My two-year old Great Pyrenees is scheduled to have a TPLOG done this week. What is the post-operative care for a dog after TPLOG ?
Many veterinarians experienced with Tibial Plateau Leveling OsteotomyG , or TPLOG , have been very pleased with the results of the surgery.
Post-operative care and physical therapy regimes will vary from surgeon to surgeon, so it is important that you discuss the recovery process with the veterinarian performing the procedure.
The typical post-operative course and physical therapy recommendations that may be implemented are as follows:
Most dogs are toe touching and putting some weight on the leg within the first few days. You can expect some swelling, first at the knee, and then the swelling will move to the ankle due to the influence of gravity. This usually resolves in the first week. A seroma, or pocket of sterile fluid, under the incision occurs fairly often, but does not usually require drainage. Seromas resolve within a week or two.
The dog is kept in a large crate or very small enclosure for the first six weeks. No running, jumping or vigorous play is permitted. Short leash walks for elimination purposes only are allowed. A towel sling can be used when walking over slippery floors or using stairs.
One may begin physical therapy with passive range of motion exercises starting on the first or second post-operative day. This consists of gently flexing the knee until the dog shows discomfort, backing off a little, and holding for 10 seconds. The same thing is done for extension. This may be repeated four to five times per session and two to three sessions per day.
At 10 to 14 days after surgery, the sutures or staples are removed. By this time the dog is usually bearing a good amount of weight on the leg. The physical therapy regime can be continued, and the crate restriction is still in place.
At six weeks post-op, it is typically time to bring the dog back in for an evaluation and x-rays. If healing is progressing normally, most dogs have a mild limp, but are bearing almost normal weight and have a non-painful range of motion. The x-rays should show beginning bone union, and the implants (screws and plate) should be stable. If all looks good, then owners may begin increasing the dog's activity level. It begins with leash walks for five minutes twice daily. If the dog seems to feel good and has no increase in lameness or discomfort, then leash walks are increased to 10 minutes the next week. Subsequently the walks are increased to 15 or 20 minutes twice daily for a week, and then to 30 minutes a week later. The goal is to get to two-30 minute leash walks per day without increasing lameness or discomfort. If the dog shows discomfort, we back down to the previous level of activity.
If an owner has access, it is also good to begin allowing the dog to swim at six weeks post-op. This is excellent physical therapy if your dog likes to swim and if you have a place. Begin with five minutes a few times a week, and work your way up gradually.
At 12 weeks post-op, it is time to bring the dog back in for evaluation and x-rays. The x-rays should show complete bone healing. The dog should be walking with only a slight limp and should not experience pain on range-of-motion exercises. If all looks good, we institute the last phase of physical therapy. Swimming should be continued, if possible. Walking the dog with a Flexi-lead leash for 20 to 30 minutes allows the dog to trot and pick up the pace a little; this is done for one to two weeks. If there is no increase in lameness, then five to 10 minutes of off-leash activity before the 30-minute walk is permitted. Increase this to 20 minutes the following week. If all is well, your dog can resume training and normal activity the following week.
Remember this is the average recovery course. Schedules will vary, and you should follow your surgeon's recommendations. If your dog has any difficulties during the recovery period, be sure to contact the surgeon, as your dog may need reevaluation. With good communication and rehabilitation effort on your part, and following your veterinarian's instructions, you can generally expect an excellent outcome.
09/05/00
