Week 2 Rehab Instructions: Walk Properly

126 Comments

1. Kathy if you can please call Martha at 888-504-2220 and she can help you with this. Don’t stress out if we already shipped you a bottle of maintenance, Martha will make everything right…she is amazing and will take great care of you. All the best, Dr.J

2. Debbie, sounds like a tough road for your boy. If you have not already you can download the TPLO rehab guide for free which I wrote. Here is the link https://topdoghealth.com/home-rehab-guides/tplo-home-rehab-guide/

   Your best bet, since has has had so many injuries and has a long way to go, is to aire on the side of conservative. Expect that full recovery for him is going to take 6 months if not more. Also it would be a very good idea to locate a canine rehab facility in your area. We have a directory on https://www.topdoghealth.com of all the facilities across the country, so check it out.

   All the best, Dr.J

3. snuffy our poodle is @ week 3 from his tplo operation ,could you please send me rehab instruction for that .He has had 3 operations since feb, 2 were crushial ligement repairs and this one is tplo he is doing really well but with being lame for so long he has very little muscle left in that leg have got some advice as to how we can build it back up he has 1.5inch diff between both legs. how far also can we walk him now he is putting his leg fully down, but with all the problems he has had we don’t want to push him

4. I just ordered the automatic delivery of the joint supplement and made a mistake. I think I should have continued with the HA instead of the maintenance supplement. Would it be possible to change my automatic shipment to the HA in moving forward? Thank you in advance. Kathy
   FYI your supplements have shown a big improvement in my dogs comfort and your step by step rehab after surgery has been invaluable. Thank you.

5. Frank I am so sorry I am way behind on messaging. I am usually never this behind but a bit overwhelmed with some external factors and I find myself way behind. My best advice to you is …when if comes to an FHO you have time on your side. The more conservative you are the better over time. My second advice is that if for any reason you think that your dog is not progressing as fast as they should, don’t hesitate to ask your veterinarian for a longer course of pain medications. I have seen this time and time again where we don’t give these dogs the benefit of the doubt and provide them with pain meds for long enough. Give me and update when you can. All the best, Dr.J

6. Hi

   I found you a few weeks into our Bernese Mtn Dog Tupper’s FHO surgery and recovery so we are actually beginning week 4- is there anyway you can jump us ahead so we are working on the right things? (i just rec’d the week 2 e-mail)

   Thanks so much.

   Frank

7. Mary Jo, sorry for the delay. This is totally normal for a dog to pick their leg while at a stand still. As long as your dog is using the leg while on a slow controlled leash walk you are totally fine.

8. We just started Week 2 with Cami. She is walking nicely and putting weight on her leg. At times, when she stands, she will pull her leg up and not put full weight on it. Is this normal? Just wondering. Thanks for your help.

   Mary Jo

9. Anita, in a situation like yours I would even more strongly advice you to seek out the help, advice or services from a local canine rehabilitation specialist. Your surgeon should be able to recommend someone or you can use of online directory of facilities across the country. You can find this at topdoghealth.com. I wish this is more that I could add specifically but I would really want to see your dog and feel what exactly is going on with the knee. Sorry I could not offer more. Dr.J

10. Heather he is still in a vulnerable phase at this point. Though she feels better know that her knee is stable and the immediate pain from surgery has subsided. That said the problem with stairs is most of the time correlating with the speed which they are ascending. If she can navigate the stairs very slowly and deliberate then that would be awesome. If no then being conservative is key.

11. Dear Dr. St. Clair
    The splint had to come off only 5 days after being put on, as it had shifted. The local vet then realized that a splint will not solve the problem as the patella was dislocated again and the entire knee seemed unstable. A week after that the surgeon had returned from his holiday and inspected the dog and the x-rays. He noted a shifted fibula next to the patella and had to assume that the sutures had torn.
    We then got referred to a surgeon in another town who operated Sneakers this past Monday (1st June). The clinical and radiological evaluation read as follows:
    – left hind grade 4/4 lameness
    – left knee swelling, joint distension and pain
    – left knee severe cranicuadal instability, positive cranial drawer, femorotibial subluxation, medial patella luxation
    – minimal secondary degenarative joint changes evident
    – the right knee was clinically normal
    The treatment was described:
    A lateral arthrotomy, capulectomy, imbrocation and cruciate ligament nylon prostetic replacement was performed. The menisci were normal.
    The surgeon mentioned that considering the history, he was concerned about post operative healing and strict rest was advised for a minimum of two weeks.

    So we are now back to square one and only today does it look like Sneakers is more or less painfree (with Tramahexal, Petcam and Zenquin) – up until yesterday she was extremely uncomfortable.
    I am very concerned about the healing process – I was also advised NOT to do any PROM or icing or heat- application.
    Currently Sneakers is not putting down her injured leg at all.
    Yes I am still interested in GlycanAid, what costs would we have to reckon with?
    Thank you for any further advice.
    Warm regards
    Anita

12. Anita if you can please give me an update now post 3 weeks and the cast off. As to your question, yes we have shipped many times to South Africa the only problem is shipping cost. Tell me if you are still interested and we will see if we can work something out for you to make it easier. All the best, Dr.J

13. I have adopted a 4 yr old boxer who has 2 weeks out from her 2nd surgery. She had her stitches out a week early and has been in her foster home for the first 2 weeks of her recovery. She is walking VERY well. She shows slight favoring when squating but otherwise it is almost hard to tell. She has stayed in her foster because they don’t have stairs and our house does. When we visited last week, she went up and down stairs on her own. I see the mentions of not pushing it but is it dangerous to let her do stairs…supervised of course.?

