Protecting
Pets, People & Planet

The meniscus is a C-shaped cartilage in a dog's knee (stifle) joint that cushions and stabilizes movement. It absorbs shock and spreads weight evenly across the joint, preventing excessive wear on the bones. Each knee has two menisci—medial (inner) and lateral (outer). The medial meniscus is more prone to injury because it is firmly attached to the tibia.

After TPLO (Tibial Plateau Leveling Osteotomy) surgery, meniscal tears can still happen, even though the procedure stabilizes the knee. This can occur due to ongoing joint instability before surgery, direct trauma, or degenerative changes. In some cases, the meniscus was already damaged before TPLO but went unnoticed.

Meniscal tears often cause pain, limping, and clicking sounds in the knee. Some surgeons perform a meniscal release during TPLO to lower post-op risks, but this may affect joint function. Early detection and treatment are crucial to prevent long-term mobility issues.

Causes of Meniscal Tears After TPLO Surgery

Meniscal tears after TPLO surgery can happen due to several reasons, even though the knee is surgically stabilized. While TPLO aims to prevent further damage, certain conditions can still stress the meniscus, causing injury.

1. Excessive or abnormal force during healing – After TPLO surgery, the knee joint still bears weight. If a dog is too active too soon, too much stress on the meniscus can lead to tearing. Sudden movements, slipping, or jumping before full recovery can put abnormal pressure on the cartilage.
2. Pre-existing meniscal damage – Sometimes, the meniscus is already torn before TPLO but isn't visible during surgery. A partial tear can become a full tear over time, especially if the joint stays irritated or inflamed.
3. Abnormal tibial alignment after surgery – If the tibia isn't properly aligned during TPLO, leftover instability may continue, causing repeated stress on the meniscus. Poor surgical technique or individual anatomical differences can lead to this problem, resulting in ongoing joint damage even after the procedure.

Symptoms of a Meniscal Tear in Dogs

A meniscal tear after TPLO surgery can cause significant discomfort and mobility issues. While some symptoms overlap with general knee problems, certain signs strongly suggest meniscal damage.

1. Limping or lameness – A dog with a torn meniscus often shows a sudden return of limping after initial TPLO recovery. The lameness may come and go, worsening after activity.
2. Difficulty bearing weight on the affected leg – Dogs may hesitate to put full weight on the injured leg, sometimes lifting it when standing still. Some dogs shift weight to the opposite leg, leading to uneven posture.
3. Swelling around the knee joint – Inflammation in the stifle joint can occur, making the area around the knee appear swollen or warm to the touch. This often indicates irritation or internal damage.
4. Pain or sensitivity when the joint is touched – Affected dogs may react when the knee is examined, showing discomfort by pulling away, whining, or licking the joint.
5. Reluctance to engage in physical activity – A previously active dog may become less willing to walk, run, or climb stairs due to pain. If untreated, this can lead to muscle loss and further joint complications.

Diagnosing a Meniscus Tear After TPLO Surgery

Identifying a meniscal tear after TPLO surgery involves a combination of clinical examination and advanced diagnostic tools. Since symptoms can mimic other knee issues, a thorough assessment is essential for an accurate diagnosis.

1. Physical Examination and Manual Manipulation – A veterinarian will evaluate the affected limb by observing gait, joint swelling, and pain response. A key test is the "meniscal click" sign, where a clicking or popping sound is felt when flexing and extending the knee. However, not all tears produce this sign, so further diagnostics may be needed.
2. Arthrotomy or Arthroscopy (Direct Visualization) – If a meniscal tear is highly suspected, direct visualization is the most reliable way to confirm it. Arthrotomy involves surgically opening the joint, while arthroscopy is a minimally invasive technique using a small camera. Arthroscopy allows for greater precision and faster recovery, making it the preferred method in many cases.
3. Advanced Imaging Techniques (MRI, CT Scans) – While X-rays do not show soft tissues, MRI or CT scans can help detect meniscal injuries. MRI provides the best soft tissue detail, though its availability in veterinary medicine is limited. CT scans with contrast can sometimes help but are less effective than MRI for diagnosing meniscal damage.

Treatment Options for a Meniscal Tear

The treatment for a meniscal tear after TPLO surgery depends on how severe the injury is. Mild cases might improve with conservative management, but severe tears often need surgery to restore joint function and relieve pain.

Conservative Management (For Mild Cases)

For minor meniscal injuries, non-surgical treatments can help manage pain and prevent further damage:

• Rest and restricted activity – Strict crate rest or controlled leash walking for several weeks prevents the tear from getting worse.
• Physical therapy and rehabilitation – Gentle exercises, hydrotherapy, and laser therapy improve mobility without putting stress on the joint.
• Pain management (NSAIDs, joint supplements) – Nonsteroidal anti-inflammatory drugs (NSAIDs) reduce swelling, while glucosamine and chondroitin support cartilage health.

This approach works best for small, stable tears and requires close monitoring for any worsening symptoms.

Surgical Treatment (For Severe Cases)

Severe meniscal tears often need surgery to restore function and prevent chronic pain:

• Partial meniscectomy – The damaged part of the meniscus is removed to eliminate pain and mechanical obstruction.
• Meniscal repair – In rare cases, suturing the tear is possible, though outcomes are less predictable.
• Expected recovery timeline after surgery – Most dogs recover within 8–12 weeks, with physical therapy helping to improve mobility and muscle strength.

Postoperative Care and Recovery

Proper postoperative care is crucial for a successful recovery after meniscal tear surgery. A structured rehabilitation plan helps reduce pain, restore mobility, and prevent further joint damage.

1. Controlled Leash Walks and Restricted Movement – Dogs should avoid running, jumping, or rough play for several weeks after surgery. Short, leashed walks on flat surfaces help maintain circulation while preventing too much stress on the knee. Crate rest or a confined space is recommended when unsupervised.
2. Passive Range of Motion Exercises – Once approved by the veterinarian, gentle bending and straightening of the knee help maintain joint flexibility. This should be done slowly and without forcing movement to avoid discomfort.
3. Ice and Heat Therapy for Pain Relief – Applying ice packs (wrapped in a towel) to the knee for 10–15 minutes several times a day reduces swelling in the first few weeks. Later, warm compresses can be used to improve blood flow and relax stiff muscles.
4. Gradual Return to Normal Activity – Around 8–12 weeks after surgery, supervised activity can increase. Hydrotherapy, slow stair climbing, and controlled treadmill walking are beneficial. A full return to normal activity typically takes 3–4 months, depending on healing progress.

Signs to Watch for During Recovery

Monitoring your dog’s recovery after meniscal tear surgery is crucial to ensure proper healing. While some discomfort is expected, certain signs may indicate complications that require veterinary attention.

1. Swelling Lasting Longer Than 5–7 Days – Mild swelling around the knee is normal after surgery, but it should gradually decrease. Persistent or worsening swelling beyond a week may indicate inflammation, infection, or fluid buildup in the joint.
2. Persistent Pain Despite Medication – Pain should decrease over time with prescribed NSAIDs and other pain relief medications. If your dog continues to show signs of discomfort, such as whining, excessively licking the knee, or avoiding movement, it may suggest ongoing joint irritation or surgical complications.
3. Inability to Bear Weight 5–7 Days Post-Surgery – While some dogs may take a few days to regain full weight-bearing ability, complete reluctance to use the affected leg beyond a week could signal continued meniscal issues, improper healing, or implant complications.
4. Any Unusual or Concerning Symptoms – Signs like discharge from the incision, fever, or a sudden increase in limping warrant immediate veterinary attention. Catching these issues early can prevent long-term mobility problems and ensure a smooth recovery.

How to Prevent Meniscal Tears After TPLO

Preventing a meniscal tear after TPLO surgery involves careful post-surgery management and ongoing joint care. While TPLO stabilizes the knee, extra precautions help protect the meniscus and support full recovery.

1. Proper Post-Surgical Rehabilitation – A structured rehab plan is essential to avoid putting too much stress on the knee. Controlled leash walks, passive range-of-motion exercises, and hydrotherapy strengthen the joint without overloading the meniscus. Sudden, unapproved activities can increase the risk of injury.
2. Avoiding High-Impact Activities Too Soon – Running, jumping, or playing too early in recovery can strain the healing knee and harm the meniscus. Gradually reintroducing activity, based on veterinary advice, reduces the risk of re-injury.
3. Regular Vet Checkups to Monitor Healing – Follow-up visits allow the vet to check joint stability, swelling, and pain levels. If instability or discomfort continues, early intervention can prevent further meniscal damage.
4. Supplements or Therapies to Support Joint Health – Glucosamine, chondroitin, and omega-3 fatty acids help maintain cartilage health and reduce inflammation. Physical therapy, including laser treatment or acupuncture, can improve mobility and prevent additional joint issues. Proper joint care ensures long-term knee function and minimizes re-injury risks.

Also Read about:

• TPLO surgery complications
• Bilateral TPLO surgery
• How to treat MRSP in dogs
• Staph infection after TPLO surgery

Conclusion

Early detection and treatment of a meniscal tear after TPLO surgery are crucial for preventing long-term joint damage and ensuring a successful recovery. Recognizing symptoms like limping, pain, and difficulty bearing weight allows for timely intervention, reducing the risk of further complications.

A structured rehabilitation plan is essential for recovery. Controlled leash walks, physical therapy, and gradually reintroducing activity help protect the knee joint and prevent additional injuries. Proper post-operative care, including pain management, restricted movement, and joint-supporting supplements, contributes to long-term stability and comfort.

If your dog shows persistent pain, swelling, or reluctance to use the affected leg beyond the expected healing period, consult a veterinarian immediately. Unaddressed meniscal damage can lead to chronic discomfort and reduced mobility. With careful monitoring, rehabilitation, and veterinary guidance, dogs can regain full function and enjoy an active, pain-free life after TPLO surgery.

FAQs

What happens if a dog tears the meniscus after TPLO?

If a dog tears the meniscus after TPLO, it can cause pain, lameness, and joint instability. The knee may produce a clicking sound when moving. If left untreated, it can lead to chronic discomfort and arthritis. Treatment options include pain management, restricted activity, or surgery to remove the damaged meniscus.

Can a torn meniscus in a dog heal on its own?

No, a torn meniscus does not heal on its own because it has limited blood supply, preventing natural regeneration. Small tears may be managed with rest, NSAIDs, and joint supplements, but severe cases often require surgical intervention, such as a partial meniscectomy, to remove the damaged portion and restore knee function.

How to know if a dog ruined TPLO surgery?

Signs of a failed TPLO surgery include persistent limping, swelling, reluctance to bear weight, and worsening pain beyond the expected recovery period. A sudden decline in mobility or unusual clicking sounds may indicate complications like implant failure, infection, or a meniscal tear. A veterinary exam, X-rays, or arthroscopy can confirm the issue.

How to fix a meniscus tear in dogs?

Treatment depends on severity. Mild tears may be managed with pain relief, restricted activity, and joint therapy. Severe tears often require surgery, such as a partial meniscectomy, where the damaged meniscal portion is removed. In rare cases, meniscal repair may be attempted, though its success rate is lower than removal.

Why is my dog limping 4 months after TPLO?

Limping four months post-TPLO could indicate a meniscal tear, incomplete healing, implant issues, or arthritis. While mild stiffness is normal, worsening lameness, pain, or joint clicking requires veterinary evaluation. X-rays or arthroscopy can help identify complications, and treatment may involve physical therapy, pain management, or additional surgery if needed.

‍

TPLO (Tibial Plateau Leveling Osteotomy) is a common surgery used to treat cranial cruciate ligament (CCL) injuries in dogs. It involves cutting and repositioning the tibia to stabilize the knee joint, reducing the need for the damaged ligament. Although TPLO has a high success rate, complications can still occur even with proper surgical technique.

Complications can arise due to factors like a dog's age, weight, overall health, and how well post-operative care guidelines are followed. Older or overweight dogs are at higher risk for delayed healing and implant failure because of increased strain on the joint. Inadequate rest, early activity, or infections can also cause setbacks.

Even with precise bone healing, some dogs may experience swelling, lameness, or implant-related issues. Being aware of these risks helps ensure timely intervention and optimal recovery. Proper monitoring, limited activity, and follow-up evaluations are crucial in reducing post-surgical complications.

‍

TL;DR: Possible Complications After TPLO Surgery

• Immediate complications: Infection, hemorrhage, implant loosening, excessive swelling, or premature suture removal.
• Mid-term complications: Delayed bone healing, seroma formation, nerve damage, tibial tuberosity fractures.
• Long-term complications: Patellar luxation, arthritis, meniscal injuries, persistent lameness, patellar ligament thickening.
• Severe complications: Osteomyelitis (bone infection), implant failure, chronic pain, or non-union of the bone.

‍

Immediate Post-Surgical Complications (First Few Days to Weeks After Surgery)

In the initial days after TPLO surgery, dogs are at risk for complications that can slow healing and cause discomfort. Careful monitoring and early intervention are crucial to ensuring a smooth recovery.

1. Infection at the Surgical Site

Infection is one of the most common early complications after TPLO surgery. It can happen if bacteria enter the surgical site, delaying healing and potentially affecting the implant.

Signs of infection include redness, swelling, warmth around the incision, pus-like discharge, an unpleasant odor, and increased pain or tenderness. Some dogs may also develop a fever or show signs of discomfort, such as excessive licking or reluctance to put weight on the affected leg.

Causes of infection include poor hygiene, contamination during or after surgery, excessive licking of the incision, and improper wound care. Dogs that lick or chew at their stitches introduce bacteria, increasing the risk of infection. Environmental factors, like a dirty bedding area, can also lead to bacterial growth.

Treatment options depend on how severe the infection is. Mild cases may be managed with oral antibiotics and regular wound cleaning using an antiseptic solution. More severe infections, especially those affecting deep tissues or the implant, require veterinary care.

This may include culture testing to identify the bacteria and, in rare cases, surgical removal of infected tissue. Preventive measures, such as using an Elizabethan collar (E-collar) and ensuring proper wound care, are essential to reducing the risk of infection.

2. Bone Infection (Osteomyelitis)

Osteomyelitis is a serious bone infection that affects deeper bone tissue and can compromise the TPLO implant. Unlike surface infections, osteomyelitis can cause long-lasting inflammation, bone damage, and implant failure.

Symptoms include ongoing swelling, increased pain, fever, pus draining from the incision, and slow healing. Affected dogs may become tired and unwilling to use the operated leg. In chronic cases, the infection can spread, causing a more widespread illness.

Risk factors include contamination during surgery, bacteria from an infected wound, or infections related to the implant. Dogs with weak immune systems or those in unclean environments after surgery are at higher risk.

Treatment involves strong antibiotic therapy, often based on bacterial culture results. In severe cases, surgery may be needed to remove infected bone tissue. If the implant is affected, it might need to be removed and replaced once the infection is under control. Early detection and strict hygiene are key to preventing osteomyelitis.

3. Implant Issues (Loosening, Breaking, or Failure)

Implant complications happen when the TPLO plate or screws don't work properly, causing instability in the knee joint. These issues can occur due to too much movement, poor implant placement, or infections that weaken the bone connection.

Signs of implant failure include ongoing limping, pain, swelling around the implant site, and unusual clicking or grinding sounds from the joint. In severe cases, the implant might shift, leading to bone misalignment. Dogs that suddenly become lame after surgery should be checked right away.

