Obtaining and carefully following post-surgery instructions from your veterinarian/surgeon is essential for a positive outcome.
Make sure you ask for a detailed, day-by-day recovery plan. You’d be surprised how often surgeons allow dog parents to go home without them.
You can see an example of a cruciate ligament (ACL/CCL surgery post-op care plan looks like here. There are some differences in the post-op instructions with different surgeries, but the example outlines the basics.
Further reading: Canine Post-op Recovery: Don’t Forget the Physical Therapy
It finally happened. Coco, my 6-yr old part boxer/bull terrier, tore his cruciate ligament on his left knee chasing squirrels in the backyard. The ACL injury, I believed, was also prompted by the wear and tear of his knees from his obsessive running and diving into a pond daily. He would do that for a whole hour non-stop, run along the bank and dive into the water, swim 2-3 lapses, run around and dive in again.
Surgery was inevitable. So why wait? He was seen by the family vet immediately, who helped schedule a consult with a surgeon that same week. The earlier your dog has the surgery, the sooner the recovery can start! It is going to be a long road to recovery.
Coco was young and in great shape. The surgery, though invasive, went very well. He was awake shortly after, and they told me that he was standing and walking around in the afternoon. I was able to bring him home the next day, alert but dazed by the medications. Coco was sent home with Rimadyl and Tramadol for pain and, of course, antibiotics.
NSAIDs, such are Rimadyl, are often prescribed for injuries or post-op recovery. While many dogs benefit from these drugs, they can have serious side effects. Therefore, I advise caution and monitoring your dog closely for any suspicious signs, particularly any changes in drinking and eating habits. When in doubt, discussing alternatives with your surgeon might be a good idea.
Days 1 to 14
The cone of shame
Coco was not too happy with the lampshade that he had to wear. He was offered food in the hospital but refused, so he needed to eat at home. And eat he did! He just didn’t like hospital food.
He flunked the LampShade Test on Day 1. Coco was a licker. As soon as the LS was off, he went for the stitches, so back on it went, and on it stayed for the next two weeks until the stitches were removed.
Your dog mustn’t lick the incision. Twenty minutes of licking can undo two days of healing! However, I don’t blame the poor dogs for hating the “lampshade”! Some alternative products out there now, such as the ProCollar, are worth considering.
Caring for the incision
The incision was about two in. long on the inner side of his left knee. It looked puffy and red, and fluid gathered just below around the ankle. Nevertheless, the boy limped around like a trooper. Oblivion is bliss! I was glad to see that he used that leg gently instead of hopping on three legs. You would want your dog to use that leg right away.
I put an ice pack on the knee for a few minutes 3 to 4 times a day. He didn’t like it that much, but it helped get the swelling down. Nothing drastic happened, but it didn’t hurt either. I also massaged the whole leg gently every day and worked on his Passive Range of Motion (PROM) by moving his leg for him, as shown to me by the vet tech. Again, Coco was outstanding and didn’t complain about it.
He was kept in the living room with a doggy bed and comforters on the floor, separated from my other two dogs. They had supervised visits, but rough play was not allowed. The couch cushions were all lifted so there would be no risk of jumping on and off. Daily 5-10 minute potty breaks on a short leash. That’s pretty much the routine for the first two weeks.
At this point, I would add a suggestion for dog owners. Take a week (or 2) off as vacation. You’ll need it. It lessens the stress off your mind worrying about the care of your dog. Trust me on that. Face it, when your dog tears a cruciate ligament, you are screwed!
Rawhide chew bones, kong toys, etc., help keep the dog entertained while he cannot have any real physical activities. For example, Coco chewed up a brand new doggy bed because he was bored.
If your dog loves car rides, your car can serve as a perfect and practical crate to confine his movement. For example, Coco can sleep in the back of my SUV in the garage for hours and often refuses to come out. (Only in ideal weather, of course.)
Two weeks post-op
Two weeks after surgery, Coco went back to have his stitches removed. He had been using his leg to scratch his chest, itching due to allergy, I was concerned that he might hurt the healing process, but the surgeon took a quick look and ensured me that it was fine.
Coco met with the Canine Rehabilitation Therapist in the same hospital facility that same day. The consultation was included in the surgical procedure, a fantastic idea. The therapist said Coco was progressing very well on his own and did not need special exercises other than the routine ones to promote further muscle strength, which was the ultimate goal of rehab. She suggested an easy workout routine: sit and up, sit and up. It is like doing squats.
Coco was also given a trial run on the hydrotherapy treadmill. He was terrified at first because he didn’t know how it worked. I decided to enroll him in several sessions to speed up his rehab. They told me all dogs were scared until they figured out how it worked. Anyway, Coco does very well now trotting along, starting for 10 mins, then 15, then 20, each session (pic). He now knows what to do, but he gets frustrated for not being able to go anywhere. He would start biting the foam noodles or taking it out on the pool toys. Silly Coco!
Sign up for some rehab sessions if possible. It really is beneficial to rebuilding the body after surgery.
One month post surgery
A month after the surgery, Coco was walking, trotting, and even lunging as if nothing had happened, except he was always on a leash outdoor so he wouldn’t take off. It was beneficial to walk him uphill for exercise at this stage to encourage him to use both hind legs to push forward. Stairs were also a good rehab tool, providing that Coco walked up slowly.
Some observations of his leg at this point: When he stood, he tended to ease on the leg, not putting 100% pressure on it. It would tremble at times. And Coco would lump after a long workout on the treadmill or a long walk. I believe it got sore. It is all part of recovery. I made sure I had some Rimadyl at hand in case he needed to ease the pain.
After his next check-up, everything looked OK, and Coco was allowed to go off-leash in the yard.
I was happy that Coco was recovering so well.
Sadly, as often, Coco’s other ACL failed too, and Coco had to undergo a second surgery.
Coco’s TPLO story is shared with us by @trailerparkdogs. Coco and Goose are badass dudes who luv their anipals. Part-time Doggy D&G for diva dogs and band members of da Shibbering Cheetos @ShibberingC. Those guys rock!
Talk to Me about CCL Injuries
TPLO Rehabilitation Guide