14. Dear Dr. St.Clair
    Thank you so much for getting back to me on the issue with Sneakers. We did bring her back to the vet to have her checked and it turned out that her kneecap had dislocated.
    They adjusted that and put her entire back leg into a splint, which is supposed to stay on there for 3 weeks. The idea is to give enough time to have tissue-growth around the side-tendons, that should then stabilize the kneecap.
    I sure hope this is the right thing to do as the strain on her healthy leg is immense, when she moves. We move her as little as possible but as she does not defecate (nor pee) on our property (no matter what we try to convince her otherwise) I have to take her across the road for that purpose, which is appr. 200 meters.
    Any tips on how to minimize the damage on her other limbs?
    Also is there any way I can obtain GlycanAid in South Africa? We currently use MobiFlex.
    Thank you and warm regards
    Anita

15. Kirsten, a few thoughts. First off what pain med protocol do they have her on? Second do you have access to a canine rehab facility in your area? We have a complete directory of all the facilities that are in the USA currently. You can find this at https://www.topdoghealth.com under directories. For right now I would not freak out that she does not let you massage, ice or heat…..why…because she is putting get leg down consistently while on walks which is her performing range of motion on her own. Though it would be great if she let you ice and heat…it is not a life or death kind of thing…the big picture is that she is slowing improving on a daily basis and that is what I always try to focus on. Look forward to your response and thanks for reaching out. Dr.J

16. Kay, just so you know Spain in near and dear to my heart. I have visited there twice for extended period of time and love the people and the country. I am in total agreement with your rational that if she is limping then pain may still be a part of that equations. I am always talking about the value of what I call a “Pain Trial”. In my mind the best way to know if pain is a part of the equation is to give good pain meds for a 5-7 day period of time and see if there is a change in function or disposition. I am just completing my first book call Dog’s Don’t Cry…and it this book I discuss this exact concept. Interpreting pain in dogs is very challenging even for trained veterinarians therefore I like to let the dogs tell us for themselves through the use of a pain trial. I am not sure why your veterinarian wanted you to avoid the tramadol when it is a well tolerate and relatively very safe medication. As for our supplements they are available in Europe through Zoomadog.co.uk …just in case you want to try them. All the best and sounds like you are an awesome doggie mom.

17. Anita if you feel the knee is it hot….if you put pressure on it does she seem painful. It sound like it might not be a bad idea to have the vet check her out if you are concerned and make sure that there is not an infection brewing there. Tell me how it goes. Dr.J

18. Anita that crackling and snapping can be a totally normal thing so I would not totally freak out yet about it. That said ..now 10 days post-op she should be at least thinking about putting the leg down. If you are still not on an anti-inflammatory and pain med like tramadol I would encourage you to go back to your vet and just discuss possibly extending that prescription. If she is resistant to the PROM then don’t force it …but if she accepts it and is relax then all should be good soon. The key is in that slow controlled walk.

19. My dog is a 7 year old husky cross who just had ACL surgery a week ago. She has not let me massage that leg or put ice or heat on it and I am worried about the amount of fluid that is building up around her ankle and foot. She is mastering the slow walk and puts quite a bit of weight on that leg so I am happy about that bus worried because she is not getting any of the other parts of her rehab. Any suggestions?

20. Thanks for getting back to us. I have to explain that we live in Spain, so it’s a Spanish vet practice. Your advice has been a lifesaver for us as we hardly got any information regarding post op treatment. The vet told us not to give her Tramadol unless absolutely necessary, but how can one tell the pain she’s going through, we presume that if she’s limping, she’s in pain. It’s day 33 now, she’s been going out in the garden on the leash at all times and walks for about 5 minutes each time ( 6 times a day). She has hip dysplasia which was exacerbated by leishmaniasis when she was a puppy ( all clear now). We’ve taken her for a 10 minute walk down country lane (Tarmac) but she’s limping again, do you advise less exercise and giving her Tramadol. She’s still on anti inflammatory medication and we are giving her supplements (unfortunately can’t get yours abroad!). We were very worried because at last check up, the vet said that he was disappointed with her progress, but after reading comments on your site, we feel reassured. We’d love to hear from you again, thanks!

21. Sorry to bother you again but I am really starting to worry. Tomorrow it will be two weeks since Sneakers had her operation (extracapsular cranial cruiciate ligament repair).
    She put her foot down on day two after the OP and the started putting a little bit of weight on it, a bit more every day, which is great. But two days ago, she stopped using her leg completely, hardly even puts it down when standing still. No matter how slow I walk her, she will not put it down. After a while, walking at sloth-pace she just sits down, and looks exhausted. How can I bring her to use her leg again? We do the icing, PROM, as well as warm applications, according to your leaflet. She is on Anti-inflammatories as well as pain med (TramaHexal 100), joint supplements and vitamins.
    As we live in the country in South Africa a rehab-clinic is not in our vicinity. The vet does not really sound concerned. She still has her stitches in, they should be removed sometimes next week.
    I just do not want to do something wrong but am concerned as the rehab seems to go backwards instead of forwards.
    Please help
    Thank you
    Anita

22. Sneakers was operated on Monday May 5th. When I do the PROM on her knee I feel a slight “Cracking, snapping” when bending it. Yesterday she did put a little weight on it while doing the slow walk, today she does not. Should I be worried? We live in South Africa and really appreciate your help.
    Thank you
    Anita

23. Kay what exactly do you mean that your vet did not advice pain medications? Was she prescribed anything after surgery? BTW I would love to know the name of the practice so that I could reach out to them and maybe they would benefit from our post-op instructions. The not using the leg when standing still is very very common and it is great that she is putting the leg down and using it while on short potty breaks. That said the pain med protocol still is bothering me. Please get back.

24. Rebecca I also wonder if this change in drinking habits is also due to the change in activity level. The fact that he is eating well makes me feel better. As for a side effect of the rimadyl I would say anything is possible but it is uncommon and would be more likely linked to inappetence and drinking more. i never hurts when using these medications though to have a basic chemistry check to see how the organs are doing.

25. Hi! We have an 8 year old Labrador who had TTA surgery on 15 April. Today is the beginning of the second week and your help has been invaluable, we have downloaded your guide and this has been great because we weren’t given much guidance as to what to expect. When she goes out into the garden to go to the toilet, she puts her foot down although limping quite heavily. However, when she’s standing still, she lifts it off the ground. How long is it considered normal for the limping to continue? We gave her Tramadol today for the first time as our vet advised us not to give her any pain killers, but surely she m&s be in pain although she doesn’t show because she’s so stoical. How long do you think we should continue with the tramadol? Thanks!