Causes include too much activity after surgery, improper bone healing, and mechanical stress on the implant. Infections can also weaken the bone and screws, increasing the chance of failure. Overweight dogs are at higher risk due to more pressure on the joint.

Possible corrective actions depend on how severe the issue is. Minor loosening might be managed with limited activity, while severe cases could need revision surgery to replace or reposition the implant. If there's an infection, the implant may need to be removed, followed by antibiotic treatment before placing a new implant.

4. Premature Suture Removal by the Dog

Dogs often lick or chew their sutures due to discomfort, irritation, or boredom. However, removing stitches too soon can reopen the surgical site, exposing tissues to infection and delaying healing.

Consequences of removing sutures include the wound reopening, a higher risk of infection, and excessive scarring. In severe cases, exposed tissues may dry out or become contaminated, requiring more surgery. If deeper sutures are disturbed, healing can be significantly delayed.

Preventive measures include using an Elizabethan collar (E-collar) to stop licking and chewing. Bandaging might help, but it must be done carefully to avoid moisture buildup, which can lead to bacterial growth. Supervision is crucial, especially in the first two weeks after surgery.

Providing distractions, like puzzle toys or chew treats, can help keep dogs from focusing on their incision. If stitches are removed too soon, a veterinarian should assess the wound immediately to decide if re-suturing or additional wound care is needed.

5. Hemorrhage During or After Surgery

Hemorrhage, or excessive bleeding, can happen during or after TPLO surgery due to blood vessel injury, clotting disorders, or improper post-operative care. While some mild bruising is normal, significant bleeding is a serious issue that needs immediate attention.

Symptoms of post-surgical hemorrhage include excessive blood oozing from the incision, swelling or bruising that gets worse over time, pale gums, rapid heart rate, and lethargy. In severe cases, internal bleeding may cause a swollen abdomen or breathing difficulties.

Causes include surgical trauma to blood vessels, clotting disorders like Von Willebrand’s disease, or post-operative strain on the incision site. Certain medications, such as NSAIDs and steroids, can also affect the ability to clot.

When to seek emergency vet care: If bleeding continues for more than a few hours, if the wound reopens, or if the dog shows signs of weakness and pale gums, immediate veterinary care is crucial. Treatment may involve pressure bandaging, fluid therapy, or surgical intervention to control internal bleeding. Quick action can prevent life-threatening complications and improve recovery outcomes.

Mid-Term Healing Complications (Weeks to Months Post-Surgery)

As the initial healing phase progresses, some dogs may experience complications that affect recovery in the weeks following surgery. Monitoring for persistent swelling, delayed healing, or mobility issues is essential to prevent long-term problems.

6. Swelling and Bruising at the Incision Site

Some swelling and bruising are expected after TPLO surgery as part of the body's normal healing process. Mild swelling around the incision site, along with light bruising, usually goes away within two weeks.

Concerning signs include swelling that doesn't go away or gets worse beyond the expected recovery time, extreme discoloration (deep purple or black bruising), excessive warmth, and increasing pain. These could indicate an infection, hematoma (blood accumulation), or poor circulation.

Managing swelling effectively requires early action. Cold therapy, like applying an ice pack wrapped in a towel for 10–15 minutes several times a day during the first 72 hours after surgery, helps reduce inflammation. After this initial period, warm compresses can be used to promote circulation. Anti-inflammatory medications, if prescribed by a veterinarian, can also help reduce swelling.

Strict rest and avoiding unnecessary movement help prevent further irritation. If swelling worsens or doesn't improve, a veterinarian should check the incision site to rule out complications such as infection or fluid buildup.

7. Seroma Formation (Fluid Accumulation)

A seroma is a fluid buildup under the skin near the surgical site. It can occur due to too much movement, surgical trauma, or minor irritation, which causes leakage from blood vessels and lymphatic tissues. Unlike an infection, a seroma is usually not painful and doesn't show redness or discharge.

It's important to tell the difference between normal swelling and a problematic seroma. A small, soft, and flexible swelling that doesn't cause discomfort is often a harmless seroma and may go away on its own. However, if seromas are large or don't go away, especially if they grow or become painful, a veterinarian should check them. Signs of infection, like warmth, redness, or pus, need immediate attention.

Treatment options depend on how severe the seroma is. Small seromas are usually managed by monitoring and using compression therapy. Reducing excessive movement can help decrease fluid buildup. Large seromas might need to be drained with a sterile needle.

If fluid continues to build up, a drain may be placed to stop further accumulation. Preventing too much movement and ensuring proper rest after surgery can help reduce the risk of seroma formation.

8. Nerve Damage Leading to Limb Numbness

Nerve damage after TPLO surgery is rare but can happen due to surgical manipulation near major nerve pathways. The peroneal nerve, which controls foot and lower limb function, is most at risk during tibial surgery. In some cases, swelling after surgery can also temporarily affect nerve function.

Symptoms of nerve damage include dragging the paw (knuckling), reduced sensation in the affected leg, lack of response to touch, or an unusual way of walking. Dogs may seem unable to place their foot properly on the ground. In severe cases, they may develop muscle wasting due to not using the limb for a long time.

Prognosis and recovery depend on how severe the nerve injury is. Mild nerve compression from swelling often gets better within weeks as the swelling goes down. Physical therapy, gentle massage, and controlled movement exercises can help with nerve recovery.

Severe nerve damage, such as a completely severed nerve, has a poorer outlook and may require assistive devices or surgery. Close monitoring and early rehabilitation improve the chances of functional recovery.

9. Delayed Bone Healing or Non-Union

Bone healing after TPLO surgery usually takes 8–12 weeks, but sometimes healing is delayed or does not happen properly (non-union). Several factors can affect bone healing, including poor nutrition, too much activity, infection, or improper implant placement.

Signs of delayed healing include prolonged limping, ongoing swelling around the surgical site, and discomfort that lasts beyond the expected recovery time. X-rays may show incomplete bone fusion at the osteotomy site, indicating slowed healing. If not addressed, delayed healing can lead to implant failure or instability in the knee joint.

Treatment approaches focus on encouraging bone regrowth. A veterinarian may suggest calcium and vitamin D supplements to support bone health. Strict activity restriction is essential to prevent too much movement at the healing site. If an infection is suspected, antibiotics are prescribed.

In severe cases, additional surgery may be needed to replace hardware, perform a bone graft, or stimulate healing with advanced techniques like bone-stimulating proteins. Early intervention increases the chances of full recovery and proper joint stabilization.

10. Tibial Tuberosity Fractures

A tibial tuberosity fracture is a rare but serious issue that can happen after TPLO surgery. The tibial tuberosity is the bony bump where the patellar tendon attaches, and too much strain can cause it to fracture, especially in large, active dogs or those not properly cared for after surgery.

Symptoms of a tibial tuberosity fracture include sudden pain, reluctance to put weight on the leg, localized swelling, and knee joint instability. Some dogs may walk abnormally or have trouble extending their leg. This fracture is usually diagnosed with X-rays, which show a break near the TPLO osteotomy site.

Treatment depends on the fracture's severity. Minor fractures may heal with strict rest, pain management, and controlled rehabilitation. More severe cases require surgery, which may involve adding screws or wire to stabilize the fracture.

Proper post-operative care, including limited movement and weight management, is crucial to prevent tibial tuberosity fractures. Early detection and appropriate treatment improve recovery and help restore normal joint function.

Long-Term Complications (Months to Years Post-Surgery)

While most dogs recover well after TPLO surgery, some may develop complications months or even years later. These long-term issues can impact mobility and joint health, requiring ongoing management and veterinary care.

11. Patellar Luxation (Kneecap Dislocation)

TPLO surgery changes how the knee works, which can sometimes affect the position of the patella (kneecap). While TPLO stabilizes the knee joint by adjusting the tibial plateau, it may lead to patellar instability, especially in small-breed dogs or those with existing knee issues.

Symptoms of patellar luxation include a skipping gait, where the dog briefly lifts the leg before walking normally again. There may also be sudden pain, occasional limping, or trouble putting weight on the leg. Some dogs might be hesitant to jump or do high-impact activities.

Treatment options depend on how severe the condition is. Mild cases can be managed with physical therapy, exercises to strengthen muscles, and weight management to lessen stress on the knee.

In severe cases, where the patella often dislocates and causes discomfort, surgery may be needed to realign the patellar groove or tighten the soft tissues around the knee. Long-term monitoring and controlled exercise can help reduce the risk of further joint instability.

12. Patellar Ligament Thickening or Desmopathy

After TPLO surgery, the patellar ligament (which connects the kneecap to the tibia) may thicken due to increased stress and changes in the tissue as it heals. This condition, known as desmopathy, is a response to the altered mechanics of the knee and may cause discomfort or limit mobility.

How it impacts mobility: Thickened patellar ligaments can lead to stiffness, a reduced range of motion, and occasional lameness. Dogs might have trouble fully extending the knee or feel discomfort when walking on uneven surfaces. In some cases, ligament thickening can contribute to patellar luxation or chronic pain.

Treatment and management focus on reducing inflammation and keeping the joint flexible. Cold laser therapy, controlled exercise, and joint supplements (like glucosamine and chondroitin) may help maintain ligament health.

In severe cases where thickening causes functional problems, physical therapy, anti-inflammatory medications, or, in rare instances, surgery may be necessary. Gradually returning to activity and avoiding high-impact exercises can help minimize stress on the ligament.

13. Meniscal Injury or Tear

The meniscus is a cartilage structure that cushions the knee joint. While TPLO surgery stabilizes the knee, it does not remove the risk of meniscal injuries. Sometimes, leftover instability or stress from implants can cause the meniscus to wear down or tear.

Symptoms of meniscal damage include a clicking or popping sound when the dog moves, occasional or constant lameness, reluctance to use the affected leg, and discomfort when bending the knee. Some dogs may suddenly experience more pain after initially showing signs of recovery.

Treatment options depend on how severe the tear is. Mild cases might be managed with pain relief, joint supplements, and controlled exercise. However, if a meniscal tear causes ongoing pain and instability, surgery is often needed.

This may involve a partial meniscectomy, where the damaged part is removed, or meniscal repair if the cartilage can be saved. Long-term management includes weight control, low-impact exercise, and joint-protective therapies to reduce stress on the knee.

14. Persistent or Recurrent Lameness

While temporary lameness is expected during TPLO recovery, persistent or recurrent lameness months or years after surgery indicates an underlying issue. Some dogs may initially regain function but later experience setbacks.

When lameness is normal vs. a complication: Mild stiffness after long periods of rest or in cold weather is common in post-TPLO dogs, especially as they age. However, continuous limping, favoring one leg, or worsening mobility suggests a complication such as implant issues, nerve damage, or progressive joint disease.

Common causes include implant loosening, nerve irritation, arthritis, or secondary joint problems like patellar luxation or meniscal injury. Improper post-op rehabilitation can also lead to muscle weakness, causing uneven weight distribution.

Rehabilitation options focus on hydrotherapy, physiotherapy, and pain relief through NSAIDs or joint supplements. Weight control is crucial in reducing stress on the knee. For severe cases, advanced pain management options like platelet-rich plasma (PRP) therapy, acupuncture, or even surgical revision may be necessary.

15. Development of Arthritis After Surgery

Even after successful TPLO surgery, some dogs develop arthritis over time due to joint wear and tear. While TPLO improves knee stability, it doesn't prevent degenerative joint disease (DJD), especially in older or previously injured dogs.

Why arthritis develops: Chronic inflammation, ongoing joint stress, or minor imperfections in bone healing can lead to cartilage breakdown. Dogs with previous CCL damage, obesity, or an uneven gait are at higher risk.

Symptoms include joint stiffness, difficulty getting up, reluctance to move, limping, and swelling around the knee. Dogs may struggle with stairs, hesitate before jumping, or feel discomfort after exercise. Symptoms often worsen in cold weather or after long periods of inactivity.

Long-term management focuses on weight control, joint supplements (glucosamine, chondroitin, omega-3s), anti-inflammatory treatments (NSAIDs, corticosteroid injections), and physical therapy. Low-impact activities like swimming or controlled walks can maintain muscle strength while reducing joint stress.

In advanced cases, regenerative therapies such as stem cell treatment or PRP injections may provide relief. Managing arthritis proactively helps maintain mobility and quality of life for years after surgery.

How to Reduce the Risk of TPLO Complications

Minimizing complications after TPLO surgery requires strict post-operative care, proper wound management, and ongoing rehabilitation.

Following veterinary instructions and ensuring a controlled recovery environment significantly improve surgical outcomes.

Strict post-op care

Strict post-op care is essential in preventing implant failure, infections, and delayed healing. Dogs must have limited movement for the first few weeks, avoiding running, jumping, or sudden movements that can strain the surgical site. A crate or confined space ensures controlled rest, while leash-walks allow gradual reintroduction to activity.

Proper wound care and hygiene

Proper wound care and hygiene reduce infection risks. The surgical incision should be checked daily for redness, swelling, or discharge. Using veterinary-recommended antiseptics and preventing licking (via an Elizabethan collar) are key to avoiding contamination.

Many surgeons now use Simini Protect Lavage, a non-antibiotic surgical lavage, to reduce bacterial contamination and biofilm formation, lowering the risk of post-surgical infections.

Rehabilitation and physical therapy

A well-structured rehabilitation plan is essential for restoring mobility, muscle strength, and joint flexibility after TPLO surgery. Early intervention helps prevent stiffness, muscle atrophy, and long-term mobility issues.

Hydrotherapy (underwater treadmill or swimming) provides low-impact exercise, reducing strain on healing joints while strengthening muscles. Passive range-of-motion exercises improve flexibility, while controlled weight-bearing activities help rebuild strength without overloading the surgical site.

Rehabilitation also includes balance exercises, cold laser therapy, and massage therapy, which aid circulation and reduce post-surgical discomfort. A veterinarian or canine rehabilitation specialist can create a customized recovery plan to ensure optimal healing and long-term joint health.

Lastly, early detection improves recovery. Watching for limping, excessive swelling, or behavioral changes helps identify issues before they get worse.

When to Call Your Vet

Recognizing when to seek veterinary care is crucial for preventing serious TPLO complications. Emergency signs that need immediate attention include excessive bleeding, severe swelling, ongoing pain, fever, an open incision, or a sudden inability to bear weight on the operated leg.

Mild symptoms like slight swelling, occasional limping, or minor wound discharge should still be checked if they persist or get worse. Delayed healing or changes in behavior may indicate an underlying issue.

Regular post-op checkups are important for monitoring bone healing, implant stability, and joint function. Early intervention helps prevent complications, ensuring a smooth and successful recovery for your dog.

‍

Read more about -

• TPLO failure symptoms
• Common causes of limping in dogs post-TPLO surgery
• Before and after TPLO surgery: Dog health & recovery timeline
• TPLO surgery for older dogs: Is it a worthwhile option?

‍

Conclusion

TPLO surgery is very effective for stabilizing a dog’s knee, but complications can occur without proper post-operative care. Understanding potential risks and taking preventive steps can ensure a smoother recovery.

