Week 5 Rehab Instructions: Hills & Balance

92 Comments

1. Lynn, I have gotten this comment several times. We don’t have that problem at all up here in the north east :) My best advice would be to be creative. It is not a make it or break it exercise to incorporate hills, it just helps to redistribute increased weight to the hind end. If you have not already it would be a great idea to visit a professional canine rehab therapy facility in your area. I pulled this one from our directory: Dr. Marta Sanchez-Emden DVM, CVA, CCRP
   Phone: (305) 665-3526 Fax: (305) 665-3576 7535 SW 62 Avenue South Miami, Florida 33143, ,animalhealthrehab.com.

   I know they could help tremendously.

   All the best, Dr.J

2. We live in Miami, so our ‘hills’ are nonexistent. Any suggestions? 4 weeks post TTAand following your rehab suggestions to the letter so far with great results. Thank you!

3. Bart sorry for the delay. I am way late. I did not realize that I had fallen off the gird for such a long time. At this point you are now 9 weeks post-op and probably off Deramaxx and doing extremely well. I am back on the grid so if you need anything please ask. Sorry again.

4. Tracy, with HA it all depends on the molecular weight. Also I think those articles were focused on certain skin cancers. That said if you are worried or concerned then by all means don’t use it. As you know osteosarcoma is one of the most aggressive cancers out their and it is well documented that by the time it is detected it has already spread therefore the treatment protocol is aggressive. I would stop the supplement and focus on pain management and treating the cancer. I am so sorry that your dog has this horrible disease. One of my boys has an aggressive form of mast cell cancer and I feel you pain. Also by all means feel free to give us a call and we can refund you for your purchase because we have a 100% guarantee always and only want dogs how benefit to be on the supplement. We love dogs and the people who love them…that is our focus.

5. Trish, this is totally typical. If she is great on walks all you have to do is continue to challanger daily with a slight increase in speed. You almost have to master each speed before you can move on the next. The fact that she is walking on the leg at a slow controlled walk is awesome…now you need to master the slightly fast walk….then you can move into a trot. As for when is the best time for the second surgery. It really all depends up to you and the surgeon. Most of my patients we do the second surgery around the 5-6 week mark but they are all different. There really is no exact time that is best. Keep up the great work…she has a great mom.

6. Hi im into week 5 of FHO my border collie is walking on it very well on leash ( 15-20 minutes twice a day and now starting hills,) but if slightly speeded up to a faster walk she just carries the leg and bunny hops on the good leg, can you tell me if she will ever ‘trot’ ( she bunny hopped on both legs from 4 months old when I started realising something was not right.. she was always fine trotting before this ) she is 6 months old and also when is the best time to get the second leg done, she had HD in the first one and also signs of HD and arthritis in the other, thank you for all your help you do a great job

7. Hello. My dog has a rib tumor osteosarcoma along with a partially torn acl. I ordered the Glycandaid HA and I’ve read online that giving a dog hyaluronic acid is not good for dogs with tumors as it can cause the cancer to spread. So is this product not recommended for dogs with cancerous tumors?

8. My 3 year old lab is starting week 5 after TPLO surgery.My vet has her on 75mg of Deramaxx per day. How long should I continue this? She is progressing very well and walking better and longer now. I will start on some hills this week She has also been taking the GlycaAid since week one.

9. Dan, you can try them now but just make sure he is on a leash and you approach and navigate the stairs very slowly. Also just make sure you are supporting the internal health of this joints with a really good joint supplement that promotes optimal joint health. Lastly say super conservative. The success of this surgery is the development of scar tissue around the lateral suture they placed. This takes a good 6-8 weeks minimal…after this point you can start pushing him more. Good luck and make sure if you have not already check out TopDogs joint supplement GlycanAid HA moving forward. Creating a optimal inner joint health environment is the key to long term success. All the best, Dr.J

10. Hello,

    We are in week 5 of lateral suture surgery. My dog is doing well. He is putting weight on his repaired leg, but some time walks with a limp. When is the right time to start going up and down stairs. There are 5 stairs to get in out of my house, when can he try them?

11. Moria…just a side note because everyone is different. I make sure with my FHO patients that I continue with pain medications until the dog is using the leg near 100% of the time. By doing this I eliminate pain ever being an inhibitor in recovery. Good luck and keep us informed of her recovery. :)

12. Hi Dr James! My dog had the FHO surgery but does not have a socket joint. We are working up to strengthen the muscles around the fake joint we hope will form. She is 2 years old and now swings the leg out like Chester from Gunsmoke. The vet said she will never be normal but will be out of pain… Ordered the Glycan Aid for her. On Hill work I go up the hill and switchback down the hill.

13. Alison in situations like this you have multiple options. The first is to simply get a second opinoin. Even myself, often recommend my own clients out for a second opinion because from my standpoint it never hurts. That said I would make sure that you are still giving her a daily anti-inflammatory and a pain med like tramadol. From there if the knee is stable I would have a tendency to soft cast the leg in FULL extension for a period of time, week to 2 weeks. Doing this alone can often make a huge difference but you best bet is to discuss this with your vet and see what they say. From there..if you can find a local canine physical therapy facility that would be great.

14. Dr. James my dog Heidi, leopard catahula approximately nine years old had MPL surgery on Jan. 21. She would not bear any weight on her leg, I took her back to the surgeon several times and he seemed to think maybe the pin in her knee was a little loose so he did surgery again on March 6th. She still won’t put any weight on her leg, she carries it up all the time. I have again had her back to the surgeon several times and he told me it was all in her head that her leg seemed to be fine. She has full range of motion, and I have been doing some exercises with her leg but she still won’t bear any weight on her leg. She has been taking Dasuquin for several weeks now but I can’t tell any difference. What do you think could be the problem and where do I start. Im just devastated. She is my companion always or was always by my side. I can’t let her go with me now anywhere. I’m so afraid her other leg is going to give out on her because of hopping on it all the time.Ive tried to keep her from losing any more muscle in the injured leg mostly with the sit and stand exersize that she does very well. Please help!

