In Week 4, we warn you about the problems that can arise during weeks 4-8. We also go over the importance of re-measuring your dog’s muscle and the importance of joint supplements.


I cannot stress this enough: Between weeks 4-8 significant problems can arise. The reason is that your dog is starting to “feel” better. Now that the pain is subsiding, your dog thinks that they can do more. Also, by 4 weeks, you are probably getting a little tired of the whole restriction thing.

All I can say is DO NOT get comfortable yet. You have got to get to that 8-week marker before you can start to ease up slightly.

I am very very serious about this!

Figure 8s: Start Big

This is a great new exercise to do with your dog while walking outside. You want to start with big figure 8s and make sure you do them in both directions. Once your dog can tolerate the wide circles, you will begin to tighten the circles over time.

Remeasure the Muscle

It is a good idea to do this every 2-3 weeks. It is a great way of knowing the kind of progress you are making with your dog. This may also be a good time to take another progress video of your dog walking. Compare it to the video you took in week 1.

The Importance of Joint Supplements

If you have started TopDog’s joint supplement GlycanAid® HA….now you see why it is so important GlycanAid® HA is the only product of its kind that includes the 3 major glycosaminoglycans that your dog needs to promote and maintain healthy joints. These are Glucosamine HCl, Chondroitin Sulfate, and Hyaluronic Acid. I always tell my clients that it takes about 3-4 weeks for Glycanaid® HA to “kick-in” where you can really start to appreciate just how good of a supplement it is. I still recommend giving the loading dose for another two weeks, for a total of six weeks. Then you can move to the maintenance dosing and even switch onto the GlycanAid® Maintenance Formula. Once you are done with the first 4-6 weeks and are ready to reorder, here are some guidelines to follow:

Dogs < 7 years of age, start on GlycanAid® Maintenance.

Dogs >7 years of age, continue with GlycanAid® HA.

Your Road To Recovery

We’re here to help you help your dog
  • 1.

    Comprehensive Education

    We are dedicated to providing pet owners with all the information you need to help your dog get back to active. From the start of your dog’s recovery, understanding the surgery and how to prepare your home Our constantly evolving rehab center is home to all the trusted resource you will need to help your dog recovery successfully

    Learn More

  • 2.

    Complete Joint Nutrition

    Our suite of joint health supplements is carefully formulated to work together to nourish and strengthen your dog’s joints. Backed by science, our supplements are meticulously formulated by veterinary professionals to ensure amazing results.

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  • 3.


    Between our free rehabilitation guides, explanatory videos, and curated blog, we’re focused on answering the questions you have and those you haven’t even thought of yet.

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  • 4.


    Whether through our Facebook support community, weekly rehabilitation emails, or dedicated customer support team, We are here for you and your dog on your journey back to active. Nothing matters more to us than your dog’s health and happiness. We want to see wiggly butts and afternoon zoomies.

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Suggested Readings


  1. Great question Jill and one that we of course get often. The first thing I tell people is that these are both great products. There are only a handful of great joint supplements on the market and these are definitely in the top 2. That said they are very different formulas with the same goal just different approach. The biggest difference I would say in GlycanAid HA we have incorporated 25mg of hyaluronic acid in each tablet. HA helps to promote lubrication in the joint via thickening of the joint fluid. Chronic inflammation over time thins out the joint fluid thereby decreasing it cushioning effect. For your dog, since you already purchase the Dasuquin and are using it I would not waste money and through it out, I would go ahead and finish the bottle and then if you like try the GlycanAid HA and then decide which product you think works best for your dog. We have a 100% guarantee on all of our products where if you don’t think it is the best for you dog just tell us and we will refund you no problem. We only want dogs who benefit to use it. Hope this answers your question and best of luck with your dogs recovery. Dr.J

  2. I have my dog on Dasuquin, initial dose level and she has been taking this for 5 weeks. She had MPL surgery almost 4 weeks ago. I have been reading about your GlycanAid product. What is the difference between Dasuquin and GlycanAid? Post surgery, is one better than the other and why?

  3. Carla, at the end of the day it all comes down to what works best for your dog. There are only a handful of what I would call good joint supplements on the market currently even though there are hundreds of products actually out there..most of which are just knock-off private labels. Again this is my option based on what I value to be important. For me the origin of the ingredients is critical. I want to know where they are from and the quality of each ingredient. Second I then look at the formula and the BALANCE that it provides for the joints. As for the SynoviG4 supplement I really can not comment because I don’t know the origin of where they source their raw materials. That being said Bayer is a huge pharma company so I am sure the quality control is good. Again the key is whether you think it is the best supplement for your dog and that it is helping them. I personally have not had any experience with this supplement unfortunately. All the best, Dr.J

  4. We were given a sample of an alternative glucosamine supplement from our vet. The name of the product is Synovi G4 by Bayer. Do you know anything about this product i.e. good quality? They area soft chews we mix with his dry food and he likes them.

  5. I have held off surgery for my Keeshonds luxating media patella, and now have her enrolled in a therapy program here in New York.I have ordered your Glycanaid product and have introduced it into her diet. She is having a difficult time digesting the product, (acid reflux) so I have begun slowly to let her system adjust to the product. My question is: After measurements the difference is 4 mm. Is this difference in muscle a critical problem, or workable in therapy?

  6. Elaine sorry for the delay. This is very unlike me to be so behind but the summer vacation with the kids set me back.When I can disconnect with my kids, I totally fall off the gird and be a dad. As per your question about Cosequin DS vs. GlycanAid HA. First off you will never here be say anything bad about Nutramaxx products. I think their ingredients are good but when it comes to cosequin this really is a supplement for 10-15 years ago if not longer. We have come a long way at incorporating additional ingredients that optimize joint health beyond the simple glucosamine, chondrotin, manganese that makes up cosequin. There are several things that really make GlycanAid HA a special product. Just briefly is our focus on only the top-self all USA ingredients. The second is the incredible formula which we developed that in addition to the core basic glucosamine and chondroitin we also added hyaluronic acid to help the joint fluid be more viscous and the addition of MSM and Cetyl-M. These two ingredients alone are amazing. I encourage you to just head over to and search for GlycanAid HA and read all the reviews from other pet owners like yourself.

    All the best, Dr.J

  7. Thanks Holly for the update. I have never heard of this product but I will do a little investigation on it and their ingredients. The best to you and your dogs. Dr.J

  8. Carrie – my dog Cooper also wouldn’t eat them, but I wasn’t surprised as he’s very picky with his treats and has never ingested any treat-supplement thing before. I found a powder form of a glucosamine supplement and my dog gets two tiny, tiny scoops (the scoop is ridiculously small) in his bowl once a day – and he’s 50 lbs. I also mix in just a little wet canned food. It’s called Mobility for Dogs (they also have a senior version) made by Wapiti Labs which is local to MN where I am. My dog eats it all up. Good luck!!

  9. Carie, even though 95% of dogs love the taste there are always those few don’t like it and there really is not way around it. Some people try coating it in cheese, cream cheese or peanut butter but some dogs simply won’t take it and that is a bummer. Again if you read most peoples experience their dogs love the taste. If your dog totally refuse to take it please give us a call and we can refund you for your purchase. This is our policy that there is no risk and we only want people and dogs who love and benefit from this great supplement to take it.

  10. My very picky little girl dog hates the GlycanAid tablets. She’ll even refuse to eat if I grind it up & put it on her food. Are they available in any other form? I really hate the idea of forcing the big tablet down her throat several times a day.

