Cranial Cruciate Repair - WHY TPLO?
TPLO vs. TTA
Both TPLO and TTA surgeries address stifle instability by leveling the plateau angle. The TPLO keeps the rotated bone segment in place using a plate. The TTA advances the tuberosity and is kept in place by inserting a titanium cage that bone grows through. However, this makes it impossible to remove at a later date if ever it was needed
The TPLO plate can be removed at any time once the bone has headlined into it's new alignment. There is evidence to support that the TPLO gives more consistent results.
For clients wanting the TTA surgery, we refer to a referral hospital.
X-rays
Prior to surgery, we will need to perform specific orthopedic x-rays to assess both knees and hips. If we have co-morbid conditions such as hip dysplasia, patellar luxation or laxity in the non-surgical knee, we will need to develop a additional plan to address these conditions in the future as well as a environmental management plan for care at home post-operatively.
The x-rays are performed under deep sedation to facilitate proper positioning for the x-rays.
Preparing for Surgery
If your pet has been diagnosed with an orthopedic concern requiring surgical repair, there is some preparation to do ahead of surgery to ensure a smooth transition back into the home for your pet.
In order to achieve the most successful results from surgery there is a medical management aspect that will require care of your pet at home for up to six months. It is our hope that we can prepare you for the care required for your pet post-operatively and will identify those areas of concern that should be addressed before bringing your pet home from surgery.
Patients that have undergone surgical repair require daily physical therapy in order to prevent potential complications such as excessive swelling, stiffness and pain, contracture of a wound or ligament, excessive muscle loss leading to weakness and increase in healing time.
PLANS
Your pet will be required to rest strictly for the first 10 days after surgery. They will be on leash for essential bathroom breaks only. You will need to start ice therapy when you return home after surgery and start PROM (passive range of motion).
Your pet will likely need some assistance getting up for the first few days; we recommend you make a homemade belly sling. This can be done by cutting the side panels out of a reusable shopping bag. Commercial slings are also available through Amazon.
Your dog's activity level will be very minimal and as such the diet should be restricted to accommodate the decrease in activity.
TOP DOG HEALTH offers a free TPLO guide that can further help you with care at home.
The TPLO plate can be removed at any time once the bone has headlined into it's new alignment. There is evidence to support that the TPLO gives more consistent results.
For clients wanting the TTA surgery, we refer to a referral hospital.
X-rays
Prior to surgery, we will need to perform specific orthopedic x-rays to assess both knees and hips. If we have co-morbid conditions such as hip dysplasia, patellar luxation or laxity in the non-surgical knee, we will need to develop a additional plan to address these conditions in the future as well as a environmental management plan for care at home post-operatively.
The x-rays are performed under deep sedation to facilitate proper positioning for the x-rays.
Preparing for Surgery
If your pet has been diagnosed with an orthopedic concern requiring surgical repair, there is some preparation to do ahead of surgery to ensure a smooth transition back into the home for your pet.
In order to achieve the most successful results from surgery there is a medical management aspect that will require care of your pet at home for up to six months. It is our hope that we can prepare you for the care required for your pet post-operatively and will identify those areas of concern that should be addressed before bringing your pet home from surgery.
Patients that have undergone surgical repair require daily physical therapy in order to prevent potential complications such as excessive swelling, stiffness and pain, contracture of a wound or ligament, excessive muscle loss leading to weakness and increase in healing time.
PLANS
- Do you have a place for them to get restricted rest? A crate or small room?
- Do you have some non-slip mats for those slippery areas?
- Do you have a leash and collar that will provide you with good control over your pet's movements?
- Do you have a sling ready to assist your pet in walking?
Your pet will be required to rest strictly for the first 10 days after surgery. They will be on leash for essential bathroom breaks only. You will need to start ice therapy when you return home after surgery and start PROM (passive range of motion).
Your pet will likely need some assistance getting up for the first few days; we recommend you make a homemade belly sling. This can be done by cutting the side panels out of a reusable shopping bag. Commercial slings are also available through Amazon.
Your dog's activity level will be very minimal and as such the diet should be restricted to accommodate the decrease in activity.
TOP DOG HEALTH offers a free TPLO guide that can further help you with care at home.
