If you are reading this, Tibial Plateau Leveling Osteotomy (TPLO) surgery is probably something you’re considering for your dog or already have scheduled.
My rescued pit bull, Scooby, tore his cranial cruciate ligament (the CCL or basically a dog’s version of a human ACL) while happily playing with other dogs. After much research and advice, we chose TPLO surgery to heal him. I do not regret the surgery one bit. I came back to update this post because I wanted to share that he lived an active and full life for several years afterward until cancer took him away from us.
My goal is to give you a dog owner’s perspective of what TPLO surgery recovery was like to help you navigate it and feel better about choosing it as a solution, though it is no substitution for the advice of veterinary professionals. Our dog recovered in less time than I had anticipated because we were proactive with things like physical therapy which I will cover in detail.
I had actually expected to write a week by week series of posts but after the first few weeks, there was nothing to chronicle other than that his walking improved every day and, of course, his rehabilitation which was time- and cost-intensive but worthwhile.
You will also need to buy some gear. Though I covered what we bought in my planning for TPLO surgery post, I’ve inserted some links to helpful products for consideration. The supplements that were recommended to us helped, too, and had a side benefit of improving his allergy-ridden skin.
Grab a coffee and let’s get started.
Why We Chose TPLO Surgery
First things first, I thought I’d address why we chose such an invasive surgery for our dog. First, our veterinarian and surgeon both recommended it. I looked at conservative management and could not imagine keeping such a normally-active dog sedentary as well as on anti-inflammatories and painkillers forever. Prolonged use of the anti-inflammatories leads to arthritis setting in earlier and more aggressively than usual, I’m told.
As surgery date neared his limp increased. Seeing him in pain broke my heart. The day before surgery, I started to hear an unbearable clicking noise when he walked, which meant his meniscus was now torn, too. He couldn’t live like that either.
Also, we have PetPlan pet insurance that covered a significant portion, but not all, of the costs.
Scooby was not able to have food after midnight or anything to drink after 5 a.m. on the morning of his TPLO surgery. I checked him into the hospital around 7 a.m. so that they could take radiographs and complete his blood work in time for afternoon surgery.
The surgeon called to say that he found masses on his leg and penis that should be cut out at the same time. He was prone to random lumps and bumps due to allergies that we were constantly monitoring. Since he was already having surgery anyway, it was a good time to cut it out and send it away for biopsy (which turned out, thankfully, to be benign). The poor guy was stitched along his leg for TPLO and also in two other spots for the mass removals.
After the surgery was over, the surgeon called to say it had been successful and that Scooby was resting comfortably. He’d spend the night under observation and I’d receive a call in the morning with pick-up instructions based on how he was doing.
I have a 9-year-old daughter who is very attached to our dog. To keep her mind off of the surgery, I scheduled a sleepover for her at our house. Crazy? Maybe. I dare say that despite the extra work, it helped keep my mind from wandering, too.
Day After TPLO Surgery
Before he came home, my daughter and I set up a queen tri-fold mattress that we had bought on the floor. Knowing how needy Scooby is, we figured he’d want to lay with us for the rest of the day.
My instructions were to pick him up at 1 p.m. and to plan for about an hour’s visit. The doctor would go over care and medication instructions in detail. I put one of his dog beds in the back of my SUV along with his ramp and headed off to the hospital. Make sure that where your dog sits in the car on the way home is free from dirt, sand or anything that might get into the wound.
The doctor brought him out using a sling under his hind hips as a precaution because they have slippery floors. She said he otherwise didn’t need it. Scooby looked great and seemed to be walking almost normally, which was I’m sure fueled by the adrenaline of leaving the hospital and also seeing us. She let him walk quite fast, but said that slow walking right after surgery is better.
I had her help me lift him into the car as he wasn’t yet good with using a ramp to get in.
Scooby, thankfully, received stitches that absorb over time in lieu of staples. However, the stitches for his masses were the kind that needed to be removed. The bevy of medicines we took home included painkillers, antibiotics, an anti-inflammatory, and a sedative.
We spent the rest of the day in our little mattress camp. He stood up to eat and to go to the bathroom. His walking was not nearly as good as it was at the hospital and looked truly painful. My heart ached while watching him try to move around.
He couldn’t quite figure out how to lift his leg to pee. He squatted once but the next time he went outside to pee I nearly squealed in pain as he lifted up his good leg, while putting all weight on the injured leg. He limped back into the house with a lesson learned. I was told later by his rehab therapist that this is the beauty of TPLO surgery — they can put weight on the operated leg like that almost immediately.