15. Hey Laura, the toe touching while standing is totally normal and can continue for some time. As long as he is weight bearing well while slow controlled walking you are doing good. The only thing I would say is just make sure you are supporting his joint health with a really good joint supplement, either our GlycanAid HA or something similar. If you have question about this product or others on the market just ask me.

16. Susan this is so sad. I hate then they have bilateral injuries. The right pain medication protocol is a big key for these they guys or gals. The post meniscus recover would follow along the same guidelines as your TPLO recovery where you just want to take it slow and monitor and track their recovery. As for the partial tear of the other ACL the braces can add additional support, my only problem with them is the cost and I have had to many dogs then go on to chew them off while the owner was not watching. My best advice would be to get a support harness for her so that you can help her around and also if you are not already doing so…get her on a really really high quality joint supplement like our GlycanAid HA of something similar. This will help to create an optimal joint environment for her. Good luck, wish I could take this pain away for the both of you, but just stay calm…she will recover it is just going to take some time (ie. 6 months)

17. Kathy it may be that there is a bone spur there that is causing some pain. My first question/comment is whether you still have your dog on pain medications? For my FHO patients I am big on long term pain meds until they are using the leg near 100%. This means a NSAID and an opiod like tramadol twice a day. I use a common sense approach of if they are not using the leg then pain very well is a part of the equation. Hope this helps. Dr.J

18. I wrote you a version of this question on week 3, but I did not get a reply so I will try again. My dog had TTA surgery 4 1/2 weeks ago and has been walking on the leg during our slow controlled leash walks since day one. However, he still walks very slowly, and spends a good deal of his time sniffing, eating grass and standing. While we may be outside 20 minutes he is not walking very far at all. He doesn’t seem to want to walk any further than he has been for the last week or so. He does the sit to stand exercises fine as well as the figure eights. He does not limp, but will still toe touch half the time while standing. Is this something I should be concerned about?
    Thanks for your help.

19. Shylah had surgery Jan 12th TPLO – still limping and raises foot of the ground when standing still. It turns out she has a torn meniscus that is being repaired tomorrow. IN addition, the surgeon checked her “good” leg as I was noticing her gait was different and she seemed to want to bunny hop or skip on her back legs and as it turns out – she has partial torn cruciate ligaments in the other leg now. I am devastated! they said I could try the knee brace first . I would like to know your opinion, and also if you have any recommendations for post meniscus surgery – would be extremely appreciated!

20. I am so worried about my dog. She had FHO surgery 5 weeks ago and still is not walking. She is a maltipoo and she is 5 years old. I started taking her to physical therapy and she would not walk on the underwater treadmill. The therapist had me do an X-ray and it appears that all is ok except for a little piece of what looks like bone is showing. Could this be causing her not to walk and what sometimes sounds like a clicking sound. I am really distraught over this and would appreciate any advice you could give. Thank you.

21. Linda I am going to assume that Chloe has a standard extra-capsular lateral suture repair for her torn ACL. If this is the case then I would say that it is totally normal for her gait to still be off at 5 weeks post-op. I would give this a minimum of 12 weeks to resolve and even you will hear me say time and time again…FULL recovery take is most cases a total of 6 months. My advice is just stay conservative and focused on doing the exercises and if you have access to a professional canine rehab facility in your area this would be a great resource for you. All the best, Dr.J

22. It seems as though Chloe (7.5 yr old Bichon) hasn’t regained her normal gait. She is at week 5 after repair of a total tear of the ACL in the right rear leg.
    When she walks, it feels just off-rhythm.
    She sometimes stands with that foot not fully down to the ground.
    We really appreciate this website and your rehab exercises.

23. Jackie great question. My best answer would be that stairs are ok as long as you are supporting her and controlling the speed. We have a harness to support the hind end if you need it..for her the SupportRx would be affordable and suitable. As for the beach just at this point I would avoid the sand because of the increase stress and workload. That said…..you email makes me think what the heck I am doing living in the middle of Connecticut…poor Dr.J :)

24. my Newfie is beginning week 5 after TPLO surgery. We live at the beach and the main living area of the house is up a flight of stairs. We have been staying down stairs throuout the rehab. Sleeping on the couch is getting old. When can we begin climbing stairs?

25. Dominique, great question. I would say that walking in snow is definitely more difficult and I would be extra careful in this endeavor. Of course it all depends on the snow depth. Your best bet is to keep it to walking on shoveled pathways or the plowed streets. If you could send some of that snow over here to the east coast of the USA we would be grateful … my family is longing for some snow to ski on.

26. How would you rate walking in somewhat deep snow versus hill & Balance. When I observe my dog walk, he needs to really move that leg, use all joints to go through it. I brake the crusty part that has formed so he can walk through it with less effort. We keep our walks short, but do 4 -5 times per day, separated by a 2-3 hours, for about 5 -7 minutes each time. Some part of that time (~ 2-3 minutes )is standing still and enjoying being outside.
    Please and thank you!

27. Victoria, usually when we have a set-back we recommend to our clients to hold back a week on the recovery. In terms of the strict rest and medications, you absolutely can still do the PROM and massage and short walking, to the level that your dog tolerates ie. if your dog is fine with a 5 minute walk to go potty but after 7 minutes shows signs of lameness, then 5 minutes is your baseline. Hope all goes well.

