time during the recovery your pet stops using the operated leg, or fails to begin using the leg within 2 weeks, please contact Dr. Might or your veterinarian.