At Aliso Beach Animal Clinic, we coordinate

advanced orthopedic surgery and TPLO care in Laguna Beach

with board-certified veterinary surgeon Dr. Zack Smith. Our veterinary team remains
involved in diagnostic testing, surgical preparation, pain management and postoperative
follow-up so that your dog can receive advanced orthopedic care through a familiar hospital.

What Does TPLO Surgery Do?

The cranial cruciate ligament, or CCL, helps stabilize the canine stifle—the joint
commonly called the knee. When this ligament becomes partially or completely torn,
the tibia shifts abnormally in relation to the femur. This instability causes pain,
inflammation, muscle loss and progressive osteoarthritis.

TPLO stands for tibial plateau leveling osteotomy. Instead of replacing
the torn ligament, the surgeon changes the angle of the upper tibia. A curved cut is
made in the bone, the tibial plateau is rotated and a plate with screws holds the bone
in its new position while it heals.

Because TPLO involves a controlled surgical cut through bone, your dog may begin
feeling better before the surgical site is strong enough for running, jumping or
off-leash exercise. Activity restriction protects the healing bone, plate and screws.

The Most Important TPLO Recovery Rules

Prevent running, jumping and slipping

For approximately eight weeks—or longer when directed by the surgeon—your dog should not:

• Run through the house or yard
• Jump onto or off furniture
• Jump into or out of a vehicle
• Chase toys, wildlife or other pets
• Wrestle or play with another dog
• Use long flights of stairs without veterinary approval
• Walk on slick flooring without added traction
• Roam outdoors off leash

Use rubber-backed runners, rugs or yoga mats to create a nonslip pathway between
your dog’s recovery area and the door.

Create a controlled recovery space

Choose a crate, exercise pen or small gated room that is large enough for your dog
to stand, turn around and rest comfortably, but not large enough for running.

Keep the recovery space on one level whenever possible. A front-clip harness,
short leash and rear-support sling may be helpful for large, weak or unsteady dogs.

Continue prescribed pain medication

Comfort supports normal resting, eating and controlled use of the operated leg.
Give every medication exactly as directed, even when your dog appears comfortable.

Contact us if your dog develops vomiting, diarrhea, black stool, refusal to eat,
unusual lethargy or another suspected medication reaction.

Learn more about our approach to monitoring, anesthesia and pain management on our

pet surgery and anesthesia page
.

Protect the incision

An Elizabethan collar or another veterinarian-approved protective device should remain
on whenever your dog could reach the incision. Licking can introduce bacteria and may
lead to skin, soft-tissue or implant-associated infection.

Examine the incision at least twice daily. Taking one photograph each day in similar
lighting can make subtle changes easier to recognize.

TPLO Recovery Timeline at a Glance

Days 0–3: Protect, Rest and Control Swelling

The first few days are focused on pain control, incision protection and safe bathroom trips.

Bathroom walks

Take your dog outside on a short leash only for urination and defecation. Walk slowly
on a level, nonslip surface. A typical trip may last only three to five minutes.

Use a sling when recommended, especially on steps or slippery ground. Do not allow
sudden turns, pulling, lunging or acceleration.

Cold therapy

When approved in your discharge instructions, place a wrapped cold pack around the
knee for approximately 10–15 minutes. Cold therapy is generally most useful during
the first several days or after an activity-related increase in swelling.

• Never place ice directly against the skin.
• Do not place an unwrapped cold pack directly over the incision.
• Stop if your dog becomes distressed or the skin becomes excessively cold.

When to call immediately

• Uncontrolled pain, crying or inability to settle
• Repeated vomiting or refusal to eat
• Significant bleeding
• Increasing redness, heat or swelling
• Yellow, green or foul-smelling discharge
• Opening of the incision
• Sudden collapse or breathing difficulty
• A foot that becomes cold, markedly swollen or discolored
• A sudden decline after your dog had been improving

Days 4–14: Encourage Safe, Gentle Limb Use

During this stage, the goal is not to tire your dog. The goal is to encourage calm,
symmetrical movement without placing excessive stress on the healing bone.