28. Suzanne, thats a great question and my answer would be every situation is different. What I mean is that every surgeon has their own “way” or “theory” and every dog is a unique situation. If your dog is not significantly lame on that other leg then I would not personally rush into surgery until the first leg is completely healed. That said I have personally done surgery even 5-6 weeks post the first surgery, again depending on the individual situation. Lastly, as you will hear me say over and over again, make sure that your are supporting the healing and overall health of all the joints with a high quality joint supplement like GlycanAid HA to ensure the optimal inner joint health from a nutrient standpoint for best results.

29. I do not think my dog is ready for week 5. She seems to have relapsed this past week as you mentioned many do. My question is when you say strict rest for 5 days and put back on NSAIDs and pain med, does this mean no massage, PROM or walks at all? Just nothing??? Thanks so much!

30. I want to thank you so much for getting back to me the other 2 times I emailed you. You are truly like having a physcial therapist consistently available! My Cavalier had MPL 4 weeks ago and the vet has told me the other knee will need surgery as well. The vet said to wait 6 months between surgeries yet recently I saw an article that said the other knee could be done after 8 weeks. I can see some benefits in overlapping the rehab time, however I want to ultimately do what is best for my dog. Do you have any experience with this and or an opinion?
    Suzanne

31. You are welcome and yes set backs happen, for sure. When they do you go back on your anti-inflammatories and strict rest for 3-5 days. If they do not return to the level of function previous then I would have her rechecked with your doctor. :)

32. Dear Dr James

    I do not have questions because you have answered all my questions before I ask them. You are great! My Pituca Mikaele started to limp after a very good recovery period what made me so sad and frustrated. Her Vet put her on rymadil two days ago. When I opened my e-mails and I read the week 5 I felt a strong relieve in my heart. Then I do not have questions , but I do wish to express my graatitute for all the help that you have provided for us, owners. Thank you, doc. God bless you

33. Robin is happens all the time. And we always recommend strict rest, anti-inflammatories and pain meds for 3-5 days. If the dog does not return to prior functions then an exam an X-rays would be needed. Good luck.

34. Bugsy had bilateral TPLO surgery 5 weeks ago this past Tuesday. We have been on house arrest still with outside leash to go potty and small walks around back yard per our Vet. So not quite on track with your Rehab instructions. Today, Bugsy started limping on the back right leg, unsure why cause one of us have been with him 100% of the time since surgery. I called the Vet and they said possibly “tweaked” something, giving rimadyl again after being off it for almost 3 weeks. Does this limping occur this far after with dogs after bilateral TPLO with it just being something as minor as “tweaking” something. He has been walking well for weeks now until today. Anyhow, our vets are informed, I was just wondering if this does occur to others..

    Thanks

    Robin V

35. Tina, yes that would be ok. You probably don’t need to go back to week one but more like week 3. The key point is to establish a slow, conservative and consistent recovery routine. The GlycanAid HA will take about 14-30 days to really kick into play. I always try to remind people that it is going to take a full 6 months for a FULL and successful recovery. Good luck.

36. Hi, My dog Sheba had cruciate surgery on August 6th. I downloaded your guide to cruciate surgery recovery and tried to follow it, however, she had a very hard time with it in weeks 2 and 3 with the sit to stand exercises and wouldn’t put weight on the leg after that for 2 days so I discontinued it. I started her on Glycenaid HA Factor this week and want to know if it is a good idea to start her therapy on week eight, but at the beginning (as if she is on week one). She is an older dog and has arthritis in her shoulder and back leg already so she has a hard time with the exercises. Thank you.

37. Lali, I am delayed here in getting back to you. Have been on vacation and avoiding my computer to spend time with my kids. Hope all is well. My advice in situations like this is always to pull way back with exercise, strict rest, anti-inflammatories for 3-5 days. If the dog is not back to where they were then absolutely you need to get to your veterinarian for an X-ray. At 4 weeks post-op you still don’t have really good callus formation and you just would want to make sure the surgery plate and everything looks good. Keep me informed and sorry for the delay.

38. Hello again Dr.J. We are 4 weeks post op Tplo. Eva ( 8 year old weim) was doing so good until today:(. She doesn’t want to put any weight on her injured leg, it feels more warm then the good one. She only goes outside for a short controlled walk to our backyard. But I saw her getting on the couch, could she injured her leg??? Or maybe too much walking? I called the vet and will see him tomorrow . Your site is the only comfort zone for me for advice and guidance, Thank you. Im so afraid that we did something wrong in her recovery and that will lead us to another surgery. Any advice will help, sorry just feeling so frustrated and upset. Thank you

39. If you relate this holding the leg up with when he has increased activity then I would say it is acceptable at this point. If he was using the leg more and now is starting to “fall back” then I would say this is abnormal and it would be a good idea to have him checked out. Often times I don’t think many of us, veterinarians, continue with anti-inflammatories long enough post op and this may be something you discuss with your doctor. Also as always, as you know, I am a huge advocate for having all of these dogs post-op and moving forward on a really high quality joint supplement that is packed with the right ingredients to support optimal joint health. As you know topdog makes an awesome product called GlycanAid HA that is raved by many dogs owners. As for the 5 min walks….I would say if your dog is lame after a 5 min walk…now 5 weeks out of surgery that is atypical and I would consult with your surgeon just to make sure all is well. Hope this helps…DrJ

