TPLO Surgery Overview

An overview of our experience with a dog going through TPLO surgery. Help prepare for your dog’s TPLO surgery with these tips, advice, and experiences.

*Disclaimer: Windsor is a VERY mellow dog which allowed for an easy TPLO surgery experience. As you read this, please remember that and know that your experience with TPLO may be very different. Also, other surgeons & veterinarians may have different advice so please follow their guidance should things differ.

Instagram TPLO Highlights: You can also check out our highlights on Instagram to see the process & prep in more detail.

WINDSOR THE MELLOW CORGI

Overall, follow the vet’s instructions and do your best. It can be hard work but you can do it!

WINDOR’S INJURY

Windsor is 5 years old and we noticed his back left leg was stiff when he’d get up. After a few steps, it would loosen and he’d walk perfectly. He was super active, ran around outside, played with his brother, no other issues. That being said, we made an appointment assuming it was arthritis.

Windsor is also a puppy mill survivor so we have no idea what his living conditions were like and whether that contributed to this.

Before we made an appointment, Windsor was running around outside like he always does and abruptly stopped and sat down. He was limping so bad he would sit until you picked him up. The problem now was his back RIGHT leg which was never of concern before.

THE INITIAL VET APPOINTMENT

Upon initial x-rays, we knew the bone was fine so they said it was likely he had a partial crucial ligament tear and we should see a specialist. They suggested we wait 2 weeks with pain meds to see if there was any improvement and there was none at all.

CONSERVATIVE MANAGEMENT VS. SURGERY

We researched both options as much as we could trying to find credible sources. There are Facebook groups you can join but they are basically at war with each other that one way is better than the other. If you are set on an option, these groups are full of valuable tips for the direction you choose but are not great at helping you choose one way vs. the other.

Conservative Management instead of Surgery

At the end of the day, we decided that conservative management wasn’t for us. We also read that a cruciate tear of any sort can never heal on its own. There are PLENTY of success stories out there of dogs that do fantastic without surgery. If cost is a factor in the decision (to avoid surgery) it seems that if conservative management is done properly dogs can still live a somewhat normal/active life — there may just be new restrictions on activities.

At this point, Windsor couldn’t even walk. He had to be carried everywhere and would take a few steps then sit down because he couldn’t walk back inside on his own. That to me signaled we have to do surgery to give him a chance at a full recovery. I imagine for less serious injuries (if the dog can still walk) there may be a place to try more conservative management techniques prior to surgery.

Surgery instead of Conservative Management

Surgery for a lot of people sounds terrifying when you read into exactly what the process is– yes, they cut into their bone. Honestly, knowing the TPLO surgery is a very common surgery and many people have gone through it made us feel better. Have we heard ‘horror stories’ of the surgery side? Sure. Anything from it causes more arthritis (which I’ve read arthritis will develop anyways with cruciate injuries both with and without surgery) all the way to surgery causes cancer- what?! That one I don’t believe at all. The reason I bring this up is that as you research you will hear all sorts of stories. Don’t get too bogged down with the extreme ones.

I relied on this Facebook Group Canine Cruciate Recovery (TPLO, CM etc.) a lot both pre and post-surgery. You can see that every dog and vet is SO different but it is helpful to hear a variety of stories. You can also search ‘key words’ in here so I often searched things that were happening and was able to see what other dogs were going through and they advice they were following.

That being said, always go by what your vet says and call your vet first with any concerns.

THE SURGEON

Our wonderful vet did some research and found a highly recommended orthopedic surgery center about 2 hours away.

The main things I knew was to always choose a board certified surgeon and to look for a place that is staffed overnight for their overnight stay.

This location has 3 board certified surgeons all with quite the resumes. We were able to find a handful of people that went there and recommended it too.

We had a consultation and our surgeon diagnosed Windsor with a bilateral CCL tear (both legs) and recommended TPLO on the right leg first then after the 8-week recovery period to come back and do the left leg. Information was provided on why they recommended TPLO and not the other surgical options. This topic has been discussed by surgeons for a long time and the decision is usually directly associated with experience and training of the surgeon. Also, we were told that TPLO is associated with the lowest level of complications and is highly preferred for bilateral tears (what Windsor has) and/or for dogs over 33 pounds.

