TPLO, Medial Luxating Patella, and other orthopedic surgeries – What to Expect
Before the Day of Surgery
It is important that your dog is healthy for anesthesia, surgery and recovery. We ask that a blood test be performed within two weeks of surgery either with your veterinarian or in our hospital the morning surgery. Some patients may require additional diagnostic tests such as urinalysis, x-rays or ultrasound to evaluate organ function. Your veterinarian and our orthopedic surgeon will arrange these tests to be performed prior to surgery.
Please discontinue any non-steroidal anti-inflammatory drugs such as Rimadyl, Previcox, Metacam or Deramaxx 3 days prior to surgery. It is critical that you discontinue any aspirin that your pet may be taking 14 days prior to the surgery day. This will help to minimize unnecessary bleeding during the procedure. If you are concerned that your pet may experience pain by discontinuing these medications, please contact your veterinarian or our hospital for alternative pain medication. Glucosamine, Adequan and omega-3 supplements may be continued without concern. If your dog takes daily medication for other conditions, please contact our hospital for guidance on giving the medication the day of surgery.
You may bathe and give oral or topical flea medications prior to the day of surgery. Your dog will not be allowed to get wet for two weeks after surgery.
All surgery patients must be food-fasted prior to anesthesia to minimize potential complications. Please feed your dog a normal dinner the night before surgery prior to 7:00 PM, no food after that, and then withhold breakfast the day of surgery. Drinking water during the night before surgery, and the morning of surgery is encouraged up until 7:00 AM.
Patients are admitted to the hospital at 8:00 am the day of surgery. A surgical nurse will assist you with the process and answer any questions or concerns you may have. An estimate for services and fees will be provided and payment is required the day of surgery. Please bring any medications your dog is taking, and any information your veterinarian has provided such as medical records or x-rays. Personal items to make your dog more comfortable such as bedding or special toys may be brought the day of surgery.
Surgery and Recovery
Once your dog has been admitted to the hospital they will be evaluated and given pre-anesthetic medications for pain and relaxation until general anesthesia is administered. Under general anesthesia your pet will be prepped for surgery, which includes the placement of an intravenous catheter, shaving the surgical site, and placement of epidural anesthesia. If required, pre-operative x-rays will be obtained for surgical planning. When the procedure is completed your pet will be moved to the recovery area and monitored by a surgical nurse. The surgical nurse or our orthopedic surgeon will contact you and update you on your pet’s progress and confirm your discharge appointment.
Most surgical patients will be discharged the day of surgery to recover at home under your care and where they are most comfortable. A discharge appointment is set up at the time of admission and is typically between 5:00 – 5:30 pm. When you arrive for your discharge appointment, a surgical nurse will explain the printed discharge forms, review medication instructions, and plan follow-up care. You will also be provided with 24 hour emergency hospital contact information should your pet require special care. Some patients are hospitalized overnight in our hospital and discharged the next day, but this needs to be scheduled in advance. In this case your pet is closely monitored by our night nurse who has contact with the on-call veterinarian in the practice.
Please see the attached (below) sample post-operative surgical aftercare sheet for more information regarding aftercare, exercise restriction, prognosis and physical rehabilitation.
We usually see your pet back at the hospital at 2 days post-operatively, again at 2 weeks post-operatively for physical rehabilitation evaluation and suture/staple removal if required, again at 4-6 weeks post-operatively, and a final re-check appointment at 10-12 weeks to evaluate progress and take x-rays to evaluate bone healing. These appointments can be scheduled by the front desk staff or nurses at your convenience. If at any time you have questions or concerns about your pet, please contact us as soon as possible at 707-838-3031.
Physical Rehabilitation Therapy
Just like human orthopedic surgery and post-op physical therapy being coupled together for a successful outcome, orthopedic surgery alone on dogs is also only 50% of the corrective procedure. The physical rehabilitation process is the other 40%-50% needed for a successful outcome. Windsor Animal Hospital highly recommends physical rehabilitation therapy for all post-op orthopedic surgery patients. With a physical rehabilitation therapy program, a patient should:
● Return to function at a faster rate compared to dogs not receiving treatment
● Reduce abnormal scar tissue development
● Improve future use of the surgical leg
● Receive pain management and reduce the need for oral medications
● Receive proper physiological stimulation through controlled activity during the post-operative recovery period
For a more detailed discussion on the benefits of rehabilitation therapy and commonly associated fees or therapies following surgery, please ask to speak to one of our doctors or Kristen Hagler, RVT CCRP CVPP COCM CBW (our credentialed physical rehabilitation veterinary technician practitioner). Kristen has 15 years of experience helping dogs recover from orthopedic surgeries, the very common TPLO surgery, tendon, ligament and muscle injuries. Kristen has worked closely with our veterinary surgeons since 2007.
Rehabilitation therapy is so critical to post-orthopedic healing that most pet insurance companies cover all or a majority of the rehabilitation therapy costs. If you have pet insurance, we recommend you contact that company about covering the post-orthopedic rehabilitation costs prior to the surgery so we can initiate rehabilitation therapy at the most beneficial time for your pet. Typical rehabilitation protocols include:
● Laser therapy: Started as early as 2 days post-op and continued weekly for 10-12 weeks
● Hydrotherapy: Started 4-6 weeks post-op and continued weekly for 6 weeks