TPLO post-op rehabilitation

Written by Michael B. Mison, DVM, Diplomate ACVS

Tibial Plateau Leveling Osteotomy (TPLO) Protocol


Weeks 2 through 5

  1. At your 2 week re-check appointment we will review this protocol and answer any questions that you might have. Sutures and/or bandages will be removed. The dog’s use of the leg will be assessed. If your pet is not using the leg well, we will determine why and prescribe appropriate treatment.
  2. If all is well, begin controlled, slow walking, outside on leash. This is performed by using a solid (no reel) leash and making the dog walk slowly. At this stage of healing, a quicker pace often will result in the animal picking that leg up, so maintain a pace that encourages use of all 4 legs. It is fine if the pet pulls you during the walk, as long as it is not so hard that they are jumping off the back legs. Start with 5 minutes, once or twice per day. Increase by 1-2 minutes per day if tolerated. Poor tolerance would be increased limping or picking the limb up and not using it for part of the walk. Please call if you notice increased swelling or suddenly not using the limb. If soothing to your pet, you can ice the incision area for 15 minutes after activity.
  3. During this period, physical therapy such as underwater treadmill or swimming can greatly improve the speed of recovery of your dog. We can provide you with a list of physical therapy resources if you are interested.

Weeks 5 through 7

  1. Increase the difficulty of the walking program by adding hills to the program. Walking time can gradually increase to (2) 20-minute walks. Some pets may already tolerate this. Judge tolerance at this stage by how he or she feels a few hours after the walk or even the next morning. If there is stiffness or less weight bearing at these times then the previous workout might have been a bit too much.
  2. Swimming can be started if your dog likes to swim. Make sure that your pet does not run in or out of the water! Start with 10 minutes and gradually increase.
  3. All outside activity, except swimming, must still be on leash.

Weeks 8 through 10

  1. If your pet is very active and you can jog, slow trotting on leash for 5 minutes of the walk is allowed if tolerated.
  2. Typically, dogs will need to be on leash for all outside activity for 4 months after this surgery to avoid quick acceleration, full running, and jumping as these activities are most likely to injure the surgical site. If your pet is very active and you would like to strengthen him or her quicker, you can start the following activities if the x-rays show good healing: Picking up the front legs and walking forward and back to make the pet dance; gradually increase the trot time and add circles or figure eights; increase the amount and steepness of hills; or increase swim time by 10 minutes per week.
  3. Schedule re-check radiographs for week 8.

Weeks 10 through 16

  1. At week 10 follow-up radiographs will be taken to confirm bony union.
  2. If your pet can trot for 30 minutes or walk for an hour without increased soreness, then off leash in a small, enclosed yard supervised for an hour at a time. Do not allow full out running, nor rough housing with other pets.
  3. If your pet “behaves”, then increase the time in the yard by 10 minutes each day for two more weeks. Then they can be in a small, enclosed yard all day. If your time allows, continue leash walking or trotting.

If no further rechecks are necessary, please know that we are happy to answer questions or see your pet if it has further problems. Rarely, the implants may need to be removed if they become loose or troublesome to your pet.

Published on July 17, 2008.