Our 3 1/2 year old yellow lab has had hind lameness after exercise for several months now. We tried rest and anti inflammatory meds for 3 weeks with no results, so finally had her examined and x-rayed.

She was diagnosed with a torn CCL, with some arthritis in her affected knee. It was a very difficult decision to make whether to operate or do conservative management. I spent nights crying about the consequences of both, and finally decided on the TPLO.

She was operated on 2 days ago and we brought her home yesterday. I was amazed that she was doing so well with some slight weight bearing on the affected leg, but was shocked at the swelling and bruising that resulted after the TPLO surgery. She is eating, drinking, peeing and pooping, and we hope that she remains infection free on her road to recovery. I am still on the fence with regards to my choice, but we shall soon see. Lots of friends have had success with TPLO surgeries on their dogs so I hope to have the same results.

Our dog was also part of a clinical trial involving CCL injury and TPLO surgery. She will be followed closely post op with regards to her gait, weight and hydro therapy.

TPLO Ligament Surgery – Taylor is a post from: Dog Knee Injury

Want to know what the best dog knee brace available is?

Don’t be shy… Post on our NEW Dog Knee Injury Forum!

In response to the high volume of comments a lot of the post have been getting, I’ve opened up the forums as a way for dog owners to connect and discuss their dog’s orthopedic issues with one another.

How to post on the Dog Knee Injury Forum:

1) You must register for a user name to post on the forum.

2) After you’ve registered and retrieved your password from your email, log in (I recommend changing the password to something you’ll remember) and start posting!

3) Keep the comments on topic, and be nice. If anyone encounters any issues on the forum please post in the comments on this page/use the contact form, and I will look into it.

CCL Repair Forum for Dogs is a post from: Dog Knee Injury

Ben is doing extremely well at 2 weeks.

Day 2
Ben is feeling much better. On our walk, he actually lifted his good leg and stood on his leg with the surgery to go pee. Never thought I would be excited watching a dog pee, but that was amazing..

Days 3-4
Ben starting walking more and more. I actually caught him a few times standing on his hind legs looking out the window.

Days 5-6
I believe he started walking better than the day before surgery. Also, he is walking and standing normal. It is barely noticeable he is favoring his leg.

Days 7-8
Ben is starting to get his “gait” back. If you every watch a Standard Schnauzer, they kind of glide effortlessly across the room. He is actually getting it back. It has been months since I have seen him walk like that.

Ben is having a reaction to the staples. His incision is starting to swell and become red. The Vet has us come in and she gives him some ointment that will soothe his reaction. The Vet is amazed as to how well he is walking.

Day 10
Ben has his staples removed and his incision looks good after using the ointment.

Day 14
Ben is at the 2 week mark and is doing great. For the most part, Ben is standing and walking normal. However, he does still favor his leg on occasion. Per the Post Op instructions, Ben is walking a 1/4 mile twice a day. Muscle definition in his leg is starting to come back.

As he is getting better, it is getting harder to keep him under control. He wants to play at every chance he can get. He is feeling better than he has felt in months and is showing it!!!

TTA Surgery, 2 Weeks Post Op – Ben is a post from: Dog Knee Injury

Ben’s Story:

Ben is a 4 year old Standard Schnauzer. We believe he suffered a partial tear in his Left CCL in December 2008. We didn’t give CM (Conservative Management) a chance until about July 2009, when he was diagnosed with a CCL tear. Prior to that, it only appeared to be a minor injury. Since July 2009 when we started CM, Ben would start walking and standing normally, but would often suffer set back after set back. I will be the first to admit that most of the set backs were due to my stupidity. I guess it could be argued we never gave CM a chance.

A few weeks ago, we gave up and did some more research. The Vet indicated that he could be healed through CM, but if we wanted him to be the athletic dog he used be, then he would need surgery. Ben was/is my hiking buddy and used to go on 7-8 mile hikes in the Utah Mtns all the time. He could run for hours and hours without taking a break. The Vet believed he would never be able to do that through CM without being down the rest of the day and/or next day. We scheduled him for TTA surgery with an Orthopedic surgeon that is believed to be the best in Utah, if not the best in West. From our research, the TTA surgery appears to be far superior to the TPLO. Dogs tend to be healed within 3-4 months. Also, they tend to be weight bearing on the leg within 24-48 hours. Within 2 weeks, some dogs are pain free.

Ben made it through surgery just fine today. The Orthopedic surgeon called us and indicated to our surprise that Ben had a complete tear in his CCL and the Meniscus was completely torn as well. If I knew he had that much damage, I think we would have scheduled surgery much sooner. The Orthopedic Surgeon did tell us that he does not believe Ben will suffer anymore arthritis than normal because of our delay in scheduling surgery. His joint appeared to be clean with only minor swelling. The surgeon believed his recovery will be just as good as if we scheduled him back in 7/09.

