ACL Post Operative Care
Your dog just had major orthopedic surgery on its leg. Know that the first night after surgery will be the most difficult for not only your pet, but for you too. We prescribe a pain reliever as well as a nonsteroidal anti-inflammatory, an antibiotic and mild sedative for after surgery. We also use Nocita® (a long-acting local anesthetic) which numbs the leg for 72 hours. These drugs will successfully manage and minimize postoperative pain. Patients are sent home the evening of surgery to recover with familiar surroundings (in their own bed and with people they know). After a few days, patients have usually started to act more like themselves, and should be eating and drinking well. It is not uncommon for your pet not to have a bowel movement for the first 1-2 days. This is due to them fasting for surgery and the pain medication they received during surgery.
Within the first 4 to 6 weeks, our typical patient is making excellent progress and quickly becomes more mobile. For dogs with high energy, it can be challenging for the owner to control their pets’ activity level. Crating your dog and/or sedating them may be necessary for some high energy dogs. We’ve dispensed Trazodone to help limit activity, but if you find your pet needs additional sedatives please don’t hesitate to reach out.
For the first 6 months after surgery, your pet will gradually start to return to their normal selves and may want to resume their normal activities. It is VERY important that even though your pet seems to be feeling better, they maintain restricted exercise to ensure the procedure has enough time to fully heal. Excessive activity can delay the healing process, and sudden bumps or falls may potentially disrupt or compromise the entire surgical repair.
The extent of your dog’s activity outside the house should be taking them out on a leash in a controlled fashion to relieve themself and come right back inside. While your pet is inside, they should try to walk slowly to simply get from here to there.
Complete restriction of activity is defined as follows:
- No running
- No jumping
- No climbing on or off furniture
- No rough play
- No excessive use of stairs (walking up or down a few stairs is ok if necessary).
(Some of Dr. Spinks’ favorite post-op recommendations are: utilizing a ‘walk out’ basement or large ‘walk in’ closet (both of these options limit use of stairs as well as things to jump up on to), and crate training has also proven to be extremely beneficial (this completely limits all movement but the patient is still in a comfortable environment that they are familiar with.))
WHAT TO LOOK FOR
Following surgery, it is completely normal for there to be some redness at the incision site and on occasion minimal bleeding may occur for the first 24-48 hours. A bandage will be placed for at least the first few days to offer some protection to the incision site. However, if you notice any of the following, this could indicate a possible infection and we would like to see your pet asap: excessive swelling, warm to the touch, filled with fluid, oozing, or excessive bleeding. If you notice ANY of these symptoms, call us immediately.
Please contact us if at any point the patient is consistently not eating, seems to be in excessive pain despite taking the medications, or if there is any vomiting or diarrhea.
If at any point it seems like the surgical site is filling with fluid, red, or enlarged, please give us a call and we can take a look. In the meantime, you can apply a cold compress and most importantly – keep that cone on!
The basis of home care & at home rehab during the first 6 months is to encourage careful & controlled use of the patient’s repaired knee. You want to try to avoid any twisting or turning of the knee, so we recommend walks on a smooth & even surface (like pavement or sidewalk). Besides the success of the surgery itself, the most important factor for post-op recovery is following discharge instructions and the suggested rehab options for your pet.
We recommend our cold laser therapy after the 2 week recheck appointment. The cold laser helps stimulate surrounding cells thus speeding up the healing process. These treatments only take about a minute and we recommend doing them twice a week for a total of 6 treatments.
The majority of dogs recovering from our Tightrope procedure will do quite well with the informal at-home post-op rehabilitation program as outlined here. A minority of our patients may potentially require the assistance of a more formal and regimented rehabilitation program such as hydrotherapy at a pet physical therapy location. Throughout physical therapy and rehab, a few basic guidelines should be followed:
Complete Crate Confinement
- Crate rest during sleeping hours, working hours and when close leash held supervision is not possible.
- Sedative medications should be used as prescribed to alleviate anxiety and control boisterous behavior.
- Leash walk outside for bathroom breaks ONLY.
- Use belly support sling during leash walks for the first 2-3 weeks. (Towel/blanket slung under lower abdomen while walking to help support and lessen weight on the back legs)
- Use e-collar at ALL times when bandages and skin sutures are in place. (Please also bring the e-collar to all post-op appointments)
Incremental leash-held walking program
- Week 1: 10 minute slow pace walk twice daily
- Week 2: 15 minute slow pace walk twice daily
- Week 3: 20 minute slow pace walk twice daily
- Week 4: 25 minute slow pace walk twice daily
Walk slowly and keep patient at a walk/trot pace. It is important that the patient places each leg individually and does not hop or carry one leg. Please moderate your pace to avoid this occurring. Walking in sand or at the beach can be very beneficial to recuperate the injured limb and if possible, can be done 3-4 times a week and may be substituted for one of the daily walking sessions. Decrease the duration of individual sessions by 50% if pool swimming is performed.
Incremental Free Exercise Program
- Week 1: Begin with a 15 minute leash walk (warm ups), followed by 5 minutes of free run twice daily.
- Week 2: Begin with a 10 minute leash walk (warm ups), followed by 10 minutes of free run twice daily.
- Week 3: Begin with a 5 minute leash walk (warm up), followed by 15 minutes of free fun twice daily.
- Week 4: 20 minutes of free run one-two times daily. *no warm up needed*
If you are concerned with the progress and there is a residual lameness, please make an appointment for the doctor to re-evaluate.