Welcome to the Recovery Center.
What can I do here?
The stories you'll find on this site detail the experiences of several different breeds of dogs, a variety of cruciate repair methods, a wide range of post-surgery rehabilitation instructions and varying outcomes. Yet there's one thing every one of us has in common: Having to confine an active dog for at least several weeks post-surgery. This area of the site is designed to address some specific issues regarding the recovery period. The dog owners I talk to all have the same concerns: Do I need to crate my dog? Should I use sedatives? Can we do stairs? Is it OK for my dog to walk in the yard if he's on a leash? How are we going to get through weeks of confinement? Won't my dog go crazy?
I can't answer those questions with finality -- I'm not a vet or a surgeon. Even among vets and surgeons you'll find degrees of differences with respect to the dog's post-surgical activity. What I'd like to do here is provide an overview of the recovery environment, and then you can get a feel for whether your vet is more permissive or conservative when it comes to recovery. Because this site is primarily for TPLO dogs, that's the specific kind of recovery we'll focus on, but many of the principles and suggestions will apply to dogs recovering from any kind of surgical procedure.
When you read the experiences of others on this site, you'll notice that some have used sedatives during their dog's recovery. This is a somewhat controversial issue. Personally, I believe sedatives may be appropriate for some dogs during their confinement period, but I fear that far too often people may use medication as a substitute for confinement. If you believe your dog needs to be sedated to keep it from running around the house, then you are not following your rehabilitation instructions.
My second concern is that people may use medication as a substitute for interacting with their dogs. It's boring to lie around in a pen all day, granted. But you'd be surprised how adaptable dogs are. I was astonished how well Kodi adjusted from high activity to no-activity. Of course, it helps if you engage them with patting, massage, grooming, games (see the Recovery Games page), training, etc. (yes, this requires a lot of effort on your part).
Now, with that said, I realize that I own Bernese, not exactly the world's most active dogs. It's easy for me to dismiss sedatives if I have a lazy, lay-around dog. The thing is, I don't. I have two extremely active, agile Bernese (that's how we got into this cruciate mess in the first place!). Their energy level is considerably higher than is typical of the breed (probably a function of their raw diet).
It is certainly difficult keeping a dog both safely confined and mentally engaged and entertained during a long recovery period, but it's do-able, and that's why all too often I fear sedatives are more an easy way out for the owner than of any real value to the dog. Ultimately, however, the dog's safety is paramount, and if the owner is not able to responsibly manage his activity, or if the dog is an escape artist or truly hyperactive, then sedatives may save them both the pain and expense of a repair due to inappropriate activity. I would hope the surgeons out there are evaluating each case and suggesting the use of sedatives only where they find it necessary for the dog's safety, not as a matter of course.
Rehabilitation links on this site:
What is an x-pen? Short for "exercise pen," an x-pen is a series of linked metal panels that form a circle, like a big playpen. Depending on the size of your dog and your x-pen (and how you set it up), the interior of the pen may be very small, almost like a crate, or quite large. That's the beauty of it -- you can shrink and expand the space available to your dog as necessary. For example, if we were home to watch Kodi, we could set up the pen so that he had access to most of the living room, but not the couch or our other dog Maddie. If we left the house he'd get a smaller area with just his dog-bed in it. As he got better and could be given more range, we continued to use the x-pen to keep him separated from Maddie and out of the slippery kitchen, but he had a good-sized area of living room rug to lay in.
There are some dogs, of course, who cannot be safely confined in x-pens. Those who show their dogs in breed or obedience can probably tell you about dogs they've seen "walking" across a show site by pushing the x-pen along with them in it! And unfortunately even the biggest x-pens may not be tall enough to confine a dog that will jump out. If you would like to confine your dog in an x-pen during his recovery, it's extremely important to try one out beforehand! Once the dog has had surgery, do not leave him alone in an x-pen unless you are positive he will not be able to escape.
When I mentioned this to Tufts, where my dog had his two TPLOs, they basically agreed with this assessment. The reason they officially say "no stairs" to TPLO clients is largely a matter of liability -- and you can't blame them. Who wants to try to determine which owners can do stairs responsibly on-lead, slowly, and those who will let the dogs go wild and then blame Tufts when something happens? It's much easier and safer for them to ban stairs for everybody, and I think this is what many vet clinics do.
So if you don't allow your dog to do stairs, you're within the guidelines of most veterinary hospitals and there's no risk to you or your dog. If you do allow your dog to do stairs, you're still within the guidelines set by the Slocum Clinic, and the risk to your dog is minimal. When asked about stairs, here's what I recommend: If you have an alternative to stairs, take it -- we covered our front porch steps (two small ones) with a ramp -- but otherwise don't beat yourself up over it. We nearly went crazy trying to avoid the stairs during most of Kodi's first recovery, until we talked to the Slocum Clinic. They told me they actually heard from someone who fell down a flight of stairs and broke a wrist trying to carry their 85-lb. dog. That's why they're now so emphatic about the stair issue -- avoiding stairs by trying to carry a large dog can result in injury to human and canine alike.
Keep the dog "quiet" for six weeks. No walks for eight weeks. For the first two weeks, the dog may only go out to potty, but then leash walks for short distances are OK. Whew -- how's that for confusing? Since all surgeons who perform TPLOs are licensed to do the procedure by the same clinic, you'd expect less variance in the post-surgery rehab instructions ... but based on the experiences shared on this site, that's not the case.
LENGTH OF CONFINEMENT
It may be that experienced TPLO vets have developed their own beliefs about the best way to handle the recovery period for particular types or breeds of dogs. Perhaps some vets go the conservative route to make sure all the dogs in their care get safely through recovery, even if some dogs who heal more quickly spend longer than necessary being confined. In the end, here's what I think is your best bet:
Handout from the Slocum Clinic, where the TPLO procedure was developed, that explains the rehabilitation process (used once radiographs have confirmed bone healing, typically 6 to 8 weeks post surgery).
Handout from Dallas Veterinary Clinic.
TYPE OF CONFINEMENT
Many people believe -- and are in fact told by their vets -- that the dog must be strictly confined post-surgery. That is, the dog must be in a crate or similar-sized area for 24 hours a day, except when it goes out to potty. After two TPLOs, my personal belief is that a sturdy x-pen and a dose of common sense make a wonderful substitute to the crate.
First off -- it's important to note that the Slocum Clinic, where the TPLO was developed, allows post-TPLO dogs to do stairs. They explained to me that there's nothing about the act of climbing stairs that is in any way dangerous or detrimental to a dog recovering from TPLO, as long as the dog is on lead and isn't running pell-mell up and down. They do suggest a sling to start out (to help prevent the dog's knee from banging against the step), and no more trips up and down each day than necessary, just to minimize the dog's activity and lessen opportunities for error.
STAIRS