40. Sarah…my answer would be both yes and no. Let me explain. If your dog is using the leg generally well while on a slow controlled leash walk and while walking around the house and yet occasionally lifts the leg up…then I would say yes (depending on the surgery) …this can be normal. If your dog is holding the leg up more often then putting it down and you are 5 weeks out of surgery then I would say that this is abnormal and I would consult with your veterinary surgeon. In some cases dogs need to continue on anti-inflammatories longer then typically prescribed after surgery. It is also a really good idea (and you will hear me talk about this often) to get your dog on a really good joint supplement that complements and supports the health of not only the surgery legs joints but all the joints moving forward. I encourage you to check out top dogs GlycanAid HA if you can. Hope this helps. Dr.J

41. Our dog Koda is just starting his 5th week post tplo. He started putting weight on the injured leg almost right away but now when he stands still he holds that leg up and it seems to be shaking. He will still walk on it and it doesn’t seem to bother him, so why would he hold it up? Should we stop doing our 2 5 min walks a day?

42. Is it common for my dog to still pick up his leg? He does walk on it,but I still see him picking it up. Any info would help. We are on week 5.

    Thank you,
    Sarah Douglas

43. Nikki I would probably have him checked out if he is starting to limp and you are this far outside of surgery.

44. My George is starting to limp. He’s got a hop, skimp to his stride. We’ve stopped his walks and are keeping him with controlled leash walks in the back yard only. He’s very active when we come home and we try to keep him under controlled. Is this normal at this point?

45. Nancy it may help if you go to https://www.topdoghealth.com and in the online rehab center there is a video on the sit-to=stand. Personally I am more of a fan of the half sit at first then having someone behind her. You can try different tactics but don’t expect perfection to soon. This is going to take a while for her to master and be comfortable doing. Good luck. Dr.J

46. Great question Susan. First off you are very welcome it is such a joy to be able to help. It is understandable that the full tear leg is slightly smaller at this point. I think the important lesson is to just not “release” your dog until you are confident that they are ready..and you have tested them out. Yes the muscle is one easy indicator but you really need to work on the transition from walking to jogging to running and making sure that her gait is solid throughout all of these speeds. Yes my goal is always to prevent future injury and yes I talk about the other hind leg in the cases of the dogs who only tear once side but that being said in your dogs situation much of the compensation is being dispersed to the back and front legs. You want to prevent injuries to these areas. At the end of the day use your best judgement and the guidance of the rehab professional that you are working with. :) Dr.J

47. My dog on 3/26/14. When I have her do Sit / Stand she wants tosplay out to the side the leg that had surgery. Is it better to have someone behind her to help her tuck it in or just have her immediately get up and try again?

    Thanks in advance for your help,
    Nancy

48. Thank you, Dr. James, for this website and your very educational information. I have appreciated this resource very much!

    My 5 year old dog, Macey, is 4-1/2 weeks out from bilateral TTA surgery on her back legs. She is doing very well and I have had to take to heart your advice about keeping her under control (in her crate or on a leash) as she now wants to jump and play. We are currently doing about 2 one mile walks a day.

    My question is this. You say it takes 6 months to fully recover. Is this because of the need to rebuild muscle in the bad leg so as not to injure the other cruciate ligament? Since my dog had the bilateral TTAs and is doing well, would you still project 6 months to recover? The rehab therapist says her right leg muscles are slightly smaller than the leg (that was the leg with the complete tear, the left was a partial tear) and it doesn’t seem as though it will take too long for the muscle to rebuild. Should I still anticipate 6 months for a full recovery?

    Thank you.
    Susan

49. Kelly, unfortunately it does take a solid understanding of anatomy and the force dynamics to appropriately test the stability of the ACL ligament. That being said I would discuss this with the surgeon or your general vet and tell them that if there is another ACL tear that you can not afford a TPLO. The lateral suture repair is a great option and works awesome and is a fraction of the cost. Discuss this with them and I wish you guys the best.

50. Your emails have been very helpful the pass few months. My dog (lab/pit mix, 8 years old 67 lbs) underwent the TPLO surgery and then 4 weeks into the recovery, the vet said her knee fell out of alignment so she had the surgery to fix her knee. Now the other (good) leg seems to be limping. How can I tell if she has a knee problem with this leg. I am not able to spend another 5k on surgery’s for the other leg.

51. Sue I think what you are doing, keeping him on leash is great. You really just don’t want him to be able to run around the house or even worse when the door bell rings him to jump up and exploded to the door. 50% of recovery is rest and the other 50% is good structured therapy.

52. What is Strict rest? I was keeping him on a leash i the house all the time in the same room with us, looped to a table leg so he could not move about.
    Is it okay for him to be let loose in the house?

53. Robin unfortunately I think only you can answer that question. If she is a short legged dog and she has to jump or bunny hop up the stairs then there is no advantage and I would avoid them still. I would focus more on the sit-to-stands and even set up some obstacles in your house like doing the caveletti poles or weaving through obstacles. This would be more beneficial. Good luck and tell your vet he/she is awesome :) Smart vet

54. Thank you for your response.Please let me clarify that i did not think the communication was due to your end. My area is not equipped to deal with 4-6 inches of snow and 1/4 or so ” of ice (IE electric, internet, phone)that my area has gotten this week.
    My dog was on gebapentin, tramadol, and carprofen for approx. 30 days.
    The dr has not suggested any med for his joints altho I do have him on 21st Century K-9 Sr. formula which has 500 glucosamine, 200 chondrotin, 200 MSM 200 Green Lipid Mussels, 13 omega 3, 170 omega 6, 10 hyaluronic acid,5 maganese,50 vit c, 15 zinc, & 2 copper.
    He still has some swelling in his knees at times, mostly at night. I’ve read that the joint sup could be responsible, but don’t want to take too many chances. We live on a hilly area so his bathroom breaks are a little challenging. He has suffered so long.
    We’ll make it these next 10 days and hopefully we will get a good report and a green light to start therapy.
    Thank you so much and again I apologize for making it seem that I was blaming you for the communication problem. I appreciate all your rehab exercises and videos and can’t wait to start them.

