It has happened to many dogs. One minute they are sprinting across the backyard and the next they yelp and return to you on three legs. You bring your dog to the veterinarian and your dog is diagnosed with a cranial cruciate ligament tear. Your veterinarian recommends a surgery called a TPLO. You plan to go ahead with but wonder what this will mean for you and your best hiking companion.
How soon after TPLO surgery can a dog return to hiking and how far can they hike? On average, most dogs are able to return to their normal activities within 6 to 9 months after having a TPLO surgery. And with some conditioning, these dogs can hike as far or even further than they did prior to their knee surgery. Low-intensity on-leash hiking (up to 40 minutes without significant elevation change or trail obstacles to maneuver) can even be started again by week 5 after surgery. Any off-leash hiking (even short ones) should wait until after 8 weeks and a good 8-week radiograph to confirm bone healing.
Keep in mind that while your dog’s bone should be healed completely after 12 weeks (unless there were any post-operative complications), it does take additional time to recondition the muscles and tissues that support your dog’s knee joint.
Generally, it takes 2-4 times as long to build muscle as it does to lose it. So for every week of inactivity associated with your dog’s injury, there will be muscle atrophy that can take 2-4 weeks to rebuild. This is why it can take 6-9 months before your dog is able to hike as far and as fast as they did before the injury.
Cruciate Ligament Injuries and the TPLO
Cranial cruciate ligament injuries are the most common injuries causing limping/lameness in the back legs of dogs. The cranial cruciate ligament in dogs is equivalent to the anterior cruciate ligament in people. So essentially, we are discussing an ACL tear in dogs.
The cruciate ligaments’ job is to hold the femur and tibia (bones on either side of the knee joint) together when weight is placed on the back leg. The following video does a great job of demonstrating the importance of both the cranial and caudal cruciate ligaments and what happens when the cranial cruciate ligament is damaged.
If you watched the complete video above, you also have an idea of how veterinarians diagnose a cruciate injury and the options for surgical repair of these injuries.
The most common type of surgery performed by board-certified veterinary surgeons to treat a cranial cruciate ligament tear is the TPLO. This stands for tibial plateau leveling osteotomy. Animated images of this surgery technique start at approximately 5:13 on the video above.
As this procedure involves cutting the bone of the tibia, after surgery, you are essentially providing care for a dog with a broken leg. Then after the bone is healed, it is important to recondition the muscles of the leg that have atrophied following the injury and surgery before your dog can fully return to the hiking trails.
But before we discuss rehabilitation to help your dog return to full hiking and backpacking condition, I just want to briefly mention some of the risk factors for cruciate injuries in dogs. As always, the best treatment is prevention.
Risk Factors for Cruciate Ligament Injuries
Although most humans with ACL injuries have stories of trauma during high-intensity activities (such as skiing or soccer injuries), trauma is not the main cause of cruciate ligament injuries in dogs. Instead, cruciate tears tend to happen less in doggy athletes and more in dogs with one or more of the following risk factors.
Risk factors for dogs include:
- Poor physical condition
- Breed/Genetic Conformation
These are all chronic conditions that result in subtle, slow degeneration that can take place over a few months or even years. Many dogs will present with partial tears of their cranial cruciate ligament that later progresses to a full tear.
Because these risk factors don’t just affect one leg, this means that many dogs who have one cruciate injury, are at a higher risk of having the same injury in their other knee. Roughly 50% or more of dogs with a cruciate injury, will have the other knee affected during their lifetime.
You can’t change your dog’s genetics, but keeping your dog at an ideal body weight and encouraging your dog to exercise regularly can help reduce the risk of a cruciate ligament injury. Specifically, avoid the “weekend warrior syndrome,” where you take an inactive, overweight dog out for an intense burst of activity without any conditioning.
Returning your Dog to Hiking after a TPLO
Helping your dog heal and regain normal function of their leg following a TPLO is a slow process that takes place over the course of several months following the surgery itself. Below is a brief overview of the stages of healing and rehabilitation.
The Initial Days and Weeks after Surgery
Immediately after surgery, your dog should not walk without support. If you have a full body harness with a handle (like the Ruffwear Flagline, Ruffwear Web Master, or Groundbird Gear Harness), consider having your dog wear this harness when moving around. The convenient handle on top of the harness will allow you to help support your dog’s body as they navigate outside for potty breaks. If you don’t have a full-body harness, consider slinging a towel under your dog’s belly to help support them for the first few days post-surgery.
In addition to your dog in and out of the house for bathroom needs, there are a couple of simple tasks that can be beneficial for your dog during the first 48 hours after surgery,. Gentle massage and passive range of motion 2-3 times per day, in addition to icing the knee (stifle) after activity, can help your dog begin a good recovery. Detailed instructions for rehabilitation can be found in this great guide created by Crestwood Veterinary Centre.
By the end of the first week, your dog should be able to go for very short (5 minute) walks. Walk slow to encourage your dog to place weight on the leg. And keep walking your dog in a full support harness so that you can keep a hand on the handle to reduce risks of slips, trips, and falls.
And please remember, for the first 2-4 weeks following surgery, your dog can not do any jumping, should be supported on stairs, and can not do any active play. It helps to remember that your dog is working on healing a broken leg. It takes about 4 -8 weeks for a bone to fully heal. So until your veterinarian gives you the all-clear after the 8 week post-op radiographs, be diligent about limiting your dogs activity.
Week 3 and 4
As long as your dog is consistently using their leg, you can begin lengthening walks to about 10 minutes and start working on other exercises to help rebuild the muscles in the affected leg. These exercises can include figure eights and sit to stand exercises. (See the link to Crestwood Veterinary Centre’s guide above for more detail).
Weeks 5 to 8
Walks can increase by about 5 minutes per walk each week up to a total of 20 minutes per walk and 60 minutes per day. You can add in gentle hills and walking in water or snow to encourage your dog to lift their leg well.
Weeks 8 to 12
Continue to slowly increase length of walks. Adding 5 minutes a week is still a good pace of increase. Your dog can also return to swimming and short off-leash activity. Increase periods of off-leash activity slowly, just like you are increasing the length of your walks.
As your dog’s muscling returns, start to add in short hikes. Before you know it, 6-9 months will have passed and (baring any complications) your dog will be back to hiking long distances with you again.
For a positive outcome story, check out this dog who had both knees repaired and is now back to regular 8-mile hikes.
In addition to the Crestwood Veterinary Center’s TPLO home recovery guide, the following resources were used when creating this post.
- “Returning to Agility Competition after TPLO Surgery” by Drs. Heidorn, Cannap Jr, Zink, and Leasure.
- Colorado State University’s article on Canine Cruciate Ligament Injury
And as always, this is general information. I am a veterinarian, but I am not your veterinarian. Please speak with your dog’s veterinarian about recommendations regarding treatment of a cruciate injury in your dog and specific instructions for rehabilitation after surgery.