Week 9 Rehab Instructions: Off Leash?

37 Comments

1. Jane, thanks for reaching out. It is not uncommon that some glucosamine will cause soft stools in dogs. To reduce this from happening we use a 100% vegetarian sourced glucosamine made here in the USA call regenasure. In fact all of our ingredients are all top shelf USA ingredients which sets us apart aside from our great formulation. In addition we make things easy for everyone who wants to try our product with our 100% guarantee, which states that if at any point you don’t think GlycanAid HA is the best supplement for your dog then all you have to do is give us a call and we will refund you 100%. We only want dogs who benefit from the product to use it, it is as simple as that. Hope this answers your question. All the best, Dr.J

2. Samantha this is a critical time when they are just starting to feel better and then want to return to their normal activity but the reality is…they shouldn’t at all. That is when problems occur. You absolutely should be taking him on controlled leash walks on a regular basis. I would strongly encourage you to head over to our online rehab center and their is a video about measuring your dogs muscles. If you feel the muscle on both hind legs at the same time, even 9 weeks out I am sure that you will appreciate the surgery leg muscles are much smaller. In my world this is the easiest way to know when he will be ready to return to normal activities. The risk of doing to much to soon is that he will injure his other good leg because of over-compensation and this would be horrible. Hope this helps answer you question. All the best, Dr.J

3. My dog just had surgery for tplo and a meniscus tear. My vet recommended glycoflex 3 but it has caused my dog to have a soft stool. Would your product give the same results? I have used your guide to rehab the dog and am so happy with your resources.

   Thanks,
   Jane

4. Hi Dr J,…our 4 year old Maltese is 9 weeks post op but is very behind with regards to your rehab program (due to many complications with the incision and being taken back in for more surgery twice) however we are pleased to see that he is finally and consistently walking on his surgery leg. My problem is that although we have put obstackes on the sofa ( which used to be his sleeping place) to stop him jumping up there , every morning for the past 4 days we have come downstairs to find he has negotiated these obstacles and jumped up onto the sofa to sleep. Luckily this does not seem to have effected his use of the leg but I am worried that he has done damage. I know you said no jumping so my question is should I be making him rest instead of the usual walking and swimming? Also at what stage would you say we should allow him to jump up onto the sofa? I think we have finally made the sofa max proof! But I know he is desperate get up there again!

5. Vanessa it is true that it is going to usually take and older dog a bit longer for bone healing. That said you should be so grateful that he is doing really well 9 weeks out. On top of that I would focus on really a “total healed” date 6 months out from surgery because your goal is to have rebuild the surgeries legs muscle so that it is proportional to the non-surgery leg. We want to make sure this is the case so that we reduce the risk of tearing the other hind leg ACL. No doubt Dr. Rob is a great veterinarian. Keep up the good work and be patient :)

6. Hi Dr James,
   Your information is so very helpful My 10 year old standard Poodle Charlie had TTA surgery on his left back leg 9 weeks ago is walking well and seems to be in no pain following your instructions carefully had is 8 week xray and vet said his bone has not grown back as much as should, said that was because he is an older dog and will need another 4 weeks on lead is this normal for 10 year old dog.
   Thank you for your email with link to vet in Australia with bioflexa am waiting eagerly to receive some as Charlie has spondolosis in his spine as well as arthritis in his knee

7. Tim did we get this to you. If not please give us a call at 888-504-2220 and we will set this straight. All the best, Dr.J

8. Chris the answer is YES YES YES. You have to get her to MASTER that slow controlled walk and then once she has you can slowly begin to CHALLENGE her and increase the speed to a fast walk…then a slow trot…then a fast trot and then running. You need to master each stage before moving on to the next.

9. I am getting low on the GlycanAid and thought I had signed up for the auto delivery.Maybe its on the way.Please let me know Tim Sisler

10. We are on week 9 after FHO surgery. My 20 pound Mini Aussie is doing really well but often picks up the back leg when walking. If I slow down she seems to then properly place the leg. Do I just need to slow down when I see her go to lift?

