TPLO Recovery Journey
Good to Know
What is the Difference in the Ligament Acronyms?
Technically dogs don’t have an ACL but this is still the most widely term. For ease of understanding, it is common for even your vet to refer to this ligament as an ACL injury too. In this post, I do use both acronyms, but now you know I’m referring to the same thing.
When talking about legs, the ACL or CCL is what holds it all together and allows you and your dog the freedom to bend and flex your bones with ease. If either are torn, the leg bones are rubbing together and unstable, causing inflammation and degenerative joint changes.
How can this happen? – Dog ACL Injury
- nutrition in-balance
- weekend warrior
Of course genetics can play a role with certain breeds being predisposed to this injury. Vets will also refer to this as a degenerative disease that can occur over time.
Pinpointing how this occurred with Dixie is unknown. Dixie is healthy, consistently exercised with averaging 8-miles a day and she eats way better than I do. However, I learned more about knees as we went through this recovery process. One thing to quickly note here is I did add joint supplements to her daily – I talk about this more below.
How to Spot the Signs? – Dog ACL Injury
- The problem often starts with a very discreet limp. We noticed intermittently limping and at first, it was hard to tell which back leg was causing trouble. This began as just a very, subtle hop that she would quickly correct. The limp was mainly noticed when she would try to stand from a laying down position.
- The limp may seem to get better with rest. My first thought was she ran too hard at doggy day care and it was just a sore muscle or a sprain. In fact, with rest the slight limp would completely disappear.
- Monitor increases in limping. Within the week the limp did start increasing in frequency and I decided to make her a vet appointment to get this checked out. I researched vets that specialize in leg injuries or orthopedics instead of using our primary vet and booked. At this point, I was looking for a vet with a wide range of physical therapy options with still thinking she had sprained something.
- Remember that dogs are experts at hiding pain and sickness. For the next few days leading up to the vet visit, she didn’t go to daycare. I watched her closely and the limp went away again. We proceeded with keeping the vet appointment anyways. I decided I would prefer to get this checked out and get an expert opinion on how best to treat the injury if she still had an issue. One important lesson that I have learned with having a dog child is that they are masters at hiding when they are hurt or sick!
How to Find a Specialist and Questions to Ask? – Dog ACL Injury
Questions to Ask:
- Check out this website link for some specific questions to consider asking: DogKneeInjury.com: Questions to Ask Your Vet Prior to CCL Surgery
- Inline with the above link, here are the general list of surgery questions: American College of Veterinarian Surgeons: General Surgery Questions
- Check Out Yelp Reviews: Search for specific terms when you click on the reviews tab to highlight ACL or CCL or TPLO experiences.
- Analyze the Website: This isn’t a deal breaker necessarily but I was looking for a focus on orthopedics beyond just listing as a quick bullet point in the mix of other services. For example, it’s the difference of there being a surgery page listing everything VS a separate page for orthopedics surgery specialties. I really wanted to see that separate page that screams we have a certified surgical specialists that routinely preforms this procedure.
- Ask Around for Recommendations: Talk to friends with dogs, fellow dog park goers, etc.
Vet Evaluation Process - Dog ACL Injury
Physical Exam and X-Ray
The initial test for back leg injuries is called the drawer test. This is a physical evaluation where the vet holds, bends and flexes the leg looking for abnormal movement. A positive drawer test signals the joint is unstable and accurately indicates a torn or ruptured ACL issue.
If you have an anxious dog (like me) … any tension and stiffness can make the drawer test hard to read. It’s a good idea to get an x-ray regardless.
In testing the drawer for both back legs, the vet said Dixie isn’t relaxed enough to get an accurate assessment. She seemed to be tensing her right back leg more. The vet proceeded with sedation and an X-ray to properly diagnosis. Sure enough the results showed that she had a slight tear but it was her back LEFT CCL. She injured her driver side not the passenger side.