26. Hi Dr – thank you so much for the informative site – it has been great for Clover! We are day 10 post op from his TTA surgery which means today is the last day of antibiotics and rimadyl. As I knew there were some possible bad side effects of rimadyl, we have been on,y giving him half the dosage every day for 10 days. Clover was weight bearing within 48 hrs and has been doing great. He is eating and pooping normally.
    Beginning yesterday, he has showed less interest in water. Now we mix wet food with his dry food and add additional water. He has only had a few sips of water on his own. My husband and I are concerned because we don’t want him to dehydrate. We are thinking maybe because he fears since we have to confine him in a play pen that he isn’t drinking as much because he doesn’t have the ability to let himself outside like normal? We take him out 4 times a day but are still keeping him quiet as he is healing. Could it be less water intake because he isn’t as active? Could this be a side effect of rimadyl even though we are in day 10? This morning was his last dose so I’m thankful. He is a chow/beagle/Shepard mix weighing 48 pounds. Thank you in advance for everything and I won’t hesitate to take him intone vet tomorrow of this continues. I’m just worried about his kidneys. Other than lack of interest in water he is completely normal. Thank you!

27. Liz you only need to use the belly support if she needs it. If you have her in full control and she is using the leg then you should be fine without it. It really is just then for support if they need it (ie. going up stairs, getting into car etc.) As long as she is not jumping around a small space is fine…she is a newfie so I am sure she appreciates that additional room verses a crate. All the best, Dr.J

28. Ihave a Newfoundland dog who had TTA on April 2nd so I am at the tail end of week 2. When I take her on her controlled leash walks I am still using the belly harness. Should I do these walks without it? Also, is it ok that she is confined to a smallroom and is allowed to move around within that space?
    Thanks
    liz

29. Crystal this makes me very sad for her and you. I will just tell you that for my FHO surgeries I do long term pain management until the dog is using the leg near 100%. In some cases this can last over 4-6 weeks. It all depends on the dog. That said from the sound of it you do need an anti-inflammatory whether it is natural or pharmaceutical…anything would be better then nothing. Minimally I agree with you that tramadol would be used. If the existing hospital does not want to work with you in terms of pain management then you are left with the only option of finding another veterinarian in your area that would be more receptive to this….and if this is what you have to do…then I would say do it. I would be curious though to ask them what suggestions they have to helping her recover. Also if you have a local canine rehab facility in your area they can help with some alternative pain therapies like cold laser or electric stimulation to help. Wish you lived near me because I would love to help you. Keep me informed.

30. Hello, my 34 lb sheltie was hit by a truck 2 weeks ago and had an FHO surgery performed due to a dislocated hip on March 18/15. Hailey will not walk at all on her own on her right leg which is where the FHO was done. She shakes when I do the controlled walking. Even at the slowest pace she still tries to walk on just 3 legs. My vet would only give me 1 more week of Tremadol at 50 mg twice a day. Hailey can’t have NSAIDs since she has one kidney and the vets don’t want to use pain killers like Medi-Cam and I don’t want to use those kind either. I pretty much had to beg for another weeks worth of Tremadol. I told the vet how she shakes and that she isn’t baring any weight on her leg, they don’t seem to have any helpful information and I am at a loss for how to control her pain. I am going to order some GlycanAid HA Advanced Formula. I don’t know if it will help alleviate some of her soreness. It’s been 2 weeks and I have seen no improvement even with doing the exercises. The sit-stand exercises she doesn’t want to do. The PROM excersises she is okay with me doing that, but not in a bicycle motion. I’m just wandering if there are other pain meds like Tremadol that can be used? Also all her vet care has been done at the University Vet College here in Saskatoon, SK, should I seek another vet’s opinion? I don’t have much money and the FHO was $2,000. When the surgeon went inside to perform the FHO she found a large Muscle Tear and they sutured the muscle tear from the inside, could the muscle tear be the cause of her lameness and reluctance to use her right leg? Thank you. Appreciate any insight on my situation. Crystal

31. Leroy…you are totally right in this thinking. The support of that bone is via the metal plate they added to stabilize the 2 pieces of cut bone but it is going to take a good 8 weeks just to form a solid callus around that cut bone.

32. My Bulldog Matilda not only had the TPLO they showed me the Xray and they had cut the bone. so Is it also like healing a broken leg?

33. Eveline, if it seems that your dog experiences discomfort with the heat then I would discontinue it. As for icing after the walk…yes that would be great. If you place the palm of your hand over the joint and appreciate heat then this would be an indication of inflammation and icing post exercise would be advised.

34. When applying heat my dog’s leg starts shaking. My heating pad is only warm not hot. Should I discontinue or is this normal?
    Also he seems to limp more since we started the walks is this normal or should we reduce the time or should we add ice or heat after the walk? He does use his leg considerably on walks. Thanks for your assistance

35. thanks for your reply. I know everyone in the northeast is dealing with the snow and ice, not a good time for a dog to have surgery. Hopefully spring is around the corner!

36. Jean if you find that she simply does not tolerate the moist heat then I would recommend avoiding this all together. You can only do what they will tolerate. That said the slow controlled leashing walking is the biggest thing to focus on for her success. This really comes down to a bit of training and if you need to utilize a choke collar (if used properly) or a Easy_Walk Harness to controller her speed then you need to find that “tool” that will work the best. I am in the north east and i totally can relate to the snow and ice…but at the end of the day the roads are still genuinely clear so I would use them. Again the primary key to FHO success is a mix of pain management for a long period of time and the show controlled walking with increase of speed overtime as they improve and gain use of that leg.

37. My dog had ACL and FHO surgery 2 weeks ago. I have found your web site very informative, but have a question regarding the moist heat. I tried using a warm wash cloth, but my dog is very suspicious of new things and everytime I go near her with it, she gets up. I tried using treats to distract her, but she still moves away as soon as I try to put the cloth on her. Any hints on how I can get her used to it? Also, Abby is a border collie mix and very strong. Even though she is still mostly using 3 legs, and I am using a leash as well as a sling to support her hind legs, she still really pulls, and it is hard to get her to walk slowly. It’s also hard because we have lots of snow and ice right now so we are limited as to where we can walk. I know as the weeks go by it will be very hard to keep her calm. Any suggestions?
    Thanks again.
    Thanks.

