# Recovery from TPO surgery - what to expect?



## Maxs Mom (Mar 22, 2008)

Clarification, you had a TPO (triple pelvic osteotomy) on an 18 month old male? I did not think they could do that past the 9-10 month age. 

My girl had a total hip replacement at 1 year. It was a long slow rehab. She did great, it was harder on us than on her but she was a good patient. My best advice is follow the surgeons instructions to the letter. Most things happen because the owners do not. 

I was impressed how fast Teddi seemed to use her leg. We supported her but she did very well. Young dogs do heal faster than older ones. I can't help you with your specific type of surgery but... I do believe with the TPO, you get to do more faster than the THR. 

Ann


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## NewToGoldens (Feb 5, 2009)

Thanks Ann (Maxs Mom)..

Yes, believe it or not, it was TPO on an 18 month old.

He met the 3 criteria for being able to do so even though he was beyond the typical age. We were surprised as well that it could be done...

And I can't remember all the criteria but I think it was no or minimal arthritis, presentation on x-ray/manipulation shows subluxation is reducible and socket must not be too worn.

The surgeon did bump his case (was 6-8 week wait) earlier so that we could optimize as he felt he was on the window for being able to have it done.

Now we are just hoping he recovers well.


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## Karen519 (Aug 21, 2006)

*Tplo*

NewtoGoldens

Do you mean TPO or TPLO?
There's quite a bit on here about TPLO.
Just did a Search and here are the topics.

http://www.goldenretrieverforum.com/search.php?searchid=1315233


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## NewToGoldens (Feb 5, 2009)

Hi Karen 59..

TPO.

Looking for anecdotal evidence from people's experiences


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## NewToGoldens (Feb 5, 2009)

*Update 18 days post TPO surgery*

Figured I'd update my own thread. 

We are 18 days post TPO surgery in left hind and athroscopic surgery in left elbow. At 13 days, staples, sutures were removed but we are still on sling support.

Pup has acclimated wonderfully to the ramp (replaces 2 steps off porch to yard) and to being quiet.

The dog is weight bearing on the leg but is definitely still wobbly but it gets stronger each day.

The muscle on that left hind is beginning to lengthen so he is no longer walking on the toe but is starting to use the whole paw.

Eating, drinking, pooping and peeing although had to go through 2 rounds of Flagyl due to loose stools. Seems to be improving with bland diet and have started adding kibble back in.

The vet approved him for very short bathroom walks in the yard (5-10 minutes) with continued sling support.

Still no slippery surfaces, no running, jumping, etc.

3 1/2 more weeks and then we go back for more x-rays to see how healing is progressing and see how the implants are doing.

Then hopefully we can begin rehab!

My pup is being an amazing patient so far. 

I'm sure my next questions will be about people's experiences with rehab.


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## blivi (May 5, 2010)

Hi New to Goldens! My Otis had TPO surgery in February on one hip and in March on the other. He's almost three months out of the most recent one and doing splendidly. The sling is super important, as is the rest. Our puppy was only 6 months old in February, and as you know, it's hard to keep them from acting crazy! Especially as they start to feel better. But stay strong!! 

Biggest piece of advice? LISTEN. Otis would look at us like, "come on, mom...I'm so ready to go, I feel GREAT!" But our vet tech family friend would keep on us to not push it. So no running, jumping, etc. And it was hard. I'm sure you're probably experiencing that same feeling right now. 

At the end of April, Otis was allowed to start ramping up activity and at the end of May, he was back to full activity. We started him swimming at the lake. It's excellent for building up those muscles. Now, he's still not 100%--he babies the most recent surgery hip a bit because it's weaker, he still takes his time on steps, etc. But every day he gets stronger and more confident. Where he used to be scared to walk on tile floors? No more. Going down the steps without the sling used to be scary too...but no more. It gets better and better. 

One of the greatest things was seeing him sit like a normal dog and finally be able to "shake" because he feels secure sitting on his haunches. It's crazy how something so simple is so delightful. 

Good luck on your journey!!
(my blog that I started about otis's surgery: otisjourney.blogspot.com)


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## NewToGoldens (Feb 5, 2009)

blivi this is exactly what I was looking for!

Your blog was fabulous! Thanks for this post.

My guy is going back for his 6 week recheck (new x-rays to check healing and implant positioning) on Wed.

