Instructions For Cruciate Surgery– Tplo
Your dog has gone through Tibial Plateau Leveling Osteomy (TPLO) surgery. This procedure is aimed at changing the biomechanics of the stifle (knee). The normally sloped tibial plateau of the dog is rotated to become flat. This eliminates the tendency for the tibia (shinbone) to thrust forward during weight bearing, which in turn keeps the menisci (cartilages) from being torn and crushed. TPLO surgery has improved success at avoiding long-term development of arthritis and leads to better resumption of normal activities than is typically seen with other surgeries for cranial cruciate ligament rupture.
When we treat patients having a TPLO, we enter the stifle (knee) joint. We prepare every patient with complete aseptic surgical technique to prevent infection of the joint. Unfortunately, joint fluid makes a wonderful breeding ground for bacteria. For this reason, please keep an eye on the surgical wound for any signs of swelling or discharge.
A small amount of reddish fluid discharge can be normal for the first 2-3 days, but this should cease within 5days. Your pet has been placed on a very broad spectrum of antibiotics to help prevent infection. Please give these antibiotics according to the prescribed twice-daily schedule until all the pills are gone.
Your veterinary surgeon has prescribed a NSAIDs (non-steroidal anti-inflammatory drugs) for use in the post-operative period. These drugs are very strong and are very safe, providing that we monitor your pet’s ituation. NSAIDs are aimed at inhibiting the COX 2 enzyme that causes pain and inflammation. It is likely that your pet has already been taking an NSAID (such as Onsior, Rimadyl, Previcox, Deramaxx or Metacam) for a period of time before surgery. You know that you need to continue to monitor for loss of appetite, vomiting and diarrhoea as your pet continues NSAID therapy after surgery. Please call if you have concerns about any of these symptoms.
Maintaining an ideal bodyweight and lifelong dietary supplementation with Omega 3 fatty acids (or fish oils) are very valuable in controlling arthritic pain.
If tolerable to your dog, apply a cold pack (using just a wet towel to start with) to the knee for 5 to 10 minutes twice daily for the first 48 hours.
We strongly suggest you make an appointment with a professional animal physiotherapist. Rehabilitation is a very important component in your dogs recovery. A physiotherapist will take into account your lifestyle as well as your pets needs to implement a plan to get your pet back to good health.
Rehabilitation is tailored specifically to your pet, who may progress faster or slower than another due to age, size and other factors. Your local vet will advise you of a local animal physiotherapist.Please bring your pet back in 10 to 14 days to remove the sutures. Please make an appointment (there is generally no charge for this rocedure). At this time your pet will start a series of 4 x weekly Pentosan Polysulphate injections (Pentosan Polysulphate is a concentrated anti-inflammatory and stimulant of cartilage synthesis, repair and protection for treating joint disease in dogs).
For 10-12 weeks following surgery, you must restrict your dog’s activity to permit normal healing. During this period the dog’s activities will be gradually increased to build muscle, stretch scar tissue and strengthen bone. During this time strict confinement is required:?
1. Your pet can be inside, on carpeted surfaces, under your direct supervision.
2. Avoid all slippery surfaces, stairs and any form of jumping.
3. They must be on a leash at all times when outside for airing and toileting.
4. When not under your direct supervision, they are to be confined into a small room (approximately 2m x 2m).
• For the first four weeks after surgery, restrict your dog to slow walks both inside and outside the house. Running, Jumping or roughhouse play should not be allowed. Be careful on slippery surfaces so your dog doesn’t slip or fall. Begin with a five minute walk, once a day, with the dog on a short lead, at the “heel” position. If the dog remains comfortable during the first 3-4 days, double the umber of walks. The dog will benefit more from 2, five minutes walk than a single ten minutes walk. If your dog remains comfortable and seems interested in more activity, continue to double the distance, duration or frequency of the walks every 3-4 days. If the dog seems uncomfortable after a walk, reduce the distance to the level at which it was comfortable. After 3-4 days, again try to double the distance. Swimming is very effective in accelerating your pets recovery from surgery. This can commence following skin stitches removal.
• After four weeks, you can begin walking your dog on a long (3-4.5m) leash. For the first few days on a long leash, cut the duration of your walk in half. Your dog’s trotting back and forth will make-up for your shorter walk. If the dog remains comfortable, the length or frequency of walks can be doubled every 3-4 days.
• 6-8 weeks after surgery, we would like to see your dog back for a recheck and radiographs to evaluate healing of the surgery site. If healing is progressing normally, you may start to exercise your dog off the leash. Off the leash activity should occur only after your normal long-leash walk and under your supervision. As with the leash walks, you should start with 5 minutes off leash and double the time every 3-4 days as long as your dog is comfortable. Jumping or free running with other animals or after toys should not be permitted.
• 10-12 weeks after surgery, A final examination will be needed to evaluate final healing. Instructions will then be given for returning your pet to normal activity.
If any time during healing, your dog appears to have increased pain or other set-backs, Please contact us.
• Your dog may or may not be using the surgery leg when released from the hospital.
• Most dogs will begin to use their surgery leg within 14 days after surgery. Use of the leg will start with light weight bearing, progressing slowly to increased weight bearing over the next 6 to 8 weeks. Generally the full benefits of surgery are only really visible after 3-4 months.
• Playing with other animals is not allowed during confinement. If there are other pets in your household, you will need to keep them separated.
• Your pet should want to eat, drink, and act normal at home. During confinement, your pet’s food intake needs to be reduced to prevent weight gain. Most dogs will maintain their current weight if their food intake is cut in half. Their water intake should remain normal.
• If at any time during your pet’s recovery and healing they have a setback or a decrease in function, we need to be contacted to make sure they have not injured themselves.
• Some swelling and bruising is normal following surgery. The knee may be swollen – it should gradually reduce in size over the next week.
Please call our office if the swelling increases after your pet goes home. Occasionally swelling will occur down the leg at the ankle area. This is usually not a sign for concern provided it is not bothersome to your pet (i.e., pet stops eating, drinking, or stops using the leg).
• You will need to monitor your pet’s incision during the first two weeks following surgery, to ensure they are not licking or chewing the area. If you notice your pet has started licking the area, you will need to take steps to discourage them from doing so. Use of an “Elizabethan Collar” is very effective in preventing them injuring their wound.
• It is not unusual for your pet to go several days without a bowel movement after surgery.