TPLO Discharge Instructions

TPLO (Tibial Plateau Leveling Osteotomy) Discharge Instructions

TPLO surgery is performed to stabilize the knee after a cranial cruciate ligament (CCL) tear. Successful recovery depends heavily on following the activity restrictions and rehabilitation plan outlined below. While many dogs begin touching the foot to the ground within a few days, complete recovery takes approximately 16 weeks.

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Weeks 1–2: Strict Rest & Early Recovery

Your pet may not be using the surgical leg at discharge. Most dogs begin weight-bearing within 1–2 weeks, are walking comfortably by 4 weeks, and return to near-normal activity by approximately 16 weeks. Intermittent toe-touching or occasional non-weight-bearing can be normal during the first two weeks, but complete refusal to use the limb after initially improving should prompt a recheck.

Activity Restriction

• Strict confinement to a crate, exercise pen, or small room.
• Outside only for bathroom breaks on a short leash (6 feet or less).
• No running, jumping, roughhousing, playing, or off-leash activity.
• Avoid stairs whenever possible.
• A few steps to enter or exit the home are acceptable while leashed and supported.
• Whenever possible, avoid slippery surfaces such as hardwood, tile, and laminate flooring. Area rugs, yoga mats, or runners can provide additional traction and help prevent falls.

Important: Excessive activity during this period can result in implant failure, fracture, delayed healing, or the need for additional surgery.

Sling Support

Use a sling or towel under the abdomen to support the hind end until your pet is comfortably bearing weight on the leg. This is particularly important:

• On slippery floors
• While navigating stairs
• During bathroom breaks

Incision Care

• Do not allow licking, chewing, scratching, or rubbing at the incision.
• An Elizabethan collar (E-collar) or Lick Sleeve must remain on at all times until a picture of the incision has been reviewed by our staff at 14 days post-operatively. If an E-collar is utilized, we strongly recommend a rigid plastic cone extending beyond the tip of the nose, as many dogs can reach the incision while wearing inflatable collars.

Normal Postoperative Findings

The following are common after TPLO surgery:

• Bruising around the incision
• Mild to moderate swelling
• Swelling of the ankle (hock)
• Intermittent non-weight-bearing during the first two weeks

It is common for dogs to have good days and bad days during recovery. Mild fluctuations in limb use are normal, especially during the first two weeks after surgery.

Contact Us If You Notice

• Excessive redness or swelling
• Drainage from the incision
• Separation of the incision edges
• Persistent worsening lameness
• Loss of appetite beyond 48 hours
• Vomiting, diarrhea, or medication concerns

Cold and Warm Compresses

First 72 Hours

• Cold therapy helps reduce pain, swelling, and inflammation.
• Apply a cold pack for 10–15 minutes, 2–3 times daily.
• Never place ice directly against the skin.
• A bag of frozen peas, crushed ice in a plastic bag, or a commercial ice pack wrapped in a damp towel works well.
• Some pets may not tolerate cold therapy immediately after surgery. Discontinue if it appears to cause distress.

After 72 Hours

• Warm compresses help improve circulation, reduce stiffness, and promote healing.
• Apply a warm compress for 10–15 minutes, 2–3 times daily for up to one week.
• A warm compress can be made by soaking a washcloth in warm water, wringing it out, placing it in a plastic bag, and applying it to the surgical area.
• The compress should feel comfortably warm to your skin and never hot enough to cause discomfort or burns.

Rehabilitation Exercises

Physical therapy is particularly important for dogs that are reluctant to use the limb. We can provide referrals to rehabilitation specialists if desired.

Physical Therapy Video Demonstration

A video demonstrating many of the rehabilitation exercises described above is available courtesy of Washington State University College of Veterinary Medicine:

Watch the Rehabilitation Video — Washington State University

We strongly encourage owners to review this video before beginning home rehabilitation exercises to ensure proper technique and maximize recovery.

Feeding

• Offer a small meal tonight if interested.
• Resume normal feeding tomorrow.
• Appetite may be reduced for 24–48 hours following anesthesia.
• Bowel movements may be delayed for several days and occasionally up to one week.

Maintaining a lean body condition is one of the most important long-term factors in reducing arthritis progression and improving comfort after TPLO surgery. Because activity is restricted, we recommend reducing caloric intake by approximately 20–25% during recovery and limiting treats.

Two-Week Incision Recheck

• Please email a photograph of the incision to [email protected] or text it to (518) 279-0700 at 14 days post-operatively.
• Once the incision has been reviewed and approved by our staff, the E-collar or Lick Sleeve may be removed.

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Weeks 3–4: Controlled Activity

Activity

• Begin slow leash walks of 5–10 minutes.
• Walks may be performed up to twice daily.
• Keep all walks controlled and on a short leash.
• If limping increases during or after walks, reduce the duration.

Restrictions

• No running
• No jumping
• No rough play
• No off-leash activity

Stairs

Limited stair use may begin if:

• Your pet is using the leg well.
• They remain leashed.
• They are closely supervised.

Rehabilitation

Continue:

• Weight-shifting exercises
• Controlled leash walks

Add:

Sit-to-Stand Exercises

• Begin with 5 repetitions twice daily.
• Increase by 5 repetitions each week as tolerated.
• If your pet consistently sits with the surgical leg extended to the side, use a wall to encourage a square sit position.

Four-Week Recheck

Your pet will return for:

• Doctor examination
• Recheck radiographs
• Evaluation of early bone healing, implant stability, and joint swelling

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Weeks 5–10: Progressive Strengthening

Activity

Gradually increase leash walks to:

• 10–20 minutes
• Two to three times daily

You may begin:

• Gentle hills or inclines (up to 5 minutes per session)
• Wide figure-eight walking several times weekly

Continue monitoring closely for signs of fatigue or increased limping.

Restrictions

Your pet is still not allowed:

• Off leash
• Running
• Jumping
• Playing with other pets

Rehabilitation

PROM exercises may be discontinued.

Continue:

• Controlled leash walks
• Sit-to-stand exercises
• Weight-shifting exercises
• Figure-eight walking
• Hill walking

Ten-Week Recheck

Your pet will return for:

• Examination
• Sedated radiographs

If radiographs confirm complete healing of the osteotomy site, activity restrictions will gradually be lifted and a return to off-leash activity may begin.

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Weeks 11–16: Return to Normal Activity

If radiographs confirm complete healing:

• Gradually reintroduce off-leash activity.
• Begin with short periods of supervised play and light running.
• Slowly increase duration and intensity over several weeks.

If soreness develops:

• Reduce activity for 24–48 hours.
• Apply cold packs.
• Resume activity at a lower level and progress more gradually.

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Sixteen-Week Final Recheck

Your pet will return for a final postoperative examination to ensure:

• Appropriate healing
• Good limb function
• Comfortable return to normal activity

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Important Reminder

Many dogs feel significantly better before the bone has completely healed. Even if your pet appears comfortable, they must continue to follow the prescribed activity restrictions.

Following these instructions carefully gives your pet the best chance for a successful outcome and lifelong comfort.

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Postoperative Exercise Timeline

Time After Surgery	Recommended Activities
Weeks 1–2	Passive range of motion, weight-shifting exercises
Weeks 3–4	Controlled leash walks, sit-to-stand exercises
Weeks 5–10	Longer leash walks, hill walking, figure-eight walking
Weeks 11–16	Gradual return to supervised off-leash activity