He is definitely getting stronger but still a long way to go. Loss of muscle and the other hip is sore from compensation. Both which will improve when he can begin rehab.

But it's good to know that 7 weeks seems to be a "milestone" of sorts.

We walk him with a sling but aren't really using it for anything, except support up/down the ramp off the front steps.

Thanks again for your informative post!

And fyi, for anyone else with a > 10 month old puppy who has issues, TPO surgery can be done if the dog meets the 3 magical criteria. In our case, although he was dysplastic, he met the criteria in 1 hip, the key being good reaction to manipulation and no arthritis (which the vets found surprising). Typically arthritis rules out TPO in dogs > 10 or so months.

We have also started Adequan injections which we will continue throughout his life. I figured with what we just spent on surgery, a monthly shot is a drop in the bucket if it helps.


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## sdain31y (Jul 5, 2010)

*A Few Questions*

Evening blivi and New to Goldens,

We have a 15 month old golden, Jazz that we rescued when she was 6 mths old. Poor sweet girl has dealt with one problem after the other and the latest is we've finally got a diagnosis of HD and the ortho surgeon recommended bilateral TPO. 

I read your blog, blivi and appreciated the information. The surgeon who's doing Jazz's surgery firmly believes in rehabilitation and his protocol is to keep the dog for 5 weeks after the first surgery for physical therapy & rehabilitation work. They'll do the second surgery 1 -2 weeks after the first. Seems like a radially different approach. We can visit a couple times a day, but they keep her there until she's well on the mend. 

Since you've both dealt with handling your dog at home, any thoughts with this approach?

Also, what are Adequan injections for?

I've kept a blog about Jazz but kept access to it fairly controlled. I'd be glad to let you see it, if you are interested. Just send me your email in a private message. Her blog is http://lifewithjazz.spaces.live.com/

Thanks for the information. Its a tough decision, especially since the first specialist said it was a torn or ruptured CCL (ACL).

 :uhoh:


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## NewToGoldens (Feb 5, 2009)

Hi sdain31y,

The Adequan is similar to the oral glucosamine that can be found in Cosequin DSU and other similar joint supps. However giving it via a shot allows it to "target" where it is needed most. Some folks feel the IM shot may work better than oral meds which may not absorb quite as well. I do the same for my horses so have some history with this approach. 

We are now 8 weeks post-op, no longer use the sling, have started short walks and he begins water therapy in 2 weeks. We do still keep him off the linoleum as it's slippery) and we still use the ramp rather than the 2 steps off the front deck.

I found that making him walk slowly when he was out walking forced him to use the leg more deliberately and I think it was helpful as his gait is back to "normal".

I have never heard of the surgeon keeping the dog for such an extended time after surgery but sounds like an interesting although expensive approach. I can't imagine being without my pup for that long though. 

Our dog was a perfect patient and I have the luxury of working out of the house so I was with him all the time so I very closely monitored his activity. If in doubt (like when someone visited), in the crate he went. I admit, the 1st 6 weeks after surgery until the follow-up x-rays to confirm healing were nerve-wracking but manageable.

Good luck with your pup and feel free to PM if you want to discuss more.


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## sdain31y (Jul 5, 2010)

Evening,

I tried to PM you, but don't have enough posts to do that yet. Oh well. Bottomline, I think 5 weeks is a very long time to have her at the clinic, but he's a strong believer in the important rehabiliation makes in the longterm success of the surgery. Besides, it wasn't a option - this is his protocol.

If I worked from home or could take that time off, it would be more of an issue for me. But, since both my husband and I work outside of our home it'd be a real challenge to give Jazz the quality and amount of care she'd need right after the surgery. It was almost a relief to know they'd be there to help her on the recovery journey. I think I'd worry myself sick trying to keep her quiet and healthy. And when she's at the clinic we'll be able to visit her everyday but surgery days and Sundays. Multiple times, if we want! 

I do worry about her being there for so long, but I stopped by there this afternoon and talked at some length with the vet's assistant about the whole thing. The vet has operated on her two dogs and each time they've enjoyed being at the clinic. Plus, the clinic is the ortho surgeon & oncologist during the day and emergency clinic at night. So there's always vets and assistants at the clinic and they check on all the patients all during the evening. A definite plus!

This whole thing is worrying me to death, but I don't think I've had a day since we've adopted Jazz that I wasn't worried about something with her. If this surgery will give her a pain free life, then I'm just going to have to deal with my issues, find a way to help her thru this and do it!