At this point it is anyone’s guess if he would be better or worse with CM. As of now, we have the peace of mind that knowing the end is near. With CM, we never knew when the road would end. I will post updates on Ben’s recovery over the next several weeks.

Day 1 (after TTA surgery)
When I picked Ben up from the Vet, he was completely opposite from what I expected. I expected a dog that looked like he had been to hell and back. Instead, Ben was dragging the Vet tech into the room. As we were talking to the Vet, he sat on his leg that just had surgery. The Vet was impressed with the very little swelling around Ben’s leg. As we walked outside, he was practically dragging me to the car. His spirits are completely high, and looked like he wanted to go play.

As we were getting into the car, I was planning on picking him up and placing him inside the car. Instead, I opened the door and he leaped into the car. He missed and gave me a complete heart attack. I caught him as he was falling to the ground. I expected him to cry out in pain, but he acted like nothing was wrong. Once inside the car, he was jumping from seat to seat like nothing was wrong. Once he was home, he immediately went for his food.

At this point he is just toe touching on the leg with the surgery, but he is getting around fabulous on his 3 legs. About 5 hours later, I took him for his first walk. We walked past a few houses before we turned around. As we got close to home, I noticed he started walking on his leg. He continued to walk on it (with a limp) the rest of the evening!!!!!! It looks like my biggest challenge at this point will be keeping him under control so that he can heal properly.

TTA Surgery and CM – Ben’s Story is a post from: Dog Knee Injury

Potato’s Story:

Potato tore her knee muscle in winter. I had insurance, but because she was limping prior to a minor sprain, they didn’t cover it. I couldn’t stand seeing her limping around anymore so i paid the $3000 for the kind of surgery where they cut the bone so the leg isn’t bowed anymore and so it stabilizes the knee (TPLO). She is doing ok and today is the second day after surgery.

I thought I had sedated her enough, but I left the room for two seconds, and somehow she got off her chair. I was going to let her sit in it with my help but now that is off limits. Then today, I left her in my bedroom with her cone on, I thought she wouldn’t be able to get on the bed…but when i got home she was on it. I have no idea how.

The most important thing I have learned from this is…THEY WILL DO WHAT YOU DON’T WANT THEM TO DO. She doesn’t understand that these two attempts could have easily ruined her newly operated knee, and me underestimating her also almost wasted that $3000. I’ve learned that i can’t leave her for one second, and that she is going to have to be crated. She really scared me.

Also, her ankle is a little swollen, but thanks to this web site i might not have to pay another $200 to see what it is. One of your contributors said that their dog had just fluids trapped there and that massage and ice helped with them. I called the vet, and they are calling the specialist who did the surgery for me and recommended heat. If it continues past the weekend I will go back to the vet, but this website helped me with the initial panic.

Thank you so much!

TPLO, 2 Days Post Op – Potato is a post from: Dog Knee Injury

It has been 1 week since Tim’s TTA surgery, and she is now starting to get very playful. It’s going to be difficult to keep her quiet. Her surgical line from the TTA is beautiful, bruising and swelling are completely gone.

Days 8 and 9 were uneventful. Timber is enjoying the great weather, and she is putting more weight on her leg with each day.

Days 10 and 11 we had been working around the outside, so I decided to let Timber on the deck; I had both sets of stairs baby gated so she could enjoy the outside. Well… I suddenly hear my husband yelling, so I quickly run to the back of the house to find that Timber jumped over the gate!! She seemed to be fine but back in the bathroom she went.

I gave her a pain pill and her anti-inflammatory and she rested for the remainder of the day.

Day 12, Timber seems to be okay since she decided to jump the baby gate. She is definitely becoming more active…I am reminding her and myself that its only been 2 weeks, and she still has a good 4-5 weeks to go until fully healed from the TTA surgery.

Day 13-14, it’s been 2 weeks since surgery. Timber will be going in for suture removal on Thursday, and I am very pleased to say that she never once licked or bit at her incision – mommy is so proud of her!

TTA Surgery Recovery – 2 Weeks, Timber’s Story is a post from: Dog Knee Injury

What is a dog TPLO surgery?