Before Surgery
✓ DO NOT feed your pet a meal/treats after 10:00 pm the night before unless otherwise directed
✓ DO allow your pet water overnight
✓ DO give any medications prescribed for the procedure as directed
✓ DO check if your pet’s other medication(s) may be given that morning
✓ DO bring your pet for your scheduled time between 7:45 am and 8:15 am
✓ DO ensure you have CONTACT and EMERGENCY CONTACT phone numbers
✓ DO allow yourself a few minutes to go over admitting information with the technician
Pre-Surgical Medications
We are always looking to improve and enhance anesthesia for our patients. The protocol we use involves sending you home with a medication to be given the morning of (it can be given with a small treat). Cerenia prevents nausea and vomiting pre and post operatively and is given the morning of. This medication lasts 24 hours and will allow your pet to eat soon after surgery.
Pre-Operative Exam
For your pet to have a safe surgical experience the veterinarian performing the procedure should be familiar with your pet's history and physical condition. With modern drugs and sophisticated equipment, the risk associated with general anesthesia and surgery is minimal for the healthy pet. However, the potential for complications still exists, and the best way to minimize the risk for your pet is to have a complete pre-surgical evaluation performed before the procedure. This allows us to determine if your pet has developed any underlying problems that might lead to complications during or after surgery, and to make any adjustments necessary to safeguard your pet’s health and comfort. The amount of preparation will be dictated by the age and health concerns of your pet, and by the nature of the procedure. Once all the information has been gathered and analyzed, our veterinarians will make recommendations about the advisability to proceed with anesthesia and surgery.
In some situations, the risk will be too great, and the procedure will be delayed allowing time to treat the underlying problem. In other cases, the decision will be that it is safe to proceed as planned. Sometimes adjustments will be made to minimize risk even further, such as using a different type of anesthetic, administering pre-operative surgical antibiotics, giving intravenous fluids prior to the surgery or additional fluids after surgery, and whatever else the veterinarian deems necessary for your pet.
A systematic visual inspection of the pet’s head, neck, limbs, and body including palpation (feeling with the hands) of the body’s outer surface (skin, fur, muscles etc.), assessment of internal abdominal organs through the body wall, auscultation (listening with a stethoscope) to the heart, lungs, and abdomen and measuring of your pet’s temperature, respiration rate and heart rate will all be assessed.
Pre-Anesthetic Blood Work
The 10 or 17 Chemistry and CBC (complete blood cell count); blood collection & interpretation charge is for blood work to be run prior to the procedure. This blood work is like an internal exam for your pet. It will check a complete blood cell count; white bloods cells that fight infection, red blood cells that carry oxygen and platelets which help with clotting. It will also look at electrolytes, liver and kidney function. Obviously, we want everything to be normal but if we find something abnormal, we can either change our anesthetic plan or defer the procedure until a later time. For this reason, we like to run the blood work a week prior to the anesthesia so any findings can be dealt with.
IV Fluids
Your pet will have an IV placed and will receive IV fluids during their surgery to maintain hydration and proper blood pressure to the body and kidneys. They may also receive pain medications through their IV as well.
Hospital Care
During your pet’s stay, we will keep them comfortable on a memory foam bed with lots of blankets, treat hypothermia with warmers, and continue IV fluids if required. They will have close supervision to assess and treat pain post-operatively. Our goal will be to have your pet up and walking outside to the washroom and eating by later in the day. They will go home the same day/evening.
Medications
We will send home pain medication to give your pet at home. These medications treat inflammation (Meloxicam) and nerve pain (Gabapentin, which will also help with breakthrough pain in the initial 72 hours). Pain control is necessary for a successful recovery and comfort at home. Antibiotics will also be sent home for a period of 5-7 days.
Updates and Discharge Instructions
We will call you at your contact number the day of surgery between 1-3 pm to relay an update on your pet, discuss discharge instructions and schedule a discharge time for the next day.
We encourage you to visit Top Dog Health to view articles and videos on rehabilitation exercises.
8-Week Post-Op Recheck
At the 8- week recheck we take radiographs (x-rays) of the surgical site under heavy sedation to assess how the bone is healing. After this recheck, activity level may be increased ONLY if bone healing is confirmed at this time. Since some dog's bones heal slower than others, this recheck is extremely important.