55. All 3 of my dogs (20-30 lbs), including the one that got surgery for MLP could use more endurance training (30-45 minute walk gets them tired now) but they are all rather strong: they go up-down 2 flights of turning stairs over a dozen times a day (each way).
    Now begins post-op week 5 and the Canadian snow makes curb walking or hill climbing impossible. However, we have “doggie steps” for the couch that we had to be REALLY strict and vigilant to prevent her from climbing all this time. Do you think she’s ready for those?

    Thanks for your simple and to-the-point instructions. You were recommended by our vet surgeon. Your analogy to pro football recovery REALLY makes the point.

56. JW…first off…somedays I don’t get to this messages until a day or two later. I have 4 kids and three business and so a bit overwhelmed, I apologize. I said this same thing to someone previously….I would simple print a copy of the TopDog Guide and bring it to there surgeon and ask them what they thing. These recommendations are very conservative overall and have help tens of thousands of pet owners and dogs before your dog. I would also ask him/her if this was a human do you think they would be getting some kind of post-op therapy or not. That being said maybe he/she wants you to be ultraconservative because this is a bilateral injury and he just wants things to heal first before you start pushing the development and strengthening. Out of curiosity id your dog still on pain management? Did the surgeon recommend any joint health supplements as well? As for the hip…if you take your dog back to the vet they should be able to do a simple evaluation and make sure there is not increased laxity in the hip. Hope this helps. Dr.j

57. Love the message Timber…little buddy. Here is the problem Timber. Everyone has their own option on how things should be done. One surgeon may be aggressive and pro after surgery therapy and another may be totally against it. What I tell people is that #1 your dogs health and well being is your responsibility and you need to do what you think is right for your dog. That being said the surgeon who did your surgery…has their way…and being conservative is never a bad thing. They are directly involve with and responsible for you health and wellbeing so here is what I would tell you…to tell your mom to do. Print out a copy of the TPLO on rehab guide. March up to the surgeons office and show it to him/her. Tell them that TopDog has conservatively helped tens of thousands of dogs recovery from surgery with our information and resources. Then ask him/her…if Physical Therapy would be mandatory for a human how had this same surgery…why is it not for dogs. Thats the best advice I can give :) I hope you get back to 100% soon buddy. Dr.J

    PS: Oh by the way..tell your mom to keep you on a leash for 6 months total until you are 100% ready to go. Sorry :(

58. The growling/snapping could be associated with pain but also just her lashing out because she feels more vulnerable after the surgery. I may be a better idea to keep them away from her and let her recovery in peace. There are so many stages to recovery and they are all usually short lived and will pass. Just do your best to pamper her and lessen her stress. Good luck. Dr.J

59. I am not sure why I am having problems sending you a msg. They seem to have gone through but when I go back to see if you have replied there is no msg for the day that I sent the msg to you. If the problem is on my end, please forgive me for multiple msgs.
    First of all thank you for your reponse to my msg about 3 wks ago on my dog who had 2 tplo surgeries 5 wks apart.
    He seems to be doing ok. I spoke to his nurse about 3 wks ago about his activity level and she made it very clear that the doctor does not want him doing anything other than going out to relieve himself and back inside to lay down. So I am very reluctant to do any of your rehab exercises.
    His right leg had a torn acl for several months before we realized that it was not going to get any better. It suffered severe atrophy during those months. While waiting on the tplo surgery, the acl tore in his left leg and the doctor wanted to do surgery on that one first since only 4 days had past since the injury,which resulted in the right leg being pushed back for
    surgery for 5 more weeks.
    He had an x-ray on his hips before either surgery and doctor said his hips were fine, but now every now and then when I am picking him up to help him, I think I feel his hip/leg joint move a little.
    I am so scared to even think or ask if this means he has a hip problem now or does it just mean that he has lost an extreme amount of muscle and things will get better when he starts to build muscle mass back.
    I know you cannot examine him, but any thought you have would gladly be appreciated.
    Thanks for your time.

60. Dr J. I have had tplo surgery on my left leg 10 weeks ago and another on my right leg just 5 weeks ago which that knee had a complex meniscus tear also.
    My mom reads your rehab instructions and answers to other’s question to help me get better and I am, but my doctor Does Not want me to do other than go potty and back to a resting state. It’s getting very hard to do that because I am feeling better.
    My mom is very concerned with with the way my right hip seems to slide in the joint and wonders if this could be because I have such a great amount of muscle loss because this leg was hurt for so long before my surgery. She has me on a great joint medicine and tends to my every need. She is so worried and wonders what you may suspect even though you are unable to examine me.
    Any advice you could give us would be greatly appreciated. I have 3 more weeks before I go back for an examine and x-rays.
    Thanks so much, Timber!!

61. We are totally in agreement with the restricted confinement after a little scare and set back which happened after I wrote the last post to you. Our dog must have been feeling pretty good because she thought it would be a good idea to jump the barrier! Uh, not so!
    She did regress a bit showing a bit more limping on the leg. We went back to stricter confinement and placed her on pain meds for 3 days. She is back to her bubbly self but we are very cautious.
    We will probably be very cautious even through the summer months as she loves to chase the squirrels.
    I have noticed that she has been snapping/growling at the other two dogs sometimes when they get too close to her confined area. My husband says that she is just being territorial. I thought it was because she was in some pain but she is still doing it after several days (on the extra pain meds). Should I be concerned about this or is doing something different?

