Michigan Veterinary Specialists

Tibial Plateau Leveling Osteotomy Aftercare Information Sheet

Kyle K. Kerstetter, DVM, Diplomate ACVS

Patient Name: Darby

Date: January 31, 2001

Surgery: The joint was stabilized by rotating the proximal tibia and leveling the angle of the tibial plateau which the femur rests upon, thus reducing the stress on the joint. The medial meniscus was found to be normal.

Prognosis: Darby has a very good chance to return to very good function on the operated limb. Arthritis was found to be already present in the knee. As a result, heavy exercise or weather changes may cause her to experience stiffness associated with the knee. The surgery should help minimize this. There are medications that can be given to her to alleviate this if needed (adequan, cosequin, buffered aspirin, rimadyl, etogesic).

Convalescent period: By IO to 14 days after the surgery she should touch the toes to the ground at a walk. From this point on, the lameness should gradually resolve. By 4 months after the surgery she should be using the limb very well. Please let us know if she does not convalesce as stated above.

Medications: 1. Tylenol #4, give I tablet three times daily only if needed to control pain. Give with food. If signs of constipation, vomiting or loss of appetite occur, stop the medication as this may be the cause. 2. Cephatexin 500 mg capsule, give one capsule three times daily until medication is gone. 3. Cephalexin 250mg capsule, give one capsule three times daily until medication is gone

4. Etogesic 300 mg, give I tablet once daily for 10 days. Give after the Tylenol is no longer needed. If you notice any vomiting, diarrhea or loss of appetite, stop this medication.

Exercise: Use a towel sling for support when taking her outside for the first 2 weeks. Limit activity to very short leash walks for bowel and urinary purposes for the first 8 weeks. Never leave Darby off of the leash outdoors. No jumping, climbing stairs or rough-housing with other pets or people. Strenuous activity can break down the surgical repair that was performed, thus prevent successful recovery. During the third month exercise can be gradually increased (on a leash). After 4 months activity can return to normal.

Physiotherapy: Oncethebandagehasbeenremovedhotpackthekneethrectimesdaily,10niinuteseach time for 7 days. A hot water bottle or a warm wet hand towel enclosed in a zip loc bag can be used as a hot pack (monitor temperature so that it does not bum the skin). Physiotherapy should be started after the bandage has been removed. This is done by flexing and extending the knee joint three sessions daily for five minutes each time (do this after each hot packing session). Continue physio for three weeks.

Bandage: The bandage should stay on for 5 days after the surgery (please remove it after this time). It should be kept dry and clean. Place a bag over the bottom of the bandage when going outside and remove the bag when back inside. Check the toes twice daily for swelling or coldness. If you notice the bandage has slipped, does not look to be in place, or if any problems arise please remove the bandage and give us a call.

Incision: After the bandage has been removed, please check the incision for signs of infection: redness, swelling, pain or discharge. Do not allow her to lick the incision. If this occurs obtain an Elizabethan collar from your regular vet. Another option is to apply bitter apple solution around the incision. She should return to us to check the leg in about 2 weeks for evaluation of the incision. There are no external sutures. The next recheck should be done in 2 months from the time of surgery for radiographs. Yearly x-rays should be taken to monitor the arthritis.

Thank you for allowing us to care for DARBY!

21600 West Eleven Mile Road - Southfield, Ml 48076-3709 - (248) 354-6660 Fax (248) 354-0303 - www.michvet.com

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