Controlled leash walking

Continue several brief walks instead of one long walk. Many dogs can gradually work
toward approximately five minutes per walk by the end of the first week, but the correct
amount depends on comfort, gait and surgeon instructions.

Walk slowly enough that your dog places the operated foot on the ground. Moving too
quickly may allow a dog to hop on three legs.

Reduce the duration and contact us if you notice:

• More limping later that day
• Increased swelling
• Worse stiffness the following morning
• Reluctance to use the operated leg
• New pain or behavioral changes

Gentle weight shifting

Begin only when your dog can stand comfortably and the veterinary team has approved
the exercise.

1. Place your dog on a nonslip surface.
2. Help your dog stand with all four feet beneath the body.
3. Place one hand near the shoulders and the other over the pelvis.
4. Gently shift the body a very small distance from side to side.
5. Begin with five slow repetitions.

The movement should be subtle. Do not shove the pelvis or force your dog to load a
painful leg.

Passive range of motion

Passive range-of-motion exercises are not necessary or appropriate for every TPLO
patient. Perform them only after a veterinarian or rehabilitation professional has
demonstrated the correct technique.

When prescribed, the hip, knee and hock are supported while the leg is slowly flexed
and extended through a comfortable range. Never twist the leg, press through resistance
or attempt to force the operated leg to match the other leg.

Massage

Gentle massage of the thigh and lower-leg muscles may help a relaxed dog tolerate
movement. Avoid direct pressure over the incision, plate or visibly swollen tissues.

Stop if your dog tenses, pulls away, pants heavily, looks repeatedly toward your hand,
vocalizes or shows another sign of discomfort.

First postoperative recheck

An incision examination is commonly scheduled approximately 10–14 days after surgery.
Skin sutures or staples may be removed when present, and the recovery plan can be
adjusted based on limb use, swelling, comfort and range of motion.

Weeks 3–4: Rebuild Basic Control

If the incision is healed and your dog is consistently using the operated leg, the
veterinary team may approve small increases in walking and basic therapeutic exercises.

Gradually longer walks

Your veterinarian may allow controlled leash walks to increase toward approximately
8–12 minutes. A common progression is to add only a few minutes per walk over the
course of a week.

Continue using flat, predictable surfaces. Avoid loose sand, steep hills, slippery
grass and crowded walking paths.

Wide figure-eight walking

Set two objects several feet apart and slowly walk your dog around them in a broad
figure-eight pattern. Wide turns encourage controlled weight transfer without requiring
a sharp pivot.

Start with two or three complete patterns. Keep the circles large and the pace slow.

Sit-to-stand exercise

This exercise functions like a controlled canine squat.

1. Ask your dog to sit squarely on a nonslip surface.
2. Make sure the operated leg is not extended far out to the side.
3. Use a treat to encourage a slow, straight stand.
4. Begin with three repetitions.

Stop if your dog repeatedly sits to one side, slips, refuses the movement or pushes
almost entirely with the unoperated leg.

Nose-to-hip stretches

With your dog standing squarely, guide the nose toward one shoulder and then toward
each hip using a treat. These gentle movements encourage spinal mobility and core
engagement.

Do not place your dog on a cushion, balance disc or other unstable equipment during
early recovery unless a rehabilitation professional has prescribed it.

Weeks 5–8: Build Strength Without Losing Control

This stage often presents a major challenge: your dog may feel substantially better
even though the bone is still healing. Continue preventing jumping, running, sharp
turns and uncontrolled play.

Low cavaletti poles

Place lightweight poles or broom handles flat on the ground with enough space for your
dog to take one slow step between them.

Walk across three or four poles once or twice. The poles should initially remain nearly
flat rather than elevated. This encourages deliberate foot placement and controlled
joint movement.

Controlled backward walking

Use a narrow hallway or position yourself in front of your dog. Slowly step toward the
dog so that the dog takes two or three controlled steps backward.

Backward walking activates different muscle groups and improves awareness of the rear
feet. Do not pull your dog backward by the leash.