11. Deb of course I can not counter the advice that your veterinarian gives you, who has both a personal relationship with your dog and you, yet what I can offer is just my overall general theory when it comes to achieving a full recovery. From my perspective it is about the big picture…the long haul and the end result. What I mean by that is from experience FULL recovery most of the time takes upwards of 6 months. How I gauge full recovery is once the dog has full bone healing with remodeling in conjunction with full return of muscle strength and mass (ie. the muscle on the surgery leg is equal to the other hind leg muscle. That being said I am always in favor of a slow conservative approach to recovery. If your dog is telling you that 20 minutes is all that they can tolerate then I would listen to your dog. Let 20 minutes be your baseline and over time slow try to increase that duration of exercise ie. 25 min then 30 min then 35 min etc. If after walking in the water, say for 10 min your dog is more pronounced lame then do push them harder..set this as your baseline for this exercise and slowly try to increase over time. From the sound of it you are doing fine, your dog may just need more time, also considering that his hips are bad. Lastly of course if you have not already gotten him started on a really powerful joint supplement like GlycanAid HA then I would encourage you to do so, to compliment your efforts. Hope this helps and best of luck. Dr.J

12. Jeri this is common practice to check the stability of the knee several weeks after surgery. There is no harm in doing this. Best of luck with your dogs full recovery. Dr.J

13. Hi Dr James,
    Can’t thank you enough for your service, you helped us around week 4 after TPLO surgery and now I’m needing your advice again! Morley, our 4 year old Newfoundland, had his 8 week X-rays last week. We thought he was doing quite well as he has been weight bearing, walking, doing the curb and weave pole exercises quite well. We weren’t real successful with the sit stand exercise due to his bad hips, so you suggested half sits which he tolerates:). However, the X-rays showed a fracture in the fibula bone that must have happened not long after surgery due to the amount of calcification. Vet also said it hadn’t healed as well as it should have. What have we done wrong re healing? Vet wants me to increase the length of his walks to 40 minutes, but Morley struggles with 20 mins! We try for 20 mins twice a day, but sometimes it doesn’t happen. When I don’t judge it right, he will plop himself down on the footpath and it is hard to get 65kg of dog up when he doesn’t want to:). We take him to the beach and he wades in the water chest high (this was suggested by his surgeon to help increase his muscle mass), and his limp is more pronounced after that. Your advice will be greatly appreciated.

14. Hello Dr. StClair – thank you so much for your valued rehab instructions. My 6 year old female Golden Retriever Sunrised had MRIT surgery on her left rear leg on 11/11 and my vet wants to recheck the “drawer movement” on 12/22 – I’m concerned that this forced movement may dislodge scar tissue and disrupt the healing process. What do you think? Thanks again, Jeri Feltner, Plymouth MI

15. Paula I apologize for the delay..I was having problems with my log-in for a while. I hope everything is ok by now. It is not uncommon for a slight set back such as this to happened even months out of an ACL surgery. What I tell all my clients is to give them an anti-inflammatory for 3-5 days with strict rest and if the dog is not back to normal after this time…then please bring the dog in for a check up. Again, sorry for the delay and hope she is well now.

16. John it is not uncommon for them while at rest to shift their weight off of the hind leg….yet use it well while walking. That being said…if she was not doing this before and now all of a sudden she is doing this what I recommend is calling your veterinarian and having her checked out. It is also not uncommon for them to have slight set backs along the way and in these situations I recommend that my clients use an anti-inflammatory and strict rest for 3-5 days. If the dog is not back to where they were previously then it is best to have it checked out. Sorry for the delay John I was having problems with my log-in for a while but now we are back up and running. Hope all is well.

17. My dog had extracap ACL surgery (back leg) on May 8th. She had been doing well until two days ago. The door bell rang and she ran to the door and tried to look out the window (standing on her hind legs) Now she is limping and not toe touching much. I’m just sick. I have gone back to keeping her in her crate. Is there anything else I can do? We are skipping the walks at this time.

18. My 11 year old female Australian Shepherd is starting her week 9 post ACL surgery rehab. She has been on GlycanAid-HA since the week prior to her surgery and we have followed the your rehab from 1 day. We started hydrotherapy 4 weeks pre-surgery and picked it up again 3-4 weeks post surgery. I noticed this week that she is allowing her surgical right hind leg to rest stretched out further back than the left leg and not much pressure on the all the pads while stand still. When she walks she has has the leg and foot with what seems to be equal pressure as the non-surgical leg. Like I said, this started this week. Should I be concerned? Thanks again for the guidance and detailed rehab program!

19. I think the treadmill is great as long as you have a harness on her and you guys can control her. We use this all the time.

20. …oh, she also had tibial crest repositionning with pins and wire…. Same vet did other leg 4 years ago and (knock on wood) did great!

21. Thanks for the thoughtful reply on week 8! Because spring season here means ice fields while the snow banks melt (and re-freeze overnight), we prefer to treadmill our dogs (all under 30lbs). Now my wife fears that Peppercorn might slip off the rolling belt and hurt herself (luxating Patella repair) and fitness freaks will explain why treadmilling is different from running on the street. So do you think treadmill is good or risky?