At night, I gave him a precautionary sedative and slept with him on the mattress. While I left his e-collar (cone of shame) on all night, I had his leash in my hand so that I would know if he moved. He slept well but pulled himself completely up five or more times in the night to slowly shift around. I’m sure he was uncomfortable.
I cut his normal amount of food by 1/3 because of his lack of activity.
I did not use the harness we bought during his recovery. It proved to be more helpful in the days leading up to the surgery when he was really hurting and I will definitely keep it for when he is older. The car ramp though is something he used for the rest of his life.
We were instructed to apply an ice pack for 10-15 minutes, 3 times for the first 24 hours and then a warm compress 3-4 times per day after that. It is very helpful to have a reusable hot-cold compress that can be placed in the freezer or microwave depending on what we need.
After the first day, it is up to pet owners to make sure the dog rehabs well. You can always call the surgeon, vet, or hospital for assistance but don’t expect a ton of handholding from here on out unless you ask for or need it.
I was totally exhausted. Several people told me to be prepared to devote two weeks to TPLO surgery recovery and they weren’t kidding.
Scooby hobbled out to the kitchen to eat but then refused his pills. As a dog who takes daily allergy medicine, he often goes through spurts where he figures out they’re being hidden in peanut butter, bread, hot dogs — you name it.
I tried hot dogs, string cheese, bread, pizza and several other things that he rejected. Finally, we settled on butter. When you’re taking 8 pills, that’s a lot of butter. He threw up only the pills about 20 minutes later and, miraculously, kept his breakfast in his stomach.
I called the doctor who advised that I give him only the painkillers and antibiotics and skip the rest of the pills temporarily. In the meantime, my husband had gone to the store to get eggs. Scooby loves egg yolks. I slipped the pills in a fried egg yolk (leaving the yolk a little soft so they didn’t fall out) and we were back in business.
I put him in a crate during the day. The crate plus e-collar combo was confusing to him as he kept whacking the e-collar on the crate’s panels. I moved our tri-fold mattress into the kitchen and left him on it instead of using the crate. He was so mellow that he laid there almost all day with his e-collar on. I was working in the kitchen so could stop him from getting up to walk around if need be but he never tried.
Going outside to pee proved difficult for him. He could put a little pressure on the injured leg but not much. I could tell he was still confused about how to pee.
There was no need for sedatives today as he was still fairly groggy. His leg looked much more bruised.
About an hour after he took painkillers, I started the recommended passive range of motion exercises. My instructions were basically to bend and extend his operated leg. I massaged his quadriceps before and after the exercise. I couldn’t bend his leg in all the way—only slightly which seemed like enough for one day after surgery. He was fighting the movements. This is a routine we’d continue until he was using his legs well during walks.
I ice packed his leg in the morning but by the time the evening hit, it was time for warm compresses.
Swelling on this day was unsettling. It happened above his incision and looked like a big red bag was hanging over his stitches. His leg also looked far more bruised and red. They told me this would happen but seeing it in real life is alarming.
The e-collar was really causing him unhappiness so I bought a few alternatives that were even worse. He could maneuver around the donut-style inflatable collar to lick his leg if need be, though it would be a great solution if he had, say, an incision on his back. I tried a floppy collar but it was so floppy that it covered his entire head and he couldn’t see. Back to the standard e-collar we went. I see why vets prefer it.
The reason why dogs need to wear the cone during TPLO surgery recovery is that licking results in complications like an infection that may lead to additional procedures.
Still groggy, I let him sun himself outside today while keeping a close eye on him. He was very lethargic so no sedatives were needed. He finally pooped, too, which was a huge relief.
I gave up floor sleeping so put him in the crate. He was so lethargic though that he slept in it without issues.
This was a very difficult day. He’d decided that he’d had enough pills and started gumming every single food item I slipped them in so that he could find them and spit them out. Sneaky.
I went to PETCO and saw the rolls of chilled food in the refrigerated section. While a little pricey, I bought a roll of salmon and veggies by FreshPet thinking I could chop it up and hide the pills in that. It worked like a charm (and he’s eaten it for meals since then).
He was putting weight on his leg so we walked around outside for about 5 minutes, per our care instructions.