1. Strict post-op care – Limiting movement, using an E-collar, and following vet instructions help prevent implant failure and infections.
2. Proper wound hygiene – Keeping the incision clean and watching for redness, swelling, or discharge reduces infection risks.
3. Early detection of complications – Signs like persistent limping, fever, or swelling should lead to immediate veterinary evaluation.
4. Rehabilitation and physical therapy – Hydrotherapy and controlled exercises help with muscle recovery and joint flexibility.
5. Regular vet checkups – Routine follow-ups ensure proper bone healing, implant stability, and early complication management.
6. Using advanced surgical solutions – Many surgeons use Simini Protect Lavage to reduce infection risks and improve post-surgical outcomes.
7. Long-term joint health management – Weight control, joint supplements, and arthritis prevention strategies enhance mobility and quality of life.

By staying proactive and working closely with your veterinarian, you can minimize complications and support your dog’s full recovery after TPLO surgery.

FAQs

What are the long-term complications of TPLO surgery?

Long-term complications can include patellar luxation, arthritis, implant failure, meniscal injuries, and persistent lameness. Some dogs may develop patellar ligament thickening or nerve-related mobility issues. While many dogs recover well, maintaining joint health, weight control, and regular vet checkups helps minimize long-term risks.

What to watch for after TPLO surgery?

Monitor for swelling, redness, discharge, excessive pain, fever, or sudden lameness. Signs of complications include persistent limping, wound infection, delayed healing, or implant issues. If the dog refuses to bear weight or shows increased discomfort over time, a veterinary evaluation is necessary to rule out serious post-surgical issues.

What are the mistakes for TPLO?

Common mistakes include allowing too much activity too soon, neglecting wound care, not using an E-collar, missing follow-up visits, and improper rehabilitation. Failing to restrict movement can lead to implant failure, delayed bone healing, or reinjury. Strict adherence to post-op care reduces these risks.

What is the complication rate of TPLO?

The overall complication rate for TPLO surgery ranges from 10-34%, with most being minor issues like swelling or mild infections. Serious complications, such as implant failure, fractures, or osteomyelitis (bone infection), occur in a smaller percentage of cases. Proper post-operative care significantly reduces complication risks.

Do dogs fully recover from TPLO surgery?

Most dogs fully recover within 12-16 weeks and regain normal mobility. With proper rehabilitation, they can return to an active lifestyle, including running and playing. However, some may develop mild stiffness or arthritis later in life. Regular exercise, weight control, and joint supplements help maintain long-term joint health.

‍

Sign up for a free wall poster

of all the TPLO Rad Steps

Click Below to Watch a Live Video Demos

We'll send you a Free Wall Poster with all the steps

I Want The Poster

Now that you are a pro

at TPLO rads

Let's take your

infection control to

the next level

Watch these videos!

Step #1

Getting Ready

Ensuring a clean surgical field starts with proper skin preparation. This video demonstrates the best practices for:

Shaving the patient – Achieving a close, even shave while minimizing skin irritation

The Dirty Scrub – The initial skin prep step to remove surface debris and reduce bacterial load before the sterile scrub.

Following these techniques helps reduce infection risk and improve surgical outcomes. Watch the video to see how it’s done effectively!

Step  #2

Reduce Your Risks

Many surgeons are shocked to find out that their patients are not protected from biofilms and resistant bacteria when they use saline and post-op antibiotics.  

That’s Where Simini Comes In.

Why leave these risks and unmanaged?  Just apply Simini Protect Lavage for one minute. Biofilms and resistant bacteria can be removed, and you can reduce two significant sources of infection.

Protect Your Patients

Step #3

Take the Course

Preventing surgical infections is critical for patient safety and successful outcomes. This course covers:

Aseptic techniques – Best practices to maintain a sterile field.

​Skin prep & draping – Proper methods to minimize contamination.

​Antibiotic stewardship – When and how to use perioperative antibiotics effectively.

Stay up to date with the latest evidence-based protocols. Click the link to start learning and earn CE credits!

Sign Up Today

Simini Technologies Product.

All Rights Reserved © 2021-2024.

103 Sato Street, Whitby Ontario L1R 1V8.

Privacy Policy

What Is Bilateral TPLO Surgery?

Tibial Plateau Leveling Osteotomy (TPLO) is a surgical procedure used to treat cranial cruciate ligament (CCL) rupture in dogs. Instead of replacing the torn ligament, TPLO alters the tibial plateau angle, stabilizing the knee joint and reducing abnormal movement.

Bilateral TPLO surgery is performed when both knees require correction. Some dogs suffer CCL injuries in both hind limbs, either simultaneously or within a short period. In such cases, a surgeon may recommend performing TPLO on both knees in a single procedure or as staged surgeries.

Large, active breeds like Labrador Retrievers, Rottweilers, Golden Retrievers, and German Shepherds are more prone to CCL injuries due to their size and activity level. Obesity, genetics, and structural predisposition also contribute to ligament degeneration, making bilateral TPLO necessary for some dogs. Early intervention helps restore mobility and prevent long-term joint damage.

When Is Double or Bilateral TPLO Surgery Necessary?

Some dogs develop cranial cruciate ligament (CCL) injuries in both knees, either at the same time or within a few months. This often occurs due to genetic factors, excessive strain on the healthy limb after an initial injury, or progressive ligament wear in both knees. When both knees are unstable, bilateral TPLO surgery is necessary to restore mobility and prevent further joint damage.

Dogs needing bilateral TPLO often show signs like severe limping, difficulty standing up, reluctance to walk or play, and an unusual sitting posture. They may shift their weight excessively, struggling to support themselves on either leg.

Veterinarians determine the need for bilateral TPLO through a detailed orthopedic exam, gait analysis, and imaging tests like X-rays. If both knees are significantly unstable, vets may recommend simultaneous TPLO to correct both knees in one procedure.

However, for older dogs or those with other health issues, a staged approach—operating on one leg first and the other after recovery—may be safer to reduce surgical risks.

Simultaneous vs. Staged TPLO Surgery: What’s the Best Choice?

When a dog needs TPLO on both knees, veterinarians consider two approaches: simultaneous TPLO (operating on both legs at once) or staged TPLO (operating on one leg first and the other after recovery).

Simultaneous TPLO

Simultaneous TPLO offers the advantage of a single anesthesia event and a shorter overall recovery period. Dogs regain balanced mobility faster since both knees heal together.

However, post-surgical care is more challenging because the dog cannot rely on a strong leg for support, requiring owners to provide intensive assistance. Risks include increased surgical stress and a higher chance of post-operative complications like swelling or infection.

Staged TPLO

Staged TPLO involves operating on one knee first, allowing recovery before addressing the second leg. This approach reduces surgical risk, making it ideal for older dogs, those with other health issues, or those struggling with post-surgical pain. However, the overall treatment period is longer, and the dog may continue to experience discomfort in the untreated leg during the recovery phase.

Veterinarians decide the best approach based on factors like the dog’s overall health, weight, pain tolerance, and the owner’s ability to manage post-surgical care.

Large dogs with strong front limbs may handle simultaneous TPLO better, while smaller or weaker dogs may benefit from a staged approach.

Benefits of Doing Bilateral TPLO Surgery at Once

For dogs needing TPLO on both knees, opting for simultaneous bilateral TPLO surgery has several advantages compared to staging the procedures months apart.

• One major benefit is a faster overall recovery period. When both knees are corrected in a single surgery, the dog undergoes just one healing phase rather than two separate ones. This means they can return to normal activity sooner compared to waiting for two rounds of surgery and rehabilitation.
• Another advantage is lower long-term costs. While simultaneous TPLO may have a higher upfront expense, it often reduces overall costs by avoiding duplicate anesthesia, hospitalization, and post-operative care fees associated with two separate surgeries. Pet owners also save on pain medications and follow-up appointments.
• Bilateral TPLO also helps prevent excessive strain on the unoperated leg. When only one knee is repaired first, the dog must rely heavily on the untreated leg, which can worsen ligament damage or lead to muscle imbalances. Simultaneous TPLO eliminates this risk by addressing both knees at once, ensuring balanced weight distribution during recovery.
• Lastly, dogs who undergo bilateral TPLO often experience better mobility post-recovery. When both knees heal together, they regain strength and stability more evenly, allowing for a smoother transition back to normal activities. This approach minimizes long-term joint issues and improves overall quality of life.

For young, healthy, and active dogs, bilateral TPLO surgery can be the best option for a quicker and more effective recovery.

Read more about - Long-Term Outcomes of TPLO Surgery

How Double TPLO Surgery Is Performed

Step 1: Pre-Surgery Preparation

Before bilateral TPLO surgery, veterinarians perform a thorough evaluation, including X-rays to assess the tibial plateau angle and confirm the need for surgery.

Bloodwork ensures the dog is healthy enough for anesthesia. The dog is then sedated, intubated, and placed under general anesthesia. The surgical area on both knees is shaved and disinfected to minimize infection risk.

Step 2: Surgical Process

During the procedure, the surgeon makes an incision over each knee to access the tibia. A specialized oscillating saw is used to cut and rotate the tibial plateau, adjusting its angle to stabilize the joint and eliminate abnormal motion caused by cranial cruciate ligament (CCL) rupture. Once repositioned, a metal plate and screws are secured to hold the bone in place, ensuring proper healing and function.

To reduce the risk of biofilm formation and post-surgical infections, many surgeons use advanced solutions like Simini Protect Lavage. This non-antibiotic lavage solution helps flush out bacteria and prevent biofilm development, significantly lowering the chances of infection and promoting a safer recovery.

Combined with sterile surgical techniques and post-operative antibiotics, these measures enhance healing outcomes and minimize complications.

Step 3: Post-Surgical Stabilization and Suturing

Once both knees are stabilized, the surgeon checks for proper alignment. Soft tissues and muscles are carefully repositioned before closing the incision with sutures or staples. A sterile bandage may be applied to protect the area.

Step 4: Immediate Post-Op Monitoring at the Vet Clinic

After surgery, the dog is moved to recovery and closely monitored for pain, bleeding, or complications. Pain medications and antibiotics are administered, and vets ensure the dog is stable before planning the transition home. Owners receive detailed post-op care instructions for managing pain, mobility, and incision care.

Risks and Potential Complications of Double TPLO Surgery

While bilateral TPLO surgery is highly effective, it comes with risks and potential complications that pet owners should be aware of.

• One significant concern is the risk of infection, which can occur at the surgical site or internally around the implants. Infection risk is minimized by using sterile surgical techniques, prescribing antibiotics, and ensuring proper at-home wound care. Keeping the incision site clean and preventing the dog from licking or biting the sutures is essential for avoiding post-operative infections.
• Another risk is delayed healing, as both legs are recovering at the same time. Unlike a staged TPLO, where the healthy leg supports weight during recovery, dogs undergoing bilateral TPLO may struggle with mobility. Strict activity restrictions, proper pain management, and joint-supporting supplements can help promote faster healing.
• Implant failure or loosening is another complication that may arise, especially in highly active dogs or those with improper post-op care. Excessive movement or jumping can put stress on the surgical plates and screws, potentially leading to implant shifting or breakage. This can require additional surgery to correct.
• Lastly, anesthesia-related risks and post-operative pain are concerns with any major surgery. Though modern anesthetics are generally safe, dogs with underlying health conditions may face complications. Post-op pain is managed with medications, but owners must monitor for signs of discomfort, swelling, or limping.

Following the vet’s post-op care instructions, including strict rest and controlled rehabilitation, significantly reduces these risks and ensures a smoother recovery.

What to Expect After Double TPLO Surgery

First 24–48 Hours: Managing Pain, Limited Movement

Immediately after surgery, your dog will experience grogginess from anesthesia and discomfort from the procedure. Pain management is crucial, with vets prescribing anti-inflammatory medications and opioids for relief.

Movement should be extremely limited, and your dog may need assistance standing or going outside for bathroom breaks. Using a harness or sling can help support their weight. Swelling around the incisions is normal, but excessive redness, oozing, or heat could indicate infection.

First 2 Weeks: Strict Rest, Keeping the Dog Confined

During this period, strict crate rest or confinement in a small, quiet space is essential. Jumping, running, or sudden movements should be avoided to prevent stress on the healing bones.

Short, controlled leash walks for bathroom breaks are allowed, but no excessive movement. The surgical site should be monitored daily for any signs of infection or swelling.

Weeks 3–6: Gradual Improvement, Light Movement

By the third week, mild weight-bearing on both legs should improve, but full activity is still restricted. Short, controlled leash walks (5-10 minutes) may be introduced if the vet approves. Most dogs begin regaining stability, but muscle weakness is common.

Weeks 6–12: Rehab Starts, Monitoring for Complications

With vet approval, rehabilitation exercises such as slow leash walks, underwater treadmill therapy, or passive range-of-motion exercises can begin. Any signs of excessive limping, pain, or swelling should be reported to the vet immediately.

Full Recovery Timeline: When the Dog Can Walk, Run, and Return to Normal

By 12–16 weeks, most dogs can walk comfortably, and by 4–6 months, they regain full mobility, including running and playing. However, high-impact activities should be reintroduced cautiously under veterinary guidance to prevent re-injury.

Read more about - Post-Surgery Recovery After TPLO in Dogs

Pain Management and Medications After Surgery

Managing pain effectively after bilateral TPLO surgery is crucial for a smooth recovery. Veterinarians typically prescribe a combination of NSAIDs (non-steroidal anti-inflammatory drugs), opioids, and supplements to control pain and inflammation.

• NSAIDs (e.g., Carprofen, Meloxicam) help reduce inflammation and swelling. These should always be given with food to prevent stomach irritation.
• Opioids (e.g., Tramadol, Buprenorphine) provide stronger pain relief in the first few days post-surgery, especially when discomfort is severe.
• Joint supplements (e.g., glucosamine, chondroitin, omega-3 fatty acids) support long-term joint health and aid in recovery.

To manage swelling and discomfort, cold therapy (icing the surgical area for 10–15 minutes, 2–3 times a day) can help reduce inflammation. Anti-inflammatory treatments, including prescribed medications and natural supplements, may further support healing.

It’s important to monitor for signs of excessive pain, such as persistent whining, heavy panting, restlessness, refusal to move, or loss of appetite. If your dog shows these symptoms despite medication, or if swelling and redness worsen, contact your vet immediately. Proper pain management not only ensures comfort but also promotes faster recovery and prevents complications.

Importance of Physical Therapy and Rehabilitation

Physical therapy plays a critical role in speeding up healing and restoring mobility after bilateral TPLO surgery. Without proper rehabilitation, dogs may experience muscle atrophy, stiffness, or prolonged discomfort.

Controlled movement helps strengthen the muscles around the knee joints, improves flexibility, and ensures a smoother recovery.

Recommended Rehab Exercises:

• Passive stretching – Gentle range-of-motion exercises help prevent stiffness and improve flexibility. These should be done 2–3 times daily with slow, controlled movements.
• Water therapy (underwater treadmill or swimming) – This is an excellent low-impact exercise that builds strength while reducing stress on the joints. Typically introduced 4–6 weeks post-surgery, if approved by the vet.
• Controlled leash walks – Short, slow walks (starting at 5 minutes per session) encourage weight-bearing and muscle engagement. Walk duration is gradually increased over time.

When to Start Rehab and Frequency:

Most rehab exercises begin around 2–3 weeks post-surgery, depending on the dog’s progress. Sessions should be daily but short to avoid fatigue. A structured rehabilitation plan, guided by a veterinarian or certified canine rehab therapist, ensures the safest and most effective recovery. Proper rehab improves strength, reduces re-injury risks, and helps dogs regain full mobility faster.

