How much will a TPLO surgery for my dog cost?  How much should I expect to spend on a TPLO repair?

TPLO, also known as Tibial Plateau Leveling Osteotomy, is a CCL repair technique through which the veterinary surgeon alters the head of the tibia and plates it to create a new joint angle.  Simply put – your veterinarian will re-invent your dog’s injured knee joint to provide increased stability through changing the way the top and bottom of the leg meet at the knee joint.  This is the most invasive, and requires the most surgical skill, of all the surgical cranial cruciate ligament repair options; it is also the most expensive.  In this article we will break down an actual TPLO cost estimate and explore the cost of choosing this type of CCL repair surgery for your dog.

Below is the estimate I received for my dog to undergo TPLO surgery. 

A few things to note before going into the details of the invoice:

1)  My dog in an American Bulldog weighing roughly 90 pounds (normal weight), and is 5 years old.

2)  He is in good health with no pre-existing conditions that would complicate anesthesia or surgery.

3)  This estimate, although some of the information has been blacked out to protect privacy, is from a speciality veterinary clinic with veterinary surgeons who specialize in cranial cruciate ligament repair surgeries in dogs.

4)  I live in Southern California, and this estimate is from a veterinary office in that area.

Here is the estimate I received for a TPLO CCL repair.  The low end of the estimate was $3,892.79 and the high end of the estimate was $4,03.58 for TPLO surgery.

I will go line by line to go over the charges included in the cost of TPLO surgery.  For smaller animals some of the values will be less, and accordingly for larger dogs.  Hopefully this invoice will give you a basic picture of what you can expect to pay for a TPLO, and where all of the money goes.

EST TPLO Surgery Med/Large – $0 – Just tells us what type of estimate we are looking at.

CBC and Chemistry Profile – $163.80 – Basic blood panel the veterinarian will want to run prior to surgery to determine if you dog is fit to be put under anesthesia and to rule out any other complications.  One way we could have saved money here was to have our dog’s regular vet perform this blood panel at a lower price than to have it done at the speciality clinic.

Radiograph, 2 Views – $224.70 – This is the x-rays that need to be performed prior to the TPLO so the surgeon is able to properly manipulate the tibia during surgery to create the desired angles.  These will need to be performed somewhere prior to TPLO, and some veterinarians will want to do the xrays themselves.

Radiology Interpretation – $45.68 – Fee charged for processing and reading the x-ray.

Catheterization, Intravenous – $94.00 – This fee is for the placement and maintainence of an IV catheter while your dog is undergoing and recovering from TPLO surgery.  Your dog will be given IV fluids and possibly medications through this catheter during the duration of surgery and post operative hospitalization.

Epidural Injection – $86.52 – Local anesthetic (pain relieving medication) will be injected into the lumbosacral (in the spine) space of your dog prior to surgery.  Depending on what types of medication(s) your veterinarian uses this can help to alleviate pain after surgery, and desensitize the effected site during surgery.

Surgery Room Use – $113.82 – Fee for using the Operating Room space to perform the TPLO.

TPLO Inhalant Anesthesia – $306.34 – Cost of putting your dog under gas anesthesia for the time required to perform the TPLO procedure.  This is used in conjunction with the epidural anesthesia.

Surgical Anesthesia Level 1 – $294.00 – Fee for dog to be put under anesthesia and monitored during TPLO surgery.

Surgical Supplies, Orthopedic – $358.05 – Cost for instruments to be used during surgery; this does not include the cost of the actual TPLO implant.

TPLO Surgical Implants, Med/Large – $358.05 – Cost of TPLO implant plates to be placed on the bone during surgery.

TPLO Surgeons Fee – $974.40 – Price veterinary surgeon charges to perform TPLO operation.

Radiograph, Post Op – $192.52 – Cost of x-ray to be taken following surgery to check placement of implant and knee joint angles.

Elective Ortho Hospitalization, General – $138.92 – Cost of overnight hospital stay following TPLO repair surgery.

Fluids – IV, Inital 24 Hours – $0-$190.31 – This would depend on whether or not your dog was being cared for at the hospital post operatively, and how much fluids your pet required.

