Cruciate Surgery – TPLO After Care

TPLO Surgery: Post-Operative Care Guidelines for Dogs

At Pittwater Animal Hospital (PAH), we want your dog to have the best recovery possible following TPLO surgery. This procedure is one of the most effective and widely performed treatments for dogs with ACL (cranial cruciate ligament) injuries. Below are clear and detailed guidelines to support your dog through every stage of their healing journey.

Day of Surgery

While it is possible for your dog to go home on the day of their TPLO surgery, we strongly recommend our capped-fee overnight care at NEVS (Northside Emergency Veterinary Service). This provides your pet with continuous, professional monitoring during the critical first night.

• NEVS Pickup: We arrange patient transport directly from PAH to NEVS.
• Monitoring: Your dog is monitored for pain, bleeding, and any complications throughout the night.
• Pain Management: A nerve block is placed in the surgical leg during surgery. While excellent for pain relief, it can leave the leg temporarily numb and may feel strange to your dog.

Day Two: Discharge and Medications

When your dog goes home the next day, they’ll come with a detailed medication plan. This has been discussed with you by the vet and includes:

• Antibiotic
• Anti-inflammatory and pain reliever
• Opioid pain medication
• Paracetamol
• Anti-anxiety medication

Every dog responds differently. If you notice anything unusual or are concerned at all, please contact PAH.

First 24–48 Hours Post-Surgery

• The effects of anaesthesia may linger for up to 48 hours. Behaviour should gradually return to normal.
• Keep your dog quiet, calm, and indoors. Provide clean bedding to minimise infection risk.
• Only offer small portions of food to avoid stomach upset. Split meals into smaller amounts over a few hours.
• Avoid all exercise apart from brief, on-lead toilet walks. No jumping, running, or play.
• Apply a cold pack or damp towel to the surgery site twice daily for 5–10 minutes, if your dog tolerates it.
• Monitor for swelling. Mild swelling is normal, including near the ankle. Call PAH if swelling increases or if your dog stops eating, drinking, or using the leg.

If you see any swelling, discharge, or problems with the stitches, please call PAH on 9913 7979 or NEVS on 9452 2933 after hours.

Wound Care & Collars

• Do not let your dog lick the wound. This can lead to infection, bleeding, or delayed healing.
• E-collars (Elizabethan collars) are usually essential. Some dogs tolerate doughnut collars better, but only if they completely prevent licking.
• No routine bandaging. Bandages often fall off or cause issues. In rare cases, we may apply a special PAH knee bandage.
• Sticky dressing: This is applied at the end of surgery. If it’s still adhered, leave it on. If peeling, use a little oil to remove it gently.

Feeding & Toileting

• Some dogs may not have a bowel movement for a few days post-op — this is normal.
• Appetite should return within 24–48 hours.
• Decrease food portions during the recovery period to prevent weight gain (many dogs need only 50% of their usual food intake during rest).

Activity Restriction & Recovery (First 3 Weeks)

TPLO surgery involves cutting and repositioning the tibia (shinbone). The surgical implant provides all the stability until the bone heals.

• Keep your dog calm, indoors, and confined. Crates are ideal for small dogs; larger dogs can be tethered indoors to heavy furniture.
• Use a belly sling to support mobility and reduce strain.
• Short leash walks only (5 mins, 2–3x daily). Gradually increase by 1 minute every few days, up to 15 minutes.
• No stairs, furniture access, running, or rough play.
• Use non-slip mats on smooth floors to prevent injury.
• Gentle massage to hind limbs may help if tolerated.

Follow-Up at PAH

• 10-day post-op check: Wound check and suture removal. First Cartrophen (Pentosan Polysulfate) injection given by vet.
• Cartrophen course:
  • Week 2: Nurse injection
  • Week 3: Nurse injection
  • Week 4: Nurse injection
• 6-week post-op x-rays: Sedated morning procedure. Your dog is dropped off at 8am but may be able to go home as early as 9.30am. X-rays are sent to the specialist. Once cleared, gradual exercise can increase.

Rehabilitation Timeline

3 to 6 Weeks Post-Surgery

• Walks up to 15–20 mins if weight-bearing comfortably.
• Begin uphill walking (max 5 mins) and figure-8 walks.
• Start sit-to-stand exercises (5 reps, increasing to 10).
• Keep leash walks slow and controlled.
• Radiographs due at 6 weeks (fasting required).

6 to 8 Weeks Post-Surgery

• Once cleared via x-rays:
  • On-leash walks up to 30 minutes.
  • Introduce controlled trotting, stairs (max 10), zig-zag walking, and obstacle walking.
  • Sit-to-stand (up to 15 reps if tolerated).

8 Weeks to 6 Months Post-Surgery

• Gradually introduce off-leash time — only after leashed walks and under supervision.
• Start with 5 minutes off leash, doubling every 3–4 days if tolerated.
• No jumping or play with other dogs until after 6 months.

Full Recovery (6 Months)

By 6 months, most dogs can return to all normal activities: running, swimming, and play. TPLO is highly successful and most dogs regain excellent function.

However, dogs who tear one cruciate ligament are at higher risk of injuring the other. Dogs who’ve had both knees repaired usually regain full activity.

Rehabilitation Support

We strongly encourage clients to engage with a professional animal physiotherapist. Tailored rehab plans help dogs recover faster and regain strength safely.

Madi at Paddling Paws

Fran at Three Monkeys Rehab

Tim at Both Ends for the Lead

Need Help? If you’re concerned at any point during your dog’s recovery, please contact us on 9913 7979 or call NEVS on 9452 2933 after hours. We’re here to support you and your dog every step of the way.

TPLO Surgery Post-Operative Care FAQ