This vet advised that most likely surgery would eventually be needed based on age, weight, activity level and her experience. With our current situation and the fact that Dixie did not appear to be in pain, conservatory management at this time was a solid option to pursue for the next month or so in order to make the best decision. The wait and see suggestion is a common first step.
Our Conservatory Management Story
For the next few weeks, Dixie was only allowed leash walks – we proceeded to monitor and I continued my research. However, after more digging, I started preparing for the fact that surgery was going to be inevitable more sooner than later.
My overall goal was for Dixie’s leg to be completely functional that allowed her to fully enjoy life. Based on science, there is just no proven treatment or alternative therapy available that is going to help this torn ligament grow back together. Surgery is the only option to repair.
Conservatory management basically means you can manage inflammation and pain with medication, and try to control further injury by limiting activity.
While I did go down the rabbit hole with reading many stories from different blogs who were successful without surgery and others where this didn’t work. I eventually circled back to weighing pros and cons from vet specialists.
Ultimately an elongated period of conservatory management that may or may not work and can lead to other issues is just not what I wanted for Dixie. She’s 6, healthy and very active.
I started to allow off leash time for Dixie, and I occupied my time with evaluating TPLO specialists, reading blogs to prepare, etc. At first, Dixie was careful with just trotting around and fine off leash. Then on August 1st, at the dog beach, she was playing with furiends at doggie day care, tried to make a sharp turn and yelped.
* With complex situations like a CCL injury and surgery decisions, it’s wise to get assessments from a few orthopedic specialists and evaluate the specific options with the certified experts.
Next Vet Appointment
I confidently settled on going to San Diego Bay Animal Hospital. Mainly, this clinic was one that came with a high recommendation from a close friend that had just gone through the same TPLO surgery with her dog successfully. I further read every review on yelp, examined the website and searched the internet some more.
I can now confirm that I did make a good decision, the whole experience was excellent!
When we saw DR Ferenstein, Dixie was still full on limping even with rest and the drawer test easily confirmed that her leg was obviously, completely unstable. Surgery was scheduled for the following week, we received pills to manage the pain/ swelling and I paid for the deposit.
(2) After Surgery: Ask if your dog pooped. Ask for assistance to express if your dog was constipated before surgery.
Why Track? Our Experience ...
TPLO Surgery Day
Dixie was required to stay overnight. This is the normal protocol with catheter, and on stronger drugs to manage pain and keep sedated. I dropped her off at 9am in the morning and charged the remainder of the bill to Dixie’s Care Credit Card.
I received a call from the orthopedic specialists around 2pm. Expect to get the update after your dog wakes up from anesthesia. The status was simple with Dixie’s surgery went great, she is awake from being under and he would continue monitoring until late.
The next hurdle for this anxious mom was the clinic was not a 24-7 vet. Dixie would be staying overnight by herself. If a specialists saw that Dixie might need overnight supervision while monitoring after surgery, there were other options that would be discussed when appropriate.
I had drilled them with enough questions to be confident in their expertise/ process/ experience at this point to get to a kinda comfortable state with this step. Nonetheless, I did not sleep much and this was a nerve racking night for me. I was that annoying dog mom that checked in right before closing, just to make sure Dixie had Wally the Wabbit with her in her kennel. Wally has a history of taking care of her when she is sick.
Besides surgery, the next worry for me is medication. Dixie is extremely sensitive to any kind of medication and is pinned as an MDR1 dog. If you have a herding breed this is something you should look into.
I won’t go into detail here about her emergency exploratory surgery last year due to a foxtail where she all of a sudden became septic. That’s another story but in regards to stronger medication, she can have unexpected, seizure like reactions. While I haven’t had her officially tested, the emergency vet has a warning in her records that states to treat as an MDR1 dog.
This basically means that the vet has to be cautious with pain medication and antibiotics due to Dixie’s past reactions. My concern was also with the fact that it is super important for her to be comfortably medicated so she can rest and heal with an intense surgery. There are not a ton of options when it comes to dogs and medicine, but her drugs and dosage prescribed were customized and monitored.