  11. Alli my 3 year old mastiff had TPLO on her back left leg on June 25
    She appears to be doing well and puts weight on her leg when walking
    But she did sneak up 12 stairs and back down when I forgot to put the gate back up!
    The challenge has been keeping her away from her sister a 4 year old boxer

    Alli and her sister have been on Cosequin DS since 4 months of age Please explain why I should switch to Glycan Aid
    Alli is still on tramadol and gabapentin
    For several months before the surgery she had laser treatment and acupunture
    A radiograph is scheduled for Aug 5
    I appreciate your newsletter and points since her surgeon did not provide any info other than to keep her away from stairs,playing running etc for 12 weeks
    Thank you again!

  12. Cynthia, right now I would not worry about getting the GlycanAid into him….focus on pain management and simply getting him through the surgeries. One he is stable again that we can reintroduce the GlycanAid HA into his long term success. This is a tough situation you guys are in for sure. If possible make sure you find a local canine rehab facility in your area to assist both you and him. Keep me informed as you move forward. I will pray for you guys for sure. All the best, Dr.J

  13. Our 5 yr old 100 lb. GSD had a TPLO on March 24 & 3 days later broke his leg while outside on leash to do his business. We have no explanation for this. As a result he had surgery with pins to stabilize the break. This became infected and pins had to be removed followed by a 4th surgery to replace the implant. He is on tramadol and chloramphenicol replacing rifampin and minocycline which caused nausea and vomiting. He still has a bit of a problem with nausea and is now on a short course of cerenia. The result of all this is we are having trouble getting him to eat and he now refuses to eat the glycanAid tablets. When the break heals he will need to have the implant removed followed in 2-4 weeks later by a TTA. I know the glycanaid would be beneficial if we could get him to eat them. Any suggestions? We have a wonderful surgeon but she has no answers for this. Wish it came in capsule form that we could pop in with the rest of the meds.

  14. Marilyn sounds like he is doing amazing…the bunny hopping will resolve over time for sure. I think it is great that you are doing PT.

  15. Sam I am way late here getting back to you. No explanation. Hope things have changed. My two comments are you need solid doses of tramadol three times a day and if possible it would be great if you could find a local canine rehab facility in your area. Please give me an update if you can. Dr.J

  16. Koda had FHO surgery 3 weeks ago on both hips. He is doing well. If he wants to run he will bunny hop, but when I can get him to walk slow he walks pretty normal on both legs. He starts physical therapy tonight. Hope all goes well. He just turned 1 year old last week. Hard to keep a puppy quiet.

  17. Further to last, max now on rimidryl and stitches are out but we seem to have gone backwards…he won’t walk at all now, won’t even get up. He wants to walk in the mornings, wags his tail but as soon as he starts to walk he literally falls over and then just lays down in the middle of the path, obviously in pain, can’t put his leg down to rest as he did before, he has it pulled up all the time. Gosh, Does the stress ever stop???? I am now at a loss as to what to do, should I just let him rest? Should I force hom to walk??? If I let him rest a few days and not walk how will that effect hos progress? Apologies for all the questions.

  18. Hi, thanks for your reply… reason he had to go back in for more surgery was because the wound did not heal and would not close up, the stitched kept dissolving. Apparently was due to his very unusual body fat distribution. The vet had to cut out the fat and sew some muscles back together. He now has stainless steel stitches which will come out later today and the wound has finally healed. Max is no longer on the rimidryl and the vet has not given us any more pain relief because he is on 150mg of antibiotics a day and he said to take both at the same time would cause stomachs problems.

  19. Samantha, I am so sorry for both of you. I have two questions for you. #1 Why did they have to go back in 2 times? #2 Do you still have him on pain medications? That said sometimes it can be really challenging to get these tiny little guys to use their leg after and FHO surgery simply because they are so light-weight and adaptable to only managing with 3 legs. That said if you can answer my question above it may help me, help you. Look forward to your response. Dr.J

  20. Elizabeth that is exactly the advice that I would give as well. Go back on NSAIDs and tramadol for 5 days with STRICT rest and then re-evaluate. Accidents/set-backs happen like this all the time and I am constantly warning people that week 4-8 is really really tough because the dogs start to feel much better but they are not even close ready to run and be free. You should be fine. Keep us informed. Dr.J

  21. Hi, we are in week 4 and yet my 4 year old Maltese is still not putting weight on the leg at all. Although he is happy to go on very short walks he will only walk twice a day, no more than that and when he does its on three legs. I am worried about this, although there were complications with the insision which meant the vet had to open it up again…twice! So although he has his FHO 4 weeks ago, he is due to have this final lot of stitches out tomorrow. Although the wound has been a real worry, the PROM has always been done 4 times a day so shouldn’t he still be putting weight on the leg or am I just being impatient??? do you think the repeated surgery will mean we are way behind where we should be? Would appreciate your thoughts as I am so worried that he will never use the leg and am not really sure which week on your guide I should be following. Any help would be appreciated:-)

  22. Bailey is in week 4 of her TPLO recovery. She was doing awesome until she darted out the back door. For 2 days she has been favoring it with little to no weight on it. I called SURGICAL CENTER and was advised to give her pain meds and a couple more days rest. If still lame, call back and bring her in.
    What are your thoughts?

  23. Pat, first off I would tell you that it is totally normal for them to shift weight off the surgery leg while in the house and rest. The key is that he is using the leg and weight bearing while at a slow controlled leash walk…it does not have to be full weight at this point but at least that you see a slight progression day in and day out. That said I would love to know the name of the surgeon and the hospital so that we may reach out to them and see if we can offer them our information to help their clients.

  24. Our 3 year old Golden Retriever had TPLO surgery on his right hind leg five weeks ago. While he is able to take longer walks, there still seems to be some issues that we are concerned about. While standing, he lifts the leg, so as to not put pressure on it. We have been doing doggie squats with him, as you suggested, but he continues to let the leg go out to the side. Is this normal in the healing procedure, or
    something we should be concerned about. We are so impressed with you and your informative website, that we thought we would turn to you for further advise. While our Veterinarian advised us to keep him on a lease and go for slow walks, increasing as he seemed ready, he did not give us any of the other wonderful advise that you have given. We have started circle 8’s and are trying to be patient, but are concerned that he might not be healing as well as we hoped. Our dog’s follow up visit is in a month. We will place a call to our Vet. to get his advice, as well. Thank you so very much for all the helpful information that you provide!