ONE LEG OR BOTH?

Another topic up for debate. The estimates show that if one leg needs TPLO there is a 40%-60%+ change the other leg will eventually need it too. With that, some people will have both legs done at the same time.

Our surgeon highly highly recommended doing them separate. While it does prolong recovery and they have to go through surgery twice, to him there are far more risks caring for 2 legs post-op than 1 at a time.

That being said…. if I could do things different, I would have requested Windsor have both legs done together. BUT, this is only because Windsor is the most calm docile corgi ever AND he’s 25 pounds and I can easily carry him everywhere.

I personally would not do both legs at the same time with a larger dog or a very active dog. I imagine it would be very difficult to keep them calm and confined on top of the fact that you can’t carry them anywhere.

I’d also suggest you think about your living situation. If they must use stairs and you can’t pick them up then both legs at the same time probably isn’t the best choice.

While 16 weeks of recovery vs. 8 is a long time, going into the 2nd leg was much easier knowing what to expect so that was a positive.

THE MENISCUS

Often with this injury they can tear their meniscus as well. Some surgeons release the meniscus during TPLO, some do not. I’d guess it depends on how badly it is injured? Windsor did get both of his meniscus’ released as he said they were pretty rough looking.

I read of a few dogs who didn’t get the meniscus released and later the dog was limping only to find out they had to go back in and do this. In these stories it sounded like going back in solely for the meniscus is an easier process. Again, these were just a couple stories I found.

I’d possibly ask your surgeon what they usually do just so you know.

SURGERY PREP & PREPPING THE HOME RECOMMENDATIONS

QUESTIONS

Write out all questions you have to ensure you have what you want answered prior to surgery. You’ll feel more prepared. I also have recorded conversations to go back to incase I heard something wrong.

I prepped a binder to keep the discharge instructions, pre-surgery to dos and any other information I was given to have it all in one place.

PREP THE HOME

Cover slippery surfaces

Make sure all non-carpeted areas are covered with any non-slip material or mats so if they do go wandering they at least won’t slip.

-We had extra carpet we laid out over the hardwood and also use yoga mats and carpet runners

Create a “Recovery Cove”

-We bought a folding metal exercise pen and put a waterproof dog pee pad in it as well as his bed, water and my bed (yes, I slept on the floor with him because honestly I was paranoid he’d get his cone off or hurt himself using his bed so I wanted to be right there to hear it).

-This area kept him confined to a portion of the living room so we could be sure he wasn’t going to be sprinting around the house.

-We only ended up keeping this up for 4-ish days post surgery but it is a nice spot to put them in if you can’t watch them 24/7.

Have a sling ready

-We used just a tie from a bathrobe and it is perfect. This helps them if they aren’t bearing weight right away and also if it’s slippery or snowy out. I like it just for helping steady them the first few days and if they appear to stumble or anything, I have their rear stable with the sling.

Other items

-Ice packs (to help with swelling and post PT exercises)

-A sling (we just used a bathrobe tie)

-Pill pockets (there are lots of meds so have something ready to give them)

-Boredom items

–Snuffle mat for food – it takes more time for them to eat (and encourages them to stand) and is a good brain activity for being cooped up

–Lick mats – we put peanut butter on and freeze. Another good activity for them (and also encourages them to stand)

Checklist printed

-I printed this check list so we could monitor his potty schedule, meds, food and physical therapy.

No deliveries/no doorbell

-I wanted to avoid anyone ringing the doorbell or knocking as Windsor will run to the door so I printed this sign and put a big storage tote outside our gate/entrance for packages to be left.

SURGERY OVERVIEW

• Every dog is going to react to EVERYTHING differently.
• Some may cry and be completely restless when returning home, some may just sleep.
• Some may have a lot of bruising and swelling, some may have little to none.
• Some may not eat, some may chow down food.
• Some may not poop for 5 days, some may poop in a day or 2.
• Some may have diarrhea and vomiting, some may not.
• Some may hate the cone, some could care less.
• Some may not handle being confined very well, some may just hang out.