Dixie’s Overnight Bag Included:
** I emphatically stress and would strongly recommend to plan on being home the first week after surgery. ** Take off work as much as you can with at least the first couple of days. Try to request work from home, as another option, preferably part-time. Hire a trusted caretaker to be at your house when you can’t be there.
This is just such a critical time for healing correctly and I am not exaggerating when I say your dog will pretty much need 24-7 attention and help. For no other reason than to avoid having to redo an expensive reconstructive leg surgery, this is when you want to be there for your furbaby.
If you are still reading this then you are most likely similar to me where your dog means more to you than having to cancel important travel plans, disappoint people with commitments and adding to your CC debt. My girl definitely needed me there and I'm 100 percent glad I made that happen.
Don’t expect hand-holding for this from your vet – you should get the basic, *discharge instructions post surgery, but you need to be proactive with figuring out additional steps. Below are my top recommendations based on my experience.
*Follow the discharge instructions to a T – nothing in this post is to be used instead of vet guidelines.
Ride Home Pack List
- Ideally you have a second person available to assist upon arrival at the very least. I would not attempt to help them with hoping down a ramp and this is not a good time for attempting stairs either. If your dog is too heavy to carry or other complex scenarios, you should consult with your vet for advice.
Invest in a Sling
There is no cast or brace on the leg and it is important to assist them with walking. This is similar to why you would need crutches if you had reconstructive knee surgery. Plus the last thing you want to do is allow them to try to hop around by themselves on drugs. The sling is their crutch – supporting them while walking is a must, and critical for the first few weeks. Dixie was lightly toe touching but we were holding her up. I believe I used the sling for over a month.
At first, we just used a towel, then we made a contraption with a pool noodle and sheet, and finally I discovered one of my running waist bands would do the trick …. Bottom line is the constant need to assist with walking and supporting peeing and pooping, I was starting to see the benefits of having a sling for the grip and ease of use. Invest in a sling, you’ll be glad you did.
The pad fit perfectly around her belly. I clipped closed and adjusted the length to be able to hold with one hand while walking. I gripped with my palm facing out and used an arm curl motion for lifting and lowering her.
I turned to Amazon and looked for the options and noticed the official dog slings actually looks a lot like a running waist belt or even a fanny pack. I ended up using a running waist belt that I had – it was one that is non-stretchy, adjustable and durable enough to perfectly support her weight.
- I do not have a recommendation for purchasing since I just used what I had that worked.
- Some key terms to search for on Amazon include: “dog sling”, “dog ACL sling”, “dog lift harness”, “dog lift support”
- To me, the most important feature is the handle grip that makes it comfortable to walk beside, lift and lower with one hand when they need to pee or poop. I found it easier to control with your palm facing out holding the grip and use an arm curl motion to lift and lower.
Larger Dogs: If you have a heavier or bigger dog then looking for a custom sling with the appropriate pad width and specialized grip/ adjustable length is recommended.
Bring a Clean Towel or Sheet to Lay on Outside
It’s a good idea to bring a sheet or towel with you when you are going outside. Dixie loved to go outside and just sit. For the first couple of weeks, I was cautious with making sure she was on a sheet or blanket to keep her incision free or dirt or grass. The last thing you want is to have an infection … When you go outside, bring a clean blanket that they can relax on – again until the wound is completely healed you want to prevent anything that might aggravate or infect from contacting
Get or Borrow a Kennel
We don’t kennel Dixie (ever) but I’m telling you now that this is a necessity for recovery. Unless you plan on having 24 hour support with multiple people taking shifts sleeping and watching when someone needs to go to the restroom or take a shower, or leave the room for a few seconds for the next ~ 30-60 days … then you need a kennel to keep them from jumping around.
I have never had a reason to kennel Dixie, but stick one of her beds in there and praise her for getting in her cave and she was happy to settle. I just borrowed a large kennel for her. I think she actually liked her cave.