Home Care and Activity Restrictions for Recovery

Creating a safe and controlled recovery space is essential after bilateral TPLO surgery. A quiet, confined area with non-slip flooring, soft bedding, and limited space to move helps prevent accidental injuries. Using a crate or a small enclosed area with baby gates ensures your dog stays in a controlled environment while healing.

Restricting movement is crucial in the first 8–12 weeks. Jumping, running, or climbing stairs must be avoided, as sudden movements can put stress on healing bones and implants. Furniture should be blocked off, and leash walks should be strictly supervised.

For mobility assistance, supportive slings or harnesses (such as a rear-lift harness) help dogs stand up, walk for bathroom breaks, and shift weight safely. This is particularly important in the first few weeks when both legs are weak.

Since physical activity is limited, mental stimulation is key to preventing boredom and restlessness. Provide interactive toys, puzzle feeders, and scent-based games to keep your dog engaged without physical strain.

Spending extra time with your dog through gentle petting and calm interaction helps keep them relaxed and comfortable throughout recovery. Careful management ensures a smoother healing process and reduces complications.

Cost of Double or Bilateral TPLO Surgery and Financial Considerations

The cost of bilateral TPLO surgery varies depending on location, veterinary expertise, and hospital fees. In the U.S., the average cost for a single TPLO ranges from $3,500 to $6,000 per knee, meaning bilateral TPLO can cost $7,000 to $12,000. In other regions, such as Canada, the U.K., or Australia, prices may be slightly lower or higher based on veterinary costs and currency differences.

Factors affecting cost include:

• Geographic location – Urban areas with higher living costs tend to have more expensive veterinary services.
• Veterinarian experience – Board-certified surgeons may charge higher fees due to their expertise.
• Hospital fees – Costs for anesthesia, post-op care, medications, and follow-up visits add to the total.

Does pet insurance cover TPLO surgery? Coverage depends on the policy. Many comprehensive pet insurance plans cover TPLO if it’s not a pre-existing condition. Some require a waiting period before covering ligament injuries.

Financing options include payment plans through veterinary clinics, CareCredit, Scratchpay, or pet-specific credit programs to help spread out the cost. Some non-profits and crowdfunding platforms also assist pet owners facing high medical expenses.

Read more about - How Much Does TPLO Surgery Cost?

Final Thoughts on Double or Bilateral TPLO Surgery

Bilateral TPLO surgery is a highly effective solution for dogs with cranial cruciate ligament injuries in both knees. While the procedure requires a significant commitment in terms of cost, recovery time, and post-op care, the long-term benefits—restored mobility, reduced pain, and improved quality of life—make it worth considering for most dogs.

If your dog is struggling with severe knee instability but surgery isn’t an immediate option, consult your vet about alternative treatments like physical therapy, joint supplements, weight management, or custom braces. However, these may only provide temporary relief rather than a permanent solution.

For pet owners navigating this process, patience and commitment are key. Recovery may feel overwhelming, but with proper care and rehabilitation, most dogs return to an active, happy life. Stay in close contact with your vet, follow post-op guidelines, and trust the healing process.

‍

Read more about -

• TPLO failure symptoms
• Common causes of limping in dogs post-TPLO surgery
• Before and after TPLO surgery: Dog health & recovery timeline
• TPLO surgery for older dogs: Is it a worthwhile option?

FAQs

Can a dog have TPLO surgery on both legs?

Yes, a dog can undergo bilateral TPLO surgery if both cranial cruciate ligaments (CCLs) are torn or unstable. This can be done simultaneously or in a staged approach. Simultaneous TPLO addresses both knees in one procedure, while staged TPLO repairs one knee first, followed by the second after recovery. The choice depends on the dog’s health and the surgeon’s recommendation.

How much does bilateral TPLO surgery cost?

The cost of bilateral TPLO surgery varies by location and veterinary clinic. In the U.S., it typically ranges from $7,000 to $12,000 for both knees. Factors such as surgeon expertise, hospital fees, medications, and follow-up care affect the final price. Some pet insurance policies may cover TPLO if it is not a pre-existing condition, and financing options are available at many clinics.

What is the recovery time for bilateral TPLO surgery in dogs?

Full recovery from bilateral TPLO surgery typically takes 12 to 16 weeks. In the first 2 weeks, strict rest and pain management are essential. By weeks 3 to 6, controlled movement starts. Around weeks 6 to 12, rehab exercises begin, gradually improving strength. Most dogs return to normal activity by 4 to 6 months, but high-impact activities should be reintroduced cautiously.

What is bilateral TPLO?

Bilateral TPLO refers to Tibial Plateau Leveling Osteotomy surgery performed on both knees to treat cranial cruciate ligament (CCL) tears. It stabilizes the knee joint by altering the tibial plateau angle, preventing excessive movement. This procedure is common in large, active dogs or those genetically prone to CCL injuries. It can be done simultaneously or in two separate surgeries.

What happens if a dog tears both CCLs?

If a dog tears both cranial cruciate ligaments (CCLs), it may experience severe pain, difficulty standing, and an unstable gait. Without surgery, arthritis and joint degeneration can develop quickly. Treatment options include bilateral TPLO surgery, custom knee braces, weight management, and physical therapy. Surgery is typically the best option for restoring long-term mobility and preventing further joint damage.

‍

What is Enterococcus faecalis?

Enterococcus faecalis is a type of bacteria commonly found in the gastrointestinal tract of dogs. It is a commensal bacterium, meaning it lives with the body’s natural flora without causing harm under normal conditions. In a healthy dog, E. faecalis helps with digestion and maintains a balanced gut microbiome.

However, this bacterium can become opportunistic and pathogenic when a dog’s immune system is weakened or when there is an imbalance in gut bacteria. Factors like prolonged antibiotic use, chronic illness, surgery, or infections can disrupt this balance, allowing E. faecalis to multiply uncontrollably and spread to other tissues. When this occurs, it can lead to urinary tract infections (UTIs), wound infections, or more severe systemic infections.

Although usually harmless, E. faecalis can develop resistance to antibiotics, making infections harder to treat, especially in hospitalized or immunocompromised dogs.

How Do Dogs Get Enterococcus faecalis?

Dogs primarily acquire Enterococcus faecalis from their own gastrointestinal tract, where it naturally exists as part of the normal gut flora. However, under certain conditions, this bacterium can spread and cause infections in other parts of the body.

One of the most common modes of transmission is fecal contamination. If a dog’s feces contain E. faecalis, the bacteria can spread to the urinary tract, wounds, or other vulnerable areas through direct contact. This often happens when a dog grooms itself after defecation or comes into contact with contaminated bedding, floors, or other surfaces.

Environmental exposure is another route of transmission. Dogs can pick up E. faecalis from contaminated water, soil, or surfaces, especially in places like kennels, veterinary clinics, or dog parks. Shared water bowls, medical instruments, and poorly sanitized environments can all serve as sources of bacterial transfer.

Additionally, direct transmission can occur through licking, grooming, or ingesting contaminated food or objects. Dogs frequently use their mouths to explore their surroundings, making it easy for bacteria to spread. Immunocompromised dogs, those recovering from surgery, or those on long-term antibiotics are at a higher risk of developing infections from E. faecalis.

Risk Factors for Enterococcus faecalis Infections in Dogs

Dogs typically carry Enterococcus faecalis in their gastrointestinal tract without issues, but certain factors can increase the risk of this bacterium causing infections, particularly in the urinary tract and other vulnerable areas. These risk factors can be categorized into urinary tract-related factors and systemic conditions that compromise the body's natural defenses.

Urinary Tract-Related Factors

Several conditions affecting the lower urinary tract (LUT) create an environment where E. faecalis can thrive and cause infections:

• Recurrent bacteriuria – Frequent bacterial presence in the urine weakens the urinary tract’s natural defenses, allowing E. faecalis to establish infections.
• Lower urinary tract (LUT) anatomic abnormalities – Structural issues such as congenital defects or acquired conditions (e.g., urethral strictures) can lead to incomplete bladder emptying, increasing bacterial colonization.
• Urolithiasis (bladder stones) – The presence of bladder stones creates a favorable surface for bacterial attachment and biofilm formation, making infections more persistent and harder to treat.
• LUT neoplasia (tumors) – Tumors in the bladder or urethra can cause obstruction, tissue damage, and chronic inflammation, providing an entry point for E. faecalis to invade and multiply.

Systemic Conditions Increasing Risk

Beyond localized urinary tract issues, certain systemic health problems can compromise a dog’s ability to fight off infections:

• Neurologic dysfunction – Conditions affecting nerve control of the bladder (such as intervertebral disc disease or spinal cord injuries) can result in urine retention, which increases bacterial colonization.
• Endocrinopathies (hormonal disorders) – Diseases like diabetes mellitus and hyperadrenocorticism (Cushing’s disease) alter immune function and can lead to sugar-rich urine, which fosters bacterial growth.
• Urinary incontinence – Dogs with incontinence may have prolonged exposure to urine on their skin and mucosa, allowing E. faecalis to migrate from fecal contamination to the urinary tract.
• Corticosteroid administration – Long-term steroid use suppresses the immune system, reducing the body's ability to clear infections effectively.
• Chronic kidney disease (CKD) – Dogs with CKD often have altered urine concentration and immune dysfunction, making them more susceptible to urinary tract infections (UTIs) caused by E. faecalis.
• Urinary catheterization – Catheterized dogs, especially those requiring long-term urinary catheters, face a high risk of bacterial introduction into the bladder, providing E. faecalis a direct pathway to colonize the urinary tract.

Understanding these risk factors is crucial in preventing and managing E. faecalis infections in dogs. Regular veterinary checkups, proper hygiene, and addressing underlying conditions can significantly reduce the likelihood of infection.

Surgical and Post-Operative Infections Due to Enterococcus faecalis

How Surgical Infections Occur

Surgical site infections (SSIs) caused by Enterococcus faecalis can develop when bacteria enter the wound during or after surgery. Several factors contribute to these infections:

• Contaminated surgical tools or implants – If sterilization protocols are inadequate, E. faecalis can be introduced into the surgical site through contaminated instruments, implants, or sutures.
• Poor wound hygiene post-surgery – Inadequate wound care, improper bandage changes, or exposure to dirt and moisture can allow bacteria to multiply and infect the incision site.
• Exposure to multi-drug resistant (MDR) strains in hospital settings – Veterinary hospitals, particularly intensive care units, may harbor antibiotic-resistant E. faecalis strains that can cause difficult-to-treat infections in post-surgical patients.
• Pre-existing conditions like diabetes or immune suppression – Dogs with conditions like diabetes, chronic illness, or those receiving immunosuppressive therapy (e.g., corticosteroids) have a reduced ability to fight infections, increasing their risk.

Common Types of Infections in Post-Surgical Dogs

• Soft tissue infections – E. faecalis can cause swelling, redness, pain, and pus formation at the incision site, potentially leading to abscesses or delayed healing.
• Deep wound infections – When bacteria invade deeper tissues, infections can become more severe, requiring drainage, debridement, or antibiotic therapy.
• Orthopedic infections – Post-surgical infections involving bones, joints, or implants (e.g., TPLO plates) can be particularly challenging to treat, often necessitating prolonged antibiotic use or implant removal.

Preventing E. faecalis infections requires strict surgical asepsis, careful wound management, and appropriate post-operative monitoring to ensure proper healing.

Orthopedic Infections After TPLO Surgery and Enterococcus faecalis

Why TPLO Surgery Is at Risk

Tibial Plateau Leveling Osteotomy (TPLO) is a common surgical procedure for repairing cranial cruciate ligament (CCL) injuries in dogs. However, TPLO surgery carries a risk of post-operative infection, particularly from Enterococcus faecalis, due to several factors:

• Presence of surgical implants – Metal plates and screws used in TPLO surgery provide surfaces where bacteria like E. faecalis can adhere and form protective biofilms, making infections difficult to eliminate.
• Post-surgical inflammation and healing challenges – Normal healing involves inflammation, which can create an environment conducive to bacterial growth if E. faecalis contaminates the surgical site.

Complications Caused by Enterococcus faecalis in TPLO Surgeries

• Biofilm formation on implants – E. faecalis can develop biofilms on metal implants, creating a protective layer that resists antibiotics and the immune system, leading to persistent infections.
• Prolonged healing time – Chronic bacterial presence can delay bone healing, cause ongoing pain, and increase the risk of implant loosening.
• Increased risk of revision surgery or implant removal – If infection persists despite treatment, revision surgery may be necessary to remove infected implants and debride affected tissue, adding to recovery time and cost.

Preventing E. faecalis infections in TPLO cases requires strict aseptic techniques, post-operative monitoring, and early intervention if signs of infection arise.

Preventing Enterococcus faecalis Infections in Dogs

Hygiene Measures

Maintaining proper hygiene is essential in preventing Enterococcus faecalis infections. Cleanliness reduces the risk of bacterial exposure and helps keep your dog healthy:

• Proper cleaning of bedding, bowls, and living areas – Regularly wash your dog’s bedding, food and water bowls, and living spaces to remove bacteria and other contaminants. Disinfecting these items frequently is essential, especially in environments like kennels or vet clinics.
• Regular bathing and grooming – Keeping your dog clean through regular baths and grooming reduces the chance of bacterial buildup on their skin and fur, especially in areas like the paws or genital region, where bacteria can thrive.

Post-Surgery Care

Dogs recovering from surgery are at higher risk for infections like E. faecalis, and proper care can significantly reduce these risks:

• Keeping wounds clean and monitored for signs of infection – Gently clean surgical wounds as recommended by your vet and watch for redness, swelling, or discharge, which could indicate an infection.
• Following veterinary guidelines for post-op wound management – Adhere to all instructions regarding bandage changes, medication, and activity restrictions to promote healing and prevent bacterial contamination.

After surgery, keeping wounds clean and monitored for signs of infection is crucial. During surgery, advanced solutions like Simini Protect Lavage can be used by veterinary surgeons to minimize the risk of infection.

This non-antibiotic surgical lavage solution helps reduce bacterial contamination and prevents biofilm formation on surgical sites.

By using Simini during surgery, the risk of post-surgical infections is significantly lowered, contributing to faster, safer healing

Managing Underlying Health Conditions

Dogs with chronic health conditions are more vulnerable to infections, including E. faecalis:

• Regular vet check-ups for dogs with chronic illnesses – Regular veterinary visits help manage conditions like diabetes or kidney disease, which may predispose dogs to infections.
• Monitoring for early signs of urinary tract or surgical infections – Pay attention to symptoms such as changes in urination, discomfort, or poor wound healing, and seek veterinary care promptly if these signs appear.

By following these preventive measures, you can help protect your dog from E. faecalis infections and promote overall health.

‍

Read more about:

• TPLO incision infection symptoms & prevention
• Signs of TPLO failure in dogs
• Staph infection after TPLO surgery
• MRSP infection in dogs: Causes & symptoms
• How to Treat MRSP in Dogs: Best Practices

Conclusion

Dogs usually get Enterococcus faecalis from their gastrointestinal tract, but infections can happen in different ways, such as through fecal contamination, environmental exposure, or direct transmission from licking or grooming. Dogs with existing health issues, surgical wounds, or weakened immune systems are more prone to these infections.