We are waiting to schedule the surgery until the vet gets the results of the analysis on her knee fluid. He said he was 98% sure its only her hips, but analysis of the fluid will definitely confirm that. We should hear the results by next week. If it turns out its her hips we'll schedule the surgery for the next day or so.


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## Karen519 (Aug 21, 2006)

*NewtoZGoldens*

NewtoGoldens

It sounds like your dog is doing very well after TPO surgery and he sure has a wonderful mom to care for him!

Sorry I have no experience with TPLO, but my Golden, Smooch, had TPLO surgery for a torn cruciate ligament in her knee at age of 10 and did very well!!


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## NewToGoldens (Feb 5, 2009)

*fluid analysis of the knee?*

sdain31y,

I'm curious..

What will the fluid analysis of the knee confirm about the hips?

It is definitely a nerve-wracking experience no matter where the dog is recuperating... 

Good luck with Jazz and do keep us posted!


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## sdain31y (Jul 5, 2010)

*Waiting*

Haven't heard back from the fluid ananlysis yet and won't schedule the surgery until then. Definitely will be interesting to hear. 

Its odd to have such differing diagnosis from specialists. I am also waiting for my regular vet to talk to the second ortho vet, so I'll be interested in her thoughts. 

The one thing that's in the favor of the second ortho specialist is his main area of research and publication is CCL problems (knee problems), so I'd think he could recognize a problem there if she had one. Still it is most unsettling. 

I'd think about a third consult, but they are costing us about $400 - $500 each time and we are still looking at the cost of surgery after. Plus, I'd really like her surgery done in Savannah instead of hours and hours away at the closest Vet Hospital, if at all possible.

I just not sure! :bowl:


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## blivi (May 5, 2010)

sdain31y--

Wow, that is a different approach. I understand it, though. Our vet kept Otis for 4-5 days. Some vets send them home once they awake from anesthesia. I'd say this doctor has probably had problems with people following the very strict regimin--slings and weight restrictions, etc. I think there are too many people who let their dogs dictate the terms of the recovery, and they end up popping screws or not healing well (which of course makes the surgery a waste of money and time). Thus, I can understand his/her protocol.

IT would be, to be honest, devastating for me. It was hard enough when he was gone for 5 days, but I'd imagine you'd get used to it. I'm guessing it would be harder on us humans than on the dog. At clinics, they tend to get tons of attention and TLC--and when they're cute little guys, it's even better.  I know Otis LOVES the vet...doesn't matter that he usually goes through trauma when he's there because he loves all the people and they all love him. He just gets so excited whenever we pull up to the vet's office! So I'm sure she'll flourish in that environment.

When you do get her back, make sure you follow the directions perfectly...and go for the physical therapy! We should have done that right away and now we're behind on normal muscle tone and range of motion.

Good luck with everything. Really. I know it's so difficult. Especially because you want to do what's best for your little gal...but it's hard to know with all of the conflicting opinions (especially on the internet). But we don't regret the decision at all. It's been hard. And EXPENSIVE (we call him our little $10,000 sweetheart, lol, like the Bionic Dog or something). But he's so much happier! And since he's our only "child", we'll give anything to make him healthy and happy. I'm happy to chat more about it if you want to chat. I know this is a hard time!


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## sdain31y (Jul 5, 2010)

*Thanks!*

Thnak you so much for your response. It definitely made me feel better.

It is odd to have to leave her there that long, but like you I can surmise why he wants to have it that way. On top of just being able to watch them and keep close tabs on their incision, healing, movement, etc., they also begin their regime of physical therapy the day of surgery. He said they place a brace on the affected leg that massages and helps control swelling with pressure from alternating warm and cold water. And the therapy continues until she gets to come home. He's a strong believer that the physical therapy is critical in their recovery. 

And you're right, it'll probably be harder on us then her. 

We are still waiting on the results on the knee fluid. It was sent off and we were told the results would take a week or more. Once we get that, then we have to make the decision. 

I'll let you know. I'll probably be looking for reassurance about then! Thanks again. :wavey:


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## Maxs Mom (Mar 22, 2008)

WOW very different approach. 

Most dogs I have heard that had a TPO were sent home the next day, and it was up to the owner to do any and all rehab. Now I am not saying the places did not offer assistance. I guess if you had the money... 