Gentle inclines

A mild, nonslip incline may be introduced after your dog is walking comfortably on
level ground. Begin with a short distance.

Walking uphill places greater demand on the rear limbs, so hills should be added
conservatively. Avoid steep downhill walking during this stage.

Hydrotherapy

A professionally supervised underwater treadmill can reduce the amount of weight
placed on the limbs while providing resistance. Water height, speed and duration
should be selected for the individual dog.

Six- to eight-week recheck

A clinical examination and follow-up radiographs are commonly performed during this
stage. Radiographs allow the surgeon to assess the osteotomy, implant position and
progression of bone healing.

Do not begin off-leash activity, running, jumping or swimming simply because your dog
appears comfortable. Wait for explicit veterinary clearance.

Weeks 8–12: Restore Endurance and Coordination

When the surgeon confirms appropriate healing, your dog’s program may progress toward:

• Longer controlled walks
• Additional sit-to-stand repetitions
• Low cavaletti poles
• Gentle hill walking
• Backward walking
• Controlled step-ups
• Progressively smaller figure-eight patterns
• Brief straight-line trot intervals
• Underwater treadmill therapy
• Carefully controlled swimming
• Advanced balance work under professional supervision

A trot interval may initially consist of only several seconds on a flat, nonslip
surface, followed by walking. Sharp turns, fetch, wrestling, beach running and dog-park
activity may remain inappropriate until later clearance.

After 12 Weeks: Returning to Normal Activity

Radiographic bone healing does not mean that muscle strength, balance and endurance
have fully returned. Muscle often takes considerably longer to rebuild than it takes
to lose.

Return to hiking, beach activity, agility, running, repeated jumping and high-speed
play should occur gradually over several additional months. Athletic dogs may need a
structured conditioning plan before returning to unrestricted sport.

Dogs with cruciate disease in one knee also have a meaningful risk of eventually
developing a similar problem in the opposite knee. Maintaining a lean body condition
and preserving balanced strength remain important long after the operated leg heals.

Therapeutic Laser After TPLO

Aliso Beach Animal Clinic offers

K-Laser therapy for pets

as part of selected multimodal treatment plans.

Photobiomodulation, commonly called therapeutic or cold-laser treatment, may be
considered to support comfort and manage local soft-tissue inflammation. It is
noninvasive and can often be performed during a brief outpatient visit.

Expectations should remain realistic:

• Laser may be helpful as a supportive comfort therapy for selected dogs.
• Published TPLO studies have produced mixed results.
• Laser has not been shown to reliably accelerate TPLO bone healing.
• It does not replace pain medication, restriction, rehabilitation or surgical rechecks.

We individualize the treatment schedule rather than automatically prescribing the
same number of laser sessions to every patient.

Acupuncture During TPLO Recovery

Aliso Beach Animal Clinic also provides

veterinary acupuncture

as part of our

holistic and integrative veterinary care
.

Acupuncture may be considered for selected dogs experiencing:

• Compensatory lower-back or hip soreness
• Muscle tension caused by shifting weight to other limbs
• Chronic osteoarthritis discomfort
• Ongoing stiffness after the initial surgical period
• Difficulty tolerating portions of a rehabilitation program

Acupuncture should not replace conventional postoperative pain medication. Direct
evidence that acupuncture accelerates TPLO bone healing is lacking. We therefore use
it as an individualized adjunct for comfort, mobility and secondary muscular problems,
not as a guaranteed way to shorten recovery.

Nutrition, Weight and Joint Supplements

Keep your dog lean

Body weight is one of the most important modifiable factors affecting the operated
knee, the opposite knee and long-term arthritis.

You should be able to feel your dog’s ribs without pressing through a thick layer of
fat, see a waist from above and see an abdominal tuck from the side.

Calorie needs commonly decrease during restricted activity, so the preoperative food
portion may be too large during recovery. Our

pet nutrition counseling service

can help calculate appropriate calories while protecting muscle mass.