Sleeping Arrangement Plan
If your dog is accustomed to sleeping and jumping on your bed – consider removing your bed frame and box spring so just your mattress is on the floor. It was a comfort thing with I also prefer to sleep in my bed instead of next to a kennel or other confined area. This was also not the time to try to reverse a habit of jumping on and off beds.
Dog Sleepy Music
Dixie didn’t sleep much and I mostly stayed awake with her for the first two weeks. Week one in particular was a full week of Netflix binging and all night slumber pawty. She would nap during the day but at night she was awake. The medicine did do a good job of keeping her relaxed which is important. In week two, she started to sleep for a few hour at night and sometimes relaxation or meditation music would help. You can find many free options on YouTube. Below are two examples.
For us, this was a hard obstacle. Dixie is allowed on furniture and it was difficult to prevent her jumping on and off the couch. She tends to be quick and sly with her movements.
I read a blog where they placed chairs on the couch to prevent this, which I thought was clever. I also placed random objects in front of the couch to prevent later in the recovery process. As mentioned, I wasn’t looking to spend time retraining – for me, dogs belong on the couch
Get a Notebook
Record everything. This is is a 90 day journey filled with several steps, and you will be thankful that you just record the days to keep it all in track. Do not try to track this all in your head. If anything is weird or goes wrong, your vet will need to know a variety of specific details down to the day and approximate time to be able to best assist.
Get a Joint Supplement
With everything I read, your dog should be on a joint supplement was in bold and highlighted.
First, I purchased Green Mussels from the local pet store when we first discovered Dixie had a slight tear.
- Helpful article on Green Mussels from Top Dog Health: The Ultimate All Natural Joint Supplement for Your Dog
- Brand Purchased: The brand that I bought is Super Snouts Joint Power.
- Dose: (It come with a tiny scoop and recommended to double the dose for the first 2-weeks with inflammation) – I was giving 50lb Dixie 3 to 4 scoops per day and this lasted almost 2-months.
- Taste: Dixie approved – she will lick this powder off my finger!
- Maintenance: I recently bought another can for maintenance and I just sprinkle 2 scoops in with her food a few times per week.
Next Dasuqin was the brand that was highly recommended by my orthopedic specialists. I purchased this when Dixie got her staples removed around Day 14 and started her on this daily. All I can say is Dixie did heal quick and I plan on keeping her on these for life.
- Dose: Dixie is 50lbs – she took 2/day for the first 2-months & now is taking 1/day for maintenance.
- Taste: Dixie is a picky treat & food dog – she likes these!
- Amazon Tip: if you do plan on adding Dasuqin as a daily staple to your dogs diet, there’s a save & subscribe option.
I’m sure there are other highly reputable options out there but I think it’s just important to pick one (or two). It is extra necessary while your dog is rebuilding their leg, putting more strain on their other leg, on meds and may not be eating as much. The extra supplementation is needed.
Get Reuseable Cool and Heat Gel Packs
You can improvise with ice packs/ cold peas/ other home remedies for a warm compress but ease of use does help.
- All you need is one or two hot & cold gel pack/s – stick inside a pillow case for a pocket. I sat next to Dixie and held this is place while she was lying down.
- We ended up buying three to alternate. One would’ve sufficed for Dixie with she did not have an issue with swelling, but the convenience of at least two was good (one to stay in the freezer and one for microwaving). Follow vet guidelines or ask questions for using this during recovery.
- Side Note: Initially we bought the Therapy Wrap that comes with a gel pack. While it has a nice pocket for the gel pack, I don’t think this is necessary. I really didn’t have a use for the velcro straps with Dixie laying down.
Get Runners or Rugs for Slippery Floors
It was nearly impossible to control Dixie from jumping around without assistance at certain points – even with my full time attention and two roommates that helped. I would recommend to make sure the floors are not slippery when they do.
- Even though Dixie was a good hopper and normally very agile – all it took was watching her take one sharp turn and slip to make us start looking for rugs. Luckily she did catch her balance but we ordered a few of these Hallway Runner Rugs that solved the slipping on any on the non-carpeted floors. There was a pathway from the living room to the back door.