My Teddi had a THR, she was sent home with me the next day. Now her rehab was VERY different. She was COMPLETELY immobile for 3 months. Crate only, leashed potty walks, period, exclamation point. After 3 months she was cleared for supervised loose in our house, she still could not do stairs BUT she could be assisted and go to our basement (our family/TV room). We could start walking her SHORT distances on a leash and still leashed potty walks. Of course 3 months post op was January.... too icy to walk her. We did get the ok from the surgeon to take her swimming for therapy instead. 

I hope all goes well for you and you have the results we had with Teddi's THR. She is two and a half years post op and loving life and running, jumping, playing and being a dog. We only did one hip and she is still HD in her other side, but doesn't seem affected. Her elbows are our bigger concern now, she too had ED, but we are managing those and we are 1 and a half years past that diagnosis, no limping (knock on wood) or any other concerns, so far our management seems to be working.

Ann


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## NewToGoldens (Feb 5, 2009)

*9 weeks post TPO*

Hi Max's Mom (Ann),

The ortho guy who did our TPO surgery said that THR is a totally different ballgame from TPO. TPO being much less of a risk than THR.

This is one of the reasons we ended up doing TPO was to hopefully save 1 hip from future THR.

For us, surgery was on a Thursday and he came home on a Sunday. I admit, he could have come home Saturday but I told them I wanted him comfortably pooping and peeing before I brought him home.

So far, 8 weeks post-op:
No longer using sling and haven't for awhile.
Up to 2 20 minute walks a day plus numerous walks around the yard.
He also hangs around with me while I do the barn, yard chores, etc.
Going up and down stairs.
Still use the ramp on/off the front porch and I lift him in/out of the vehicle.
I just started letting him walk on the slippery floors in the house (linoleum and hard wood) but that's because I swear he slips worse than any dog I know of.
We start water therapy next week for 6 weeks.
His hair is finally starting to grow back! Yeah!


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## Karen519 (Aug 21, 2006)

*Great*

It sounds like your baby is doing wonderfully!!


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## Karen519 (Aug 21, 2006)

*Sdain*

Sdain

Just sent you three emails and also please notice NewToGoldens post


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## NewToGoldens (Feb 5, 2009)

*Another update 4 months post-op... (TPO surgery in 15 month old)*

Figured I'd provide another update.

Finished water therapy which I highly recommend!

Water treadmill and boy did it make a difference. 2x/week for 3 weeks. Therapy included cavellettis, balance board and other exercises to make him use that left hind. I also found (carefully) driving around while he is standing helped alot as he had to use both legs to balance (floor of back seat of pick-up truck - did I say carefully?). Vets agreed.

Dog is now very good on the hip and almost back to normal activity. He runs, plays, etc although we are cautious and don't do "hard stop" ball playing or games like that. And other than unavoidable logs in the woods, he doesn't jump. Don't want torque on the elbows and hips but we have many other ways to have fun.

Taking long walks with swimming, some fields and hills and some zoomies for good measure. 

I think he is sound enough and recovered enough for me to finally begin playing around with very basic agility! Yeah!


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## Karen519 (Aug 21, 2006)

*NewtoGoldens*

NewtoGoldens

I am SO GLAD your baby did so well.
What does TPO stand for?


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## NewToGoldens (Feb 5, 2009)

Hi Karen519,

TPO = Triple Pelvic Osteotomy

Typically a preventative surgery (to avoid later in life) hip issues due to too much movement of the hip in and out of the socket (too loose) which leads to arthritis.

Usually done before the dog is 10 months since there are strict criteria for being able to do it. Fortunately, my dog met the criteria at 15 months. The biggest being that although he has crappy hips (very loose), he had NO arthritic changes (yet), the hip manipulated properly and he is not overweight.

The surgery basically detaches the pelvis and rotates it forward (in our case the average of 30 degrees) and then it is pinned into place with implants. The idea behind it is that it closes the gap (tighter fit) when the hip is too loose in the socket.

I am SO happy that this is pretty much behind us. I'm sure the dog is too. 

My dog was an absolutely wonderful patient this entire summer but I can't imagine recovery and rehab on a dog that isn't as willing to "hang out quietly " as ours is. (Too anyone who has a not-so-great patient, you have my sympathy!)


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## Jax's Mom (Oct 16, 2009)

Wonderful news! So glad your boy is doing much better. You sound like a wonderful doggie parent!!


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