TPLO Surgery Restrictions & Recommendations

​During the first eight weeks, we are completely relying on the implants (plate and screws) to stabilize the surgery site. It takes a minimum of eight weeks for bones and soft tissues to heal. This process can take longer in geriatric pets or those with other systemic health conditions. Please speak with your veterinary surgeon to find out their exact recommendations for post-operative restrictions. Below is a general guide for restriction recommendations and return to activity.

• Your pet should be confined to a kennel or small room (up to 6×6 feet) until radiographs show good bone healing. He/she should not have free roam of the house or playtime with other dogs.
• Any running (inside or outside), jumping on or off furniture, or playing could lead to severe complications.

Weeks 1 and 2

• Controlled leash walks to go to the bathroom 3-5 times daily.
• Walks are best performed on a short leash (no flexi-leads). Go slowly at first to help gradually improve strength. Walking slowly may help encourage use.
• Using a sling, harness, 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.
• Physical rehabilitation exercises:
  • Passive Range of Motion: Gentle flexion and extension of the operated limb can be done 2-3 times daily to ensure very good range of motion of the stifle joint. Support just above the stifle (knee) and at his hock and gently flex the leg up to the body and then extend the limb first straight down in a standing position and then back behind him/her to extend the hip. Hold each position 3-5 seconds and repeat the exercise 10-15 repetitions. This may take a second person to relax your pet in the front end, but this should not be painful.
  • Massage: Gentle massage of the thigh and lower leg muscles will help your pet to relax and it can encourage him to use his leg better and to allow better range of motion exercises. It can also help reduce some swelling in the limb. It can be performed for 5 minutes before the range of motion exercises.
  • Weight Shifting: Please encourage your pet to stand on the operated leg at all times, or at least to keep his/her toes on the ground. Gentle weight shifting can be done by carefully pushing the hips side to side, while they are standing. Reward your pet when he/she is standing on the limb. It can be performed for 5 minutes before or after the range of motion exercises.
  • Ice packing: For the first 5 days following surgery, you may ice the incision for 10 minutes 2-3 times per day. A frozen bag of vegetables or an ice pack works well. Do not place an ice pack directly on the skin without a thin cloth or paper towel over it.
  • Warm packing: After 5 days of icing, a warm washcloth *in a plastic bag* may be used on any residual swelling or bruising to aid in the reduction of swelling, bruising, and to increase circulation. Please make sure the warm pack is of a temperature comfortable on your own skin before applying it to your pet’s skin. If he/she does not tolerate the icing or warm packing well, please discontinue.

• No off-leash activity.

*If your pet fails to begin using the surgical 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. If sutures or staples were placed to close the skin, they are typically removed at the 10-14 day recheck.

Weeks 3 and 4

• Passive range of motion can be reduced to twice per day.
• Continue ice therapy as needed if your pet seems sore after walking/exercise.
• In addition to bathroom breaks, you may increase leash walks to about 5 minutes of ‘active walking’ 2-3 times per day and can then increase the duration by 5 minutes each week, as long as your pet is using the surgical limb.
• Incorporate the following exercises into leash walks as directed by your veterinary surgeon or rehabilitation therapist, 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 15 minutes up to 2-3 times a day.
• Week 6 increase length of walks up to 20 minutes up to 2-3 times a day.
• Week 7 increase length of walks up to 25 minutes up to 2-3 times a day.
• Week 8 increase length of walks up to 30 minutes up to 2-3 times a day.
• If your pet seems sore or tired as you increase the length of walks, then decrease the duration of the walks. In general more frequent short walks are better than one or two long walks.
• No off-leash activity.

Weeks 8 through 12

Radiographs will be taken at 8 weeks to confirm appropriate bone healing. Only after the x-rays confirm bone healing should your pet be allowed to return to running and jumping. Assuming the tibia is healed:

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