Major fatigue had set in on my part which is why I didn’t keep much of a diary during this time. The swelling was pretty major until about day seven. I frequently had to sit with him to keep this normally active dog calm which means not a lot got done at work or around the house.
He was a very happy dog during this time, however. I think about how grumbly I’d be after such a major surgery and he showed zero signs of suffering or pain.
He seemed to get a little energy back so I tried using the sedatives to keep him calm. They didn’t really work as he could fight through the maximum recommended dose after a short nap.
The cone was pretty depressing for him so I kept it on him when he was out of my sight but took it off otherwise. He is not really a licker though and pretty mellow so this worked for us.
We were walking for about 5-10 minutes, twice a day. I think he could have handled more but I was nervous to push him too hard. He would still raise his hurt leg when standing still, which I’m told is normal.
As I said, he required more attention from me to keep him from moving around too much. I had to keep him on a leash at all times when outside of the crate. Toward the end of this timeframe, we felt okay to leave him for short spurts alone in the house inside of his crate. Until this timeframe, someone had always been at home with him.
Earlier in this timeframe, he was still so mellow that I let him sleep in his normal bed outside of the crate (he did not like being crated). I kept his leash on and slept with it looped on to my arm so that I knew when he was getting up. He did need to get up a few times at night to go to the bathroom.
When he became a bit more active at the end of this timeframe, I put the crate around his bed. Our crate has 6 panels which can be extended into a rather large sleeping area. I felt he needed the extra room to shift around as he is a big dog. However, he did start to also want to jump back into our bed so I put the top on the crate eventually.
He’d been so well behaved and mellow that I allowed him to walk around our one-story, stairless house on his own. Well, that was a terrible idea because he jumped on my daughter’s bed. Granted, her bed is low to the ground but it was still not something he should do. It’s the most comfortable bed in the house and he knows it. I nearly lost it. I lifted him off the bed and he did limp but, thankfully, he did not re-injure himself.
A lesson was learned and he stayed on a leash at all times for the next week.
The stitches from his masses were removed today thank goodness but they still wanted him to restrict movement and wear the cone for a few days while the incision healed a bit more. Things looked pretty good though.
As long as he was willing to walk, the surgeon said it was fine for him to walk him as far as he could handle as long as I didn’t have to carry him home. (Your doctor may say otherwise.) We did not need to continue the passive range of motion exercises but the surgeon suggested that I continue with the massage.
Day 18 — Formal Rehabilitation Begins
Today, he started rehabilitation at a canine therapy center near our house. Our consultation started with measuring muscle atrophy that occurred in both legs, which is normal given this type of surgery. The goal is to rebuild muscle in both legs to prevent a CCL tear or any injury to the good leg. Apparently, there have only been a handful of dogs at this center who have injured the good leg after completing their recommended physical therapy.
They loaded him into the water treadmill, filled it, and had him slowly walk. As a dog who hates water, this was quite a shock to him (and also funny to watch). The buoyancy of the water reduces the amount of painful downward impact on joints and muscles during exercise.
Some dogs love the water treadmill. Mine needed a toy in his mouth to act as a pacifier.
He was on the treadmill for about 25 minutes, dried off and then had cold laser therapy and a massage for another 30 minutes. Cold laser therapy uses a beam of light to stimulate cellular regeneration that helps reduce swelling, promote healing and relax the muscles.
Luckily for us, this rehabilitation is partially covered by our pet insurance but I would gladly pay for it out of pocket. I truly believe that he has recovered quickly because of it.
He did 10 sessions of rehab and at the end was able to run but was still not allowed to pivot, chase balls or play with other dogs just yet.
We have a one-story house with no stairs or hazards like slippery tiles. He was free to walk around the house and yard at leisure. I was worried about him constantly standing up and laying down but the therapist said this is actually good to help him strengthen the leg and not to worry about it.
Walks were upped to about 20–30 minutes twice per day. He did slow down toward the end of the walks. I am used to taking him on a long walk once a day so this is a bit tough on me during busy days but one walk for 40–60 minutes was not doable for him at this point.
A few other exercises were added into our recovery routine. I slowly walk him up and down curbs and stairs and for a few minutes every day. And, around week 5, it was suggested that I take him to the beach as walking in the sand will also help strengthen his muscles.
He continued to go to rehab twice a week and was still hilarious to watch on the water treadmill.
He is walking normally. In hindsight, seven weeks doesn’t seem like a lot but at the time, it felt like forever.