62. Donna I wish I could answer that question for you but unfortunately I can’t because I have no way of evaluating her. If you do not have a rehab facility in your area then you just have to use your best judgement. If she does great and is using the leg well just going to the end of the driveway and she is not more lame after that exercise then i would increase the distance slowly and pay attention to her limits. Recovery is a balance of PUSH and PULL…you need to push slowly forward in challenging her and slowly overtime she will get stronger and stronger. Best of luck. Dr.J

63. Our dog Kita has a partially torn cruciate ligament in her right back leg. She is 12 years old and has had cushing disease for 7 years. Due to her medical conditions she was not a candidate for surgery. We are now in week 5 and have been following your rehab instructions. We have had her on Rimadyl for 2 weeks now and wonder if it is time to take her off it. She had a set back yesterday due to getting into the car for her blood work. We expect to rest her for a few days to see if this improves. Is it too soon for her to be taken on longer walks? Right now she goes to the end of the driveway and back? Thank you.

64. Thank you for such a kind email. A message like this validates the love and years I have put into this project. If we can improve one life we are adding value to the world and that is what we try to do every day. On that note…I have to get a little strict here..dont set a date ie.8 weeks to let her FREE. Even though the bone will be healing well at this point I am sure if you where to measure her thigh circumference on that leg it would not equal that of the opposite hind leg. We have to remember that our goal is not only a successful recovery and healing of the surgery leg but also a PREVENTION or INJURY to the other hind leg and back. I need to have a billboard somewhere that says FULL recovery takes 6 months total…therefore at 8 weeks yes she can have a little more freedom but you have to test her and she has to earn that freedom based on how well she is doing. My goal is to make sure she is no a statistic (ie. 30-50% of dogs who tear one ACL where tear the opposite hind leg ACL with one year). We don’t want this to happen therefore we have to make sure she is ready for increased activity. As for the crate and confining….if you have a dog who jumps on the bed, or charges the door when someone knocks…then you have a dog who needs to be confined until they are healed. :)

65. Our dog had TPLO surgery on 1/7/14.
    We keep her crated at night and when we are not at home. When we are home, we have her confined to a small area with the crate open so she can go in and out as she pleases with an extra bed outside of the crate too.
    Question: How long should the crating and confining to small area be kept up?
    She has only been a month into recovery so we expected not to let her roam free until at least 8 weeks have gone by which the vet says the bone would have healed by then. Just wondering what your thoughts are.
    Also, we bought the GlycanAid HA formula so we could start her on it the week before her surgery and we are now giving it to all three of our dogs. My husband thinks that this is helping our dog who had the surgery recover better. She is doing remarkably well and our vet thought so too when we took her in for a follow up visit. Our min-pin has been on Carprofen for her leg and after a few weeks of her dosing, I haven’t seen her favor her leg lately and I haven’t given her the Carprofen for a few days now. Will keep you posted on her progress too.
    We also purchased the harness which we just love it! We ordered after surgery and wish we had had it for taking her home with it for the use of the back portion of the harness and use for that first week! We now use the front harness part (without the back portion) to help guide her where we want her to go. We also found that we use it to grab a hold of the top strap that goes along her back when our larger german shepherd walks around her in the event he accidently throws her off balance. We just love it and highly recommend it to anyone whose dog has this surgery. Your website, emails and products have been so very helpful to us. We cannot thank you enough for all the information you provide and the videos to help us walk through the processes. Thank you!

    Aurora, IL

66. Daniel we have a video at https://www.topdoghealth.com/rehabcenter where I show the sit-to-stand exercise. One of the recommend things you can do is not focus on a FULL site but on a quick half sit..This of course works best with a dog who is treat/food motivated. Also my suggestion is that you are only 6 weeks out sooooo you are still really easily in the process. It just take time and repetition and you no doubt will achieve the results.

67. My golden retriever is 6 weeks out from tightrope procedure. So far so good. He is putting more weight on the leg during gait and has show an increase in thigh circumference. The problem lies during sit to stand. He still puts a majority of his weight the non surgical leg approximately 90% of the time. Any ideas to help? He was dx with moderate oa in his surgical stifle at the time of surgery.

68. Beth, I loved reading this. Thank you so much for taking the time to contact us…it honestly means so much. I am so excited that she improving everyday and I love the fact that you “get it” and accept that this is a process that IS going to take time. Please by all means if this information helped you guys, which sounds like it did, relay this to your veterinarian so that he can pass it along to over clients in the future.

    All the best and thank you again,

    Dr.j

69. Granite, our 6 yr old lab, had FHO. surgery on her right back side..we were very scared when we brought her home, but thanks to your website, guides and videos, I can happily state she is doing so well! We live in an area of foothills in California and Granite’s daily mile walks include lots of slow hill climbing, puppy sits, obstacles and curb work..she is now trying the “lab trot” which she never attempted before and has her “lab ” moments which crack us up! Our beloved dog is coming back slowly and we are so thrilled.. Your Top Dog website has made this frightening process so much easier..we are far from done, but just wanted to say thank you so much! I would hug you if I could reach that far! Sincerely, Beth and Bob Dougall

70. Christina you are very welcome. It brings our company great joy to be able to help individuals like you. Its all about our dogs :) We love them so much and just want to help make their lives better. When you have set backs I always recommend that you rest for 3-5 days and give NSAIDS during this time. If your dog does not return back to normal level of leg usage then I would call your vet for a recheck. One thing you can do is keep a leash on her while in the house and attach it to you so that she is never more than a few feet away…This will stop the SOFA accidents :)

71. Lorrie awesome and I promise that you are going to be nothing short of impressed at how well GlycanAid HA is going to help your dog. Best of luck and we are always here to help in any way.