38. Nadine..boy this is a tough one. The best part of this whole story is that as least her TPLO leg is doing well and should at this point be 100%. As for the other leg my suggestion would be to look through the weekly recovery guidelines and FIND HER BASELINE. What can you tolerate and then slowly move forward from there. I am sure that in your area there has to be a professional rehab facility. On our website https://www.topdoghealth.com we have a directory of all the national rehab facilities. If you can I would strongly encourage you to seek our there expertise and conditioning equipment. This would not doubt accelerate her recovery. If you can’t do this then again find the weekly guideline that is your baseline and slowly move forward with her therapy at home. The GlycanAid HA will no doubt help in a big way as you move forward but you have had such a tough go that my best advice would be to take things slow, be conservative and shoot for a full recovery outwards of 4-6 months at this point. Make sure you watch the video on measuring your dogs muscles on the topdog online rehab center. If there is anything I can do more to help please tell me. All the best and I acknowledge you for the amazing pet parent that you are. Dr. J

39. Zoe is not a normal case. Had TTA on right side 6-12-14. She did not show a definite problem with xray and surgeon evaluation but knew her condition was deteriorating since Feb. Did surgery found a scar tissue and a badly frayed cruciate. 8 weeks into recovery found tibia was broken at implant ,did 4 weeks of complete sedation re xrayed and set to do xrays again in four weeks starting her back on 5 minute leash walks. 3 weeks later her left side completely ruptured. Went to original surgeon who sent us to specialist for her knee to be scoped and he did TPLO on left side. This surgery was done 10-2-14.
    She was recovering well till noticed right side again she started holding in air. when die the xrays at 9 weeks after TPLO found that TTA implant had failed. Surgeon who did TPLO did surgery on right side, found that her meniscus was torn which explained her pain and did a side lateral stabilization on her knee. Took 5 days before she would change position of leg but soon she was back walking and doing well on controlled leash walks.Have started her on laser treatment day before Christmas. We finish first 6 pack on Monday. Have decreased her pain meds to Novox 100mg split in 3, giving her 1portion AM and PM along with 50mg tramadol. Finally last week my vet gave me your web site and I immediately down loaded your TPLO format. I have ordered Glycanaid-HA for both of my girls.Zoe will be 6 on 1-20 and Nakita is a 12 year old . Both are Huskies. This has aged Nakita since they are very bonded. Zoe has been on Dasuquin .I do not know what I should be expecting at this point. The right side is such a concern. Yes she is walking but how far do I go with rehab on her?
    Thanks for your wonderful site so wish I would have known from the beginning. Also original surgery was done at Coral Springs animal hospital and I do firmly believe it was done wrong.
    any advise will be appreciated
    Nadine

40. Mary Beth in the last 12 years of practice this is the first situation like this I have ever heard of. I am so sorry that this has happened to your boy. I can’t image how an injury like this happened outside of there being a previous underlying condition with that right hip. What is the plan presented by your veterinarian?

41. Did a traditional repair on my 6 yr old PWD rear left knee and just one day shy the 3 week mark his right hip went out. Do you find this often? He is on your supplements.
    Very sad mom.

42. Amanda first off you are totally welcome. I feel blessed that I am at least able to help as many people as I can to make sure their dogs are recovering safely. As for the you hill situation…the answer is YES. I would not worry about the hills at all. Just make sure you have your dog on a short leash and are controlling the speed. When we get into hill walking for strengthening I am really talking about concentrated exercises (ie. up and down the hill multiple times). Hope this helps and good luck with the recovery. :) Dr.J

43. Hi,

    First, thank you so much for all of the info and demonstrations on post-surgery rehab! So very much appreciated!!!

    I’m following your rehab on a TPLO surgery with my 7-yr old lab. I’m feeling a little “stuck” because I live in a large valley with littler hills inside of it. My driveway is in the middle of a small hill about 50 meters long.

    I feel stuck because your rehab mentions hills as strength training at week 5. Can I walk her up and down my hill to access the straight sections of road before week 5? (I just hit day 8…)

    I would appreciate your thoughts!

    Best,
    ~Amanda

44. Sandi this is something that you really need to address with your veterinarian and have them check him out. Unfortunately this is something I can’t help advise you with because I can’t see it. No doubt if it seems to be getting worse then I think it is important to bring this to their attention. Sorry I can’t provide more value to you. All the best, Dr.J

45. Dr. James
    My 10 year old beagle/spaniel mix had TTA surgery 1 week ago.He is getting around just fine, but the surgery site and his leg and belly are bright red. It became redder as the days went by. Is this normal?
    Thank You

46. Geraldine, moist head is best applied prior to any stretching or massage. The best is minimum of 2 times a day and it is best to apply for 10-15 minutes if possible. Unfortunately we have not gone through the daunting task of registering GlycanAid HA with the Australian government and therefore since it is not registered it can not be imported into the country. I wish this was not the case because we would love so much to supply it to you. All the best, Dr.J

47. With the moist heat therapy, how many times a day do you do this and how long do you leave it on the leg?

    Also I was told we cannot order the Glycan joint formula in Australia as it won’t get through customs is there any place in Australia we can order the joint formula?

    thanks so much for all of this info,

48. Stefany, after the first few weeks you really should be using the harness only as a safety measure. I would allow the dog to fully weight bear but you just have the harness just in case they need help…i.e.. with stairs and such. As for swimming the key is really about getting into the water safely….there really is no risk with the exercise of swimming itself. Also one thing to know is that when it comes to the hind legs swimming is not really going to build any muscle mass, though it will condition lean muscle. If you think about it when a dog swimming the focus really is on the front legs where they are pulling themselves through the water. The hind legs are most of the time tucked up with some forward propulsion coming from kicking below the hock. If I have not mentioned this before to you I hope that you have her on a good joint supplement moving forward, for me this is a critical step to optimizing their immediate and long term joint health.

49. I have downloaded your online book but am awaiting the hard copy since I’m sure you cover all of these questions in your book :) my surgeon is very far away from us and where I work we are just a small vet hospital so we don’t specialize in Ortho. Thank you for answering my questions. It’s much appreciated. I worry since she has the other fracture. But with the previcox on board it makes a big difference in her once that kicks in.

