Happy Wednesday, everyone!  Today, we are talking about Maggie’s ACL TPLO Surgery, which she had last week at Ohio State University Veterinary Medical Center, Columbus, OH.  If you have been reading my blog for a while, you will know that Jake had his ACL TPLO surgery done with the same surgeon, Dr. Jonathan Dyce, whom we have great respect for.  He saved Jake from a complete leg amputation, so when Maggie tore her ACL, we automatically called OSU to have her meet with Dr. Dyce.  Maggie spent two nights at the hospital having surgery on her knee and sebaceous cyst removal from the tip of her tail.  We spent the time with Jake taking him shopping and out to eat with us.  In this post, you will see the type of surgery Maggie had, along with the surgeon’s notes, care post operation, photos of Jake and Maggie, and Jake’s cute photos at Rod’s Western Palace, Bravo, and Town Hall Restaurant.

I’ve been asked how I knew Maggie tore her ACL, and I can speak from experience.  I also knew something was wrong when I watched her run after a deer, go down as if she were lying down really fast, get back up, and pull her leg in close to her chest.  I went out to bring her back to the house, and she wouldn’t put much weight on her leg.  I knew she had torn it, so I made an appointment to see our regular vet.  He confirmed what I already knew and put in the referral to Dr. Dyce’s office.  Two days after my appointment with Dr. Mike, I called back to make an appointment because I thought Maggie had a UTI.  Tests confirmed I was correct, but also indicated she might have adrenal issues/tumors.  When we got to OSU, we found out she had high blood pressure and two bilateral adrenal tumors.  Internal medicine was called in, and from there, many tests were performed to rule out cancer and Cushing’s.  They put her on Amlodipine Besylate 5 mg tablets to lower her blood pressure before Orthopedics would even touch her for surgery.

We worked with our local vet, Dr. Mike at Pleasant Valley Animal Clinic, Dr. Ha, Internal Medicine at OSU, and Dr. Dyce, Orthopedics at OSU, coordinating tests, results, and a plan for Maggie.  All the while, Maggie was on pain medication and doing fine.  You would never know she had this many issues.  She’s doing amazing with her recovery.  A checkup is scheduled for September 19th, along with another X-ray of her leg at OSU.  We meet with Dr. Mike this Friday to get her stitches out.  He will look at her leg and tail, as well, to make sure everything is healing correctly.

I hope that by posting this, it will help you if your pup ever needs to undergo an ACL or ACL TPLO operation.  The total cost for this operation, including removing the cyst, was $5,754.98.  The way the Ohio State University Veterinary Medical Center works is that they meet with you, examine your pet, and give you an estimate of what the procedure will cost, ranging from low-end to high-end.  Once you agree, you pay 75% up front before surgery and the remaining balance after surgery when you pick up your pet.  They explain everything up front, call you to update you on how your pet is doing, call you as your pet is going into surgery, and the surgeon calls you afterward to let you know how the surgery went, answer any questions, and give you a discharge time.  OSU is a teaching hospital, and everyone we have met has been excellent. 

Surgeon’s Notes:

Cranial Crucite Ligament Rupture

Based on history, radiographs, and orthopedic exam findings, Maggie was diagnosed with a left cranial cruciate ligament (CCL) tear. Medical and surgical management was discussed and a tibial plateau leveling osteotomy (TPLO) was recommended and elected. This injury is very common in dogs. This condition is considered multifactorial with early degeneration of the ligament, genetic factors, and overload often from daily activity.

A left TPLO was performed to stabilize the left knee on 7/22/25. This procedure alters the angle of the tibial plateau (shin bone), and thus changes the distribution of forces on the knee to compensate for the ruptured ligament. Prognosis after TPLO is good with 85-90% returning to near normal function. Maggie had a torn meniscus that was debrided in surgery.

Latent meniscal tears can occur in a small population of dogs (~5%) that may warrant an additional surgery later in life if she becomes considerably lame. Approximately 50% of dogs eventually have rupture of the cranial cruciate ligament on the opposite leg within 1-2 years. If you notice lameness on the right side in the future, she should be evaluated. You may noticed Maggie scuff her toes on the left hind limb for about 24 hours post-operatively due to the nerve block she received prior to surgery.

Complications of this procedure include infection, dehiscence (opening up of surgical site), seroma formation (fluid pocket under the tissues), delayed bone healing, patellar tendon thickening, fracture, and implant failure. Follow the instructions above to optimize recovery and contact OSU if you have any concerns at any time.

While the TPLO stabilizes the stifle joint and improves function, osteoarthritis will still be present within the joint. Depending on the severity, Maggie may benefit from targeted therapy for arthritis such as joint supplements, fish oil, weight control, continued use of anti-inflammatories, joint injection, or physical rehabilitation.

In addition to her TPLO, Maggie also had a sebaceous cyst removed from her tail that has been submitted for histopathology.  We will contact you when these results are made available. Complications associated with this procedure include infection, bleeding, scarring, necrosis of the tip of the tail, or recurrence. The bandage on her tail can come off in 2 days (7/25/25).

Orthopedic implants are commonly used in veterinary medicine for elective orthopedic procedures and treatment of traumatic injuries such as fractures. Although the majority of these implants remain in for life, there are cases which require removal, even months or years following surgery. Please notify us if you notice any discomfort, local swelling, implant exposure, or drainage around the area of the implant at any time.