  25. Crystal as for pain meds of course I can’t give you specific advice but what I can tell you is this. Tramadol should be use at a minimum dose of 1mg/lb and used three to four times a day. As for natural pain relief you may want to check out Dog Gone Pain which is an herbal supplement. As for your question about the shaking of the leg after exercise, this is very much a sign of pain or fatigue. With these FHO patient if you get the pain under control you will get better and faster results for sure. As you know the key to success with this surgery is muscle development to support that femur. Swimming can be a great exercise and if possible, yes I would do it a least twice a week. Good luck with Haily…be persistent and consistent and she will do great.
    All the best, Dr.J

  26. Hi I have a 4 year old sheltie that got hit by a truck and had an FHO surgery. I wrote before about not being able to get pain meds. I was wondering if just giving her Tremadol without an Nsaid would work okay for the pain? I don’t know of any natural NSAIDs, do u have any u recommend? My vet doesn’t feel that Hailey is in much pain however, her leg shakes sometimes during exercise and after. Is the shaking a sign of pain? She shakes after the sit to stand exercises. The Rehab centre here is booked solid until June 9, so I have been taking her to do hydrotherapy in a pool that is for dogs. It’s not a rehab centre it’s just a place people can take their pets to swim. I get to go in to the pool to. I have taken her twice 30 min each time and she gets to rest on the ramp so it’s not 30 min. straight swimming. Last week she wanted to float the leg and I could feel her leg shaking. The attendant used different techniques to get her to use her right leg, which worked somewhat. Should I swim Hailey more than once a week? My vet said start doing hills- up and down, I am doing this. Hailey has a lot more trouble going up then down. Also I am supposed to walk through long grass which I am doing. She still is mostly holding her bad leg up in the house. While on leash she is using the leg much better. I bought a supplement it’s called Pure Motion Optimum for Joint Therepy. It has 500 mg of pure Glucosamine HCL from shrimp shells, 100% pure 100 mg of Chondroitin Sulfate, 300 mg of MSM and 10 mg of Hyaluronic Acid. Does this sound like a pretty good product? I plan to get the one u supply but I needed something now and for less money. With this product it’s 2 teaspoons a day = 10 g daily, supposed to give this in a divided dose morning and evening. It says it takes 3 months to see beneficial effects :( I wanted it because it has the Hyaluronic Acid which a lot of joint supplements don’t have. Any ideas on what I am doing right or wrong very appreciated. She is only walked on leash for 15-20 min 2-3 times a day. She is off leash to go to the bathroom but doesn’t run around, just goes and comes in. Sorry for all the questions, the main question is can Tremadol be the main pain med. for Hailey?

  27. Hi Wendy and thanks for the message and I am glad that he is doing well so far. It always excites me when there are successes. As for the supplements we do ship them to Canada that only unfortunate part is the shipping cost which we both end up paying to much for. Please try the 1-888-504-2220 number again or the direct # which is 203-686-0880. We will do anything we can to accommodate both of you. :) All the best, Dr.J

  28. My dog recently had FHO surgery and I have been so thankful to have access to your rehab website. I really would like to try your supplements to maximize his recovery. He is doing rather well. So true he is really starting to get rambunctious at this 4 week period. We have put carpet over my hardwood floors and installed baby gates. He is not allowed to roam in the house and is crated at night and on the days that we work. I find myself feeling guilty for having to crate him even more lately but I know it is for his well being. Anyway, I live in Ontario, Canada and was hoping to be allowed to obtain your supplements through the mail. Please let me know. I have been trying your 1800 # with no luck. Thank you. Wendy

  29. Peggy though 95% of dogs love the taste of our supplement there is always that handful of dogs who simply won’t take them. Some options are to crumble the tablet and mix with food, or wrap the supplement in a piece of cheese and get the dog excited about getting a treat. If these don’t work then I would say simply give us a call and we will refund your purchase. On all of our products we have a 100% guarantee. This is a bummer but it does occasionally happen. Keep me informed. Dr.J

  30. Terry this is one of the unfortunate though usually uncommon realities of compensation. Either she had previously injured that other hind leg or it was a result of the increased pressure she had to place on it after the first surgery. First things first you need to get that leg evaluated and see if she has a tear of that ACL. As for the rehab you need to stay focused on the first few weeks were restriction is everything until you get this new problem addressed. Please keep me informed and if there is anything I can do to help just ask. :( Dr.J

  31. My Labrador had TTA surgery (Left leg) on the 27th of December. She had her stitches out Jan 10th. Immediately after this appointment she began to favor the “NON Surgical” rear right leg. She is now bearing weight on it but favors it more than her surgical leg. I am not sure what to do for her rehab now that her right leg seems so compromised. Any thoughts on how to continue with rehab?

  32. Carmen this question is unfortunately impossible for me to answer due to the fact that I do not have a doctor/patient relationship with your dog. That said my best advice would be to utilize the rehab instruction is the TTA home rehab booklet or better yet seek local professional rehab advice from a certified canine rehab practitioner. All dogs recover differently. If you can not find a professional then utilize our online rehab center and consult directly with your surgeon.

  33. I have a pressa that is in week 4 of recovery from TTA surgery….how often and how long can he be taken on walks?

  34. Joyce this concerns me as well. First thing I would ask is…Is your dog still on any pain medications? Often dogs are only given pain medications for 10-14 days after surgery, but I find that often they need it for far longer. If your dog is not on any pain medications currently then I encourage you to discuss this with your doctor. Second you need to make sure that the knee is still stable and that there is NO infection. It is not uncommon for dogs after knee surgery to compromise this surgery. Make sure you have this checked out. Third, if you have access to a professional canine rehabilitation facility in your area get there ASAP. On we have a directory of all the facilities across the country. These professionals are the life line to aftercare so use them if you have access to them. Lastly, if your dog hates the PROM then stop doing it. We never want to push them or do what is uncomfortable to them, within reason. Hope this helps and please keep me updated. Dr.J

  35. We are at week 4 and he is still not using the leg. I am doing prom but he hates it. He is active and is doing well on 3 legs but will only put the 4th leg down when he is relaxed and forgets. Once he realizes it, he pulls it up. The muscle has atrophied. I am very concerned that he will never use the leg.

  36. Thank you for the reply and thank you for all the resources you provide. You are helping so many people with their injured doggies to get well.

  37. From the sound of it you are doing really well 4 weeks out. That being said it is now during this time of the recovery process when you need to be extra careful because he is “FEELING” better and he is going to want to do more. You really are just trying to avoid the explosions i.e.. running, jumping which it seems you have a great handle on that. Keep up the great work. Dr.J

  38. We are about to start week 4, i am dealing with an ultra hyper 11 month old boxer. I have managed to avoid zero runs and he is not free to roam at all! From his crate to being tied to my waist is his life… However he manages a few really hard pulls and a few desperate stands!!! Im scared of a failure here and ending up reinjuring. He does not limp and seems to put good weight on his leg, we went thru the sitting stages well, we will start number 8’s tonight… Is it to quick for him to be walking so much? He is caged pretty much 6am -5pm and walking with me around the house until sleep time about 9pm.

  39. Just remember that it gets harder the better they feel because they “think” they can do more but the reality is they are not ready yet. Just continue to stay conservative. You need to have that bone heal and being that she is an older girl it may take longer. :)

  40. Dear Dr James.

    My Pituca Mikaele is on week 5. She is 13 years old. Will be 14 on december 13th. She is very smart and very active. She runs when she goes out for pipi. She runs and jumps when I arrive in home. Of course I do not allow these behaviours. I sit down on the floor and make her to calm down. Reading all the informations of week 4 has helped me so much. Thank you so much for this great job. Pituca Mikaele also thanks you so much.

  41. Wendy the first question I would have for you is how are you going to prevent future jumpings on the couches or bed. If she did it once she is going to do it again. This is why I strongly advocate either crating them while in the house (during this recovery period) or always have a leash on them in the house and have them attached to you. As for this recent set back…yes this happens all the time and what I recommend my clients to do is strict rest for 3 days with walks only to go to the bathroom and give anti-inflammatories for those three days. If your dog is not back to where they were before…then call your veterinarian and have them checked out. Hope this helps. Dr.J

  42. Thank you Dr James I’ll try that. Another question, she has been walking well on her leg barely limping then I took her for a 10 minute walk this morning and she now seems to be limping pretty bad on her leg, is this normal. Should I let her rest for a few days and see how she does or should I keep walking her? Last night she did jump on the couch and I caught her and set her back on the floor but she seemed to be OK even this morning when we left for the walk. Just nervous.

