TPLO post-op care
TPLO surgery or Tibial Plateau Leveling Osteotomy, is currently the most common surgery for the correction of a cranial cruciate ligament disease. TPLO surgery involves correction of the tibial plateau with an osteotomy (cut in the bone) and attachment of a stainless-steel bone plate to restore stability and function.
Post-op care can be challenging but not impossible. It is essential to allow your pet time to heal and to avoid re-injury during recuperation. Short-term challenges (generally up to 14 days post-op) are mainly wound management and restriction of activity,
while long-term challenges (2 weeks to 3-4 months post-op) regard pain management, restore of limb function and osteotomy healing.
Wound protection:
Monitor the incision daily for signs of infection such as increased redness, swelling or discharge.
Your pet should not lick the incision, therefore it should wear an E-collar until sutures are removed, as licking can be a source of infection. As an alternative for E-collar, a full body or only hip & thigh wound protective sleeve can be used. Incision should remain clean and dry.
Activity:
Running, jumping, stair-climbing, rough playing or any unrestricted or off-leash activity should be avoided.
Activity must be limited to short leash walks three-four times a day.
Restrict activity for the 6-8 weeks post-op will allow complete healing of the surgical site.
Confinement in an enclosed area such as a small room or dog crate might be suggested in case of extremely active dog or inability of the owner to restrain the patient. After rechecking radiographs confirm adequate healing at 6-8 weeks postoperatively, your pet may gradually return to full activity.
Pain management:
pain-medication such as non-steroidal antinflammatories (NSAIDs) are routinely prescribed for several weeks during recovery. NSAIDs are often associated with other analgesics such opioids, gabapentin/pregabalin.
An adequate pain management protocol for your pet will minimize surgical pain and allow a comfortable return to normal function.
It is crucial to remeber that long term use of NSAIDs can cause gastrointestinal symptoms such as loss of appetite, vomiting or diarrhea. In these cases, you should contact your veterinarian immediately. Furthermore, avoid association of NSAIDs with a steroid since it can cause gastric ulcers and subsequent gastrointestinal tract bleeding. Some prescribe sedatives for your pet’s safety and to assist you in enforcing exercise restriction, but it is a surgeon preference.
Limb function:
Most pets will begin to use the operated limb within 2 weeks of surgery and should show steady, continous improvement. If your pet is not touching the leg down and using it within 10-14 days after surgery, you should contact your Vet, as well as if your pet present lethargic or acutely painful.
Your pet should progressively improve his/her ability to walk on the operated limb. Many patients will not walk on the limb initially but begin to walk on it over the next several weeks.
Some clinicians may suggest post-operative physical therapy exercise to perform at home daily which will improve muscle recovery, pain-management and functional use of the limb.
In spite of this increase in comfort and use, you must continue to enforce the exercise restriction. Burst, uncontrolled, off-leash behavior can be devastating to your pet and injure or tear the joint and undo the surgery.