Medications:

Notice: Contents of this patient summary contains copyrighted material and should not be copied or used for non-OSU uses or for patients outside of OSU or for uses beyond the intended treatment for this specific OSU medical record/patient.

1. Rimadyl (Carprofen) 75mg tablet: Give 1 tablet by mouth every 12 hours for 10 days, then give as needed to treat pain and inflammation. Give with food. This is a non-steroidal anti-inflammatory medication (NSAID) to reduce pain and inflammation. Side effects include gastrointestinal upset, including vomiting, diarrhea, stomach ulcers, and rarely, liver or kidney damage. If you notice any lack of appetite, vomiting, diarrhea, dark/tarry stool, or decreased appetite, STOP the medication and contact a veterinarian. Do NOT combine with any other NSAIDs (aspirin, ibuprofen, Metacam, Deramaxx, etc) or steroids (prednisone). Next dose due at 8:00 pm tonight

2. Cephalexin 500 mg capsule: Give one 500 mg cephalexin capsule and one 250mg cephalexin capsule (total dose 750 mg) by mouth every 12 hours until gone (10 days). Give with food. This is an antibiotic. Side effects include GI upset (lack of appetite, vomiting, diarrhea). Give with food to minimize side effects.
Next dose due at 8:00pm tonight

3. Cephalexin 250 mg capsule: Give one 250 mg cephalexin capsule and one 500mg cephalexin capsule (total dose 750 mg) Give with food. This is an antibiotic. Side effects include GI upset (lack of appetite, vomiting, diarrhea). Give with food to minimize side effects.
Next dose due at 8:00pm tonight

4. Trazodone 150 mg tablets: Give 1- 1 ½ tablet(s) by mouth every 8-12 hours, as needed, to facilitate activity restriction. This is a sedative and anti-anxiety medication. It takes approximately 90 minutes to take effect. This medication is generally well-tolerated; however, side effects after use may include excessive sedation or hyperactivity. Please contact us if you are having trouble keeping Maggie calm with this medication.
Next dose can be given at anytime

5. Gabapentin 300 mg capsules: Give 1-2 capsule(s) by mouth every 8-12 hours, as needed for sedation. This is a sedative and anti-anxiety medication. It takes approximately 90 minutes to take effect. This medication is generally well-tolerated; however, side effects after use may include excessive sedation or incoordination.  Please contact us if you are having trouble keeping Maggie calm with this medication.
Next dose can be given at anytime

At-Home Care Instructions:

1. Exercise Restriction:
Maggie’s activity must be restricted for at least the next 8 weeks, until there is radiographic evidence of bone healing. During this time, running, jumping, rough play, and off-leash activity are prohibited. Stair climbing should be limited as much as possible. If not possible, Maggie should be kept on a leash and encouraged to take slow and controlled steps. Alternatively, you may carry her. Maggie should not play or roughhouse with other pets during this time. Maggie must be confined to a kennel/pen or small room without furniture to jump on, when she is not being directly supervised. Maggie should be walked outside on a leash for urination and defecation purposes only for the first 2 weeks. Maggie is to be kept on a leash at all times when outside and should NOT be allowed to run free. All leash walks should be on a short leash, and Maggie should be encouraged to take slow, controlled steps. Excessive activity may result in implant failure, delayed bone healing, and other healing complications.
Weeks 1 – 2:Leash walk outside for urination and defecation only, assist with a harness if needed.
Weeks 3 – 8: Maggie may begin 5-minute leash walks 2-3 times a day starting week 3. You may then increase the leash by 5 minutes every week as tolerated (no increase in lameness) up to 20 minutes by week 8. If lameness is noted after the walks, decrease the time for a few days.

2. Incision Care:
Please monitor the incision daily for any evidence of infection such as worsening redness, swelling, pain, or any discharge. There is an incision on the inside of the left knee. A small amount of bruising, redness, and swelling can be normal immediately following surgery. If these signs are not resolving, please contact the OSU-VMC Orthopedic Surgery Service. The incision must remain clean and dry until incision heals (10-14 Notice: Contents of this patient summary contains copyrighted material and should not be copied or used for non-OSU uses or for patients outside of OSU or for uses beyond the intended treatment for this specific OSU medical record/patient. days). Do not allow Maggie to lick or chew at the incision. Please refrain from bathing Maggie during this period.

3. Elizabethan-Collar:
We have Provided Maggie with an E-collar that must be worn AT ALL TIMES until the incisions are evaluated at the 2-week recheck and deemed to be healed. Any self-trauma (licking/biting) at the incisions can promote infection and delay wound healing.

4. Feeding Instructions:
Feed Maggie as normal. Keeping Maggie at a leaner weight will decrease clinical signs associated with joint disease. Low-calorie snack food/treat options include green beans and carrots.

5. Post-Surgery Bowel Movements:
Maggie may take a few days to have a bowel movement due to the surgery and anesthesia. As long as
Maggie is not straining to defecate, you should not be concerned.

I hope this helps you or someone you know who is dealing with the same issues with their pet.  These tears are very painful, and that’s why I got Maggie on pain meds immediately.  The bottom graph shows what a dog’s leg looks like after a TPLO surgery.  Both Jake and Maggie have the same surgical steel implant in their legs.

 

     

 

References:

https://vcahospitals.com/know-your-pet/cranial-cruciate-ligament-repair-tibial-plateau-leveling-osteotomy-tplo

Luxating Patella/Cranial Cruciate Tear