50. Thank you Dr… I’ve been using the sling quite a bit especially on the stairs which I think are important but nice of hear she can have some freedom as far as weight bearing. She is weight bearing nicely. Still with a limp of course, which I think is a lot from the fracture also. I was worried in reading people that use the sling for 12 weeks as their muscle atrophies so quickly I want to make sure she can start to get a little back. One last question…..when do you recommend that they can begin some swimming at about what week? I know it would have to be a very slow introduction. But I know it’s a great way to help them get muscle without the risk of falling etc.
    Thanks Dr!
    Stefany

51. Stefany if she is weight bearing on the leg and you are just out on level ground then the hind end support should not be necessary at this point. The key is to keep her from getting over-excited and over-confident. Often I just use the hind-end support as a safety measure.

52. Stefany from the sound of it she is doing well and should be able to tolerate short controlled leash walks. Of course since I am not there with you to evaluate her it would be best to just run this by the surgeon or your veterinarian who has a more intimate relationship with here. So far it sounds like you are an amazing mom taking care of her. All the best, Dr.J

53. It is recommended to apply the moist heat for at least 10 minutes.

54. Kelia, my suggestion for you is to follow along with the free cruciate booklet on our website entirely as if he did have surgery. Most importantly it comes down to being conservative and allowing the appropriate amount of time for some scar tissue to form. That said the second most important thing for him is pain management for at least the first 4 weeks and the third would be to make sure you have him on a really high quality joint supplement like top dogs GlycanAid HA. If necessary to help him along we also do have support harness available to you on our website. Good luck. Dr.J

55. My follow up question for my GSD that has the fractured fibula is how long does a normal dog need the assistance walking with the sling post op TPLO? And should I use it longer than that for my dog because of the fracture? It obviously isn’t near the surgery site being a different bone but of course it’s of concern to me. She is slightly toed out now because of it. The surgeon said it would most likely heal that way. I am recovering from hip surgery and my shoulder surgery which is very bothered by carrying my dogs weight but I take her as first priority. Thank you!

56. Hello,
    My GSD had a TPLO two weeks and two days ago. She had what they said was a seroma starting the second day. I wasn’t sure that’s what it was. I’m a vet tech of many years. That said I had a weird feeling. I ensured, and guess I went overboard, that when she came home I had a lot of help as I live 3 flights of stairs up in a condo. There’s nothing I can do about this. My dog fought the help a lot. I think this is how she got so swollen. Long story short my surgeon was out of town. I had taken my dog through emerg several times with no avail. I decided to take my own xrays where I work. I hated to put her through this so early on but…..turn out she had a fractured fibula. She was so good the first day of surgery but become acute after week one. With th te xrays revealing this fracture the dr said it should heal along with the rest involved for the TPLO. I wanted to ask….if I could begin show walking or is my stairs enough activity for my pet? She is an amazing dog and I worry she’s too stoic. She walks even with the fracture, now that it’s healing, very very well. Of course I support her fully in the hind end with a harness and handle. I carry about 80-90% I would say of her weight behind on the stairs. Apart from that she’s quite sound on her own. I DO NOT allow her to walk on leash yet other than potty. I see in your instructions they can begin at week two very short very slow walks. With this fracture can I follow these guidelines? Or should I take it slower because of this? I know the fibula is not a weight bearing bone, but I don’t want to make anything worse. It’s very hard when she feels somehow, so good already. She try’s to play etc in my condo and I have to use a prong collar to keep her from trying to trot on the short leash. Thank you!

57. How often and for how long do I apply moist heat

58. My dog is 15 yrs old. No surgery allowed. Trying to heal torn acl on his own. Suggestions?

59. Marie I am assume that you are describing the stretching exercises and you are doing this when she is laying on her side. If she is reacting and trying to get up or get away from you while doing this exercise, she most likely is telling you that she is uncomfortable. I never recommend that a pet owner with limited experience “push through” the exercise if the dog does not like it or is uncomfortable. Your best bet is to skip doing this and focus on the exercises that she will allow you to do. Even better would be to find a certified canine rehab specialist in your area to work with in your dogs recovery.

60. Hi

    Can you help me with suggestions of
    helping me with the extension exercise.

    My dog wont keep her head down she keeps turning hence the exercise is not flowing

    Thanks.

61. Lali, first off you are totally welcome. It is a joy to be able to help. As for the food, in my 11 years of experience it is rare that the recommended guidelines on the back of the dog food bags produce healthy weights in dogs. I am not sure if the contributing factor is the food itself of the lack of exercise that the typical domestic dog gets these days. From the sound of it your food restrictions should provide weight loss. I find that for the average dog who needs to be 70-75 lbs. the 1 cup twice a day is perfect. If possible I always add ware water to the dogs food bowl to bring out the flavor and add no-calorie bulk to their feedings. My dogs love it but some dogs are not keen on water with their food.

62. Hi, Eva was always on a heavy side, she is a big girl . She is back to her old diet( dry food). I buy for her weight management food were there us 18-20% of clude protein. We feed her twice a day and I decreased the amount of scoops, so she only gets 2 scoops per day. She has been 91 lb for sometime now. No more under the table. She seems to put more weight on her bad leg, which is good, but she wont let me do any moist heat and PROM. Should I force it???
    I really want to thank you for all the support you privide , without this I would be completely lost in terms of how to take care of her. Thank you, Lali

63. Lali that is great that she is receiving smoothly so far….just stay conservative because as she “feels” better it will only get more and more difficult to control her. In terms of your question of leaving her alone in a confined room..this is really a tough one for me to provide guidance to you on. It really all depends on the circumstances and her behavior. If she is comfortable in that room and has been confined to that space before and has not shown any signs of distress then you have to use your best judgment and move forward. Obviously you can’t be there 24-7 watching her. In terms of her weight…I would ask you what is her ideal body weight and what food is she currently getting and how much. Yes it is true that with decrease activity you would want to decrease her total caloric intake but it really all depends on what she has been previously getting. Looking forward to your response. Dr.J

64. Heidi…to your first question. I would still have the sling harness on her for walking but you don’t necessarily have to use it…it is best if just there for support. Just in case you stumbles or falls. As for the pulling, absolutely you can use a anti-pull harness system. I gravitate to the Easy_Walk Harness but there are many on the market. What every it takes for you to gain control. I really difficult time is when they are 5-7 weeks out of surgery and REALLY ready to go and you still need to restrict them. Good luck and if you have any other questions I am here.
    All the best, Dr.J

65. Hi again, Dr.J. Ok one week after TPLO!! I think Eva ( 8 year old weim) is doing ok. She still on meds twice a day plus supplements that I ordered from topdog. I took a week off from work to stay with her and slept next to her every night just to make sure she is ok. Her swelling is almost gone and she us trying to put weight on her leg. She even sleeps on the injured leg, i hope it is ok. My question is it ok to leave her alone in a room , which is her confinement room. ???? She is getting up and wonders around the room until she settles again. Am not sure if it is ok. My second worries is her weight. She is currently 91 lb, she is a big girl to start and I worry that since we keep her limited she will gain more. Please help!!! How to control her weight and keep her healthy??? Thank you, you are a life sever for our family, Lali. Cant wait for advice

66. Just 2 quick questions about the Slow-controlled walking. I was given a sling to help support my dog when she’s, but she doesn’t seem to really need it outside in the grass – in fact it was becoming more of a hindrance. I noticed in your video demo you used the leash to keep them close and didn’t mention a sling at all. So is it okay to walk without the sling (my dog is 8 days post surgery)?