Get Pill Pockets
Prepare for needing to give your dog multiple pills daily. After a surgery situation, some dogs might not be hungry and be more difficult than usual. Others figure this out with anything you try to hide a pill in. Dixie does both being difficult and finding pills to spit out. This is what worked for Dixie this time: Greenies – Chicken Flavored
If your dog does become unexpectedly difficult at taking pills, even with pill pockets, then you might have to resort to the stick the pill down their throat method. I had to YouTube this last year after an unexpected fox tail surgery and it definitely tops as my least favorite thing to do. However these pills prevent infection, reduce inflammation and manage pain are all critical for healing.
Thankfully she started to take the pill pockets this time. For some reason, she needs to hear “this is your pill that is going to make you better” before she takes it. I swear she understands English sometimes. .
Buy a Can of Organic, Canned Pumpkin
As a side effect of pain medicine, constipation is normal. Lengthy constipation can cause other problems. Pumpkin is what helped Dixie.
- We got the canned pumpkin at Sprouts, local grocery store, in the dog food section. The brand I purchased was Nummy Tum Tum for Pets. I checked on Amazon and it is only available in bulk: 12 Pack of Pumpkin for Dogs. You will most likely only need 1 or 2 cans. However any canned, organic pumpkin without things like added sugar or other unsafe for dogs ingredients will suffice.
- With Dixie, I opened the can and put into a glass container to store in the fridge. I would take this out, dip my finger, get her to lick off and repeat a few times. It really doesn’t take much for this to help.
Stubborn or Picky Dog Tip for Pumpkin:
Boop a little bit on their nose. I had to do this at first with Dixie – I put a dab on her nose and praised her when she licked it off. Later she would just lick this off of my finger.
Restoring function and regaining muscle …
Download Top Dog Health Rehab Guide
Subscribe / download the appropriate FREE rehab guide from Top Dog Health: https://www.topdoghealth.com/rehab-guides/
I was extra impressed with the information details, guides and videos provided. It was as simple as filling out a short form and the full guide is emailed for download. Plus I received weekly emails that focus on one week at a time. These emails detailed the recovery plan, expectations, exercise recommendations with steps and video explanations for the week. This was extremely helpful, easy to follow and really well put together! I do recall that the weekly email series didn’t come immediately so give that a few days to arrive.
The weeklies also came with an extra email summary from Dr. James – specifically I remember reading week 4 that started with explaining the “Danger Zone”. He was exactly on point and it was a great reminder!
- Purchased cones from Amazon: QuickPlay 9″ Pop-Back Marker Cones (Set of 6) Collapsible Slotted Cones – these cones are short compared to your normal cone but worked for Dixie. If you have a dog with longer legs then you may want to consider finding a taller cone or support for the PVC pipes. The point is getting them to lift and bend their leg to build strength.
- Purchased PVC pipe from Home Depot
Besides the Dr James Rehab Guide, Hydrotherapy is the other standard recommendation for recovery if you can afford. However one advantage to living in San Diego is there is a beach. When she could walk without sling support, we started DIY hydro sessions with walking in water against currents. Likewise trail hikes where there are hills was a part of our regiment.
As Dixie’s inexperienced physical therapist, with getting guidance on what exercises to do from a pro via emails, I would often put myself in her situation. This may seem obvious but I’m pointing out anyways since this is what I did that helped me to understand what she most likely needs… For example, Dixie is not going to show signs of being sore unless it’s extreme but I can take an educated guess based on thinking about the situation and trying to catch subtle hints.
- Since Dixie is prone to pushing her limits it was helpful to think about things like: if I have not been using this leg for x amount of days, then I would need to work on rebuilding the ability to bend, lift and regain muscle.
- I would also need to consider the other leg that is being lazier than usual, but at the same time, is carrying extra weight.
- I would assume when her legs might be sore and follow the blogs video guides on massaging for both legs.