Other than the fact that his leg is still every so slightly shaved, you can’t tell he had the surgery. He likes to run on the leash a little which we allow on a limited basis. Rehab continues twice a week.
We headed back to the surgeon for a routine check-up. This is where they take further radiographs to see how the bone has healed. Because he needs to be sedated for radiographs, he was not allowed to eat anything after midnight the night prior.
Everything looked good. By this point, most dogs have 100% bone healing, however, Scooby only had 80%. The surgeon wasn’t at all worried about it because we were going to rehab, he looked great and was walking fine.
We were told that this was the last time we needed to see him.
Rehabilitation also ended this week. His good knee no longer showed any signs of muscle atrophy associated with the surgery. Our instructions were to climb stairs for a few minutes several times per week, walk in deep sand, and use the ocean as our water treadmill. Walking dogs in the ocean at just below their shoulder height provides enough resistance to build strength.
So then we were on our own. I can pretty much get him to do everything but walk in the ocean. We live in San Diego and he’s deathly afraid of it.
Week 9 and Onward
Scooby’s level of activity went back to normal with a few caveats. He used to go to a camp to play with other dogs. After consulting the camp director, who has seen many dogs go through TPLO surgery, we decided that this would not be a good idea to continue. I think this was the hardest change for him because we were basically isolating him from other dogs. I avoided them during our walks, too, because he became so excited and jumpy upon seeing another dog (we had to work on this with a dog trainer).
We used ramps to get him into the car for 100% of the time going forward. Getting a dog to walk on a ramp takes some training for which we also sought professional help.
We did let him get on our bed and our daughter’s bed by using a soft ramp with scalloped steps. Once he understood how to use the car ramp, getting him to use the indoor soft ramp was easy. He did occasionally skip the ramp to jump on or off of the beds but used it the majority of the time. But, he was a very mobile and happy dog.
Change of Diet and Supplements
As part of a campaign I was working on with the pet food company, Petcurean, I interviewed their nutritionist about how a dog’s diet can impact their joints and ligaments. It does and you can read her interview using the link below.
I discovered that we were probably over-feeding him as cutting his intake by 1/3 has kept him in the ideal weight range. We’ll continue at the reduced level.
Also based on advice from the surgeon and veterinarian, we continue with a high-quality glucosamine supplement. Apparently, quality matters. He takes a brand called Dasuquin that is a little bit cheaper on Amazon than at my vet. It’s a chewable pill in a flavor that he likes. (My new rescue dog loves it, too.)
He also needed daily Omega 3’s forever to help reduce inflammation. Right now, I’m using a salmon oil supplement that I pump into his food that he seems to like. I used to use another brand but the pump was constantly getting clogged. I think that consistent use of this brand has his skin looking way better than it did with his previous Omega 3. I also wonder if adding the Ligaplex II below has helped his skin in some way, too, but I have no proof.
His therapist recommended Ligaplex II, a food-based supplement that promotes joint and ligament health that many people rave about online. You can now buy it on Amazon. You simply break open the tablets and sprinkle the supplement on top of food. Or, just toss the tablets into food.
(Almost) No Table Scraps
I read that processed grains and carbohydrates lead to inflammation in dogs, too. That means no bread and little scraps my husband used to feed him. He’ll get the occasional raw carrot or cooked egg but that’s about it.
I’m really grateful for our medical and rehab team and that we had a good result with TPLO surgery. It was stressful and time-consuming but, in our case, completely worth the effort.
Scooby lived a full life after surgery. Those lumps they removed were precursors to a common type of dog cancer that you may have never heard of called hemangiosarcoma. I hadn’t until it happened to him (and if you read the comments of shocked pet owners worldwide, I’m not alone), but it’s common and death is unexpected and imminent leaving you no time to prepare. It was tied to the lumps we that I mentioned were cut out during his TPLO surgery but they were also growing inside of him and we didn’t know until one on his spleen ruptured years later. If you have a big dog like a pit bull, Labrador retriever or golden retriever please learn about it because you will want to recognize the symptoms. We now have another rescued pit bull named Ruby and I am keeping an eye on her knees and her skin.
Circling back to the entire point of this post, I hope that your dog never needs TPLO surgery. If he or she does, I wish you all a very speedy recovery!
Also, this book called The Essential Dog Owner’s Manual for CCL Injury: What to Do Before, During & After Surgery was recommended (thank you) by a reader in the comments below. It looks like it can also help and something I wish was available when Scooby had his surgery.