  43. Wendy no doubt it gets tougher and tougher to prevent re-injury during the recovery process the better they begin to feel. In this case yes you need to figure out a solution to getting her to NOT jump when you take her out of the crate. You can try town different things. First when you open the crate door do not pay any attention to her (i.e.. don’t talk to her and give her any recognition) and allow her the time to calm down. The other option would be to immediately put the leash on her and sit with her on the floor again calmly not paying attention to her until she calms down. One thing is for sure I am not a trainer my any means but one of these solutions may help and would be worth a shot.

  44. Dr. James I totally agree with you my dog Bailey is doing really well and definately wants to do more but she tends to be mostly content when in the crate so I have no problem leaving her in there, I will not allow any opt for her to undue all the great progress. I do have a question though she has always been a jumper so sometimes when I take her out of the crate she is excited ND wants to jump on me. I’ve been considering getting a jumping harness for her as I obviously need to break her of this. What are your thoughts. Again thanks so much for all of the great information and advise.

  45. Penny I would not get overly worried about this still at this point. Getting them to sit “square” or appropriately takes time. In the sit to stand video I discuss how to practice “half” puppy squats. This is where you ask them to sit and when they are just getting themselves prepared to sit and a quarter to a half of the way down in a sitting position you ask them to quickly get up. I call these half squats. With some dogs this can be difficult to master because they sit very quickly but with a good treat and some quick action this can be an effective way to slowly build proper form. I never really had success with having them sit, then adjust or position the leg properly and then have them get up. Therefore these half squats help them repetitively practice “small sits” and over time you can let them sit further and further. Hope this explains well. Also since you are going to the rehab facility on a regular basis see if the therapist can help you with this. All the best, Dr.J

  46. ALSO… She has very minimal limping. Just very slightly. Usually when getting up from having laid down & relaxed for a long period of time. I’m so worried about her not sitting correctly. It is always well off to the side.
    As far as to what I let her do… She walks the house unleashed now as of this week but if I feel she is overdoing.. I put the leash back on while in the house, I still assist with potty business, & 8’s, acupuncture & therapist assisted water therapy. (94* heated therapy pool & light assisted swim (mostly float right now but held while she moves her legs a bit) and the jets ate put on the leg with TPLO surgery. Still want to take things very slow & easy.
    Thanks for any help…

  47. I’m very happy to say that Baloo is back on track and is doing great. We had his 4week X-ray’s Friday and everything seems to be healing well. Thank you again so much for taking the time to answer my questions and give me reassurance! Your resources are wonderful!

  48. Mona when you have a immediate setback like this you need to pull way-back, give anti-inflammatories for 3-5 days and strict rest…and then reevaluate. At week 4 this is unfortunate and totally common that they are feeling great and then ESCAPE from our close watch and overdo-it. If she does not return to where she was then I would call the surgeon and just have them check her out.

  49. Lindy, the way to think about hot and cold is this. If there you sprain your ankle and it is an acute injury then you would want to use cold therapy for the first 72 hours to decrease the inflammation. After this initial period it is then that you use moist heat therapy to increase good inflammation into the area to promote healing. That said if you have a set back…you need to go right back to cold therapy to work at decreasing the inflammation, such is that case in your situation.

  50. Hi Dr James. First off I have a 10 1/2 year old lab. ThisTTL surgery is her second surgery. In 2009 she had the TPLO on the other knee.
    We are now in the middle of week 4 and she is on the Glycan-Aid-Ha for about 31/2 weeks so far. My concerns are as follows.
    Everything seemed to be going well til sometime last wee. She got out and of course went running until we could get her. She seemed ok, but I noticed that when we started doing the “Sits down” exercise, she definitely keeps her knee and leg out. Sometimes she will put the knee in, but she will not tuck the leg under the knee.. I went back to doing the bicycle exercise and the knee seems a little stiff.or she is holding it tight so I can’work her knee.. Also when we are going for our walks, her leg does not look strong at all,

  51. Thank you so much for your response. I started him back on the deramax that he had prior to surgery and am limiting his walks. He seems to be putting a little more weight on it when we go out but still has some difficulty getting up from a sitting position. I will keep a close eye on him and call the surgeon if he does not show improvement. He is scheduled for his 4 week x ray on Friday.
    Also he does not tolerate the heat well at all (only about 6-8 min max at a time) should I continue to try and do heat 2-3 times a day or should I switch back to cold (which he loves).
    Thanks again so much for your help throughout all of this…. Your guides and resources have been invaluable! I will let you know how Baloo does.

  52. Lindy set backs happen all of the time. My recommendation is always this. Go back to strict rest for 3-5 days with only short walks to go to the bathroom. During this time I also recommend having the dog on an anti-inflammatory. If there is not significant improvement with rest and medication and your dog does not return back to where they were before the set-back, it is critical to make and appointment with the surgeon and have the leg evaluated. You need to make sure the implant is still in place and there is not infection. Tell me please how things progress. Dr.J

  53. Robert currently our supplements are not registered with the Australian government and therefore are not available in the country. We even can’t ship them in to you because they will be stopped by customs. This is an unfortunate reality right now. Sorry. Dr.J

  54. First of all thank you so much for your wonderful guides and videos. They have been very helpful. I have a 2 1/2 yr old Newfoundland who had a TPLO surgery 3 weeks ago and recovery has been going a along very well and I have been following your guidelines as well as giving the glycanAid.

    Last week I increased his walking to three 10+ min walks a day and added some hills (some fairly steep) and he did them beautifully all week. His progress was great. I also started a little of the sit stand but didn’t push him with it. 2 days ago he seemed to regress with his leg and not want to put as much weight on his leg. Once we get going he does ok but it is obvious to me that it is not as good as it was!
    There was no specific incident and I have consistently kept him on a short lease with slow walks but now I’m really worried that I have allowed him to do too much and he has done some damage to his leg. He seems to have a harder time standing up as well.

    My questions are should I go back to shorter walks (which I’ve done ) and no sit/ stand exercises… should I continue the rehab as before only less… Or should I give him a few days with very limited walking? Is this setback normal or how do I know if he’s done something to really mess it up?

    Thank you so much for taking the time to answer this… I really want to make sure I do what’s best for him … He’s such an awesome dog!

  55. Gaye, I would discuss this with your veterinarian who recently evaluated her. Usually is this circumstances I would hold off on the exercise and go with strict rest until she improves and is weight bearing again. Then I would slow reintroduce the exercises. Good luck and hope she is ok. Dr.J

  56. Hi, My Maltese had ccl and a luxating patella surgery. Last week princess woke up and was holding her hind leg up despite her awesome range of motion and almost full weight bearing on her leg the previous week. The xray shown no injury. The vet suggested we continue short leash walks,warm moist heat and metacam for 10 days. Should we not do figure 8’s and continue walks 2x day? Thank you!

  57. Charles, the simple answer to your question is yes…it could be some bit of mental component but most likely there is some residual discomfort. First and foremost I would just make sure you are providing her with a good joint supplement that provides all the essential ingredients for optimal joint health. This should make a big difference. Glad to here that she has improved though. All the best, Dr.J

  58. Thank you for the response. My Lab did seem to recover after a couple days of rest. She does well on walks putting full weight on her leg. However, she still seems to hold it up in her cage while standing. Besides holding it up here and there, she seems to be in no pain. Could this be a “mental issue” since her leg has been hurt for a couple months?