22. Lara, no doubt set-backs happen and the reason for these can be so many potential things. If this was a patellar tendonitis secondary to the TTA surgery then I would say, yes that is more common. your best bet would be to find a canine rehab facility in your area and have a professional rehab specialist work on him. There are a number of modalities from ultrasound to cold laser to certain exercise that can be performed to help resolve this. As for where to start with therapy…just remember that full recovery takes a full 6months so you have plenty of time. You would not want to do anything to worsen this condition so it is best to get this resolved. On the home page of https://www.topdoghealth.com we have a link to our directory of all the canine rehab facilities in the continental US.

23. Hi Dr.

    Thank you again so much for your service. It’s really wonderful. My dog is 8.5 weeks post tplo (7 yr, 80 lbs). Things were progressing nicely until about 7 weeks, when I noticed she was limpier. We just got her 8 week xray and the doc said it was fully healed and nicely advanced for the short time. However, he too saw he gait and noted that her patellar tendon was inflamed and said that was likely the cause for her mild regression. I have tried to keep her on reduced activity for the past few days, but haven’t noticed any changes. She had a bit of an upset stomach issue, so she unfortunately hasn’t been able to have medicine in 2 weeks. I’m waiting for that to settle to resume medication and hope that will make the difference. Is this something to be concerned about? The doc said it happened a lot and generally resolves with time, but how much time are we talking? She hasn’t had any pt exercises for almost a week, and I’m confused about whether to resume these given her limp is still more pronounced then it used to be (it was never totally gone, and she was not yet fully weight bearing when standing, but it was nearly imperceptible when she walked, and she was certainly trying to run more (which I made sure to contain). I’m just feeling deflated and don’t know how many e xcercises to do that don’t aggrevate the tendon. Are there specific excercises that would help for this? She also has pretty significant hip dysplasia, so am wondering if that impacts her healing here. I would love any of your thoughts. Thank you!!

24. Beth the reality is the only way to know whether or not they need the pain medications is to test them off of them. If there is a change and they are not doing as well, then obviously then still need the medications. For my patients with FHO I use the medications until they are walking near 100% on the surgery leg and then I start to test them off the medications. Hope this helps and sounds like you are doing an amazing job. :)

25. Our 6 yr old lab, Granite, is now 9 weeks out of FHO surgery and doing extremely well..She is about 50 % rebuilt muscle on her surgery leg. We are leash walking about 2 miles per day on hills, obstacles and very little flat ground. We live in the foothills at 3,000 ft in California..Granite is now on a long leash and is allowed short jogs, we call it lab trots, on each walk..she is doing well and stamina is building..my question is this: Do we need to continue Meloxicam and Tramidol on a daily basis? She gets 1/2 of a 7.5 Meloicam every AM and 1/2 a Tramidol every evening..She is putting full weight on the surgery leg and very seldom limps or hops..just wanted your opinion on this.we are very pleased with her progress and she seems to be too! Thanks..Beth/Bob Dougall

26. Larry it totally depends on how she is doing. If she is walking really well on the leg and you have tested her at some increased speeds and she is doing well with that, then yes that would be fine. I just always aire on the conservative side. It takes a full 6 months to get back to 100% so just keep that in mind.

27. Bailey is doing great, but has never been a big walker. I take her for 1/2 mile everyday and swimming twice a week. Is it ok to let her play a little on a long leash?

28. You are very welcome Dolores. :)

29. Thank you. It a relief to know I can turn somewhere and get my questions answered. Thenk you again for your support.

30. Absolutely…Dorlores…you continue with all the exercise until your dog is back to 100%. Exercise, Exercise, Exercise….of course in a very controlled fashion.

31. I was just wondering if I’m suppose to keep up the “puppy squats”, figure 8’s, weave poles and curb work, also.
    Thank you for your support.

32. Debbie you just have to start slow with the figure 8s and work up to increased repetitions, greater speed and tighter turns. As for the joint supplement I did do some research on the product. I am will never bad mouth another product but I have written a lot on the topic of joint supplements and the importance of quality ingredients and also being an informed and smart consumer. Don’t ever just blindly believe what others tell you, research yourself and understand. So here is what I think. This supplement that you mentions Active ingredients is CISSUS QUADRANGULARIS which is primarily touted as and antioxidant/anti-inflammatory. There is very very limited research available to it efficacy or effectiveness. Does it work? Maybe but I personally have not tried it. But the reality is that if we are going to provide complete/comprehensive joint health support than just using a natural anti-inflammatory alone is not the right course. That being said I also am a big snob when it comes to ingredient quality. I want to know where the ingredient is coming from and if it is pure.

