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Wednesday, 6 June 2012

Recovering from TLPO surgery


I hope someone may have undergone a similar experience and advice, I am so worried...

I have a six-year-old chocolate Lab called Coco. Last year she had TLPO (tibial plateau leveling osteotomy) on her left hind leg and a second operation six weeks after for a meniscal tear due to lameness. In April this year she had TLPO on her right but, due to a fracture on her tibial crest, a pin and tension bands were also put in place:

Week 1 - Coco had a slight limp and toe tapping, which I expected
Weeks 2 and 3 - she seemed to use her leg very well, foot on the ground and weight bearing
Week 4 - leg in the air, and would not put her foot down

I went back to the surgeon/vets and she was prescribed with clindacyl 150mg, marbocyl 20mg and carp reive 50 mg. Whilst she has improved to some extent in the fact that she walks on her leg some of the time, the majority of the time she still holds her leg in the air. She also does not use her leg to get up from a lying position. It seems like her leg is not strong enough. She is happy in her self, what is going wrong here?

Please, if you can offer any advice I would be eternally grateful.

Sue and Coco, by email

Alison Logan, vet, advises...

I can understand why you are concerned about Coco. Having had a TPLO on her left hindlimb last year, you are expecting a similar time course for recovery following the TPLO on her right hindlimb this year.
It is worth remembering, however, that there was a complication for the TPLO this time round with there being a tibial crest fracture so she has the additional metalwork. There is therefore more healing to occur.
When you returned to your vet, Coco was given a course of two antibiotics which would have been aimed at any infection occurring, and a non-steroidal anti-inflammatory (carprofen). It would have been useful to have known how long it is since the surgery, because it can take several weeks for healing to occur, and also how long since you returned to your vet and how long the courses of antibiotics and NSAID were. However, whether or not Coco is still taking the antibiotics and NSAID, I do think you should go back to your vet. It does sound as if she is still experiencing pain and, if she is not receiving any analgesia, it may simply be a matter of being dispensed more carprofen, perhaps with physiotherapy or swimming therapy, for example, to strengthen the muscles. If, however, there are underlying problems then follow-up radiography and other investigations may be needed.
It is very hard for us when owners do not come back despite being concerned about their dog’s progress because we can only assume that there has been a full recovery. 


  1. My GSD had TPLO at about 3 yrs old (10 now). The absolute best thing for rehab after limb surgery is swimming. Try and find a hydrotherapy pool near you. Your local vet surgery should know where any are. I am surprised it hasn't been recommended by your vet/surgeon. For Jake his recovery was slow but steady. Nothing longer than ten minute walks locally about 3 or 4 times a day for about 3 or 4 weeks, or as long as seems necessary. Swimming was half an hour twice a week which I kept up with him once a week until recently. His DM is fairly advanced now. The other thing we used to do was massage any time he was laying down on the correct side to access the operated leg. Also some mild physio. Stretching and bending gently - ask your vet for guidance or a qualified animal masseur. Not allowing the dog to get too excited playing at home - I know just how tricky that can be! Try gentle indoor search games; Jake's favourite was find the cheese. I think that if Coco was fine and suddenly has gone lame again you need to get her checked by the vets just in case though, as it sounds like she must have caused herself some pain somehow. But can only reiterate that swimming really is the absolute best rehab and exercise. I hope she settles down and recovers fully.
    Lynn H

    1. Thank you for taking the time to reply. Because her previous recovery was text book I was tending to think the worst In the fact that her recovery is slower.
      The advice you have given me is both reassuring and helpful. I will be looking for a hydrotherapist for coco after she has been back to the vets next week.
      Thank you

  2. Hi Sue, I hope Coco is OK. Fargo, my nine-year-old Labradoodle, had TPLO surgery on his right leg about a year ago and in my experience, a good physio/hydrotherapist is worth their weight in gold.

    As a dog-owner, I found the early months of Fargo's recovery quite a challenge. Fargo had lost a lot of muscle from his afflicted leg and I needed to give him very short, very slow walks to build it back up and protect both his knees. I could see how easy it would be to push him too far when he made good progress or to worry about any sign of stiffness. Then, even though I kept a close watch on him, my untrained eye didn't always see the subtle signs that the physio could see. Our weekly physio/hydrotherapy sessions have been really important because any small issues or improvements are noted - and all my questions answered - on a regular basis and we've always been able to nip any potential problems in the bud.

    Fairly early in the recovery process, Fargo stopped putting his foot down for a few days (he'd previously been doing really well and had even balanced on that leg to cock his other one!). The physiotherapist examined him and, while he thought Fargo may have 'tweaked' his knee, he also found nothing wrong with the joint itself. He suggested that so soon after the operation, Fargo's reluctance to put weight on his leg could be more mental than physical. So it was important to keep an eye on the physical side, but also to carefully encourage Fargo to bear weight on his leg so he didn't simply get into the habit of limping on it. Without the physio's expert advice I wouldn't have known what to do for the best and could quite easily have done the wrong thing for Fargo. As it was, a week of short walks did the trick, accompanied by our daily routine of stretches and massage and a few days of applying ice and heat packs. There were little tricks to try too, such as 'tickling' Fargo on his right hip, which encouraged him to put a bit of weight on his right leg. It wasn't long before Fargo was happily using the leg again.

    I'm not suggesting that this is what's happening with Coco, but it goes to show the value of regular advice from an expert. It was also a while before Fargo used his right leg to get up from lying down, and this has improved gradually as his leg has got stronger.

    Fargo is doing very well now. His legs are well muscled and we've been able to wean him off anti-inflammatories. He'll always have arthritis in his right knee now, so we'll continue to keep an eye on it. He loves his weekly swims in the hydrotherapy pool which give him great exercise with minimal impact on his knees. And I'm reassured by the check-up he has each time. I hope that his story helps you, and that Coco makes just as good a recovery.