  59. Charles it is not uncommon for them to “tweak” their leg this far outside of surgery. She must have done something along the walk that bothered her. 4 weeks out of surgery she should technically be able to handle a much long walk but moving forward my recommendation is one of two things. Often I will tell my clients to rest the dog for 3-5 days while giving them their anti-inflammatory on a daily basis. If the dog is not back to where they previously were then I have them bring them in. If the dog continues during this time to get worse then I absolutely have them come in ASAP for an evaluation and X-ray. Hope this helps and hope everything is ok.

  60. My lab had TTA surgery. She is entering week 4. Last night I took her out for a 5 minute walk (per rehab instructions) She came in favoring the leg. She woke up this morning holding the leg up but eventually used it when going pee outside. I gave her a tramadol last night before bed. When she sits her surgical leg is sort of away from her body. She has been crated ever since the surgery only going out on bathroom breaks and walks. Should she still be limping at week 4?

  61. Michele the reality is that if she has a FULL tear of her ACL then surgery is the best option no doubt. You can find stories of dog owners online saying that they avoided surgery and their dog recovered 100% but there are many problems with this. If a dog has a full ACL tear and does not have surgery to stabilize the knee..then yes scar tissue will form to some degree and stabilize the knee BUT it is certain that this dog will develop arthritis at an accelerate rate. Also this dog will be at much greater risk of injuring the other hind leg muscle because of compensation. If your dog only has a partial ACL tear and you decide to not have surgery then my best advice would be to download our cruciate recovery guide and follow along step by step as if your dog did have surgery. Keep her on leash at all times until you are confident that she is doing really well. You need to really focus on protecting the other hind leg (it would be devastating for her to have both hind legs with blown ACL’s), therefore no running or jumping until she is truly ready. Hope this helps. This is a tough situation and tough one to give advice on.

  62. My dog is 10 and diagnosed with ACL tear. I am getting your e mails because I am interested in the rehab process but I have done the surgery with my dog. She is a very active dog and I am very afraid to have the surgery. She has been through enough in life ( pitbull attacked her 6 years ago and 5 month rehab process). I am trying the hollistic route of a few months very limited activity along with glucosomine with tart cherries, rimadyl, and salmon oil. Have you heard of success stories and is there any other suggestions you may have to avoid surgery? It is greatly appreciated.

  63. Mary thanks so much for taking the time to reach out to me. You sound like an awesome mom and you are doing everything you can to help Murph. As for the the long acting fentanyl patch…. I have not had any experience with this and it sounds like an very unfortunate side effect. Personally I have never been a huge fan of Fentanyl, though I know many doctors are. Dr. Degner is a great surgeon and a great guy hands sounds like this was an unfortunate rare situation with Murph. Thank god he is back to doing well. Lastly I totally appreciate your constructive advice about my grammar and spelling. This has long been a sore point for me and no doubt I need to address it in the near future. I guess for me I focused so hard on the content and the message and over looked the technical grammar oddities. :) Thanks again and hope Murph continues to improve.

  64. Dr James, My dog Murphy (and I) are entering week 4 of his 2nd TPLO. I read and follow to the letter every word you write, use the GlycanAid HA, and have supreme confidence in you. I am a single retiree and cannot afford my wonderful local canine therapy clinic. I work a few hours a week for my son who is a “human” P.T. so I believe in rehab with all my heart. Murph made a stellar recovery from TPLO #1, and I was his therapist. Somehow, two and a half years later (while chasing a squirrel) he suffered a complete tear in the opposite ACL. Thank God only two hind legs! That was two trips to Europe! This is why I lean on every word you and my noted surgeon Dr Dan Degner utter. Two things: just as a word of caution to your patients who are considering surgery, my Murph had a serious adverse reaction to the pain medication Recuvra, which is a long-acting canine Fentanyl product applied to the skin for pain relief. Rather than sedated he became agitated and crazed, which required re-admission to the emergency clinic, IVs and two catheterizations. Four days of increased misery. This is an uncommon reaction but the product is rather new and wanted you to be aware of this dysmorphic reaction. Not anyone’s fault and could not have been predicted ahead of time but a bit of a nightmare. He is doing well now and we continue to follow your protocol religiously. Dr Degner said “whatever you did last time worked great, so just do it again.” A compliment to you!

    The second thing is little, but you might consider having someone proof or edit your online guides for grammar and spelling.

    Thanks for being out there! We really need you. MA and Murph

  65. Pamela…Let me first say that I totally understand where your are coming from and as can imagine have been through this thousand of times. That being said I will honestly tell you that the smaller the dog the harder the recovery. These little ones adapt so well to three legs and not using the leg that bothers them the most…it can be maddening. Provided that the surgery was a success you have to remember that you are only 4 weeks out. I always tell people that full recovery takes a full 6 months in order for everything to balance out again. If you are unsatisfied with the results so far you should bring him back to your surgeon and just make sure everything is secure and the knee is stable. Then you may want to ask them for a refill on your anti-inflammatory drug so that if he is having a hard day you can give this to him. Also if you have not already you really should consider purchasing our GlycanAid HA joint supplement and keeping him on this for optimal joint health. Hoep this helps.

  66. Dr. James!
    My 6 lb. Yorkie had ACL Repair 4 weeks ago. I have been following your instructions faithfully since his surgery. I read them every day as if they were the bible!
    I have been virtually a slave to this little dog 24/7.
    Where we live it is very hot. I get up at 5am to walk him and have to wait until 8pm to walk him again. I am 68 years old.
    My dog is walking EXACTLY as he did before the surgery – maybe worse!
    I am ready to throw myself off a bridge.
    I don’t know what else to do.
    You explain if they walk too fast they will skip – why?
    I walk him so S-L-O-W!
    Any little deviation and he is hopping or limping or kicking his leg out sideways.
    I think I just put my little dog and myself through hell for nothing!

  67. Glorya, what I would say is just think of tramadol and an anti-inflammatory as tools in your tool-shed. Though you may not think he is in pain the only way you will ever know is to try him back on pain medications and see if there is a difference. If there is not difference then you can safely assume that there is not pain. Good luck and you are going to love the GlycanAid-HA it is a great supplement.

  68. Thanks for your reply Dr. St. Clair. My dog was on Tramadol for 15 days and he is now off. He does not seem to be in any disomfort. He is still confined to the living room/dining room and locked behind a gate in the bathroom in the evenings or when I leave the street level floor. We walk 3x a day in a regional park behind our house, so he is not walking on a jarring surface. I have started deep massage on his hip and leg and he has started to slowly put down his foot and immediately lift it, but it’s happening more often so I know it will soon become something he does with out thinking about it. He is finishing the supplement (Dasuquin) he was on prior to surgery, but I’m going to order your GlycanAid as soon as he is a week away from finishing his therapy levels.

  69. Glorya my question for you would be…is he still on pain medications and if you which ones and at what dose? Also are you using a joint supplement at this time also?

  70. My dog is a 51 lb. 7.5 yo Pitt/Chi mix (we know both parents), and was born with arthritis in his hips and knees. He is pure muscle, which helped with his first FHO 2 years ago on right leg. Aggressive PT and by 5 weeks or so he was walking very well on 4 legs.

    4/29/14 he had a FHO and TPLO on left leg. Happy to find your guidelines. They look pretty much the same for both procedures, except the TPLO requires confinement, which we have done. Following your guidelines for TPLO religiously, including deep therapeutic massage on leg and hip.

    15 days in and we have seen him trying to put weight on his foot but it’s still a trial and not a regular thing. But I am sure his hip has something to do with that.

    From your invaluable experience, is there anything different from your regular guidelines you would suggest since he had both procedures done at one time?