72. Just want to thank you for the weekly emails – they are great! and you are right on about the minor set back week 5 – Baby seems to be limping a bit more than she was – and she is a little too confident sometimes and tried jumping up onto the sofa! Thanks again!!

73. Thank you so much Dr. James. The weekly newsletters and advice are invaluable in dealing with recovering pets. We opted for MPL on only one leg, as the second leg was only stage two. I’m ordering Glycanaid in hopes of avoiding future surgery.

74. Lorrie no doubt you have to be really careful. At 4.5 weeks that level of activity and jumping would make mu nervous. If you can not crate him then maybe you could at least always have him on a leash even in the house so you can control is “fun wild” behavior. If he is feeling good and no limping after this EXTRA exercise then you are probably fine but it never hurts to just have your veterinarian confirm that he is doing well. I am a HUGE fan of crating these little guys. ::)

75. Thanks a great question Jackie. My suggestion in your situation would be to follow the advice for the rehab professional that you are working with. My focus is always on the LONG-TERM result therefore I have a tendency to be more conservative. Your dog has had a ton of surgery and there are lots of things that need to come back into balance. One thing for sure is that a FULL recovery is and should going to take you a good 6 months. What I mean my FULL recovery is where she is ready to be off leash and is running well without gait abnormalities. From the sound of it…she is doing great and I would just slowly increase the level of exercise, duration and intensity incrementally over time. It is always good to keep a little log book to help you keep tract of her progress. Wish I could give you more specifics but they are all individuals and some recover faster then others. In general just be cautious and continue to advance and dont entirely LISTEN TO HER because she is going to think the is ready and Good-to-Go well before she actually is.

76. We are 4 1/2 weeks post op on MPL surgery for a 9 year old toy poodle mix weighing about 11 lbs. At 3 1/2 weeks, we started the sit/stand exercises as he was not using the leg at all. He suddenly started walking fine and acting as if nothing were bothering him. Now we can’t keep him down. As soon as he is freed when we arrive home he immediately dances on his back legs. This morning I was holding him when he launched himself from my arms jumping from the couch half way across the room. He’s been walking around since then acting as if everything is fine. Should I take him in for an X-ray just to make sure he hasn’t done any damage? Any suggestions on keeping him calm for the next few weeks since he is not cooperating?

77. Our Springer had surgery on both cruciates/1 meniscus only 3 days apart. She’s doing well, walking basically even on both legs, started the sit/stands, which are still alittle difficult. Has a lot of muscle to rebuild. Always have the support harness on her when she’s up, providing assistance when needed. She’s a month post-op, also in rehab on water treadmill and cold laser twice a wk. Other than therapy and walks, she’s on strict confinement. Given she’s had both knees done-how should we modify the timeframe for exercise advancement? My husband and I don’t always agree on this. She’s ahead of the curve at this point, but don’t want to push it.

78. Wayne there should be no reason at this point 4 weeks out of surgery that you could not bathe him. Of course use common sense and maybe just put a towel on the bathroom and tub floor to avoid any potential for slipping. Good luck and be careful.

79. How long must I wait to give Smokey a bath. We are just finishing up his fourth week of rehab. There have been a couple minor set backs but he seems to be putting much more weight on his injured knee as he walks and does the various exercises. I’m used to giving him a bath every week or two. Thanks for any advice concerning bathing Smokey.

80. Evelyn you are totally on the right tract. You GET IT! just keep doing what you are doing and you will get great results. Conservatism is a good thing…never we ashamed to be conservative.

81. Thanks Dr. J,
    Dock is just starting 6 weeks post op. We ordered and started Glycan Aid as soon as we found your site. Do you think that putting him on an Omega 3 supplement such as Flexerna would be beneficial? I have been measuring both hind legs every two weeks as per your video instructions. There was 1 1/2 inch difference post op. So far we have gained back a definite 1/4 inch but perhaps a little more. I am erring on the conservative side.
    Thanks again will load up on Glycanaid for the next couple of weeks

82. Evelyn, I would say that since your dog is still early in the recovery stage I would say you are OK. I think the recheck and reevaluation in a few weeks is going to be really important because they will be able to evaluate the stability of the knee. I would say if you are not already…load up on the dose of GlycanAid HA for at least the next two weeks and then lets go from there. From my experience FULL recovery takes a good 6 month and the most basic way I evaluate that is based on the size of the surgery legs muslce compared to the “good”legs muscles. I would just stick with the program until your recheck and continue to be conservative. Hope this helps.

83. Karen I would agree that this popping noise is very well a meniscus tear. That being said the most important thing to figure out is whether the limp is related to the pop. You have to remember that it is possible for the meniscus to heal on its own depending on what kind of tear it is and how bad the tear is. I would strongly encourage you to purchase our GlycanAid HA joint supplement and use the loading dose for the next 4 weeks. In no way and I saying that this will “heal” the injury but GlycanAid-HA has many essential ingredients that effectively support optimal health within the joint. If the limp is related to the “pop” and is severe then you may have to undergo a second surgery to fix this problem. I am a big fan of conservative management though when it is warranted.

