The Rehab Protocol
TPLO: General Rehab Protocol
Disclaimer: The information provided on this website is only meant to serve as a guideline for recovery. It is best to seek a local certified canine rehabilitation expert to assist you in your dogs recovery. TopDog Animal Health and Rehabilitation is in no way responsible in any case of injury to your dog.
For More Detailed Instructions and Pictures: Download our 35 page Home Rehabilitation Guide
The first 12 weeks immediately following the tibial plateau leveling osteotomy (TPLO) surgery is a critical time of recovery and rehabilitation. There are certain activities and exercises which are designed to help your dog to regain and develop full use of the affected limb. When done correctly and introduced at the proper time, you will dramatically improve your dogs chances for a safe and successful recovery.
This general TPLO Home Therapy Protocol we are presenting is focused on achieving a safe & sucessful recovery of the affected limb. In addition, we our goal to assist in decreasing pain, improving range of motion and promoting strengthening of the surgery limb while protecting further or future injury to other parts of the body.
The recovery period is indeed a critical time and therefore must be taken very seriously. Though the surgery corrected the structural problem quickly, it is the post-surgical recovery extending over 10-12 weeks that will solidify everything. When not in therapy, whether it is therapy at home or therapy at an established canine rehabilitation center, your dog MUST be kept in STRICT CONFINEMENT. This is only a recommendation to protect them for potential injury.
Remember that like humans, dogs don’t have the same speeds of recovery. Don’t force your dog to do certain exercises especially when it manifests pain or discomfort. Aside from the precautions you will find in this protocol, your Veterinarian is a rich source of advice and information regarding precautionary measures you should take during the rehabilitation phase. Be patient and gentle with your pet.
MUST READ: This information is only meant to serve as a guideline and in no way meant to replace professional therapy performed by a certified canine rehabilitation specialist.
1. Ice Therapy: One of the first things to focus on when you dog gets home is icing. It is also called cryotherapy and should be applied for 10-15 minutes at least 3 times a day. Icing can be an extrememely effective form of anti-inflammatory and also can help to reduce pain.
2. Massage: Another great and every soothing therapy is perform is massage. Do your best to calm your pet and get them used to the rubbing motions of your hand. Start running your hand from the toes of the affected limb and up the leg using less pressure and building it up one day at a time until you are able to apply moderate pressure. At this early phase in the rehab period, do not force any therapy if you notice that your dog is still uncomfortable in any way. Massage is done for 10-15 minutes, 3-4 times per day.
3. Passive Range of Motion (PROM): This procedure is best done after massage when your pet is still lying down on its side and is already calm. The purpose of PROM is to physically simulate the normal range of motions of each joint of the limbs using your hands. PROM is done by slowly extending and flexing the joints starting from the hip down to the knee and ankle. Your other hand should firmly support the leg while performing the procedure. PROM is performed with 10 repetitions, 3-4 times a day.
4. Short and Slow Controlled Leash Walks: During the first week, you can take your dog for a short and slow controlled leash walk in order for them to go outside and go to the bathroom. It is very important to understand that the slower you walk you dog the more likely they are to put weight on the leg. If you deem it necessary, you can put on a support harness such as the our SupportRx:Total Body Harness System which will allow you to fully support the hind-end of your dog. This is often both safer for your dog and safer for you. These walks should not exceed 5 minutes, 3-4 times a day.
1. Moist Heat Application: Ten minutes prior to performing the exercises, apply a commercial moist heat product. Although you can use heating bottles or heating pads, moist heat has been shown to more efficiently penetrate the affected tissues better than dry heat. If you can’t easily find one, you can improvise by wetting a washcloth with warm water. Be careful though that the heat you are applying is just right to the touch and will not cause burns.
2. Massage: 10-15 minutes, 3-4 times a day
3. Passive Range of Motion (PROM): 15-20 repetitions, 3-4 times a day
4. Short Slow Controlled Leash Walks: 5-10 minutes, 3-4 times a day
1. Moist Heat: as needed
2. Massage: as needed
3. PROM: as needed; when you notice that your dog is using his leg when walking, PROM can be discontinued
4. Short Slow Controlled Leash Walks: 15-20 minutes, 3-4 times a day
5. Sit-to-Stand Exercises: These exercises are also known as “puppy squats”. In this activity you encourage your dog to sit down and immediately stand up to encourage extension and flexion of all the joints in the rear legs. This very effective exercise works all of the major hind leg muscles in one simple exercise. Since this is an activity involving obedience, it is best done with a good treat. Though this may seem like a simple exercise, to perform properly it may take time and repetition. You want to make sure that your dog sits perfectly square and does not sit “lazy” ie. fall to one side. In the TopDog Home Rehabilitation Guide you will learn some tricks to making this one of your most powerful exercises.
6. Post-therapy icing: Icing after exercise is never a bad thing.
1. Moist Heat: as needed; if you notice that your dog enjoys the heat, you can do it 1-2 times a day.
2. Massage: as needed
3. PROM: as needed
4. Controlled Leash Walks: increase time
5. Sit-to-Stand Exercises: 10 repetitions, 3-4 times a day
6. Figure 8’s: Simply walk your dog through an imaginary “8” on the ground. Start with a bigger 8 to encourage your dog to regain his balance and at the same time increase muscle strength.
NOTE: If you notice that your dog is limping or is uncomfortable with the increasing number of repetitions of some of the above exercises, you should revert to the previous week’s level of activity until you feel that your dog is able to tolerate the increase in the number of repetitions.
When you notice your dog is using his limb constantly now, Moist Heat, PROM, and Massage are discontinued.
1. Controlled Leash Walks with Hill Work: Let your dog walk slowly up and down an incline. By walking up an incline you are encouraging more weight to be placed on the hind limbs. Again make sure that this is slow and controlled.
2. Sit-to-Stand Exercises: increase repetitions
3. Figure 8’s: increase repetitions
4. Curb work: This type of exercise is best to increase muscle strength, girth and balance as well as improve flexion and extension of the affected limb. This activity is performed by simply stepping up and off a length of curb while walking with your dog.
These are the last few weeks of the recovery period. At this time, most of the exercises and activities are aimed in strengthening the musculoskeletal system of the body to enable your dog to regain full use of his limb.
1. Stair work: It is ONLY AT THIS TIME after TPLO surgery that climbing stairs is allowed. Be sure to provide support to your dog during the first few days by using a belly harness or a towel. Introduce walking up and down slowly starting with 3 stairs and increasing the number of stairs each day depending on the progress of your dog. At this time, it is not advisable to give your dog free access to the stairs. Keep him on a leash at all times and the stairs must be off limits when not doing stair work.
2. Supervised, off-leash or long leash activity: Ask your Veterinarian if it is alright for your dog to have some off-leash time. However, this should be done under strict supervision from you. If your dog loves to jump, chase balls, toys, and run with other dogs, your dog’s better off on a leash at this time.
3. Controlled Leash Walks with Hill work: increase time and repetitions
4. Sit-to-Stand exercise: increase repetitions
5. Figure 8’s: increase repetitions
6. Curb Work: increase repetitions
7. Jogging: Since jogging can increase muscle strength and balance, you can start to incorporate this into your walks.
8. Swimming: With your Veterinarian’s approval, you can take your dog swimming. However, it should be done in a controlled environment, such as in a pool, and under direct supervision. Be sure to be very careful with how your dog enters and exits the water. Never allow your dog to jump into or out of the water. The local canine rehabilitation facility is an excellent place to let your dog swim.