Omega-3 fatty acids

Marine omega-3 fatty acids, particularly EPA and DHA, have useful evidence for
supporting dogs with osteoarthritis. The correct amount should be based on the combined
EPA and DHA content rather than simply the total quantity of fish oil.

Ask us before starting a product, particularly if your dog has gastrointestinal disease,
pancreatitis risk, a bleeding disorder or takes medication that affects clotting.

Undenatured type II collagen

Emerging research suggests that certain undenatured type II collagen products may
support mobility in some dogs after TPLO. Results are product-specific and do not mean
that every collagen supplement will provide the same benefit.

Glucosamine and chondroitin

These ingredients are widely marketed, but evidence for meaningful pain relief is
inconsistent. They should not replace weight control, prescribed medication,
rehabilitation or appropriate follow-up.

Botanical supplements

Turmeric, Boswellia and other botanical ingredients may be considered in selected
patients, but natural products are not automatically safe.

Botanical products may:

• Interact with prescription medication
• Affect blood clotting
• Irritate the stomach or intestines
• Contain inconsistent ingredient concentrations
• Duplicate ingredients found in another product
• Create concerns before anesthesia or another procedure

Tell our veterinary team about every chew, oil, powder and herbal product your dog receives.

Suggested Integrative Follow-Up Plan

Approximately 10–14 days

Incision examination, suture or staple removal when applicable, medication review,
gait assessment and instruction in appropriate home exercises.

Approximately four weeks

Mobility and muscle assessment, exercise progression and evaluation for secondary
back, hip or opposite-limb tension.

Approximately six to eight weeks

Surgeon-directed examination and radiographs, followed by a decision about progressing
hills, hydrotherapy, trotting or more advanced strengthening.

Approximately 10–12 weeks

Strength, symmetry and endurance assessment with a gradual return-to-activity plan.

Long-term follow-up

Weight monitoring, arthritis management, nutritional support, appropriate supplements
and optional laser or acupuncture for selected ongoing mobility needs.

When to Stop Exercises and Call Us

Stop the exercise session and contact Aliso Beach Animal Clinic if your dog develops:

• A sudden increase in lameness
• Refusal to bear weight after previously using the leg
• Increasing knee swelling or heat
• New clicking accompanied by pain
• Crying, snapping or marked resistance
• Incision redness, discharge or opening
• Fever, lethargy or poor appetite
• Vomiting, diarrhea or black stool
• A fall, jump, collision or uncontrolled run
• Persistent next-day soreness after increasing an exercise

A brief reduction in activity may be appropriate after a mild flare, but a sudden or
persistent setback should not automatically be treated at home without veterinary guidance.

Frequently Asked Questions About TPLO Recovery

References and Further Reading

1. Crestwood Veterinary Centre. TPLO Home Recovery Program.
   Patient-education booklet used as a background reference for general home-safety,
   controlled walking and progressive therapeutic-exercise concepts. This Aliso Beach
   Animal Clinic guide has been independently rewritten, reorganized and expanded.
2. American College of Veterinary Surgeons.
   
   Cranial Cruciate Ligament Disease
   .
3. Alvarez LX, et al. Systematic review of postoperative rehabilitation interventions
   after cranial cruciate ligament surgery in dogs. Veterinary Surgery. 2022.
4. Baltzer WI, et al. Evaluation of the clinical effects of diet and physical
   rehabilitation in dogs following tibial plateau leveling osteotomy.
   Journal of the American Veterinary Medical Association. 2018.
5. Renwick SM, et al. Influence of class IV laser therapy on the outcomes of tibial
   plateau leveling osteotomy in dogs. Veterinary Surgery. 2018.
6. Chavez OA, et al. Photobiomodulation therapy in dogs undergoing tibial plateau
   leveling osteotomy after cranial cruciate ligament rupture.
   American Journal of Veterinary Research. 2024.
7. Barbeau-Grégoire M, et al. Systematic review and meta-analysis of enriched
   therapeutic diets and nutraceuticals in canine and feline osteoarthritis. 2022.