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

The mechanism for cruciate ligament degeneration prior to rupturing is not clearly understood, but it is clear that certain factors predispose certain dogs to sustaining a cranial cruciate ligament injury. Certain breeds, such as Labradors and Rottweilers (and other large breed dogs), are much more commonly affected than others, as well as dogs that are overweight. This suggests there is an inherited component to the condition, possibly related to conformation or gait and/or the displacement of weight within the stifle (knee) joint. While there is nothing that can be done to prevent CCL injury, by recognizing the symptoms of CCL damage soon after onset you can give your dog a head start with recovery.

What Causes the CCL to Rupture? is a post from: Dog Knee Injury

During the drawer test the veterinarian with stabilize your dog’s femur with one hand while manipulating the tibia with the other. If the tibia moves forward, known as a positive drawer because of the way the bone moves similar to a drawer being opened, the ligament is ruptured. If the rupture occurred some time ago, there will be swelling on the side of the leg that faces the other leg – this phenomenon is known as a medial buttress and is indicative of arthritis. The presence of a medial buttress, coupled with your dog’s state – if they are anxious or tense – can make it difficult to obtain an accurate drawer sign. Tense muscles can act as false stabilization of the knee, preventing demonstration of the drawer sign upon manipulation; sedation is indicated in these cases.

Your pet’s doctor will take the results from the drawer sign test into consideration when determining a treatment plan for your dog. A negative drawer sign does not necessarily mean your canine does not have a cranial cruciate injury, and the only way to be absolutely sure of injury in the absence of a positive drawer is to have an ultrasound performed; unfortunately not many vets offer this service.

Drawer Sign Test and Tibial Compression Exam is a post from: Dog Knee Injury

Canine Cruicate (Knee) Injury Symptoms:

1. Decreased range of motion.
2. Hind leg extended when sitting – this is known as the sit sign.
3. Crepitus – crackling noise of bones rubbing against each other.
4. Pain – when stifle (knee) joint is touched.
5. Unwilling or resistant to exercise.
6. Restricted mobility or extension.
7. Stiffness after exercise.
8. Swelling of joint.
9. Thick, firm feel to knee are, may be hot to touch.
10. Weight shifted to one side of body when standing.
11. Exhibits toe-touching while standing.

There are also a few other conditions with similar symptoms to a cruciate injury, which is why it is important to schedule an appointment to see your veterinarian if your dog is exhibiting any of the symptoms listed above.

Conditions with similar symptoms to cranial cruciate ligament tears/rupture:

1. Acute arthritis – related to lyme disease or immune disorders
2. Stifle (knee) joint sprain
3. Meniscus (cartilage within the knee) injury
   
4. Hip dysplasia
5. Patellar (knee cap) fracture or luxation
6. Myelopathies – diseases of the nervous system

Cranial Cruciate (Knee) Injury Symptoms in Dogs is a post from: Dog Knee Injury