Though physical rehabilitation protocols have been found to be beneficial in the recovery following TPLO, there is not an established rehabilitation protocol approved by all surgeons or rehabilitation specialists across the world. If you have elected to proceed with a TPLO on your pet, we strongly recommend that you follow the recovery protocol provided to you by your veterinary surgeon. However, this protocol may give you a general idea of the recovery period. Some pets may limp after surgery. If this occurs, please have your dog seen by your veterinarian so a treatment plan can be instituted.

Weeks 1 and 2

Controlled leash walk

  • Walks are best performed on a short leash. Go slowly at first to help gradually improve strength. Walking slowly may help encourage use.
  • Walks can be done three to five times per day for five minutes at a time for elimination purposes.
  • Using a sling or folded bath towel under your dog’s belly can be used for support when walking on slick surfaces such as tile or wood floors, and even on other surfaces if they are unsteady on the surgical limb. The sling can also be used to help slow your pet’s pace down if they are pulling hard on the leash.
  • No off-leash activity

Passive Range of Motion (PROM)

  • Lay dog on his side with surgical limb up.
  • Flex and extend the affected joint gently to resistance.
  • Support knee joint to prevent twisting or rotation of limb.
  • Repeat 2 – 3 times daily for 10 to 15 minutes.

*PROM should not cause pain, discomfort or negative reaction. 

Ice and Heat therapy

  • Use of ice packs after walks and PROM for the first 3 to 4 days after surgery.
  • Drugstore packs, crushed ice in a Ziploc bag, or frozen peas or corn can be used.
  • Ice around as much of the circumference of the knee as possible.
  • While a paper or thin towel can be used to absorb moisture from the ice pack, a thick towel may prevent icing from being effective.
  • Ice for 15 minutes per session.
  • Use heat packs prior to PROM after initial 3 to 4 days.
  • Drugstore packs or socks filled with uncooked rice heated in a microwave work well.
  • Test pack on your wrist first. If it is too hot for your skin, it is too hot for your dog.
  • Insulate the heat pack with a thin cloth.
  • Use for ten minutes per session.

*If your pet fails to begin using his leg during the first two weeks, please contact your veterinarian.

**A recheck should be performed at two weeks so the incision site can be evaluated. Sutures or staples are typically removed at the 10-14 day recheck.

Weeks 3 and 4

  • PROM can be reduced to twice per week.
  • Continue ice therapy as needed if your pet seems sore after walking/exercise.
  • Increase leash walks to ~8 minutes in week 3 and ~10 minutes in week 4 as long as your pet is using the surgical limb.
  • Incorporate the following exercises into leash walks as directed by your veterinarian, to build strength and body awareness:
    • Walk in large figure 8 pattern
    • Stepping slowly up onto and down off of a curb in an S pattern
    • Gentle inclines (a mild slope on a street or a driveway)
  • The following exercises can also help build balance and core strength. Perform these exercises on a non-slip surface, with 5-10 repetitions each
    • Gently nudge the hind end from side to side while standing
    • Sit to Stand exercise – have your pet repeatedly sit down, then stand up
    • Three-Legged Standing Exercise – Have your dog in a standing position, then lift one leg off the ground at a time for 10 to 15 seconds (alternate with all but surgical leg)

*No off-leash activity

Weeks 5 through 8

  • Icing and heat-packing can be discontinued
  • Continue performing the previously mentioned exercises
  • Week 5 increase length of walks up to ~12 minutes up to 3-5 times a day
  • Week 6 increase length of walks up to ~15 minutes up to 3-5 times a day
  • Week 7 increase length of walks up to ~18 minutes up to 3-5 times a day
  • Week 8 increase length of walks up to ~20 minutes up to 3-5 times a day

*No off-leash activity

Weeks 8 through 12

Radiographs will be taken at about 8 weeks to confirm appropriate bone healing. Assuming the tibia is healing:

  • Continue performing the previously mentioned exercises
  • Continue to gradually increase the duration of the walks
  • Gradually introduce off-leash activity, starting week 9 with about 5 minutes of off-leash activity 3-5 times a day, week 10 up to 10 minutes of off-leash activity 3-5 times a day, week 11 up to 15 minutes of off-leash activity 3-5 times a day, week 12 up to 20 minutes of off-leash activity 3-5 times per day.

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