84. Hi Dr. J,
    Just had a couple of questions concerning expectations in regards to the way my dog is walking. He travels differently on his right (surgical) leg than his left. Does not stride quite as straight and places his leg slightly inside toward the centre of his body, but when he is standing he turns the whole leg from hip to toe slightly out. When sitting he does that “puppy sit” with the knee and the hip pointed out. Does sit with good form during the “puppy squats”. He still puts more weight on the left leg than the right leg when standing and eating. I did the pain trial as suggested by you because I wanted to see if pain was as issue. There was no difference in his movement or standing. Is what I am seeing normal in your opinion. We see our surgeon in a couple of weeks for his second checkup a three and a half hour drive for us. I am anticipating he will do x-rays and check status of bone healing. Thanks for the timely reminder re how critical weeks 4 to 8 are. It is difficult to remain in control sometimes when you have a young dog who REALLY REALLY wants to run and play.Thanks so much for this site I learn a lot from your replies from other dog owners. I see many instances that parallel my situation
    Evelyn

85. My Golden is 29 days, post op, she still has a limp and a “popping” noise, in her surgical knee area, at least 1/2 of the time when she walks. Our Vet says it is probably her meninscus. We have another re-check and x-ray, in 2 weeks. He says that my “Shelby” is otherwise doing really well. What do you think?

86. Hi Dr. St. Clair…I wish I would have asked you this on my first post, so apologize for another question. Because Kimba’s BUN level was only 31, and hoping that it’s back in normal range when we re-check it, I’m just wondering if you would consider putting him back on the Rimadyl and/or GlycanAid HA? It’s just that since he has come off the Rimadyl and your joint supplement, it’s very obvious to me that he is just more sore. He is using the leg and the check-up was great, so I have to assume the set-back in pain related. It’s hard to see your baby not feeling as good as he was a week ago, and I am wondering if you think the elevated BUN was more likely from being on Rimadyl or the GlycanAid HA? Btw, I’m a 24/7 dog mom and very in tune to my boy, so I realize I am probably much more aware of changes to his comfort and progress vs. most people who work all day, come home, greet dog, dog is very happy to see them, etc. Thanks so much. Valerie

87. You are so welcome Valerie. Good luck.

88. Thank you so much for the prompt reply, Dr. St. Clair. This site, and your accessibility, is truly invaluable to dog owners going through the post-TPLO surgery experience. Will update you after Kimba’s next bloodwork. Thanks again and have a wonderful week. Valerie

89. Valerie…no doubt that the increase in BUN is due to the supplement. This is such a mild increase overall that I would not get overly concerned but of course you need to follow the advice and recommendations of Dr. Hoots who knows him. In these slight set backs I always recommend that people pull back slightly on the level of activity for 3-5 days and then re-evaluate. Please keep me updated on his progress.

90. My 1 1/2 Yr. Old Yellow Lab had TPLO surgery 6 1/2 weeks ago, and had his second x-rays a couple of days ago at which time Dr. Eric Hoots DVM, MS (Southern Oregon Vet. Specialty Ctr.)
    declared his bone healed and said everything looked beautiful. Continue gradually increasing walks, exercises, etc. I had Dr. Hoots take blood sample to check how he was doing on Rimadyl as my local vet suggested. His BUN level was slightly elevated at 31 and everything else was normal range so Dr. Hoots recommended discontinuing Rimadyl and re-checking in one month. Day three after great check-up and a little more walking and no more Rimadyl, my lab pulled up on his surgery leg this morning, though still walking on it. Took him back in to the pen. He was not happy of course so after an hour took him back out and he continued to walk on the leg, but obviously he is sore. Not sure if it’s soreness from doing a bit more walking and/or coming off the Rimadyl. Dr. Hoots is an excellent surgeon, and because we just had a great check-up 3 days ago, I am wondering if I should really let him have a couple of days off, and also wonder if the elevated BUN was Rimadyl related or the fact he did not fast that morning as I have read? Oh, also another question: I have had him on your GlycanAid HA and can I absolutely rule out that having any effect on kidneys and his BUN level? Thanks so much for your site and emails…both have been very helpful and encouraging during this “fun” ordeal. :-)

91. Amber in your situation, please don’t consider this a second opinion, considering that I can not see or properly evaluate your dog. That being said that fact that you are only 4 weeks out of surgery and he is using the leg but ginger and limping slightly I would not be overall concerned. I am a huge fan of pain management AS LONG AS THE PET OWNER IS BEING VERY CONSERVATIVE AND CAREFUL WITH ACTIVITY LEVEL. The reason I say this is that many people see that their dog is improving and therefore become LAX about restrictions and let their dog do way to much. I try my best to repeat and repeat and repeat to owners that FULL recovery from this surgery take a FULL 6 months. You are really not safe till at least 12 weeks at minumum. It is pretty classic for them to slightly turn the knee out while talking. This will correct itself over time. If you have a real concern again I would take him in for an evaluate with the surgeon and just let them watch him walk. Also if you have not already it would be great if you found a professional canine rehab facility in your area to help with the recovery process. Also if you dont have him on a really good joint supplement then get him on one. There are only a few great products on the market and TopDog’s GlycanAid is one of them so you may want to consider that. Hope this helps and best of luck.

92. My 5 year old yellow lab had TTA surgery 4 weeks ago and I am wondering how long he needs to be on his pain medication and anti inflammatory. He is still ginger and limping slightly on the leg. More so in the last couple of days actually. But does not seem to be in any more pain than usual. He does not seem more uncomfortable during his sit to stands or his ROM. Just slightly turning his knee out when walking.

    His surgeon, who is fantastic, said that as long as we thought he needed it we should give it and refilled the tramadol prescription for another month. I wanted to get a second opinion because I feel like we should be cutting back to see if he is in any pain with less medicine before we get too far into his rehab process. But at the same time I don’t want to put him in pain for no reason.

    Thanks so much.

    Amber