    As for TopDog’s joint supplement GlycanAid-HA…yes it is promising and yes it is slightly more expensive, but quality comes at a price. If we had large scale distribution across the entire US then it would be possible based on the economies of scale for us to bring the cost down. At this point we don’t but maybe as we continue to prove ourselves as we have in the last 3 years..anything is possible. But our focus right now is on you and improving your dogs life. GlycanAid-HA is a very comprehensive joint health solutions incorporating all USA ingredients and only the top shelf ones at that. ;)

    We want you to do what you feel most comfortable with. If you want to try GlycanAid HA then great…if not right now then that is fine as well. I only ask that you be a smart consumer for your dog and find and support companies whom make truly quality products that make sense and treat the dog holistically.

    All the best, Dr.J

33. Thanks so much for responding to my many questions! You asked about whether Maxx has had hip xrays, and he has. It was done when they x-rayed his leg and confirmed the ACL was torn. I was told that his hips and other leg all looked good.
    We are now walking 1 mile once a day, and a shorter route which is more uphill also once a day. I am also trying to do some curb walking with him, and have tried some figure 8’s – he doesn’t like those!
    He has been taking a daily glucosamine pill for awhile. I am also looking into better options – my vet suggests Dasuquin, and I know many use Cosequin. I’ve also heard of another option, VG750 (http://www.nutra-9.com/Joint-Care-Management/VG750.html). Your recommendation also looks very promising, but it is costly. I do want to learn more about it.
    Thanks so much for your help!I look forward to learning more about this as I help Maxx with his recovery.

34. Debbie, you have a lot going on in this email so I am going to try to address on thing at a time. To start, much on my push for conservative recovery is based on the statistics of how many dogs tear there opposite hind leg ACL with-in a one year period of time. (up to 50-60% in some reports, others say 30%…either way it is a lot and I want to avoid this at all costs..not only is the surgery expensive but the injury is expensive to your dogs health). That being said I tell people FULL recovery takes upwards of 6 months..and I generally base this on the balance of thigh muscle size in the hind legs….they should be 100% the same before the dog is READY to RUN FREE.

    The bunny hopping that you describe that he has displayed since pup hood bothers me in a big way. Did they take X-Rays of his hips prior to surgery or has he had these X-rays done in the past? This is a commonly a clinical sign of hip problems in dogs and I would want to know moving forward whether or not he has hip issues or not.

    As for the trot to run transition goes…you need to test and train him how to do this. I have a simple video on https://www.topdoghealth.com/rehabcenter that discuss the jog-trot-run transition. You should watch this.

    The last thing I would tell you is that hands down your dog needs to be on a really good joint supplement moving forward. This is not just a use during recovery thing..this is a lifetime thing. I would strongly encourage you to read the reviews on amazon.com for top dogs joint supplement GlycanAid-HA. To date there are over 220 …5 star reviews. If you are already using a joint supplement just make sure that it is a good one. Providing the optimal ingredients to the joints as you move forward in his recovery and life is critical to the long term health of the joints.

    Hope I answered all of your question and if you have more feel free to post again.

    All the best, Dr.J

35. Hi –
    My 9 year old beagle had MRIT surgery on August 19. Unfortunately, I was not given much instruction other than on leash for 16 weeks, with gradual increase of activity; and the no stairs, no jumping, no running.

    I wish I had seen this weeks ago – it would have been so helpful to me!
    Maxx seems to be doing very well – but I’m not sure how far we should be walking – I walk him twice a day, but only for about 2/3 mile each way. Some of it is uphill. We also walk around the yard – a lot! Being a beagle he wants to sniff everything! He walks very well and at a good rate – like a trot. At what point should he be putting full weight on his leg without favoring it? He really wants to get out there and run, but I do notice that even when he tries on leash to run a bit, he will usually favor his injured leg and lift it to run a few steps. Is that because it still hurts, or from habit?
    I know he should be back to full activity by 16 weeks, but I’m not quite sure how to know if he’s ready and has done enough therapy.
    Thanks so much for any info you can give me!
    FYI – Maxx is the kind of pup that often goes up or down stairs like a bunny – hopping rather than walking. Does that effect anything?

    Debbie

36. Great question Jay. I always say that you have to MASTER what they can do and are good at, while you continually are pushing the limits with speed and duration. I would continue to just focus on master the fast walk if she is doing well with this and increase the duration of the walk. Every once in a while you then try to introduce a slow jog. At 9 weeks you are still early, remembering that 6 months is the time for FULL recovery. Sounds to me like you are going a great job though and really THINKING.

37. just another quick question as i know we have asked a few. Daisy is doing better and getting stronger now in week 9. She still is not there yet with putting full weight on her leg or at least consistently anyways. is it ok that at this point jogging is not feasible? She walks fast but if she moves to a jog she lifts it up as she is not comfortable yet. just making sure that is ok at this point. We started some stairs today and that is going well- she eve leads with the recovering leg. Hoping jogging will be possible soon. Thanks as always for your input!