    My second question has to do with the pulling my dog is doing. I really don’t want her to keep doing this as I do activities where she will need to heel on leash. Can I use a walking harness like the Freedom Harness?
    Thanks!

67. Absolutely Jackie…once the incision is healed you can start that hydrotherapy. Good luck.

68. My 8 year labrador had tta surgery 12 days ago and is doing well walking only 4 toilet walks max 5 mins each.She is booked for a few mins hydrotherapy friday which will be 15 days post opp.Do you think this is ok?
    Thanks

69. So jessica is he doing any better now that you have taken him off the medications? Is his appetite better?

70. He is on Rimadyl,tramadol,omega 3,dasaquin and now Pepcid. I stopped all meds because he was so sick. Took him back to vet and he lost 10 lbs more.

71. Jessica what kind of pain meds is he on currently?

72. My vet said to make Cody use steps .he is 21/2 weeks FHO
    Surgery on both legs. He is having a lot of trouble doing that we use the harness to lift him in back. He can do one step. He seems to be tired after a 10 min slow walk. He wants to chase balls and squirrels and of course we won’t let him he seem s to be getting down. He really hasn’t eaten in about three days only snacks but seems fine. He is 11 mos old. I think he should have more energy I know he has had major surgery . He starts pt next Sunday .what am I doing wrong.hhe puts weight on both legs rt seems better than left before surgery it was the other way .

    Thanks
    Jessica

73. Denise if you think it is safe for him to do more then by all means you can do it. I always tell people that full recovery takes a good 6 months and you just have to by patient and systematic. Just use your best judgement and be careful. Make sure you use the video on topdoghealth.com in the online rehab center.

74. Thank you for your advice,my Springer Bertie,who was a very fit dog,prior to his TPLO operation 10 days ago,seems to need more than the recommended walks,he’s been walking on the operated leg since day Three and is straining on the lead to walk faster and further.Should I walk him a bit further or stick to the guidelines.Thank you in anticipation,you are doing a great job.Denise

75. Wow…Joanie…what a hard road for this boy. I makes me so sad. So here is some of my simple rational to your situation. If he is still not using the leg them I would put money on it that he is still in some kind of discomfort or pain. I would ask your veterinarian to continue with the pain medications another 2 weeks. With this surgery most dogs start using the leg almost day one so I am not sure why he is delayed. Also if possible…please take him to a canine rehab facility in your area for an evaluation and therapy. If not then focus on pain management and home therapy (provided in the topdog home rehab guide) and continue with pain management until he is moving forward and using the leg with some kind of frequency. Of course make sure that you incorporate a comprehensive good joint supplement into his diet… Good luck. Dr.J

76. Sarah, I apologize for the delay. I assume by now that she has defecated. In the future you can always use Miralax as a resource for helping with constipation. It is amazing how well this works and provides regularity at the right dose. Sorry I was not sooner for you.

77. Our 7 year old lab had TPLO surgery 3 weeks ago. He developed severe hip dysplasia as a puppy and he had a complete hip replacement at the age of 11 months. He had the TPLO surgery in the same leg as the hip replacement. He is still not placing very much weight on the leg and I am not sure if he is in pain and how many times a day and for how long I should slow walk him. He has lost a lot of muscle in that leg. We have had him on both tramadol and rimadyl for 2 1/2 weeks after the surgery and just recently took him off.

78. Our dog, Sadie (black lab 8-1/2 years, 85 pounds), came home from TPLO surgery Thursday night. She still hasn’t defecated or urinated (Sunday morning). She is getting two 50mg tablets every 6-8 hours and vetprofen 75mg every 12 hours. How can we help her to go?

79. Mary of course you should always call your veterinarian if you are concerned about this. That said…if the fluid is a clear blood tinged fluid this is called serosanguinous discharge and it generally accepted as ok after surgery. It should slowly diminish over time as the healing continues.

80. I’ve noticed some bleeding from my golden retrievers incision when she walks. This just started two days ago. She is 9 days post surgery. Is this an urgent concern? It does stop when she is resting.

81. Sandy, wow…poor Fynn. If you did not know already I also have a bulldog named Marty. He is my sidekick and goes to work with me everyday. He is a bit if a hygiene gross dog but I love him dearly. So I think that it really all depends on how well he is doing. If her is not wight the 2 tablet a week category then if you can afford it then I would go up to 2 tabs a week. If he was doing fantastic after his first round of puppy surgeries then I would say it is ok to stay with one tab a week. Because he recently had an ACL tear and TPLO surgery I think that it makes sense to provide him with 2 tabs a day for the next month and then re-evaluate. My gut feeling is that being 5 and had several already orthopedic issues and based on this weight, I would at this point stick with 2 tabs per day. Hope all is well, Dr.J

82. Hi there. My bulldog, Fynn, had luxatting patella surgeries on bth legs when he was 9 & 11 months old. He has been on GlycanAid-HA ever since. He just turned 5 and weighs 55 lbs. I have had him on one tablet daily but see now that he is in the weight range for 2 tablets a day. Should I up his dose? Also, he is 6 days post-TPLO surgery and I was wondering if I should use the loading dose while he recovers. Thanks! Love your website, guides and supplements!

83. Nancy you only need to provide her support if you think she needs it. Many just have the belly support as a just in case but if she is doing well and bearing weight 3 weeks out, as long as you control her speed with the short leash I am sure you will be fine.