I think it’s important to hear stories from all different situations so you know the potential hard parts and issues so if it happens you are ready. If they don’t, count that as a win!

SURGERY DAY & DISCHARGE

I was given a pre-surgery checklist with rules to follow and some tips on what to expect.

If you are not proactively given something similar, ask for guidance. There were rules on not feeding after a certain time the night before, noting current medications and the last time they had them and what to bring to drop off.

P.S. the no eating after a certain time is critical! Yes, we think they are starving in the morning not getting breakfast but don’t sneak them any food and if you do, don’t lie! The medications + food could cause them to vomit while they are under (or so I’ve read… not worth it!)

Windsor had a morning drop off time scheduled and they say they can not tell you the exact surgery time because every day is different depending on the dogs on schedule. Some more difficult patients or those on special medications may need to do surgeries first. The vet tech did text us when they knew the order though and said “2nd surgery of the afternoon” so we at least knew all morning he wasn’t starting.

The surgeon called us as soon as they could post-op with a report and to let us know they are awake.

The orthopedic center required an overnight stay and is staffed overnight with a text line where they will send you pictures and reports on how they are doing.

This is something I HIGHLY recommend. I have heard of places where they require an overnight stay and they are not staffed. It’s nice to know should anything happen, someone was there monitoring.

Also, I’ve read that some dogs upon waking up do not react well to the after-effects of anesthesia (crying, whining). While I didn’t ask, I imagine this overnight stay allows them to be in the care of vet-techs that know how to react to different dogs vs. the owners. We as owners of course are going to panic if they are crying or acting odd.

Discharge was the following day where they talk through all medications and schedule the 8-week x-ray check in. If they don’t already indicate this, make sure to ask when they are due for their next rounds of medications. The vet was already giving them pills so we continued on the schedule from when they started.

Upon discharge, you can expect them to be pretty out of it. Windsor looked like he barely recognized us. He looked exhausted, his eyes had crusties in them and he was a mix of ‘I’m so tired I’m going to pass out’ to ‘wait, what’s happening? am I safe now?’.

For the drive home, the hubby drove and I sat in the backseat with him. I put several blankets down to make the seat even more comfortable and Windsor just passed out most of the drive.

After being home for a few hours he was a little more awake but the first day home you could tell he was still out of it.

#1 PIECE OF ADVICE – THE CONE IS KING

THE CONE IS KING & the care of the incision is incredibly important.

Think about it, their bone was literally sawed and getting any bacteria in that cut can have terrible terrible consequences.

Basically, the bacteria in their tongues is the worst thing they can get on their incision.

I read somewhere that humans tend to see the cone in a worse light than a dog does. Sure, they may dislike it on but it’s likely not quite as bad as we see it.

Never let yourself think “oh but they must be so uncomfortable” or “they won’t lick the incision” and cave to taking it off. Think of how miserable they will be if the healing is prolonged with a severe infection… now the cone may be on twice as long.

And trust me, they are QUICK. Don’t ever fall into the trap of “I only turned my back for a second” as that can be all it takes.

You have to think about the cone 100% of the time. It’s so easy to take it off quick to let them eat or ice their leg then stand up and either put their bowl or ice pack away without realizing you didn’t immediately put their cone back on.

I usually have the cone on my lap or somewhere where if I accidentally get up I’ll basically step on it incase I forget to put it right back on.

HARD CONE ONLY

We have a soft inflatable donut cone but it is easy to get off. Our surgeon 100% advises to avoid these and recommends the standard plastic e-collar only.

WHAT TO EXPECT POST-SURGERY

The first day home I think will be a crapshoot because it’s too hard to know how every dog will react to the anesthesia, wearing a cone plus the potential pain.

I’d say you know your dog and how they normally act so just be prepared before surgery as much as you can so you can the first day home you can focus on them and not getting the house ready or needing to go out shopping for items.