Misc. Medications, Orthopedic - $450 – This includes prescription medications given to your pet post operatively and those sent home with you during the post operative period.  They would include a sedative (Acepromazine), pain relief (Tramadol), anti inflammatory (Rimadyl), and an antibiotic(Cephalexin), and possibly other medications at your veterinarian’s discretion.

Fentanyl, 75 mcg patch – $65 – Pain relief patch that will be placed in your pet to control post operative discomfort.

Buster Collar, Clear – $25.26 – Collar to be placed on your dog during the post operative period to prevent them from ripping out their stitches or injuring the surgical site.

Included:  X-ray at 8 weeks to check the post operative recovery and  misc. sedative (not sure if this is sedative used during the surgery itself or the sedative medication to take home with you following TPLO surgery).

Also included are all of the post operative recheck visits, but be aware that if you pet develops any complications related to the surgery you will be required to pay for any additional expenses incurred.

What is the Actual Cost of TPLO Surgery? is a post from: Dog Knee Injury

Age is also a risk factor for CCL injury, and there are two types of CCL onset related to a dog’s age when the injury occurs. Chronic onset, degeneration over time with subsequent rupture (usually from aging), occurs in 80% of cases and occurs in dogs 5 to 8 years old. Acute onset, a tear caused by injury, is most common in dogs under 4 years old. Young dogs of large breeds are more susceptible to rupture than young dogs of small breeds. Older dogs are also at greater risk for CCL tears if they already have arthritis and/or have decreasing musculature, especially surrounding the knee joints.

To sum it up, there is no way you can protect your dog from a CCL injury, but there are risk factors which make dogs more likely to sustain a serious cranial cruciate ligament tear or rupture. Large and giant breed dogs do more commonly sustain CCL injury, but this is usually compounded with other risk factors, which are mentioned below.

Risk Factors in Dogs for CCL Damage:

• Age
• Arthritis
• Previous injury to knee joint
• Overweight
• Large or giant breed
• Poor musculature, especially surrounding the joints
• Structural abnormalities – luxated patella, etc.

Are CCL Injuries More Common in Certain Dog Breeds? is a post from: Dog Knee Injury

The menisci are ‘fibrocartilaginous’ structures which can be thought of as spongy elastic pads between the bones at the joint, composed predominately of collagen and open space filled with joint fluid. The menisci contribute significantly to joint lubrication. The fluid of the joint moves through the porous structure of the menisci. Because 70+% of the total weight of menisci is fluid, normal movement causes compression of the menisci which squeezes fluid out from them into the joint space to allow smoother gliding of the joint surfaces. The menisci re-expand when the pressure is reduced, drawing in fluid. This pumping action also helps to distribute synovial fluid throughout the joint and aids in the nutrition of the articular cartilage.

By compressing under a load, the menisci also act as shock absorbers, absorbing energy and reducing the shock to the adjacent cartilage and subchondral bone. The menisci protect the cartilage by acting as buffers between the surfaces of the femur and tibia where they meet and move against each other at the joint. The menisci transmit forces across the knee joint. The menisci provide added mechanical stability to the normal gliding of the femur on the tibia by deepening the surface of the tibial plateau to increase the congruity between the femoral condyles and the tibial plateau.

What is a Meniscus? is a post from: Dog Knee Injury

The cranial cruciate ligament, or CCL, in canines is analogous to anterior cruciate ligament, or ACL, in humans. The CCL is the main supporting ligament within a dog’s knee, or stifle. This ligament bears the weight of a majority of the stifle’s load, which is why instability of the CCL results in lameness, arthritis and other degenerative changes of the knee joint and surrounding tissue. The strength of this ligament will decrease as a dog ages, with larger dogs experiencing an increased rate of degeneration versus smaller breed dogs. Obese dogs are at a higher risk for CCL rupture as obesity places additional stress on the ligament. Ruptures of the cranial cruciate are the most common orthopedic injury for dogs and the leading cause for arthritic tissue in the stifle.

The cranial cruciate ligament’s essential function is to prevent forward movement of the tibia relative to the femur. If this forward movement is present the dog is classified as having a positive drawer test, or displaying a positive cranial drawer sign. The caudal cruciate ligament prevents backward displacement of the tibia relative to the femur, which is known as the caudal drawer. The CCL also works to limit hyperextension of the stifle and internal rotation of the tibia during flexion.

Anatomy of the Cranial Cruciate Ligament is a post from: Dog Knee Injury