✓ DO NOT feed your pet a meal/treats after 10:00 pm the night before unless otherwise directed
✓ DO allow your pet water overnight
✓ DO give any medications prescribed for the procedure as directed
✓ DO check if your pet’s other medication(s) may be given that morning
✓ DO bring your pet for your scheduled time between 7:45 am and 8:15 am
✓ DO ensure you have CONTACT and EMERGENCY CONTACT phone numbers
✓ DO allow yourself a few minutes to go over admitting information with the technician
Pre-Surgical Medications
We are always looking to improve and enhance anesthesia for our patients. The protocol we use involves sending you home with a medication to be given the morning of (it can be given with a small treat). Cerenia prevents nausea and vomiting pre and post operatively and is given the morning of. This medication lasts 24 hours and will allow your pet to eat soon after surgery.
Pre-Operative Exam
For your pet to have a safe surgical experience the veterinarian performing the procedure should be familiar with your pet's history and physical condition. With modern drugs and sophisticated equipment, the risk associated with general anesthesia and surgery is minimal for the healthy pet. However, the potential for complications still exists, and the best way to minimize the risk for your pet is to have a complete pre-surgical evaluation performed before the procedure. This allows us to determine if your pet has developed any underlying problems that might lead to complications during or after surgery, and to make any adjustments necessary to safeguard your pet’s health and comfort. The amount of preparation will be dictated by the age and health concerns of your pet, and by the nature of the procedure. Once all the information has been gathered and analyzed, our veterinarians will make recommendations about the advisability to proceed with anesthesia and surgery.
In some situations, the risk will be too great, and the procedure will be delayed allowing time to treat the underlying problem. In other cases, the decision will be that it is safe to proceed as planned. Sometimes adjustments will be made to minimize risk even further, such as using a different type of anesthetic, administering pre-operative surgical antibiotics, giving intravenous fluids prior to the surgery or additional fluids after surgery, and whatever else the veterinarian deems necessary for your pet.
A systematic visual inspection of the pet’s head, neck, limbs, and body including palpation (feeling with the hands) of the body’s outer surface (skin, fur, muscles etc.), assessment of internal abdominal organs through the body wall, auscultation (listening with a stethoscope) to the heart, lungs, and abdomen and measuring of your pet’s temperature, respiration rate and heart rate will all be assessed.
Pre-Anesthetic Blood Work
The 10 or 17 Chemistry and CBC (complete blood cell count); blood collection & interpretation charge is for blood work to be run prior to the procedure. This blood work is like an internal exam for your pet. It will check a complete blood cell count; white bloods cells that fight infection, red blood cells that carry oxygen and platelets which help with clotting. It will also look at electrolytes, liver and kidney function. Obviously, we want everything to be normal but if we find something abnormal, we can either change our anesthetic plan or defer the procedure until a later time. For this reason, we like to run the blood work a week prior to the anesthesia so any findings can be dealt with.
IV Fluids
Your pet will have an IV placed and will receive IV fluids during their surgery to maintain hydration and proper blood pressure to the body and kidneys. They may also receive pain medications through their IV as well.
Hospital Care
During your pet’s stay, we will keep them comfortable on a memory foam bed with lots of blankets, treat hypothermia with warmers, and continue IV fluids if required. They will have close supervision to assess and treat pain post-operatively. Our goal will be to have your pet up and walking outside to the washroom and eating by later in the day. They will go home the same day/evening.
Medications
We will send home pain medication to give your pet at home. These medications treat inflammation (Meloxicam) and nerve pain (Gabapentin, which will also help with breakthrough pain in the initial 72 hours). Pain control is necessary for a successful recovery and comfort at home. Antibiotics will also be sent home for a period of 5-7 days.
Updates and Discharge Instructions
We will call you at your contact number the day of surgery between 1-3 pm to relay an update on your pet, discuss discharge instructions and schedule a discharge time for the next day.
We encourage you to visit Top Dog Health to view articles and videos on rehabilitation exercises.
8-Week Post-Op Recheck
At the 8- week recheck we take radiographs (x-rays) of the surgical site under heavy sedation to assess how the bone is healing. After this recheck, activity level may be increased ONLY if bone healing is confirmed at this time. Since some dog's bones heal slower than others, this recheck is extremely important.