ACTIVE DOGS

If they are very very active, consider using the sedative longer so they are less active in the first weeks of the incision and bone healing. I’d maybe check beforehand if you will be prescribed a sedative. If not and you have an active dog, you may want to ask for this just incase. It did make Windsor sort of loopy and almost sad looking but he didn’t want to move around much at all which made it easy to ensure he wasn’t up and trying to run anywhere (even in his recovery cove).

*The sedative did have its drawbacks for Windsor. See TRAZODONE details under the medication section*

WEIGHT BEARING VS. NON

It seems that all dogs are different, some will walk out of the vet and some may not put weight on it at all. Windsor was “toe-tapping” the first 1-2 days and tried to use it fully but you could tell it wasn’t comfortable. By the 3rd day he was walking on it well.

EATING

Again, all over the board what to expect here. Windsor ate at the vet when they gave him food and was fine eating his normal food right away. We did ease him back in as recommended doing about 1/3 of his normal meal then working back up to the normal amount over a day or two. You could try more enticing options if they are not eating such as boiled chicken and rice or canned food.

POOPING

The first poop! It can be 3-5 days before they poop due to the anesthesia and medications so don’t be alarmed! Windsor luckily went on the 2nd day both times.

BRUISING & SWELLING

The leg will have swelling (Windsor carried a lot around his ankle) and bruising starts to show up over a few days. The bruising can look pretty ugly. I took pictures of any bruising and of his incision each day so I could compare it. I highly recommend doing this because it can be helpful to compare whether it looks worse or the same.

KEEPING THE INCISION CLEAN/DRY

Windsor came home with a bandage fully covering his incision that we could remove after 2-3 days. The bandage was very hard to get off and they said I could use wet a Q-tip on the sticker areas to try to lessen the adhesive. In the end, I had to just rip it off like a bandage. I iced it after that as it looked like it hurt.

After that, the goal is to keep it clean and dry. This is when the sling helped me a lot if he had a tendency to sit down on potty breaks. I used the sling to keep him standing so he couldn’t put his leg into the snow (his surgery was in the winter) or the mud when the ground was thawing.

For rainy days, I did ask what we should do because clearly his leg was going to get wet and they said just to make sure to dab it with a towel when he was done.

TODDLER PANTS! You may see people using a pant leg to cover the leg and this was another recommendation if it was wet out. I found a pair of 2T child leggings and cut one leg completely off and shortened the other so he had 1 pant leg over his incision. He used this once but did have it if needed.

I was also told to not put anything on the incision. Don’t use products to try to clean it and do not let it get wet.

ACTIVITY & PHYSICAL THERAPY

ACTIVITY

We were given a strict schedule of short walks but absolutely no running, stairs, jumping, anything else.

The phrase was “Windsor does not know the extent of his injury.” In other words, he’s likely going to try to run and do normal things so it is up to us to ensure that doesn’t happen.

Weeks 1-2 = 2-3 short 5 min. to 10 min. walks daily

Weeks 3-4 = 2-3 15min. to 20 min. walks daily

Increasing every 2 weeks from here

ALWAYS on a leash outside.

PHYSICAL THERAPY (PROM EXERCISES)

We were advised to start these right away. I did avoid the first night home and started them the next day.

Our instructions say only to do these if your pet will tolerate them. Windsor had no issues. I did try to massage the leg prior and always iced after.

I actually practiced these on his non-surgical leg to get the feel for what the leg feels like extending because I was scared to hurt him. Once you get the feeling of how the leg moves, it gets easier.

The first few days the leg may be more swollen and bruised but I still did these exercises 3 times per day as he didn’t appear to be in pain. 3x daily for 2 weeks post-op.

Here is a good video of the exercises

MEDICATION

TRAZODONE (Sedative)

Windsor started on this every 8 hours.

Windsor was prescribed Trazodone as a sedative. That being said, because Windsor is so mellow, this basically made him not move much… which was great for making sure he wasn’t up trying to run around but, there are side effects.