Early detection and prevention are key to reducing the risks of E. faecalis infections. Keeping good hygiene, checking wounds, and managing health conditions can greatly lower the chance of infection. Regular vet visits are important, especially for dogs with chronic illnesses or those healing from surgery.

If you notice signs of infection like redness, swelling, discomfort, or changes in behavior, contact your vet right away. Quick action is crucial to stop the infection from spreading and to ensure proper treatment, which helps support your dog's health and well-being.

FAQs

Can Dogs Get Enterococcus faecalis?

Yes, dogs can get Enterococcus faecalis naturally from their gastrointestinal tract. It’s normally harmless and part of their gut flora. However, if the immune system is compromised or there’s an imbalance, E. faecalis can become pathogenic, leading to infections in areas like the urinary tract, wounds, or post-surgery sites.

What Is the Most Common Source of Enterococcus faecalis in Dogs?

The most common source of Enterococcus faecalis in dogs is their gastrointestinal tract. It lives naturally in the gut and can spread to other parts of the body, especially through fecal contamination or poor hygiene. Contact with contaminated surfaces, water, or food also poses a risk for infection.

What Causes Enterococcus faecalis Infections in Dogs' Urine?

Enterococcus faecalis infections in dogs' urine are often caused by fecal contamination, urinary tract abnormalities, or conditions that compromise the immune system, such as diabetes or chronic kidney disease. Factors like urinary incontinence, prolonged catheterization, or surgical procedures can also increase the risk of urinary infections due to this bacterium.

What Kills Enterococcus faecalis Naturally?

Enterococcus faecalis can be killed naturally by the body’s immune system, which typically fights off infections in healthy dogs. Natural remedies like probiotics and a healthy diet can help support immune function. However, in cases of infection, antibiotics are usually required to target the bacteria, especially if it’s resistant to natural defenses.

Can Enterococcus faecalis Go Away on Its Own?

Enterococcus faecalis infections can go away on their own in some cases, particularly if the dog has a strong immune system and the infection is mild. However, if the infection is persistent or severe, such as in urinary tract or surgical site infections, veterinary intervention and antibiotics are usually needed to clear the infection effectively.

‍

Methicillin-resistant Staphylococcus pseudintermedius (MRSP) is a bacterial infection in dogs that doesn't respond to many antibiotics. It is related to MRSA (methicillin-resistant Staphylococcus aureus), which affects humans. MRSP often leads to skin infections, ear infections, and, in severe cases, deep tissue infections.

The biggest challenge with MRSP is its antibiotic resistance. Common antibiotics like penicillins and cephalosporins don't work against this bacteria. This resistance happens because of the overuse or misuse of antibiotics, making infections harder to treat. Treatment options are limited to specific, carefully chosen antibiotics or alternative therapies.

Signs Your Dog Might Have MRSP

Dogs with MRSP may show persistent skin infections that do not respond to regular antibiotics. Symptoms include:

• Red, inflamed skin with sores or pustules
• Excessive itching and hair loss
• Recurrent ear infections with discharge
• Slow-healing wounds
• Swelling or pain in the affected area

If your dog shows these signs, a veterinary diagnosis with bacterial culture testing is crucial for proper treatment.

Treatment Options for MRSP in Dogs

Home Care & Infection Control (Immediate Actions)

When dealing with MRSP, preventing the spread of bacteria is just as important as treating the infection. Since MRSP is resistant to many antibiotics, proper hygiene and containment measures can help protect other pets and humans in the household.

• Isolate the infected dog: Keep your dog separated from other pets to prevent bacterial transmission. MRSP can spread through direct contact, shared items, or contaminated surfaces.
• Practice strict hygiene: Always wash your hands thoroughly with soap and water after handling your dog. Use disposable gloves if treating wounds.
• Disinfect frequently used items: Clean bedding, collars, leashes, bowls, and any surfaces your dog touches using pet-safe disinfectants. Wash fabric items in hot water and dry them completely.
• Prevent self-trauma: Dogs with MRSP infections often scratch or lick the affected area, worsening the infection. Use an e-collar (Elizabethan collar) or protective clothing to prevent irritation and reinfection.

Proper infection control begins in the operating room, and if a veterinary surgeon uses an advanced wound irrigation solution like Simini Protect Lavage during surgery, it can help reduce bacterial contamination, including MRSP, lowering the risk of post-operative infections.

Topical Therapy (First-Line Treatment)

Topical therapy is a crucial first step in managing MRSP infections. Since MRSP bacteria live on the skin, direct application of antiseptics and antibiotics can help reduce bacterial load and promote healing.

• Antiseptic baths: Bathe your dog 2–3 times per week using an antiseptic shampoo containing 2–4% chlorhexidine. This helps kill bacteria on the skin and prevent new infections. Allow the shampoo to sit on the coat for 10 minutes before rinsing thoroughly.
• Mupirocin ointment: Apply twice daily to small, localized MRSP lesions. Mupirocin is effective against Staphylococcus pseudintermedius and helps treat infected wounds or hot spots.
• Topical amikacin spray: This antibiotic spray can be used once or twice daily to control bacterial growth in severe or widespread infections. It is often recommended when oral antibiotics are not an option.

Consistency is key—continue treatment for at least 2–4 weeks or as directed by your veterinarian. If symptoms persist or worsen, further medical intervention may be necessary.

Systemic Antibiotic Therapy (For Severe Cases)

Systemic antibiotics should be used only when necessary, as MRSP is resistant to many common antibiotics. Overuse can lead to further resistance, making future infections even harder to treat. In mild cases, topical therapy alone may be enough.

• Culture and sensitivity testing: Before starting any antibiotic, a veterinarian should perform a bacterial culture and sensitivity test. This identifies which antibiotics are effective against the specific MRSP strain in your dog. Treating without testing can lead to failed therapy and stronger resistance.
• Avoid beta-lactam antibiotics: Penicillins and cephalosporins are ineffective against MRSP and should not be used. This includes commonly prescribed antibiotics like amoxicillin-clavulanate or cephalexin.
• Alternative antibiotic options: Depending on test results, chloramphenicol, aminoglycosides (amikacin), clindamycin, or doxycycline may be prescribed. These are not first-line antibiotics and should only be used under veterinary guidance due to possible side effects.

Systemic antibiotic therapy typically lasts 4–6 weeks and requires strict follow-up to monitor effectiveness. If symptoms persist, adjusting the treatment plan may be necessary.

Duration of Treatment (How Long to Continue)

The duration of treatment for MRSP infections depends on the severity and depth of the infection. Stopping treatment too early can lead to recurrence, making the infection harder to eliminate in the future.

• Superficial pyoderma: This is a mild to moderate skin infection affecting the outer layers of the skin. Treatment with topical therapy and, if necessary, systemic antibiotics should continue for at least 3 weeks or one week beyond visible healing.
• Deep pyoderma: If the infection has spread into deeper skin layers, treatment is more intensive. Therapy should last 4–8 weeks or longer, continuing for at least 1–3 weeks after all lesions have healed to prevent relapse.

Why is extended treatment necessary? MRSP is highly resistant, and stopping treatment too soon allows surviving bacteria to multiply, leading to reinfection. This can also make the bacteria more difficult to treat in the future.

Regular veterinary check-ups and follow-up cultures help ensure the infection is fully cleared before stopping treatment.

Supporting Your Dog’s Recovery at Home

Diet & Supplements to Boost Healing

A nutrient-rich diet and targeted supplements can strengthen your dog's immune system and support skin healing after an MRSP infection. Proper nutrition plays a crucial role in reducing inflammation, repairing the skin barrier, and preventing future infections.

• Omega-3 supplements: Fish oil rich in EPA and DHA helps reduce inflammation and promote healthy skin. These essential fatty acids improve the skin barrier, making it more resistant to bacterial infections.
• Probiotics: If your dog has been on antibiotics, adding probiotics helps restore gut balance and support immune function. Look for Lactobacillus and Bifidobacterium strains, which promote good digestion and reduce antibiotic-related side effects.
• Hyaluronic acid sprays: Topical hyaluronic acid (HA) sprays enhance skin hydration and barrier repair, reducing irritation and supporting wound healing. They also help create a protective layer, preventing bacteria from re-entering the skin.

Feeding a high-quality, protein-rich diet with these supplements can help your dog recover faster and build long-term resistance against skin infections. Always consult your veterinarian before adding supplements to your dog’s routine.

Hygiene & Environmental Adjustments

Creating a clean, bacteria-free environment is essential to prevent reinfection and support your dog’s recovery from MRSP. Since MRSP can survive on surfaces, proper hygiene and environmental control help minimize bacterial spread.

• UV sterilization wands: These devices eliminate bacteria, viruses, and fungi on surfaces like bedding, collars, leashes, and food bowls. UV-C light disrupts bacterial DNA, making it an effective chemical-free disinfection method.
• Air purifiers with HEPA filters: MRSP bacteria can spread through air and dust particles. Using an air purifier with a HEPA filter helps capture airborne bacteria and allergens, reducing the risk of reinfection.
• Regular grooming: Keeping your dog’s skin clean is key. Bathe them with antimicrobial shampoos as recommended and brush their coat regularly to remove dirt, dead skin cells, and bacteria. Clean ears, trim nails, and check for any signs of skin irritation.

By maintaining strict hygiene practices and a clean home environment, you can lower bacterial exposure and help your dog heal faster.

Preventing Future MRSP Infections

Preventing reinfection is crucial for dogs that have recovered from MRSP. Since MRSP bacteria can persist in the environment and on the skin, consistent hygiene, early monitoring, and veterinary follow-ups are essential to keep your dog healthy.

• Regular bathing and hygiene: A weekly or biweekly bath with antiseptic shampoos (2–4% chlorhexidine) helps control bacterial levels on the skin. Regular cleaning of bedding, food bowls, and grooming tools prevents contamination.
• Monitoring for early signs: Dogs prone to skin infections should be checked regularly for redness, bumps, hair loss, or excessive scratching. Catching infections early allows for faster treatment with topical antiseptics, reducing the need for systemic antibiotics.
• Routine veterinary checkups: If your dog has a history of MRSP or recurrent skin infections, schedule regular checkups every 3–6 months. Your vet can perform skin cultures or cytology to detect bacteria before a full-blown infection develops.

By staying proactive with hygiene, early intervention, and veterinary care, you can significantly reduce the risk of future MRSP infections and keep your dog’s skin healthy.

When to See a Veterinarian

While home care and prescribed treatments can help manage MRSP infections, some cases require immediate veterinary attention. If your dog’s condition does not improve or worsens, a veterinarian can reassess the treatment plan to prevent complications.

• No improvement after 2 weeks: If your dog is receiving topical or systemic treatment but the infection persists after 2 weeks, it may indicate treatment resistance. A vet may need to adjust the antibiotic plan based on a new culture and sensitivity test.
• Worsening or spreading infection: If redness, swelling, or sores continue to spread despite home care, the infection could be deepening. MRSP can sometimes penetrate deeper tissues, leading to cellulitis or abscess formation, which requires stronger medical intervention.
• Systemic illness signs: If your dog becomes lethargic, refuses food, or develops a fever, the infection may have entered the bloodstream (sepsis) or caused a secondary illness. This is a medical emergency requiring urgent veterinary care.

Early veterinary intervention can prevent severe complications, ensuring a faster and safer recovery for your dog.

Read more about:

• TPLO incision infection symptoms & prevention
• Signs of TPLO failure in dogs
• Staph infection after TPLO surgery
• MRSP infection in dogs: Causes & symptoms

Conclusion

Treating MRSP in dogs involves a thorough approach, combining home care, topical treatments, and, in severe cases, systemic antibiotics. Quick infection control, good hygiene, and using antiseptic shampoos, mupirocin ointment, or amikacin spray can help manage mild cases. For deeper infections, antibiotics prescribed by a vet should be used based on culture and sensitivity tests to prevent resistance.

It's important to complete the entire treatment course—stopping early can lead to reinfection and antibiotic resistance. For surface infections, treatment should last at least 3 weeks, while deeper infections may need 4–8 weeks or more.

If your dog's condition does not improve or gets worse, consult a veterinarian right away. Regular checkups and early intervention can help prevent complications. By being proactive and following the right treatment steps, you can ensure a full recovery and lower the risk of future MRSP infections. Always seek veterinary advice for the best results.

FAQs

What Are the Symptoms of MRSP in Dogs?

MRSP infections in dogs typically cause persistent skin issues that do not respond to standard antibiotics. Common symptoms include red, inflamed skin, sores, pustules, hair loss, and excessive itching. Dogs may also experience chronic ear infections, slow-healing wounds, and pain or swelling in affected areas. In severe cases, MRSP can spread to deeper tissues, leading to systemic illness requiring urgent veterinary care.

Can MRSP in Dogs Be Cured?

Yes, MRSP infections can be effectively managed with proper treatment, but complete elimination depends on the severity. Topical antiseptics, targeted antibiotics (if needed), and strict hygiene help control the infection. Since MRSP is resistant to many antibiotics, culture and sensitivity testing is crucial for choosing the right medication. Long-term management, including regular checkups and preventive care, is necessary to reduce the risk of recurrence.

Is MRSP in Dogs Contagious to Humans?

Yes, MRSP can be zoonotic, meaning it can spread from dogs to humans, though the risk is low for healthy individuals. People with weakened immune systems, such as the elderly or those with chronic illnesses, are at higher risk. Proper hygiene, including handwashing after handling an infected dog, is essential to reduce the risk of transmission. Close contact, such as sleeping in the same bed, should be avoided.

Can MRSP in Dogs Go Away Without Treatment?

No, MRSP infections do not resolve on their own. Since MRSP is resistant to many antibiotics, untreated infections can worsen and spread. Some cases may respond to topical antiseptics and improved hygiene, but veterinary treatment is often necessary. Without proper care, the infection can persist for months, leading to chronic skin issues and potential systemic complications. Seeking veterinary guidance is essential.

How Long Does It Take for a Dog to Recover from MRSP?

Healing time depends on the severity of the infection and the treatment approach. Superficial infections typically improve within 3 weeks, while deep infections require 4–8 weeks or longer of continuous treatment. Treatment must continue for 1–3 weeks after visible healing to prevent recurrence. Regular follow-ups and bacterial cultures ensure the infection is fully resolved before stopping treatment.

‍

What is MRSP Infection in Dogs?

Methicillin-Resistant Staphylococcus pseudintermedius (MRSP) is a type of bacteria that causes infections in dogs and is resistant to many common antibiotics, including methicillin and other beta-lactam antibiotics.

MRSP is a strain of Staphylococcus pseudintermedius, a bacterium naturally found on a dog’s skin and mucous membranes. While regular S. pseudintermedius infections can be treated with standard antibiotics, MRSP infections are much harder to manage due to their resistance to multiple drugs.

Unlike typical bacterial infections, MRSP does not respond to first-line antibiotics, making treatment more complex and prolonged. This resistance develops when bacteria are repeatedly exposed to antibiotics, leading to mutations that allow them to survive even in the presence of these medications.

MRSP is a major concern for veterinarians and dog owners because it can cause persistent skin infections, surgical site infections, and deep tissue infections. These infections are often recurrent and challenging to eradicate.

