So My Dog Needs TPLO Surgery. Now What?
This was my first thought when Mack’s vet told my husband and I that he had a torn cranial cruciate ligament (CCL), which is the human equivalent to an ACL, back in November 2019.
While Tibial Plateau Leveling Osteotomy (TPLO) surgery is not the only option available for dogs who have torn their CCL, Mack was a very active, almost two-year old dog who loved getting out for long walks, to sniff the world around him. A TPLO was his best option for his lifestyle.
For those who don’t know what the recovery from a TPLO looks like, it can be daunting once you learn about it for the first time. Anywhere from 8-12 weeks of activity restriction: no hiking, no jumping, no running... basically no fun for the dog!
At the time of Mack’s injury, we were going on multiple walks a day, playing fetch in the backyard, and he was going to daycare a couple of times a week when we had long workdays. All of that had come to a screeching halt.
We met with his surgeon in early December and learned Mack actually has not one, but two torn CCLs. We decided we would do one TPLO and then 6 weeks later, do the second one. The countdown was officially on: he would be getting knee number 1 done the day after Christmas.
Start preparing as early as you can
What stood out the most to me was that he was going to need to wear a cone for 2+ weeks while his incision healed, he would need to be confined to a crate or small pen for a couple of weeks, and he would need help getting in and out of the car.
When we adopted Mack, he had lots of feelings about wearing a collar, harness, jacket, basically anything that touched him. It took lots of positive reinforcement and desensitizing to teach Mack that putting on his collar and harness meant something fun was going to happen.
I knew immediately that we were going to face an uphill battle if he was going to need to wear a cone for any amount of time. He had cut his foot a few months after we adopted him and had to wear a cone for a few hours. He was paralyzed the moment his vet put it on him and shook with fear with it on when we got home. It broke our hearts to see him so stressed out and afraid of plastic around his neck. Making the cone less scary was the first thing we were going to need to tackle!
Desensitizing the cone
Luckily for us, Mack LOVES food. We’ve actually yet to find something he won’t eat. If your dog is not as food motivated as Mack is, you can always use a toy, play, or whatever your dog finds super rewarding.
I started making the cone less scary for Mack by first rewarding him every time he looked at the cone that I put on the ground. Look → treat. Look → treat. Then I upped the ante by waiting until he started to move towards it. From there we progressed at what felt like a snail's pace until he would sniff the cone on the ground, sniff the cone when I was holding it, put his head through the opening for 1 second, put his head through the opening and let me move my hands away, then finally move around the room with the cone on his head. All in all, this probably took us 2-ish weeks to get to the point where he would voluntarily put his head into the cone and I could give him a food puzzle to eat out of.
We went through *a lot* of peanut butter but even all these months later, he’s still completely cool with wearing a cone. In fact, this year I decorated one like McDonald’s french fries for Halloween since I knew he would be more comfortable wearing a cone than an actual costume.
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I decorated one like McDonald’s french fries for Halloween since I knew he would be more comfortable wearing a cone than an actual costume.
Getting used to confined spaces
When we first adopted Mack, I was 100% on board with crate training. He panicked the first few times we tried to use it and unfortunately, we gave up on making it a safe and comfortable place for Mack. He has never been destructive when we’ve left him alone so no big deal, right? Hindsight is 20/20.
I didn’t think that we’d be able to successfully get him to a place where he would be OK with being in a crate for nearly 24 hours a day for those first few weeks and after talking to his surgeon, we decided that a small exercise pen would be completely fine, as long as there was nothing he could jump on.
Once we got the pen set up in the room we would be using as his recovery space, we started to make it a fun place to hang out. Mack really enjoys food puzzles, sniffing for food/treats in the recycling, chewing on bully sticks, etc. so we started to do all of these enrichment activities we would normally do around the house in his pen. We also set up his water bowl in there (it was already in his room, just in a different spot) and put an extra dog bed in there. By doing all of this, it became a regular place he would want to hang out and feel comfortable being in.
Changing how to get in and out of vehicles
Mack doesn’t like to be picked up and at nearly 60 pounds, he’s not exactly easy to carry anyway. My husband and I both drive SUVs and this is actually how we began to realize that something may be wrong with Mack—he normally would happily jump into either of our cars but earlier in the fall, started to hesitate before jumping up. He did a really good job hiding his pain for weeks or even months, and this was one of the very few indications that he had torn his CCLs. Towards the last couple of weeks before his surgery, he wouldn’t jump up at all and would very slowly climb up, one leg at a time.
He would growl if we tried to lift him up, so we knew this wasn’t going to work post-surgery and the last thing we wanted to do was add more stress to an already stressful situation. We decided to order a car ramp that he could use to get in and out of our cars more easily, and on his terms.
Like the cone, I decided to introduce the ramp slowly and reward each time he sniffed it, then walked across it while it was laying on the ground, then when he’d walk up it slightly elevated, etc. We ended up running out of time doing a lot of practice using it getting in and out of the car since Mack was limited on what he could do before his surgery and for him, going into the car = fun adventure! We didn’t want to turn going into the car a negative thing by never letting him go anywhere. I made sure to practice using the ramp wearing his cone since that was something that was going to add some complexity to walking up and down the ramp.
Determine what your enrichment plan will be
The last big thing I did was figure out how we would keep a very active dog’s needs met when he wasn’t going to be able to do a whole lot for 12+ weeks. Some of his favorites ended up being:
Frozen Kongs or rubber stuffing toys
Real Dog Box chews
This dog toy (it's one of the cheapest I could find, so if your dog destroys toys like Mack, you won’t feel like you wasted a ton of money when it’s ripped up in 5 minutes)
Pro tip: if you end up doing a lot of food puzzles and chews, just remember that your dog’s activity levels are decreasing and you don’t want to accidentally overfeed them. Your surgeon can advise if you’ll need to cut back his normal food amount at all. We froze a lot of Mack’s meals into his Lickimat and Kongs, and then used some of his remaining kibble in his snuffle mat and the treat dispensing toy. This helped us avoid adding too many extra calories into his diet that he wouldn’t be able to work off.
The big day finally arrived on December 26, 2019 and I felt like we were as prepared as we were going to be.
Tune in again soon to read how we successfully survived 14+ weeks of restricted activity and what life looks like on the other side of two TPLOs.
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We froze a lot of Mack’s meals into his lickimat and kongs, and then used some of his remaining kibble in his snuffle mat and the treat dispensing toy. This helped us avoid adding too many extra calories into his diet that he wouldn’t be able to work off.