He peed & pooped without realizing it. The first night home, he just started peeing and you could tell he didn’t really notice. Thankfully, he didn’t pee on his bandage.

The second and third days, he’d poop a couple turds without noticing while napping.

I stopped it on the third day and the random peeing & popping stopped.

I did have to stay on top of making sure he wasn’t jumping up at noises or trying to move too quickly though now that the sedative wasn’t doing that for him.

GABAPENTIN (Pain)

Windsor started on this every 8 hours.

About 1 week post-surgery I noticed he wasn’t pooping as often and I found a few posts that mention this could be part of it. We changed this to every 12 hours and his pooping went back to normal. Again, I’m not a vet so not sure if that was the issue but it worked for us. We dropped this down to once daily at around the 2 week mark then stopped completely a few days later.

RIMADYL (Anti-inflammatory)

Windsor started on this every 12 hours WITH food.

When we slowed down his Gabapentin to every 12 hours, we changed this to one daily and did it between his Gabapentin times. Stopped completely around 14-16 days post-op.

CEFPODOXIME (Antibiotic)

Windsor took this 1x per day until done (14 days).

I assume our vet gave us this as a precaution incase there was any issue with the incision. I have heard of other surgeries where they do not get this unless there is an issue. Personally, I like him getting this just incase.

WHEN TO STOP MEDICATION

This was another topic that was all over the board. Our vet said most people just do the meds for 2 weeks post-op then as needed after that.

I’ve also heard both sides of whether you should stop the meds cold or ease them off. His vet said there was no need to ease them off the meds but I did anyways.

RECOVERY / ALL CLEAR

We aren’t completely clear yet due to doing back to back surgeries but he did get 8-week x-rays of his first leg and they were very happy with how it has healed.

I would like to do additional PT now that both legs are done so will look into water treadmills after we get a few more weeks post op.

With that being said, we have yet to find out what life is like after surgery and if he is able to return to full activities. I’ve heard of set backs, dogs overdoing it and limping, the potential for hardware removal (the hardware could fail — but I haven’t read much about this) and so many other things. We will cross those bridges if we ever have to. For now, Windsor is healing and can actually walk on his own again so at this point in time we are happy with our decision to do surgery.

THE SUMMARY & TOP ADVICE

1. THE CONE IS KING & the care of the incision is incredibly important. Always be thinking about the cone and if you take it off, never turn your back on them even for a second… that can be all it takes.
2. TAKE PICTURES of the incision and any bruising and swelling. This helps to compare over time to know if things are improving or not.
3. DON’T BE AFRAID TO ASK QUESTIONS OR CALL THE VET. I had all of my questions written out ahead of time so I had what I wanted answered prior to surgery. After that, don’t be afraid to call them for any questions or concerns. Don’t feel like you are being a burden to them… you aren’t a vet, they are the experts.

POTENTIAL QUESTIONS TO ASK

*This is a generic list to begin. Make sure to read any instructions you are given as they may answer many of these. If they don’t, jot additional questions down.

CONSULTATION

1. Have you ever not recommended surgery? If so, why?
2. Have you seen success with conservative management?
3. What are the greatest risks involved with surgery?
4. What are the potential future issues cause by surgery? (arthritis? hardware failure?)
5. Post-surgery/all clear will any activities still be off limit?
6. MY FAVORITE – If this were your dog, what would you do?

PRE-SURGERY

1. What activity restrictions are recommendations prior to surgery? (likely no, jumping? stairs?, running?)
2. Have you done this procedure on (insert breed) before? (I specifically asked about corgis because of their short legs as I was curious if things are done differently)
3. (If only one leg) What is the probability the second leg will need this surgery too?
4. (If both legs) Do you recommend 1 leg at a time or both at once? Why do you make that recommendation?
5. Will an overnight stay be required? Is there an overnight staff to monitor?

AT DISCHARGE (if these are not already answered in your discharge instructions)

1. Who/what number do I call for questions?
2. Who/what number do I call in an emergency?
3. When was each medication last taken?