‍

TL;DR

• MRSP spreads through direct contact, contaminated surfaces, and repeated antibiotic use, making multi-dog environments high-risk.
• Antibiotic resistance makes standard treatments ineffective, leading to persistent and recurrent infections.
• Infected dogs often develop skin lesions, swelling, non-healing wounds, and, in severe cases, fever and lethargy.
• Topical antiseptics and targeted antibiotics may help, but MRSP-related surgical infections remain difficult to manage.
• Simini Protect Lavage is the only effective non-antibiotic solution for MRSP surgical cases, preventing bacterial biofilm formation and reinfection.

‍

How Common is MRSP in Dogs?

MRSP infections are becoming increasingly common in veterinary medicine, with rising cases reported worldwide. While Staphylococcus pseudintermedius is a normal part of a dog’s skin flora, the methicillin-resistant strain (MRSP) has been identified more frequently in veterinary clinics, kennels, and households with multiple pets.

Studies indicate that MRSP prevalence varies by region, but infection rates have increased due to widespread antibiotic use in veterinary medicine. Some research suggests that up to 40% of S. pseudintermedius isolates in certain veterinary hospitals show methicillin resistance.

Where MRSP is Commonly Found

MRSP is often detected in dogs with chronic skin conditions, post-surgical wounds, ear infections, and deep tissue abscesses. It is frequently seen in:

• Dogs with recurrent pyoderma or allergic skin disease
• Postoperative surgical site infections
• Dogs undergoing long-term antibiotic treatment
• Pets in shelters, kennels, or multi-dog households

Why Antibiotic Resistance is Increasing

The overuse and misuse of antibiotics are the primary drivers of MRSP resistance. Repeated exposure to antibiotics, particularly in cases where treatment is stopped early or used unnecessarily, allows bacteria to develop resistance.

Additionally, MRSP can spread between dogs through direct contact or contaminated surfaces, making infection control crucial in veterinary settings.

How Do Dogs Get MRSP?

MRSP is a highly resilient bacterium that spreads easily in veterinary settings and among dogs in close contact. Unlike typical bacterial infections that respond to standard antibiotics, MRSP thrives in environments with frequent antibiotic use, causing treatment-resistant infections.

Ways Dogs Can Contract MRSP

• Direct Contact with Infected Animals - Dogs can contract MRSP by coming into contact with another infected pet. This is especially common in multi-dog households, kennels, and veterinary clinics where animals interact closely.
• Exposure to Contaminated Surfaces - MRSP can survive on objects such as bedding, grooming tools, medical equipment, and kennel surfaces. Dogs that frequently visit grooming facilities, boarding kennels, or veterinary clinics may be exposed to these contaminated environments.
• Repeated Antibiotic Treatments - Overuse or misuse of antibiotics contributes to MRSP infections. When a dog is given antibiotics repeatedly—especially if treatments are stopped early—the bacteria can develop resistance, making future infections harder to treat.
• Weakened Immune System - Dogs with compromised immune systems, whether due to chronic illnesses, endocrine disorders, or stress, are more susceptible to MRSP. Their bodies struggle to fight off infections, increasing the likelihood of colonization by resistant bacteria.

Risk Factors for MRSP Infection

• Dogs with Allergies or Endocrine Disorders - Conditions like atopic dermatitis, hypothyroidism, or Cushing’s disease weaken the skin barrier and immune response, making dogs more vulnerable to MRSP infections.
• Frequent or Prolonged Antibiotic Use - Long-term antibiotic exposure alters bacterial populations, increasing the risk of antibiotic-resistant strains like MRSP.
• Extended Hospital Stays or Frequent Veterinary Visits - Dogs that require hospitalization, surgery, or repeated treatments are at higher risk due to increased exposure to MRSP-contaminated environments.

By understanding these transmission routes and risk factors, veterinarians and pet owners can take preventive measures to reduce the spread of MRSP and protect canine health.

Signs and Symptoms of MRSP in Dogs

MRSP infections primarily affect the skin but can also lead to deeper tissue infections. Since MRSP is resistant to many antibiotics, symptoms often persist despite initial treatments. Recognizing the signs early can help in timely diagnosis and management.

Common Skin-Related Symptoms

MRSP often presents as a skin infection (pyoderma) with visible lesions. You may notice:

• Abscesses or pustules (small pus-filled bumps)
• Redness and inflammation around the affected area
• Crusting or scabbing of the skin
• Non-healing wounds that worsen over time

Hair Loss and Excessive Itching

Dogs with MRSP infections may develop patchy hair loss (alopecia) due to chronic skin irritation. Constant itching, licking, or chewing of the infected area can lead to further skin damage and secondary infections.

Swelling, Pain, or Discomfort

Affected areas may become swollen and tender to the touch. If the infection spreads deeper, pain and localized warmth may be noticeable.

General Signs of Illness

If the infection becomes more severe, dogs may show systemic symptoms, such as:

• Fever
• Lethargy or weakness
• Loss of appetite

Since MRSP infections can mimic other skin conditions, a proper veterinary diagnosis is crucial for effective treatment.

Diagnosis: How Vets Confirm MRSP in Dogs

Diagnosing MRSP requires laboratory testing because it cannot be identified through visual examination alone. Since MRSP is resistant to many antibiotics, early and accurate diagnosis is essential for selecting the right treatment.

Culture and Sensitivity Testing

The most reliable way to confirm MRSP is through bacterial culture and antibiotic sensitivity testing. A veterinarian will collect a sample from an infected area—such as a skin lesion, wound, or ear discharge—using a sterile swab.

This sample is then sent to a laboratory, where technicians grow the bacteria and test its response to various antibiotics. If the bacteria show resistance to methicillin and other common drugs, MRSP is confirmed.

Why MRSP Requires Lab Testing

MRSP infections look similar to other bacterial skin infections, making it impossible to diagnose based on appearance alone. Without lab testing, standard antibiotic treatments may fail, leading to prolonged or worsening infections.

Importance of Early Diagnosis

Timely identification of MRSP allows veterinarians to prescribe the appropriate antibiotic or alternative treatments, reducing the risk of complications. Early diagnosis also helps prevent the spread of MRSP to other pets, especially in multi-dog households, veterinary clinics, and kennels.

How is MRSP Different from Other Staph Infections?

MRSP (Methicillin-Resistant Staphylococcus pseudintermedius) differs from typical Staphylococcus pseudintermedius infections in one key way: antibiotic resistance.

While both types of bacteria can cause skin infections, wounds, and post-surgical complications in dogs, MRSP is resistant to methicillin and many other commonly used antibiotics.

This makes it much harder to treat than regular S. pseudintermedius infections, which typically respond to first-line antibiotics like cephalexin or amoxicillin-clavulanate.

MRSP vs. MRSA: What’s the Difference?

MRSP is often compared to Methicillin-Resistant Staphylococcus aureus (MRSA), another drug-resistant staph infection. However, MRSP primarily affects dogs, while MRSA is more common in humans. Although MRSP can occasionally spread to humans, the risk of transmission is lower compared to MRSA.

Why MRSP is Harder to Treat

• Limited antibiotic options – Many standard antibiotics fail against MRSP, requiring veterinarians to use second-line or specialized treatments.
• Recurrent infections – MRSP infections often return after treatment, requiring long-term management.
• Environmental persistence – MRSP can survive on surfaces like bedding, kennels, and grooming tools, increasing the risk of reinfection.

Because of its resistance and persistence, MRSP requires careful antibiotic selection and strict infection control to prevent outbreaks in veterinary clinics and multi-pet households.

Are Certain Dog Breeds More Prone to MRSP?

Some dog breeds are more susceptible to MRSP due to genetic factors and breed-specific skin conditions. Breeds prone to allergies, skin folds, or chronic dermatitis have a higher risk of developing bacterial infections, which can lead to MRSP if antibiotics are overused.

Breeds at Higher Risk

• Bulldogs, Pugs, and Shar-Peis – Skin folds trap moisture, creating a breeding ground for bacteria.
• Labrador Retrievers and Golden Retrievers – Prone to allergic dermatitis and chronic ear infections.
• German Shepherds – More likely to develop deep pyoderma, a severe skin infection.

Proper skin care and infection prevention are key for these breeds.

Is MRSP Contagious to Other Dogs?

Yes, MRSP can spread between dogs, especially in multi-pet households, kennels, and veterinary clinics. It spreads through direct contact with infected dogs, contaminated surfaces (bedding, food bowls, grooming tools), and shared environments.

Risk Factors for Transmission

• Dogs in kennels, shelters, or veterinary hospitals
• Shared items like toys, blankets, or grooming tools
• Open wounds or skin infections that allow bacteria to enter

Can Asymptomatic Carriers Spread MRSP?

Yes, some dogs carry MRSP without showing symptoms but can spread it to others, making infection control crucial. Regular hygiene and isolation of infected dogs help prevent outbreaks.

Treatment Options for MRSP in Dogs

MRSP infections require a multifaceted treatment approach due to their resistance to common antibiotics. Treatment typically includes culture-guided antibiotic therapy, topical antiseptics, and infection management strategies to prevent recurrence.

Medical Treatments

• Antibiotic Therapy - Since MRSP does not respond to many first-line antibiotics, culture and sensitivity testing is essential to identify effective options. Some MRSP strains remain susceptible to chloramphenicol, doxycycline, rifampin, or amikacin, but each case requires individualized treatment.
• Why Some Antibiotics Don’t Work - MRSP carries resistance genes that make it immune to methicillin and other beta-lactam antibiotics, such as cephalexin and amoxicillin-clavulanate. Using ineffective antibiotics can worsen resistance, leading to chronic or recurrent infections.

Topical Treatments

• Antibacterial Shampoos and Solutions - Regular bathing with chlorhexidine or miconazole-based shampoos helps reduce bacterial load and prevent reinfection.
• Medicated Wipes and Ointments - For localized infections, antiseptic wipes, gels, or ointments (containing chlorhexidine or mupirocin) help control bacterial spread and promote healing.

The Role of Simini in Surgical MRSP Cases

For MRSP-related post-surgical infections, Simini Protect Lavage is a critical non-antibiotic solution. MRSP increases the risk of surgical site infections (SSIs), which can be difficult to treat with standard antibiotics.

Simini Protect Lavage effectively removes bacteria, disrupts biofilms, and lowers infection risks without contributing to antibiotic resistance. It is particularly beneficial for orthopedic surgeries, wound management, and post-operative care, where MRSP contamination poses a significant challenge.

For non-surgical MRSP infections, a combination of targeted antibiotics, antiseptic treatments, and strict hygiene measures is necessary to prevent recurrence and transmission.

Managing MRSP at Home: Infection Control and Prevention

MRSP can spread easily in multi-pet households, making strict hygiene and infection control measures essential. Since MRSP is resistant to many antibiotics, preventing transmission is just as important as treating the infected dog.

Strict Hygiene Measures

• Wash hands thoroughly after handling an infected dog, especially before touching other pets or household items.
• Use disposable gloves when applying topical treatments to avoid spreading bacteria.
• Limit direct contact, such as cuddling or allowing the dog to sleep on furniture, to prevent contamination.

Cleaning and Disinfecting

• Wash bedding, toys, collars, and bowls frequently using hot water and pet-safe disinfectants.
• Clean surfaces like floors and furniture with antibacterial solutions to eliminate lingering bacteria.
• Use separate grooming tools and feeding dishes for the infected dog to prevent cross-contamination.

Minimizing Spread to Other Pets and Humans

• Keep the infected dog in a separate space until the infection resolves.
• Regularly bathe pets with antibacterial shampoos if they share a home with an infected dog.
• Although MRSP is rarely transmitted to humans, immunocompromised individuals should take extra precautions when handling an infected pet.

Consistent infection control measures help prevent MRSP from spreading and reduce the risk of reinfection.

How to Prevent MRSP in Dogs

Preventing MRSP infections requires a proactive approach that focuses on responsible antibiotic use, regular veterinary care, and maintaining a strong immune system.

Since MRSP thrives in environments where antibiotics are overused or misused, reducing unnecessary antibiotic exposure is key to controlling its spread.

Responsible Antibiotic Use to Prevent Resistance

One of the biggest contributors to MRSP infections is antibiotic resistance, which develops when antibiotics are used improperly. To prevent this:

• Always complete prescribed antibiotic courses, even if symptoms improve before finishing the medication.
• Avoid using antibiotics without veterinary guidance, as incorrect treatment can promote resistant bacteria.
• If your dog has a history of bacterial infections, ask your vet about alternative treatments, such as antibacterial shampoos or topical antiseptics, instead of relying on systemic antibiotics.

Regular Vet Check-Ups to Detect Early Signs

Routine veterinary visits help catch skin infections, wounds, or other risk factors before they become severe. Early intervention reduces the chance of an infection becoming resistant to treatment.

Dogs with allergies, endocrine disorders, or chronic skin issues should have frequent skin assessments to monitor for signs of bacterial infections.

Strengthening the Immune System Through Diet and Hygiene

A strong immune system helps dogs fight off bacterial infections naturally. To improve immunity:

• Feed a balanced diet with high-quality proteins, essential fatty acids, and vitamins. Omega-3 and Omega-6 fatty acids support skin health, reducing infection risk.
• Maintain good hygiene by regularly bathing dogs with veterinary-approved shampoos to remove bacteria from the skin.
• Keep bedding, grooming tools, and food bowls clean to prevent bacterial buildup.

Prognosis: Can Dogs Recover from MRSP?

How Long It Takes to Treat MRSP

The duration of MRSP treatment depends on the severity of the infection and the effectiveness of treatment.

• Mild skin infections may resolve within 4-6 weeks with proper antibiotic and topical therapy.
• Deep or recurrent infections can take several months to fully heal, requiring a combination of antibiotics, antiseptic treatments, and strict hygiene measures.
• Post-surgical MRSP infections require specialized wound management, and in severe cases, additional procedures may be needed to remove infected tissue.

Chances of Recurrence and Long-Term Management

MRSP has a high recurrence rate, especially in dogs with underlying conditions like allergies, hypothyroidism, or chronic skin disease. Preventing reinfection requires:

• Monitoring for early signs of reinfection, such as skin redness, pustules, or excessive itching.
• Following hygiene protocols to minimize bacterial spread in the home.
• Using non-antibiotic alternatives like antiseptic washes and medicated shampoos to reduce bacterial load without contributing to antibiotic resistance.

When to Seek Veterinary Care for Persistent Infections

If a dog’s MRSP infection does not improve with treatment, spreads to deeper tissues, or recurs frequently, veterinary intervention is crucial. Seek immediate care if:

• Lesions worsen or new infections appear despite antibiotic therapy.
• The dog develops fever, lethargy, or loss of appetite, which may indicate a systemic infection.
• A post-surgical wound shows signs of MRSP, as these infections require specialized management to prevent complications.

With early detection, responsible treatment, and infection control, dogs with MRSP can recover and live healthy lives while minimizing the risk of recurrence.