    Our hearts thank you,

  71. Michelle, four weeks our and still licking the joint can or can not be normal, it all depends on the dog and the type of surgery. Obviously he is licking because it still hurts or bothers him. You may want to ask your vet if he could go back on tramadol for a few weeks and see if that helps. This is a super safe medication and does a decent job at controlling pain.

  72. Lynn stairs can be navigated safely with the right support. You may want to invest in a support harness like the once we have at topdog. The key is CONTROL. If you can safely control his speed and support his hind end going up…I am ok with that. The problem comes in dogs who wanting to run or hop up the stairs on their own. To answer your question…it is you who misses him more upstairs :)

  73. My dog is still on rimadyl, 4 weeks out of surgery, but he still seems to lick his bad leg pretty often. Is this normal? Thanks!

  74. First..thank you for your program which is helping us immensely. Darby is doing well, had TPLO Apr 9…Weight bearing well, and loves his walks tho would take off in a heartbeat if we would let him…..which we wont. Just starting figure 8.s Question..he always slept in our room, since the surgery we moved his bed downstairs so he has a few around that level…He has tried to go up the stairs (we block them) but at what stage can he go up at night..then we would walk him down in the am…we would gate off so he couldnt go down on his own? Not sure who misses him sleeping upstairs more ..Darby or us. Thanks lynn

  75. I am glad that he is doing better. To answer your question though the exercises and plans are created specifically for dogs with knee or hip injuries the principle of recovery are generally the same. I have long been wanting to finish a guide to IVDD (intervertebral disc disease) recovery but have not had the time yet. So to answer your question, yes you can use the basic guidelines but as always it is best to find a professional rehab specialist in your area that can provide more specific instructions. Hope all continues well moving forward. Make sure you keep him from ever jumping off furniture, bed or down a flight of stairs in the future.

  76. My mini dachshund had surgery about 4 wks ago (rupture disc around neck area; he was paralyzed). We followed your exercise plan & Schnitzel is walking with ease (he’s 11). He’s crate confined & only comes out to go potty, do his exercise & meal time. My question is; does your exercise plan applies to dogs with spinal core injuries? Thank you & awaiting for your reply.

  77. Barbara, this is obviously an unfortunate setback but hopefully in the end will provide the ultimate stability that his knee needs. As always I try my best to encourage people to find a professional canine rehab facility in their area for optimal recovery success. Tools like the underwater treadmill provide such an amazing low impact high resistance form of exercise that really can not be replaced by land exercises. No doubt dogs who can utilize these tool will recovery faster, but as you know facilities like this are not easily available every where so many people have to rely on home exercise plans like the ones we provide at topdog. At 4.5 weeks out you are still in the early stages and the success of the second surgery relays on the development of good scar tissue to support the sutures that were placed. This takes a good 8 weeks so you are half way there. As for the pain management I would consult your veterinarian on this because they know your dog best and have a personal one-on-one relationship with you and your dog. That being said many times the only way to know if the pain meds are needed is a trial and error approach with careful assessment of any changes when you decrease the pain medications. You should discuss with this your vet and ask them if you can try decreasing the pain meds further. IN the grand scheme of things you are doing so well and are so close to success, that continuing to me slow and conservative is your best option. I really encourage people to keep a log of their dogs exercise plan and results. Meaning if you are doing 15 min slow controlled walks and your dog is doing fantastic with that…then either you try increasing the time to 20 min or you increase the intensity of the exercise ie. incorporate more hill work. Hope this helps and keep up the good work, I know he appreciates all that you are doing. All the best, Dr.J

  78. Hello Dr. James,
    You have answered questions for me in the past 4 months.
    My 5 year old Shorthair had TPLO surgery in Dec 2013 and all went well except his LCL was injured as well and required 2 40lb sutures, surgery March 4th (just when his muscle mass and rehab were really going well at 3 months).
    This surgery seems to have caused him more post surgical pain than TPLO did. I realize the sutures have tightened his knee and he is not used to it.
    Rehab is going well thanks to your weekly instructions.
    This is week 4 1/2 for second surgery.

    Two questions:
    1. Is there anything else I can do to help improve muscle mass? He was almost equal and then had second surgery. I am very concerned about compensation on both the front and rear non surgical side. (We are doing all exercises you suggest plus three legged stands. He is taking GlycanAid HA.)
    2. How do you assess need for pain meds? By this time with TPLO he was taking no pain meds, just Metacam as needed. He is currently on 1 50mg tab Tramadol every 8 hours. Down from 2 every 6 hours. He seems fine. I don’t know how to tell when to decrease or discontinue, or increase time in between doses. (He weighs 63lbs)

    Thank you. Sorry if lengthy. I appreciate your help very much and I know you are busy.

  79. Barbara, you are so welcome. We are just thrilled to have developed a natural supplement that works as well as it does and continue to support and educate pet owners, like yourself to improve the quality of life of their beloved dogs. We are grateful everyday. All the best, Dr.J

  80. Dear Dr. St. Clair,

    Thank you so much for prompt reply to my questions. I have begun to research rehab facilities in the area with underwater treadmills in preparation for Daisy’s second TPLO surgery. She has been on the GlycanAid and it’s made all the difference. Thank you so much for doing what you do!
    Barbara C.

  81. Wow Barbara this makes me so sad. She is one lucky dog that she has you. So yes the clicking sound if not related to pain could be that but more importantly I really think it would be beneficial for you to seek out a canine rehab facility in your area that has an underwater treadmill. You are going to need some additional help and guidance. We have a directory of all the facilities in the country here on our website.…If you don’t have access to a facility like this then you need to just continue to be conservative. I would make sure that you get her started on a good joint supplement…of course our product GlycanAid HA is an amazing choice if you have not already. We are here if we can help in any way.

    All the best, Dr.J

  82. Dear Dr. St. Clair,

    Thank you so much for these wonderful videos and sharing your excellent program. It has been extremely helpful as my dog Daisy and I take this TPLO journey together.

    Daisy will be 4 weeks post TPLO tomorrow. Unfortunately, 2 weeks after her first TPLO, she ruptured her other cruciate and is scheduled for her next surgery in a few weeks. Last week she developed a clicking/popping in her surgical hip. Is this common? Can it be because of the loss of muscle mass? I’ve been severely limiting her activity and using a belly band to support her hind legs.

    Any insight/exercises you could pass along would be greatly appreciated.

    Barbara C.

  83. Molly keep plugging along. With a Corgi having shorter legs it sometime is difficult to master the half sit like I talk about in the Sit-to-Stand video on If you can work on that it would be great. Make sure you have some really really tasty treats.

  84. Our 5 1/2 year old Corgi is starting her fourth week of rehab after TPLO surgery. She has been almost 100% weight bearing right along,however she will not sit square still. She insists on shoving her legs under herself, or out to the side.. do I need to worry yet, or keep plugging along?
    Thank you

  85. Paul it really comes down to how well your dog is doing. If your dog is using the leg while walking and otherwise the leg is down then you can stop those at this point. That being said there is absolutely no harm in continuing any of these moving forward. Hope this helps. Dr.J

  86. Hi,

    Our 2 1/2 years old Lab had TPLO surgery 3 weeks ago. We have been following the Rehab Guide and were wondering about what you meant by “As Needed”. In Week 4, Moist Heat, Massage, and PROM are all performed “as needed”. Should we do this as often as in previous weeks, or when we can see our dog is uncomfortable? We are unsure of what to look for and we certainly don’t want to stop altogether in fear this would be detrimental to his recovery.