TPLO stands for Tibial Plateau Leveling Osteotomy, which in simple english means that they are changing the bones of the knee joint to make them work in a different, more “level” manner.  The veterinary surgeon will start by making an incision in your dog’s injured leg, and the cut will be made down the length of the leg.  Through this incision the veterinarian will then access the injured acl (or ccl as it is more properly called in dogs) and begin by removing the severed, torn and/or ruptured ends of the ligament.  Once the cranial cruciate ligament damage has been removed, a cut is made in the top of the tibia.  Measurements are then taken and compared to those from the pre-op x-ray, and the tibial plateau is positioned to make the slope of the knee level.  A plate is then screwed into the top of the bone to allow the bone to heal in its new angular position; the metal plates can be removed later, although this involves another procedure.  To read more about this surgery click TPLO Surgery Procedure.

TPLO Cost?

A Tibial Plateau Leveling Osteotomy is a difficult veterinary procedure, and you should expect to be billed accordingly.  While prices vary across the US, I can tell you first hand an estimate I received for my 90 pound dog.  The estimate came with both a high and low price, and included all of the pre and post operative care, barring any complications, which are not included.  This estimate was from a veterinary speciality hospital, and my dog would have stayed overnight following the surgery with monitoring and pain control.  The low end of the estimate was $3,892.79 and the high end of the estimate was $4,03.58 for TPLO surgery.  The lowest quote I have seen for a TPLO knee repair was $2,500 at a rural veterinary clinic in one of the midwestern states, and I have heard up to $6-7,000 for a TPLO acl surgery at one of the leading veterinary school’s affiliated clinics.  Vets are aware that the cost of a TPLO surgery for your dog can be a difficult burden, and many are willing to work with you to cut out on extra costs and/or create payment plans.

TPLO Surgery Dogs is a post from: Dog Knee Injury

Timber went in for TTA surgery on Tues March 9th, and the surgery went great. I picked her up on Wednesday, the staff said she a had a good night, she was so sweet, she was one of the quiet ones and she didn’t cry or bark. Her first day home was uneventful. She was just so happy to be home and see her brother Tucker (he is my 12 year old male shepard mix). She doesn’t seem to have much pain, her surgical line looks beautiful, and she has moderate bruising and some swelling. She is currently on anti-inflammatory meds, ABT, and pain meds (as needed). The hardest part was taking her to go potty, because she has to be on a leash (which she is not used to), so she would just stand there and stare at me!

Timber is toe touching by Day 3 following the TTA surgery. I think she sometimes forgets and actually puts weight on her leg, but then realizes that it’s still too sore. She has been eating and drinking without difficulty and chewing on her toys (she’s a great patient!!) I forgot to mention that she has taken over my powderoom, that is the only room on our first floor that we can keep her in. She has never been crated, and the other rooms have oversized doorways that we cant baby gait, so the bathroom it is…I think she really likes it!

It’s Saturday March 13, Day 4. We are in the middle of a severe rain/wind storm, so getting Timber to go potty is an obstacle. She wants nothing to do with going outside…UGH! Other than going potty she is doing very good. There is definitely a difference between the two recovery periods, even though she had a great recovery from the TPLO, she had much more discomfort, didn’t eat much, and wasn’t putting weight on her leg at this stage of the game. So far, so good!

Not much to report on Days 5 and 6. Oh yes there is – one thing, I wasn’t paying attention and I forgot to put the baby gait up and the little bugger walked up the entire flight of stairs!!! Mommy was not very happy but she seemed to be okay…thank god!

TTA Surgery Recovery – 1 Week, Timber’s Story is a post from: Dog Knee Injury

Timber is a 6 year old female shepard mix; she is my baby. In August 2006, Timber tore her left ACL and she underwent TPLO. She recovered beautifully from TPLO surgery. Nearly 4 years later, she developed an abscess over her TPLO scar. I took Tim to my local vet, and she said that it looks like it could have been a suture from her surgery that did not dissolve. In for surgery to remove the abscess she went.

After two weeks the abscess started to grow back, so I took her to the surgeons office (who did the surgery 4 years ago), to find out that the stainless steel plate she had, had become infected. He recommended to remove the plate left in after the TPLO surgery. On Feb 7, 2010, Timber went in for plate removal, and on that same day she was also diagnosed with a torn ACL in her right knee. I was told I needed to wait 1 month until she had her right knee operated on because she had 2 types of bacteria growing on the plate in her left leg; she needed a course of antibiotics.

So we waited, and mommy did her research. After plenty of reading I chose the TTA (Tibial Tuberosity Advancement) surgery, which uses a titanium plate. I felt that she was at a greater risk of rejecting the stainless steel plate with the TPLO surgery. I did my research on the two type of metals, and titanium seems to be the better of the two, so we went with TTA.

TTA Dog Knee Surgery, Timber’s Story is a post from: Dog Knee Injury

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