Read more about:

• Effective ways to prevent infections in dog wounds
• How to prevent surgical site infections in dogs
• Post-operative infection in dogs: Symptoms and solutions
• TPLO incision infection: Symptoms and prevention
• Staph infection after TPLO surgery

Summary

• MRSP is a severe, drug-resistant bacterial infection that makes standard antibiotic treatments ineffective, leading to persistent or recurrent infections.
• Dogs contract MRSP through direct contact, contaminated surfaces, or repeated antibiotic exposure, making multi-pet households, kennels, and vet clinics high-risk environments.
• Symptoms include non-healing skin infections, abscesses, redness, swelling, and fever, which can worsen without proper treatment.
• Accurate diagnosis through lab testing (culture and sensitivity) is essential, as misidentifying MRSP can lead to ineffective treatments and prolonged illness.
• Treatment requires targeted antibiotics, medicated shampoos, and antiseptics, while Simini Protect Lavage is the only proven non-antibiotic solution for surgical cases.
• Preventing MRSP involves strict hygiene, responsible antibiotic use, and early detection, helping reduce resistance and protect both pets and veterinary environments.

FAQs

Can humans catch MRSP from dogs?

MRSP is primarily a canine-associated bacterium, and transmission to humans is rare. However, immunocompromised individuals or those with open wounds may be at higher risk. Practicing good hygiene, such as handwashing after handling an infected dog, helps minimize the risk. Unlike MRSA, MRSP is not a significant human health threat but requires proper infection control.

How long does MRSP last in dogs?

The duration of MRSP infections depends on severity and treatment response. Mild cases may resolve in 4-6 weeks with targeted antibiotic therapy and topical treatments. However, severe or recurrent infections can last several months, requiring long-term management. Regular vet check-ups and strict hygiene measures help shorten recovery time and prevent reinfection.

What happens if MRSP is left untreated?

Untreated MRSP infections can worsen and spread, leading to chronic skin infections, deep tissue abscesses, or systemic illness in severe cases. Persistent infections may cause pain, discomfort, and hair loss, and in post-surgical cases, they can lead to serious complications. Since MRSP is antibiotic-resistant, early diagnosis and proper management are crucial to avoid long-term health issues.

Can MRSP come back after treatment?

Yes, MRSP infections have a high recurrence rate, especially in dogs with allergies, chronic skin disease, or weakened immune systems. Reinfection often occurs due to environmental contamination or incomplete treatment. To prevent recurrence, follow strict hygiene protocols, use antiseptic washes, and monitor for early signs of reinfection. Regular vet visits can help manage underlying conditions.

Are there vaccines for MRSP prevention?

No, there is currently no vaccine for MRSP. Prevention relies on responsible antibiotic use, good hygiene, and early detection of infections. Regular bathing with antibacterial shampoos, maintaining a clean environment, and avoiding unnecessary antibiotic use help reduce the risk of MRSP infections in dogs.

‍

A Staph infection after TPLO surgery is a bacterial infection caused by Staphylococcus species at the surgical site. These infections happen when bacteria enter the incision, leading to inflammation, pain, swelling, and, in severe cases, delayed healing or implant issues.

The most common bacteria involved are

• Staphylococcus pseudintermedius (S. pseudintermedius is naturally found on a dog's skin and can become problematic after surgery.)
• Staphylococcus aureus (S. aureus is less common in dogs but can still cause serious infections, sometimes resistant to antibiotics like MRSA.)

TPLO surgeries are particularly prone to infection because of the metal implants, which provide a surface for bacteria to stick to and form biofilms. Additionally, open incisions, surgical trauma, and a dog's licking or scratching increase the risk of infection.

Using proper sterile techniques, taking care of the wound after surgery, and detecting infections early are crucial for preventing complications and ensuring a smooth recovery.

‍

TL;DR

• Staph infections after TPLO surgery are rare but can happen, with Staphylococcus pseudintermedius being the most common culprit.
• Early treatment with antibiotics is crucial as infections typically won't heal on their own and can lead to serious complications.
• Untreated infections may cause osteomyelitis, implant failure, or systemic illness, requiring more invasive treatments.
• Proper post-op care and monitoring the incision site are key to preventing infections.
• If an infection is severe, the TPLO plate may need to be removed to prevent further complications.

‍

Causes of Staph Infection After TPLO Surgery

Staph infections after TPLO surgery occur when Staphylococcus bacteria enter the surgical site, multiply, and trigger an inflammatory response. These infections can develop due to various factors, often related to contamination, improper wound care, or the dog's overall health.

Surgical Site Contamination - Even with strict sterile protocols, bacteria from the skin, surgical instruments, or operating room can enter the incision. Staphylococcus pseudintermedius is naturally found on a dog's skin and may infect the site if proper antiseptic measures are not followed.

Improper Wound Care - After surgery, poor wound management increases infection risk. If bandages are not changed regularly, the incision is exposed to dirt, or the dog licks the wound, bacteria can enter. Delayed healing also creates an opportunity for bacterial overgrowth.

Weakened Immunity - Dogs with weakened immune systems due to age, chronic illnesses (like diabetes or Cushing’s disease), or prolonged use of immunosuppressive medications are more vulnerable to infections. Their bodies struggle to fight bacteria, increasing the risk of severe complications.

Hospital-Acquired vs. Environmental Bacteria - Hospital-acquired infections, often resistant to antibiotics (e.g., MRSA), pose a serious threat. Environmental bacteria, from bedding, floors, or other animals, can also infect wounds if hygiene is inadequate. Proper post-op care and monitoring are essential for prevention.

Risk Factors for Developing Infections Post-TPLO

Several factors increase the risk of Staph infection after TPLO surgery, including dog-related, surgical, and post-op care factors. Understanding these risks helps in preventing complications and ensuring a smooth recovery.

Dog-Related Factors

Certain dogs are more prone to infections. Older dogs, immunocompromised pets (diabetes, Cushing’s disease), and breeds with skin folds (like Bulldogs) are at higher risk due to weaker immune defenses or bacterial colonization. Overweight dogs also have reduced blood flow to the incision, slowing healing.

Surgical Factors

Implant contamination is a major concern, as metal plates provide a surface for bacteria to form biofilms, making infections harder to treat. Prolonged surgery times, non-sterile conditions, and inadequate antibiotic prophylaxis increase infection risk.

To minimize this, many surgeons use Simini Protect Lavage, a non-antibiotic surgical lavage that helps reduce bacterial contamination and biofilm formation on implants, lowering the chances of post-op infections.

Post-Op Care Factors

Excessive licking, poor hygiene, and delayed wound healing significantly raise infection risks. Dogs licking their incision introduce bacteria, while unclean bedding and surroundings expose wounds to environmental contaminants. Owners must follow strict post-op wound care guidelines and monitor for early signs of infection.

Symptoms of a Staph Infection After TPLO Surgery

Recognizing the early signs of Staph infection after TPLO surgery is crucial for timely treatment. Infections can range from mild to severe, potentially leading to implant complications or systemic illness if left untreated.

Early Signs - In the initial stages, the infection may cause redness, swelling, and warmth around the incision site. Mild discomfort is normal post-surgery, but persistent inflammation or increasing pain could indicate bacterial activity. Some dogs may start licking or chewing the incision, further worsening the condition.

Moderate Symptoms - As the infection progresses, pus or thick discharge may develop, often accompanied by a foul odor. The incision may start to separate or appear moist and inflamed. Dogs might also show signs of discomfort, such as limping, stiffness, or reluctance to bear weight on the affected leg. These symptoms suggest that the infection is spreading deeper into the tissue.

Severe Symptoms - In advanced cases, the infection can lead to systemic illness, causing fever, lethargy, loss of appetite, and general weakness. If bacteria spread to the bone or implant, it can result in implant loosening or failure, requiring urgent medical intervention. Immediate veterinary attention is needed to prevent complications and ensure proper healing.

How Staph Infections Are Diagnosed After TPLO Surgery

Diagnosing a Staph infection after TPLO surgery requires a thorough veterinary examination, laboratory tests, and sometimes imaging to assess the severity of the infection and its impact on the surgical site.

Veterinary Examination and Wound Assessment

A veterinarian will start by visually inspecting the incision site for signs of infection, such as redness, swelling, pus, or a foul odor. They will also check for pain, heat, and any abnormal discharge. If the dog is limping, lethargic, or showing signs of discomfort, it may indicate a deeper infection affecting the bone or implant.

Lab Tests: Bacterial Culture and Antibiotic Sensitivity

To confirm a Staph infection, a bacterial culture is performed by collecting a sample from the infected area. This test identifies the specific bacteria causing the infection, typically Staphylococcus pseudintermedius or Staphylococcus aureus.

Antibiotic sensitivity testing is then conducted to determine which antibiotics will be most effective, especially important for resistant strains like MRSP (Methicillin-Resistant Staphylococcus pseudintermedius).

Imaging Methods for Implant-Associated Infections

If an infection is suspected to have spread to the bone or implant, X-rays or advanced imaging like CT scans may be used. These help detect signs of bone lysis, implant loosening, or deep tissue infection, which could require additional surgical intervention. Early diagnosis is crucial to prevent complications and improve treatment outcomes.

The Role of Multidrug-Resistant Bacteria in TPLO Infections

One of the biggest challenges in treating Staph infections after TPLO surgery is the presence of multidrug-resistant bacteria, particularly Methicillin-Resistant Staphylococcus pseudintermedius (MRSP). This bacterial strain has developed resistance to many commonly used antibiotics, making infections harder to treat and increasing the risk of complications.

What is MRSP?

MRSP is a resistant form of Staphylococcus pseudintermedius, a bacterium normally found on a dog’s skin. In healthy dogs, it rarely causes issues, but after TPLO surgery, it can infect the surgical incision and implants, leading to persistent infections. MRSP is similar to MRSA (Methicillin-Resistant Staphylococcus aureus) in humans, making it difficult to eliminate with standard antibiotics.

Why Traditional Antibiotics May Not Work

Since MRSP is resistant to beta-lactam antibiotics (penicillins and cephalosporins), commonly prescribed antibiotics may be ineffective. Inappropriate antibiotic use can worsen resistance, making treatment options more limited. Infected implants and biofilm formation further protect the bacteria, requiring alternative treatments.

Impact on Treatment Complexity and Recovery Time

Resistant infections prolong recovery, as stronger antibiotics, prolonged treatment, or even implant removal may be necessary. In severe cases, advanced antimicrobial therapies, surgical debridement, or alternative infection-control measures like Simini Protect Lavage may be required to manage the infection and prevent recurrence. Early culture and sensitivity testing is essential for selecting the most effective treatment.

How Biofilms on Implants Worsen Staph Infections

Biofilms are colonies of bacteria that form a protective layer on surfaces, such as TPLO plates and screws. In post-surgical infections, Staphylococcus pseudintermedius and other bacteria can attach to the metal implant, creating a slimy, protective matrix that shields them from antibiotics and the immune system.

How Biofilms Form on TPLO Implants

After TPLO surgery, bacteria from the skin, surgical instruments, or environment can adhere to the implant. Once attached, they produce a sticky extracellular substance, allowing them to grow and form a dense bacterial community. These biofilms anchor bacteria to the implant surface, making infections harder to eradicate.

Why Biofilms Resist Antibiotics and Immune Responses

Biofilms create a physical and chemical barrier that prevents antibiotics from fully reaching the bacteria. Additionally, bacteria within biofilms enter a dormant state, reducing their susceptibility to drugs that typically target active bacterial growth. The immune system also struggles to clear biofilms, as white blood cells cannot penetrate the bacterial layer effectively.

Treatment Challenges and Surgical Interventions

Because biofilm-associated infections are difficult to treat, prolonged antibiotic therapy alone is often ineffective. In severe cases, surgical debridement or implant removal may be required.

Many surgeons use Simini Protect Lavage during TPLO procedures to reduce bacterial adhesion and biofilm formation, helping to lower the risk of persistent infections.

Complications of Staph Infection After TPLO Surgery

A Staph infection after TPLO surgery can lead to severe complications if not treated promptly. The presence of metal implants, biofilm formation, and antibiotic-resistant bacteria make these infections particularly challenging.

• Implant Rejection or Failure - When bacteria colonize the TPLO plate, they can cause loosening of the implant, preventing proper bone healing. The immune system may recognize the infection as a foreign threat, triggering chronic inflammation and implant rejection. In severe cases, implant removal and revision surgery are required.
• Chronic Infections Leading to Osteomyelitis - Untreated or persistent infections can spread to the bone, causing osteomyelitis (bone infection). This condition leads to bone destruction, pain, and ongoing inflammation. Osteomyelitis often requires long-term antibiotics, surgical debridement, and sometimes implant removal to eliminate infected tissue.
• Increased Surgical Costs and Prolonged Recovery - Managing an infection often involves extended hospitalization, additional lab tests, imaging, and stronger antibiotics, significantly increasing treatment costs. The healing process is also delayed, prolonging the dog's discomfort and recovery timeline.
• When Amputation Might Become Necessary - In rare and extreme cases, if the infection is severe, untreatable, or has caused significant bone damage, limb amputation may be the only option to prevent systemic infection and further suffering. Early intervention is critical to avoid this drastic measure.

Treatment Options for Staph Infection Post-TPLO Surgery

Antibiotic Therapy

Common antibiotics for Staph infections include Clindamycin and Cephalexin, but resistant strains like MRSP require targeted antibiotics based on culture and sensitivity testing. If standard treatments fail, fluoroquinolones or chloramphenicol may be necessary. Completing the full antibiotic course is essential to prevent recurrence and resistance. Improper use of antibiotics can worsen resistance, making future infections harder to treat.

Surgical Interventions

If the infection is severe or antibiotics fail, surgical debridement is required to remove infected tissue and biofilm. In persistent infections, implant removal or revision surgery may be necessary. Surgeons may use antibiotic-impregnated beads to deliver localized medication directly to the infected site. This approach helps manage deep infections while preserving limb function, reducing the need for implant removal.

Supportive Care & Wound Management

Topical treatments like chlorhexidine and silver-based dressings help control bacterial growth at the incision. Proper wound cleaning, bandaging, and preventing licking are essential for recovery. Pain management with NSAIDs or opioids reduces discomfort, while anti-inflammatory medications control swelling. Supportive care ensures healing and prevents the infection from worsening or spreading further.

Why Early Detection and Intervention Are Crucial

Early detection and intervention are essential in preventing serious complications from Staph infections after TPLO surgery. The longer an infection goes untreated, the more likely it is to spread and cause severe complications such as osteomyelitis (bone infection), implant failure, or systemic illness. Timely treatment helps limit the damage, reduce recovery time, and avoid costly surgical interventions.

How Early Treatment Prevents Serious Complications - When infections are caught early, antibiotics can effectively control the bacteria before it forms a biofilm on the implant, making it resistant to treatment. Early intervention reduces the chances of bone destruction, chronic infections, and the need for implant removal or amputation.

When to Consult a Vet Immediately - If your dog shows any signs of infection, such as increased swelling, redness, warmth, or pus at the incision site, limping, lethargy, or fever, contact your vet immediately. Foul-smelling discharge or worsening symptoms require urgent attention, as they indicate that the infection is spreading.

The Importance of Regular Follow-Ups After TPLO Surgery - Post-surgery follow-ups are crucial for monitoring the surgical site and identifying early signs of infection. Regular check-ups help ensure that any issues are detected before they develop into more severe problems, ensuring the best possible recovery and reducing the risk of complications.

How to Prevent Staph Infections After TPLO Surgery

Pre-Surgical Prevention

Preventing Staph infections starts before surgery with proper planning. The sterile surgical environment is crucial in minimizing contamination during the procedure. Surgeons should follow strict sterilization protocols to prevent bacteria from entering the wound.