    Thank you

  87. Nick…what did the surgeon say about the pop? Do you notice the pop being associated with any increased lameness or limping? Do you have Cooper on a joint supplement currently and if so which on? Look forward to your response. Dr.j

  88. Morning Dr. James

    We are currently in week 4 of the rehab process of our TPLO. Cooper is doing great, but his leg as started to pop when he walks. Is this normal, should I confine him when we are not at home? My vet mentioned that it was okay for him to walk around the downstairs and that is what we have let him do. Thanks taking the time to answer.


  89. Catherine, I think because of her slow healing and the fact that you have a lot of time head of your for her to heal I would aire on the conservative side. Instead of treating her as a dog who is 6 weeks out and doing well I would start at around the 2-3 week make and mover forward from there unless she is doing really well. You need to find her baseline and then increase activity and difficulty from there. As for the GlycanAid-HA of course since I am not her veterinarian and not totally clear on what the GI issue actually was I would recommend passing that question by your veterinarian. That being said it never hurts to start conservative to gauge how they tolerate it. Some glucosamines can cause GI upset, though we use an awesome vegetable form, made here in the USA and it is well tolerated. I wish I could be more specific but I have to be very very careful and always recommend that people also consult with their doctor where a doctor-patient relationship exists. I wish you guys all the best and hope everything continues to progress in a positive way.

  90. David from the sound of it he is doing really well. If he is using the leg well on short controlled walks that is awesome and then most important. You just have to be super careful from this point forward because as he starts to feel better and better he is going to get more and more daring to try things, pull and jump. Just be very careful. Obviously if you have any major concerns or need confirmation that he is doing well I would just have him quickly checked out by the surgeon who did the surgery.

  91. My 9 year old yellow lab Olivia had her 2d TPLO 6 weeks ago. She healed very slowly on the first one, and doing the same on this one, complicated by the fact that 3 1/2 weeks out she had a major GI upset and had to be hospitalized for IVs for 2 days. Don’t know what caused it but had to take her off all pain meds in case that was it. The GI problem seems resolved but she lost a good 2 weeks of rehab as we dealt with that. She is going to PT but is way behind…still limping a lot. Two questions: how do you deal with the rehab schedule when this happens? And, just before the GI illness I had ordered your GlycanAid-HA. I held off starting her on it because of the stomach issues but would like to put her on it now–should I do the “loading” or better to use the regular dose from the beginning because of her stomach issues? Thanks–your website and rehab instructions have been wonderful for us.

  92. Dear Dr. J
    It’s been 4 weeks since TPLO on my lab. He’s walking great but still favors his leg when turning around. We have to take 1 step down when going outside and you can tell he tries to keep weight off of it. This is probably normal but just want to be sure. The first couple of weeks after surgery he pulled pretty hard on the leash and jumped a couple of times. Is there any way this could have affected the plate?
    I’m probably worrying to much, but want to know if on schedule with the recovery. Also, that’s a great reminder about the cutting of the bone and rotating it. Reminded me again just how serious this is. Thanks again for your help and the GlycanAid! David

  93. Barbara, Thank you so much for contacting me. You comment validate that at least my messaging is getting through to some people. It is such a joy for me and my team to know that we are helping make your life and your dogs life better…even in our own little way. We would love for you to share your experience with your veterinarian and hopefully it will help others in the future. As for the moist heat…lets put it is way…it never hurts but most likely it is unnecessary if the other leg is doing fine. All the best to you and your family. Dr.J

  94. My dog is in week 3 after TTA and I ordered your Glycanaid. My dogs have always been given another joint supplement. Once I begin using yours, should I start as directed with 4 tabs or begin the regular dosage?

  95. Dear Dr. Sinclair.
    I want to thank you again for all you provide – support through videos, the weekly rehab emails and website in general. Thank goodness for the week 4 warning!!! I am feeling just as you said and the desire to relax just hit yesterday. Plus, this is exhausting. However, I didn’t give in, remembering the checklist!! Be conservative.
    Thank you. I am going to share your website with my vet. The recovery is so scary at times and you have been a life saver. The reminder about compensation injuries is etched in my brain.
    Is it worth doing moist heat and massage on the “good” leg too?
    Thanks again for all you do.
    Barbara Koskos

  96. Jan, it is totally normal for them to have a set-back like this. I always recommend that people give NSAIDs, Pain meds like tramadol which you did, and strict rest for 3-5 days. If they are back to normal after this then great. If not then I would call your vet and have her rechecked. I can’t even tell you the number of people that contact us when their dogs have these sudden set-backs but 95% of the time they are ok in a few days. Sounds like the meds made a big difference quickly so just rest for a few days and I am sure you will be fine.
    All the best, Dr.J

  97. Our Golden had TTA surgery on 11/11 and is doing really well. Monday evening, we took her out and we’re not sure what happened. She was on the leash but must have stepped on something. She started favoring the injured leg. When she came in she was having visible muscle spasms. We gave her Tramadol, a sedative and anti-inflammatory and put her collar on because she was trying to check the injured leg. She calmed down later in the evening. We did call the vet but they had closed. We have been watching her closely and continuing her daily routine. She is back to “normal” and putting weight on the injured leg with no limping. Is this something that can happen during the recover period? She was in obvious discomfort but seems to be fine now.

    Jan Richardson

  98. Robin this is a tough question. Only you would know really how he is doing. If he is doing well and you always have him on a short leash going up and down the stairs (IN FULL CONTROL) especially speed then try him without the belly support but just be careful.

  99. My male yellow lab Sunny, had TPLO surgery 110113 . I have five steps to my house entrance. Do I still need to support w/ a towel under his belly when he walks up and down the wooden stairs?

  100. Nancy I am just not a fan of letting these dogs RUN until I have PROVEN that they are ready to run, meaning I have tested them with increasing activity levels. ie. They have mastered the slow controlled walk, they have master the consistent jog/trot and I have tested them running on leash. I have a video on called walk/jog/run. This is transition work. As for your description of his sitting style the leg that is getting tucked under is the leg most likely that bothers him the most. YOu have to work on training him to sit properly again. I have this video called puppy squats in the rehab center also. You need to do quick short sitting exercises where you are not allowing him to plop down on the side. Start with only a few and then work up from there. The biggest concern for me always with overactivity in these FHO dogs is that they are compensating not only in the other hip but also the knees and the back and you really want to do everything in your power to make sure that they don’t get some compensating injury. Full recovery takes a good 6 months so you still have time.

  101. Doctor I’m fostering a GSD (approx 1 yrs) that was rescued from the e-list at our local pound. He has horrible hips & had an FHO on 10/15. He didn’t start any therapy until I brought him home approx. 2 wks ago & have been trying to play catch up to wk. 4. Great progress has been made but I am worried that I’m letting him get too active. He is currently taking Glucosamine, Tramadol, Gabapentin & soon Rimadyl to control pain for other hip, which will need FHO surgery too. I know you have stated the next 4 wks. are potentially problem wks. This little guy is able to run some now but should I be allowing this? It doesn’t seem to bother his FHO hip…he can walk long distances but has trouble standing for any length of time, will sit & then plop down on his side. Not sure if this is just a habit he developed as youngster or just has no strength to stand. I’ve started slow walking up inclines, figure 8’s and stepping up on 6″ box moving head side to side. He is doing wonderful but am I going too fast? It appears his thigh is developing some muscle mass now & has increased by about 1/2-3/4″ in 2 wks. What potential problems can happen w/an FHO during the next 4 wks.? Thank you so much for providing all of us w/much needed instructions for therapy.