84. Sorry, for the misspelling-we are starting our third week of rehab and want to know if I need to use the towel with handles to keep the pressure off the knee when we take her out for bathroom relief? She had the TPLO surgery. Thank you

85. Sherri everyone is different including dogs. You have to move at her pace. If you think that she still would benefit from daily anti-inflammatories and pain medications then by all means have that discussion with your veterinarian. I see medications like this as a tool to recovery and often I think we stop them to soon. As you I am sure are trying to do, you have to listen to her and if she can not tolerate a 10 minute walk or she is more lame after then you need to scale back and use your best judgement. I wish I could see her and help guide you.

86. I am week 3 with my 2 yr. old Rottweiler. Some days Tia 2 is fine, then sometimes at night she cries, like she is in pain. I give her some tramadol and an hr. or so later she is fine. Am I control leash walking her too long, applying the moist heat wrong. She really wants to please me, by not complaining. I’m really trying to do what the list says, but worried I am not doing a good enough job. Thank You, your videos, do help.

87. Jeff, some surgeons put on a soft cast and some don’t. Each has there own style. Once the cast comes off, yes you can start the moist heat therapy and the exercises. Make sure that your veterinarian agree with the home rehab protocol that we provide for your dog.

88. My dog had surgery last week and has a “soft cast” on which is slipping down. I am ready to start manual manipulations with her(which is what I call it) and the vets off ice said to remove the wrap, even though they told me it was there for support. She is a 8 yr. old black lab, hunting dog who is walking on the leg and has been since I picked her up from surgery. Because of this “cast” I have not used heat, and my question is should I start as soon as this comes off?

89. Ingrid that is really uncommon for a dog to not love the taste of them…though we have had a few in the last two years but few and far between. Two things. Either you can try putting peanut butter on them, wrap them in cheese or even cream cheese. I would avoid putting them into her food bowl because you would not to get any food avoidance behavior starting. If you find that she will not take them then please tell us and you can send them back for a full refund and maybe I can find an alternative in a capsule. :(

90. Nalu does not like the taste of the GlycanAid supplements at all!!! I have to cut 2 up & crumble in her small bowl everyday. She knows it too!! I watch her pick out the bigger chunks and bury them in her crate! what can I do? She is on a diet and I cannot figure how to double her intake for the first month. HELP!!! She had her surgery on the 5th.

91. Ohhh Susan unfortunately I can not comment on anything to dog with medications and dosing. You have to follow your vets advice or do what you think is best for her. I am so sorry. Dr.J

92. Thank you, you have been a lifesaver. She is walking out to potty but doesn’t go very often & is drinking a lot of water. Our vet wants us to cut way back & discontinue pain meds. I am not comfortable with that. She is on Tramadol & down to 1 pill 2-3 times a day. Is this ok? Also, how long should she be out. She is not going potty very often, Sunday she did not urinate for 24 hours.

93. Susan everyday is a little bit better. You can totally let her walk to go outside…you just want to avoid any full flight of stairs. That is great that she is toe touching and just focus on the short leash walking. Make sure she is getting good pain management and you will be fine.

94. Marley had her ACL surgery 6 days ago. We have been carrying her outside to potty only. She is toe touching just a little. How long should we allow her outside to potty? Today, she was sniffing around more & pulling but keeping her on short leash, per your video. It’s very damp & cold & since that leg is shaved up to her hip, she appeared to be shivering, so we came back inside. At what point should we let her walk to go out?

95. Thank you so much!!!

96. Parisa, you are very welcome. It is such a joy to be able to help you guys. As for the knee and the clicking. If the clicking does not correlate with some additional lameness then I would not be overly concerned at this point and I would be conservative and push forward. If you have not already I would strongly suggest you consider starting her on our GlycanAid HA joint supplement and start with the loading dose for at least 4 weeks. You can split the dose to twice a day. If there is a correlated lameness then I no doubt would have her evaluated by the surgeon. I wish you guys the best of luck. Dr.J

97. Dr. James, I can’t thank you enough for even having this website and the TTA guide. Thank you thank you!I have a 80 pound german shepard / golden mix dog who’s 8 years old and she just got TTA surgery (also had a dislocated kneecap) 9 days ago. She is progressing well thanks to your in depth TTA guide, but her knee makes a clicking sound only when she walks a bit faster and pulls on the leash (usually happens when I take her outside to relieve herself). When I short leash walk her slowly she typically does ok. Is this normal? Or should I be worried? Is there anything I should not do? Thank you!

98. David, Honestly my mentality is…if your dog hates it and it is stressful for both of you then…Are we doing more good or bad? The primary purpose of passive range of motion is to move a joint that is otherwise not being moved in order to maintain a healthy joint.Joints are dynamic structures and therefore they are always changing. We are continually producing new joint cartilage, new joint fluid, new joint capsules. Because I am not your direct doctor and your dog is under the care of other professionals I have to say…you need to follow their advice BUT simply call them and talk to them. Tell they how much your dog dislikes it and then ask WHY do you need to continue doing it..?

    Good luck David.

99. Hi Dr. James, I’m beginning week 3 after TPLO surgery on my lab. The University where it was done says I should continue with the PROM therapy but you say if they’re walking fine that it could be discontinued. He is walking great but the PROM therapy is uncomfortable for him. He’s most uncomfortable flexing. Just watching him when he is laying he seems to flex and extend his leg really well on his on. I hate to make him uncomfortable if I don’t have to but feel I might be missing an important step in his rehab. How important at this point is the PROM?
    Thanks, David

100. Barbara..you are very welcome. Yes this is totally fine for him to do this. That is great news that he is using the leg at this point. You are going great.

101. First, let me say thank you, for the website, booklet and weekly rehab notes. I check them often. My German Shorthair is on his 6th day post TPLO. He comes out of his kennel and stretches front and back. Quite a stretch! Is it OK for him to do that?
     He is putting weight on leg,taking short slow controlled walks. I don’t want to overdo anything.
     Thank you.

102. Lara and we are equally grateful for the opportunity to help you guys :)

103. Thank you!! You have no idea how grateful I am for your time and your site!!

104. Lara yes that is totally normal and typical. You are good:)

105. Hi again Dr. StClair,

     Thank you for your response last week. We are now on day 9, 80lb shephard mix. She’s definitely acting happier over the past few days, so that is a relief. I think I saw this on your site somewhere, but just wanted to double check. She is doing very well on her slow walks, and putting a good amount of weight when walking. However, when she stands, or just briefly walks around the living room, she does not put weight on her leg, especially when standing still. Is this normal?