- Of course remember that dogs are good at hiding pain and their knee was cut then re-positioned with a plate and screws.This is a pretty intense surgery even if they don’t act like it was. Watch closely for signs of pain and control it! Keep them sedated for the first week or so to allow rest and healing – yes, knock them out! I had to call the vet a few times to advise on upping pain medication dosage for Dixie. Work with your vet to find what works.
Swelling – Example from Week One
Dixie didn’t have a problem with swelling and the moderate amount she did have lasted about a week and a half. I took a picture every day the first week just to document and be able to compare.
The pictures are of week one and is normal to mild –
- Top Row: Day 1
- Middle Row: Day 3
- Bottom Row: Day 5
On Day 5 – I circled in red a staple that had raised. I emailed this picture to the vet which saved me a trip. The vet said not to worry, the wound looked excellent and was healing perfectly.
Worth it Purchase!
As I started to think about how long a 90 day recovery process is with limited activity, I could clearly picture the slow death of Dixie’s spirit. I know my dog and I just wanted a better solution to getting her out more for the mental stimulation that she needs. As always, I researched for days before I settled on the Doggie Ride Novel Stroller. It’s not the cheapest option but there is a list of reason why I chose this one for Dixie. So here’s me trying to be frugal after an expensive surgery – I immediately charged a tank to my CC. No regrets, it was completely worth it just to see her smile!
As an added bonus, this thing also helped me to not go crazy as well! I honestly didn’t consider being stuck in the house too. Dixie was even carted into no dog zones, like the grocery store, with ease and this doubles as a buggy. The tank really ended up being a sanity saver for both of us!
Why “TANK”? When she was first getting adjusted, we zipped closed with only opening the top sunroof. She would slowly peep her head out the top hole and then crouch down to stare through the mesh like she was in a tank. However, it didn’t take long for her to be completely comfortable with riding, jogging, and going off-roading over large bumps with the front unzipped. She felt safe in there, and this is why the tank is still appropriate.
Safety: There is a latch at the top to hook her collar to. This safety latch has been kitty, bunny and squirrel unexpectedly tested and passed – Dixie could not jump out. One of the reasons why the padding accessory is a good idea is it is extra shock absorbent and like a thick gymnast mat.
Features I like:
Note: You will need the accessory padding, Doggie Ride Luxury Mat, unless you want to DIY with possibly sticking a thick bed in there. The bottom isn’t padded without the mat.
I just purchased the stroller + pad, but my ultimate goal was to also get the bike hitch attachment for this eventually. (This is how I was validating spending money because I was planning on spending more money.) However, I ended up selling this to another dog in need, King Charlie. One day, in the future, I would like to buy this same trailer with the bike hitch. I think it would be fun, but I’m going to work on being an adult with a budget for now.
Doggy Ride definitely has my seal of approval!
Follow Up Appointments
- 14 day – staple removal
- 60 day – x-ray to check on if the bone was healing properly
- 90 day – x-ray to clear bone is healed
The vet told us that Dixie’s 60 day x-ray looked like a 90 day x-ray. Her bone was completely healed already! Nonetheless this didn’t mean we could allow her to go crazy – she still needed to follow a rehab plan – but this was really great news! The 90 day x-ray was also still good and he gave us some further instructions with basically stating that exercise is still important and watch her weight. Dixie did gain 5 pounds during the process that she needs to lose.
Customize plans specific to your dog – there is no one size fits all when it comes to things like dietary best, exact here’s what to expect and exercise protocols that will guarantee success. As always, consult with your vet and/team of experts. I hope some of our journey tidbits will help ya too!
Be prepared! You've got this! Good luck and godspeed!
Dixie and Lisa
Disclosure: Made Pawsible is a participate in the Amazon Services LLC Associates Program, an affiliate program designed to provide a means for sites to make a small commission by linking to Amazon.com products. As an Amazon Associate I earn from qualifying purchases at no extra cost to you. All opinions and recommendations in this post are entirely my own. This content is not sponsored in anyway.