  102. You are sincerely welcome Jeanne. It is my pleasure. I just like to think we are improving lives in our own little way, one dog at a time. :)

  103. Thank you Dr. St. Clair,
    You have no idea what a lifeline you have been for Brody and me! We so appreciate all your help. I’ve been following your advice to the letter and will see if bringing out the ball on our walks perks up my best friend with a low key game of catch. I’ve been very careful with him, since I wouldn’t want to see him have to go through this again because I rushed him before he was ready. I love him so much, it doesn’t matter to me how long or hard I have to work to get him well – just so he gets there eventually.
    Thank you again for all you are doing to help the process. Jeanne

  104. Obviously because she is not my patient and I can not see her, I really can not comment on whether it is something to worry about or not. That said…tweeks or set back are common and my recommendation to my clients is always if your dog has a slight set-back then give anti-inflammatories for 3-5 days and strict rest. If you dog does not return to where they were prior to the set-back then it is best to pay a visit to your veterinarian to have her checked out. Hope everything turns out ok.

  105. Penny I responded to your email to me but I am just going to comment here for the benefit of the community. The rule of thumb is that if your dog has been on a joint supplement and you have recently switched to GlycanAid HA then I would just start and stick with the maintenance dose. If your dog has not been on a joint supplement before then it is best if you can do the loading dose for 4 weeks. In your case I think it is a good idea to split the dosage because occasionally but very rarely glucosamine can cause and upset tummy. We use a vegetarian sources glucosamine which seems to be very very well tolerated. Best of luck.

  106. Jeanne, you are so very welcome. It is incredible to hear that we are positively helping you and Brody. I love it. So I totally understand the point at which you are at now. He is feeling better, the pain is subsiding and he is ready to GOOOO!…but…this is when the most set-backs occur because not only are the dogs ready to go but we the care givers start to get a little tired of the restriction process. I would just say stick with it for a few more weeks. That said you can and need to challenge him for what he is capable of doing. ie. If you are taking him for 15 minute walks and he can stand more then by all means you can SLOWLY put the limits….starting with 20 min and then 25 min. You can also bring the ball out and play with him BUT he just can not run or be off leash. Maybe you just play short range catch with him still on the leash. Be creative but most important BE CONSERVATIVE. As for Dasuquin with MSM vs. GlycanAid HA….both are exceptional products but they are very different in many respects. The key difference is that GlycanAid HA has the 25mg of hyaluronic acid which improves joint fluid viscosity which we have found to be very important in the comfort equation. Again both are the best of the best on the market so either one is great.

  107. My Siberian is at wk 4 post TPLO SURGERY & I noticed that she has a different walk & seems very uncomfy for 2 days. I keep her calm & relaxed & on a leash at all times. She seems better today & not in so much discomfort but… Not liking this little twerk/tweek her surgery leg does & occasionally she holds it up. She has been watched & we have been very struck on her due to having hardwood floors thru most of the house, it scares me… I feel it’s her hip vs the place where surgery was done. She also wears a harness to help assist going out to do her business & lifting her in/out of the car. Do you feel I have anything to worry about? She has a slight limp also… Husband & I were just saying how nice she looked walking straight again & then she was laying by my feet & when she got up… This was the result.

  108. Just started my Siberian on GlycanAid HA Factor. Giving 2 tablets. Should I be giving her 4 for the first month? Also… If she is suppose to have 4…. All at once or should I split it up AM & PM… Thank you for your help Dr.

  109. Dear Dr. StClair,
    I want to thank you for the invaluable information you are providing. I was pretty scared when I left the Veterinarian’s office following my beautiful lab’s ACL surgery without much information on how to care for him in his recovery. Today marks week four and, true to your word, you’ve been there every step of the way.
    I am an older person who adopted Brody from the local SPCA when he was 9 months old. I cannot thank you enough for all your wonderful help.

    Brody is getting pretty bored with the daily walks around the yard and I was wondering if you have any suggestions as to what I can do to help him not be so bored? He’s just a young guy (will be 2 on Nov. 1) and he was used to playing ball, frisbee etc and now he has to be pretty quiet. Also, I wanted to ask about your GlycanAid, he’s on Dasuquin with MSM at the present time would it be better for him if I switched him over when I run out of the Dasuquin? I just want to do what’s best for him.

    Thank You.

  110. Dee I hope this works out for you. Make sure you focus on protecting the other leg. This is his life-line now.

  111. Alfie is at week 4 after 2 restarts. The first week we didn’t know he had torn his ACL so after 1 week he reinjured. Then 2 weeks in Alfie bolted from the pen and reinjured. So… now we are at week 4 finally after restarting and seeing improvement. And as you said I’m noticing Alfie is beginning to feel like his old self. I will be very careful since I don’t want him to start over. This is all without surgery and I am seeing improvement and hope Alfie can prove my vet wrong in suggesting surgery was the only alternative. I enjoy your posts and they are great reminders. Thank you.

  112. You see how difficult it gets the better they start feeling. You can only do the best you can do. Just make sure when you are getting her out to have a leash in hand and block the front of the door when you open it. I hope that she is fine. You made it safely to 4 weeks just keep doing the great job that you have been …:)

  113. Please help my boxer just took off running through my house today. Thursday will be week 4 i was scared like I opened her crate and she took off running down the hallway how do I stop this its not making me feel any better that ibhave to crate her so much

  114. Mary the short answer to this is absolutely. Supplementing these core ingredients can never be a bad think and definitely justified in a very active agility dog. I would just stick with GlycanAid Maintenance and at a maintenance dose and this would be a great choice.

  115. I have a dog that is starting week 5 post TPLO surgery. He just turned 8 and is on Glycan-Aid. He’s been x-rayed head to toe and doesn’t have any other joint issues or signs of arthritis, but I plan to continue with joint supplements even after he recovers from his CCL tear. I have another dog that turned 3 in April. Though he has never had radiographs, he appears to have healthy joints, as he is very athletic and can jump twice his height (I’ve seen it). My question is would there be any benefit to starting him on a joint supplement at his age, if he does not appear to have any problems, in hopes of preventing issues/injuries in the future? Both dogs compete in agility. Obviously, my TPLO dog is not at the moment, but we hope to return at some level in the future. I’d like to do whatever I can to give my young dog a healthy and long career in agility, and in general. So, I was wondering if starting him on joint supplements now would be beneficial to him in the long term, and if so, what would you recommend?


  116. Brenda If he is holding the leg up and still now using it …and the surgery was back on May 23rd. then something is not right. THere is not doubt that behavior habits can be a part of the equations but I would encourage you to have him sedated and rechecked for the knee stability. If the knee is good and stable then pain management and the right exercises will be enough to get him back to normal. No doubt the process is long (i.e.. a good 6 months)….But in your case you NEED to make sure the knee is stable.

  117. Dear Doctor,

    I have a 9 year old Airedale, his name is Theodore. On May 6, 2013, he started holding up his left hind leg, did that for a couple of weeks then took him to the vet and had ACL surgery on May 23rd. Then the 2nd-3rd week into June he wasn’t doing well, took back to vet and he had re-injured his leg. I think he is doing pretty well now, however, he will not walk on his leg and very rarely touches it to the ground. However, he will scratch with it and sometimes runs on it (I know that’s a bad thing). Surgery is holding up just fine. I really think it has become a habit and he remembers that it hurt in the past to walk on. Any suggestions?

    Thanks Brenda

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