     Thanks,
     Lara

106. Pete, I would say overall post-TPLO 2 weeks your dog should be placing the leg down on a consistent basis. I would definitely discuss this with the surgeon and definitely get your dog on pain meds again for a longer period of time. Both a non-steriodal and tramadol at minimum. It would also be a good idea to also just have them check her out. Hope all goes well and we are here for you if you need us.

107. It has been 2 weeks scince my dogs TPLO and she is still holding her leg high could this be due to pain? and should I be slow walking, if so how long ?

108. Jeanne it is totally normal for them to lay on the surgery leg. This is often a protective mechanism.

109. Is it ok for my Alexis to alway lay on the surgery leg? She likes that side , I guess. I do get her out and walk around some but this is the first week out , post- op???

110. Pam if you are getting frustrated and your dog is moving backwards then I think you really should go back to the surgeon and have them evaluate him. Also if he is not still on pain medications then this may be an important conversation to have with your veterinarian. Also make sure you have him on a good joint supplement moving forward if you are not already doing this.

111. I am getting frustrated with myself! It is almost 4 weeks now. My progress is going backwards. He is using his leg less than he ever actually tried, which isn’t much anyway. He won’t even bother to try to use it….. Ugg

112. Dora sorry that I am late to this question as you are now well past that point. Icing is really focused around the first 72 hours and then of course if you have any acute set backs in the future. Past 72 hours we recommend the moist warm heat to to improve blood flow to the area. Hope all is well.

113. Zoey is now in her 7 weeks recovery since her surgery and doing great.
     We doing a little exercise and longer walks 20 mins now.

114. My GSD HAD TPLO surgery Oct 10. We were able to ice the incision the first 2 days that he was home. But now he will not tolerate it. The swelling and bruising is subsiding. The incision looks good too. Should we try to continue icing?

115. Lollie, it is always a really good idea to first speak with the surgeon. Each of them has their “own” protocols and we want to just follow them the best we can. The fact that he can not bend as much is totally normal and you would just help improve this with Moist heat therapy and good controlled stretching. You are still very early in the process but from the sound of it you are on the right tract for success. If you have not already I would strongly recommend that you get your dog on GlycanAid HA from TopDog. This will make a huge difference.

116. Teddy had his ACL & MPL surgery on October 7th. Notice that I cannot bend in his hind leg in as much as the other. Is this normal at this point? If yes, then should I put slight pressure on it to move it closer together? Or do I need to talk to my vet?

     p.s. Thanks for all the information. My vet went through all of it at the clinic put forgot half of it by the time I got home. Having the step by step instruction video and 24/7 access to the info has been very helpful.

117. Evelyn though he is only 4 weeks post surgery I think that we really should wait for me to comments until after he is evaluated by the surgeon and they physically can check whether the surgery is holding and the knee is stable. If he is laying around a lot then I would consider that he may be in pain and you may want to bring this up with the surgeon. Maybe they will prescribe him some tramadol for the next few weeks to get him over a hump. They most important thing is that if he is walking well on a slow controlled leash and he is weight bearing while walking you need to just continue doing this with him and pushing the distance for each walk.Good luck.

118. great info from your web site. My dog will be week 4 post surgery on Oct 10. Goes to surgeon for assessment.Could you please advance your newsletters to me to reflect this. I have been following your at home rehab guide. I notice that Dock my Labrador reverts to his old pre surgical habits when he is not doing the slow walks or sit to stands. He lays down most of the time. He is only 2.5 years old He also has a limp for 3 or 4 steps when he first gets up.Does not appear to show lameness when he walks. Only pain meds are Metacam. I will of course ask the surgeon at the assessment. Wondered your thoughts on this. Thanks
     Evelyn Elliott and Dock

119. Carol I am excited for you guys that he is feeling so good after this second TPLO. That being said you are only 1 1/2 weeks out and from the sound of it he is already asking to do more. I try my best to get pet owners to realize that though he “wants” to do more he is no way near ready. Considering we has his whole life ahead of him it is critical that we restrict him and allow enough time to pass so everything can heal. My suggestion would be to follow the Home Rehab Guide for TPLO and stick to it. At least the end result will be a SAFE recovery and a functional dog for life.

120. Thank you for your help…we love your site! We are on our second TPLO rehab now…our 60 lb. pit mix is doing great after 1 1/2 weeks and now we have to hold him back! Wondered how long of a walk on a slow leash is ok at this point. Thanks!

121. Karen when my clients dogs do this..I always tell them to ice, STRICT rest, NSAID (anti-inflammatory) and pain meds for 3-5 days. If there is not improvement then she really needs to be seen by her doctor. Since it was a holiday weekend I understand your pain. She really needs that NSAID though! Call your vet in the am. Good luck.

122. HELP. HELP HELP! MY 13 lb. 5yo yorkie under went cruciate ligament repair 3weeks ago. Today we gother
     Out of her crate and she was keeping her affected leg up! She is miserable. We have been putting ice on it and giving her tramadol. Will she have to have another surgery? Here it is a holiday weekend and no one to ask! REPLY SOON PLEASE! Thanks.

123. Missy our web person is working on this right now as we speak.

124. I would like to watch your video on Moist Heat and Slow Controlled Leash Walking. The website says these videos are not available. Can you please look into this?

125. Hello Charlotte,

     Great question, by all means YES start him on a loading dose for 4 weeks and then you can move to the maintenance dosing of 1 tablet. At 21 lbs you may even be able to get to 1/2 tablet in the future. Best of luck and please stay in touch with this progress :)

126. Hello Dr James,

     I am so glad I found Topdog! My son Omar will soon be going through the ACL surgery next week and I was concerned as to what to do afterwards. Thank you sooooo much for providing the necessary tools to get through this very stressful situation. I will be ordering your joint supplements for both of my dogs. The reviews are very encouraging and I know they will be good for my boys! Question: Omar is just shy of 21 lbs and I was wondering whether I should start by giving him 2 chews instead of one?

     Thanks, Charlotte