For high-risk dogs, pre-operative antibiotic protocols are recommended, especially if the dog has underlying health conditions like diabetes or is older, as these factors can weaken the immune system and increase infection susceptibility.

Post-Surgical Care Guidelines

Post-surgery, wound monitoring and cleaning are essential for preventing infection. Keep the surgical site dry and clean, changing bandages as instructed. Using an e-collar (cone of shame) can help prevent your dog from licking or biting the wound, which can introduce bacteria.

Avoid exposing your dog to contaminated environments, such as dog parks, dirty floors, or areas with other animals, until the wound is fully healed. This minimizes the risk of external contamination.

Long-Term Prevention Strategies

To maintain your dog’s health after surgery, ensure they have a well-balanced diet and consider supplements that support immune function, such as omega-3 fatty acids. Regular vet checkups help monitor recovery and prevent potential infections.

Even months after surgery, look for signs like swelling, redness, or changes in behavior that could indicate infection risks. Early intervention can prevent complications and ensure your dog’s full recovery.

‍

Read more about:

• Post-Surgery Recovery After TPLO in Dogs
• TPLO Surgery for Older Dogs: Is It a Worthwhile Option?
• Common Myths About TPLO Surgery Explained
• 13 Long-Term Effects of TPLO Surgery on Dogs

‍

Final Thoughts

Staph infections after TPLO surgery can be very serious, leading to implant failure, bone infections, and longer recovery times. Early signs like redness, swelling, or discharge around the incision should never be ignored. Quick treatment with antibiotics and, if needed, surgery is vital to avoid serious problems.

Catching these infections early is crucial to stopping them from getting worse. Noticing the signs early and getting veterinary care right away can lead to better results and lower the risk of long-term harm. Proper post-surgery care, like cleaning the wound, using e-collars, and avoiding dirty areas, is key to preventing infections.

Pet owners should actively monitor their dog’s recovery and keep up with regular vet visits. If any issues arise, consult a vet without delay. Prevention and quick action are the best ways to ensure a smooth recovery and reduce the risk of Staph infections after TPLO surgery.

FAQs

How common is a staph infection after TPLO surgery?

Staph infections after TPLO surgery are relatively uncommon but still a risk, especially in high-risk dogs. Approximately 5-10% of dogs undergoing TPLO may develop infections, with Staphylococcus pseudintermedius being the most common bacterial culprit. Proper sterile technique during surgery, post-op care, and infection prevention strategies can reduce the chances of infection.

Can a staph infection after TPLO surgery heal on its own?

A staph infection after TPLO surgery typically does not heal on its own. Bacterial infections require medical treatment, such as antibiotics, to clear up. Without proper treatment, the infection can spread, causing serious complications like bone infection or implant failure. Seeking veterinary care immediately for proper diagnosis and treatment is essential.

What happens if a TPLO infection is left untreated?

If a TPLO infection is left untreated, it can lead to severe complications such as osteomyelitis (bone infection), implant failure, or systemic illness. The infection may spread deeper, causing chronic pain and delayed healing. In some cases, untreated infections may require surgical intervention, including implant removal or even amputation in extreme situations.

How long does it take for an infection to clear up after TPLO?

The time it takes for an infection to clear up after TPLO surgery depends on the severity of the infection and treatment method. Mild infections may clear up in 2-4 weeks with antibiotics, while severe infections can take several months and may require additional surgeries. Follow-up care is crucial to monitor progress and ensure full recovery.

Are certain dog breeds more prone to infections after TPLO?

Certain dog breeds are more prone to infections after TPLO surgery due to factors like skin folds, immune system strength, or breed-specific health issues. Breeds like Bulldogs, Pugs, and Boxers with compromised immune systems or skin conditions may have a higher risk of infection. Additionally, older dogs or those with chronic conditions like diabetes are more vulnerable.

What should I do if my dog’s TPLO incision looks infected?

If your dog’s TPLO incision looks infected, such as showing redness, swelling, pus, or a foul odor, you should consult your vet immediately. Early intervention with antibiotics or surgical debridement is essential to prevent the infection from spreading. Avoid letting your dog lick the wound and keep the incision clean while awaiting professional care.

Can a TPLO plate be removed if it causes infection?

Yes, a TPLO plate can be removed if it causes infection. In cases where the infection is persistent or deep, or if the implant becomes loose or infected, removal of the plate may be necessary to eliminate the source of the infection. The veterinarian will assess the situation and determine whether removal or revision surgery is the best option for recovery.

TPLO (Tibial Plateau Leveling Osteotomy) surgery is a common procedure to stabilize a dog's knee after a cranial cruciate ligament (CCL) rupture. It involves cutting and repositioning the tibia to reduce strain on the ligament, allowing for better joint function. Like any surgery, TPLO has a risk of complications, with incision infections being a primary concern.

Infections can happen due to bacterial contamination during surgery, improper post-op care, excessive licking or chewing of the incision, or underlying conditions like diabetes or a weakened immune system. Signs of infection include redness, swelling, warmth, discharge, and delayed healing.

The risk of infection after TPLO is relatively low, occurring in about 3-10% of cases. Factors like surgical technique, sterile conditions, and strict post-operative management greatly affect the outcome. Early detection and quick treatment with antibiotics and wound care are crucial to prevent complications and ensure a successful recovery.

Symptoms and Warning Signs of TPLO Incision Infection

Recognizing the symptoms of an infection early is crucial for preventing complications after TPLO (Tibial Plateau Leveling Osteotomy) surgery. Infections can range from mild to severe, potentially affecting healing and the long-term success of the procedure. Understanding the difference between early and advanced signs can help ensure timely intervention.

Early Signs of Infection

In the initial stages, an infection may present with mild symptoms that can sometimes be mistaken for normal healing. These include:

• Redness and swelling around the incision site, which may be slightly warm to the touch.
• Mild pain or tenderness, which persists beyond the expected post-surgical discomfort.
• Clear or slightly yellow discharge, which may indicate the presence of bacteria.

If detected at this stage, infections are often manageable with topical treatments, antibiotics, and proper wound care.

Advanced Signs of Infection

As an infection worsens, more severe symptoms may develop, indicating deeper tissue involvement and potential systemic infection. These include:

• Thick, pus-like discharge from the incision, often accompanied by a foul odor.
• Significant swelling and warmth, which may extend beyond the incision area.
• Fever and lethargy, as the body mounts an immune response.
• Increased lameness or reluctance to bear weight, signaling pain or joint involvement.

Advanced infections require urgent veterinary care, as untreated cases can lead to delayed healing, implant complications, or systemic illness. Immediate intervention, such as antibiotics, wound debridement, or even surgical revision, may be necessary.

Monitoring the incision closely in the weeks following TPLO surgery is essential. Any changes in the wound’s appearance, excessive discomfort, or behavioral changes in your dog should be reported to a veterinarian promptly to prevent complications.

Causes of TPLO Incision Infection

A TPLO (Tibial Plateau Leveling Osteotomy) incision infection can occur due to various factors, either during the surgery or in the post-operative recovery period. Identifying and minimizing these risks is essential for ensuring a smooth healing process.

Bacterial Contamination During or After Surgery

Despite strict sterile protocols, bacteria can sometimes enter the surgical site during the procedure. This can happen due to contamination from the skin, surgical instruments, or even the surrounding environment. Post-operatively, improper wound care or exposure to unclean surfaces can introduce bacteria, increasing infection risk.

Poor Post-Op Wound Care

Proper post-operative care is critical to prevent infection. Failure to keep the incision clean and dry, skipping prescribed antibiotics, or neglecting follow-up visits can allow bacteria to proliferate. Owners must follow all veterinary instructions carefully, including cleaning protocols and medication administration.

Licking or Chewing the Incision Site

Dogs instinctively lick their wounds, which can introduce bacteria from their mouths into the incision. Excessive licking or chewing can also cause trauma to the site, delaying healing. The use of an Elizabethan collar (E-collar) or medical pet shirt is essential to prevent self-inflicted wound contamination.

Moisture Buildup Around the Incision

A damp environment around the incision can promote bacterial growth. Moisture can accumulate from bathing, wet bedding, or excessive sweating, making it essential to keep the area dry until fully healed.

Underlying Health Conditions

Dogs with pre-existing conditions such as diabetes, Cushing’s disease, or immune disorders have a higher risk of infection due to impaired wound healing. Such cases require extra vigilance in monitoring for signs of infection.

Implants and Their Role in Infection Risk

The metal implants used in TPLO surgery can serve as a surface for bacterial adhesion. If bacteria form a biofilm on the implant, it can lead to a deep-seated infection that may require implant removal or surgical revision.

To minimize this risk, many surgeons use Simini Protect Lavage, a non-antibiotic surgical lavage designed to reduce bacterial contamination and prevent biofilm formation. Unlike traditional solutions, Simini Protect Lavage actively disrupts bacterial adhesion, helping to lower infection risks without contributing to antibiotic resistance. Its use in TPLO and other orthopedic procedures has shown promising results in enhancing post-surgical outcomes.

Preventing infection requires a combination of strict surgical protocols, diligent post-op care, and close monitoring of the incision site for any signs of complications.

How TPLO Infections Are Diagnosed

Diagnosing a TPLO incision infection requires a thorough evaluation by a veterinarian to determine the severity and appropriate treatment plan. Early detection is key to preventing complications such as delayed healing, deep tissue infections, or implant failure.

Physical Examination

The first step in diagnosing an infection is a detailed physical examination of the incision site. The veterinarian will check for common signs of infection, including:

• Redness and swelling around the incision.
• Abnormal discharge (pus, thick yellow fluid, or foul-smelling secretions).
• Increased warmth in the surrounding tissue.
• Pain response when the area is gently palpated.
• Signs of systemic illness, such as fever or lethargy.

Diagnostic Tests

If an infection is suspected, further diagnostic tests help confirm the presence and extent of the infection.

• Wound Culture and Sensitivity Test - A swab of the incision site is collected to identify the specific bacterial strain causing the infection. This helps determine the most effective antibiotic treatment.
• Complete Blood Count (CBC) - Blood tests check for elevated white blood cell counts (WBCs), which indicate an immune response to infection. Other markers, such as increased neutrophils, may suggest a bacterial infection.
• X-rays or Advanced Imaging - If the infection has progressed or involves the surgical implants, X-rays or ultrasound imaging may be used to assess deep tissue involvement. In some cases, an infection can lead to osteomyelitis (bone infection) or implant loosening, requiring further surgical intervention.

Prompt and accurate diagnosis ensures that treatment is initiated quickly, reducing the risk of complications and improving the chances of a full recovery.

Potential Complications of an Untreated TPLO Incision Infection

If a TPLO incision infection is left untreated, it can lead to serious complications that may jeopardize the success of the surgery and the dog’s long-term mobility. Early intervention is crucial to prevent these risks.

Implant Failure and the Need for Removal or Revision Surgery

TPLO surgery involves the placement of metal implants (plates and screws) to stabilize the tibia. If bacteria colonize the implant, they can form a biofilm, making the infection difficult to treat with antibiotics alone. This can lead to implant loosening or failure, requiring removal or revision surgery to replace the affected hardware. A second surgery increases recovery time and risk of further complications.

Read more about - Signs of TPLO Failure in Dogs & When to See a Vet

Deep Bone Infection (Osteomyelitis)

When an infection spreads beyond the incision site into the bone tissue, it can cause osteomyelitis, a severe and persistent infection. Bone infections are challenging to treat and often require long-term antibiotics, surgical debridement, or even partial bone removal in extreme cases. Osteomyelitis can significantly delay healing and may compromise limb function.

Delayed Healing, Prolonged Pain, and Lameness

An untreated infection slows down wound healing, leading to persistent inflammation, chronic pain, and prolonged lameness. Infections interfere with the body’s natural healing process, increasing the risk of poor scar formation and weakening the stability of the joint. This can result in long-term mobility issues, affecting the dog’s quality of life.

Risk of Systemic Infection (Sepsis)

If bacteria enter the bloodstream, the infection can become systemic, leading to sepsis, a life-threatening condition. Sepsis causes widespread inflammation, organ dysfunction, and severe illness. Immediate hospitalization, intravenous antibiotics, and aggressive supportive care are required in such cases.

Preventing complications requires early diagnosis, strict post-op care, and immediate treatment of any signs of infection to ensure a smooth recovery.

Treatment Options for TPLO Incision Infections

A TPLO incision infection requires prompt and appropriate treatment to prevent complications and ensure proper healing. The treatment plan depends on the severity of the infection, the presence of bacterial colonization on the implants, and the dog’s overall health.

Antibiotic Therapy

Antibiotics are the first line of treatment for a TPLO incision infection. The choice of antibiotic depends on wound culture and sensitivity testing, ensuring effective targeting of the bacteria.

• Oral antibiotics (e.g., cephalexin, clindamycin, or enrofloxacin) are commonly prescribed for mild to moderate infections.
• Topical antibiotics (e.g., silver sulfadiazine or mupirocin) may be used to manage surface-level infections.
• If the infection is deep-seated or spreading, intravenous (IV) antibiotics may be required for better systemic control.

Wound Cleaning and Care

Proper wound care helps clear bacteria and promote healing. This includes:

• Cleaning the incision with veterinary-approved antiseptic solutions (chlorhexidine or diluted povidone-iodine).
• Avoiding excessive moisture buildup around the wound.
• Preventing licking or chewing with an Elizabethan collar (E-collar) or medical pet shirt.
• Ensuring the bandage (if used) is clean and changed as recommended by the veterinarian.

Pain Management

Infections cause inflammation and discomfort, so pain relief is an important part of treatment.

• Non-steroidal anti-inflammatory drugs (NSAIDs) such as carprofen or meloxicam may be prescribed to reduce pain and swelling.
• If severe discomfort persists, stronger pain relievers may be necessary.

Surgical Intervention

For infections that do not respond to antibiotics or involve the implants, surgical intervention may be needed:

• Flushing and debridement – The vet may clean and remove infected tissue under anesthesia to prevent further bacterial spread.
• Implant removal or revision – If bacteria have colonized the TPLO plate and screws, implant removal may be necessary, followed by a prolonged course of antibiotics to clear the infection.

Timely and appropriate treatment is essential to prevent long-term complications and ensure a smooth recovery. Close veterinary supervision and adherence to post-op care instructions significantly improve outcomes.

When to Call Your Veterinarian

Recognizing the signs of a TPLO incision infection early and seeking veterinary care promptly can prevent serious complications. Certain symptoms indicate the need for immediate medical attention:

• Excessive swelling, redness, or warmth around the incision.
• Thick, pus-like discharge or a foul odor from the wound.
• Persistent pain or worsening lameness beyond the expected healing period.
• Fever, lethargy, or loss of appetite, which may indicate a systemic infection.
• Sudden changes in behavior, such as reluctance to move or increased sensitivity around the incision.

How Quickly Should an Infection Be Addressed?

If you notice any signs of infection, contact your veterinarian immediately. Mild infections caught early may be treated with antibiotics and wound care, but delays in treatment can lead to deeper infections, increasing the risk of implant failure or systemic illness.

What to Expect During a Vet Visit

Your veterinarian will:

• Perform a physical examination of the incision.
• Conduct diagnostic tests (wound cultures, blood tests, or X-rays) if needed.
• Prescribe antibiotics or pain medication based on the infection’s severity.
• Recommend wound cleaning protocols or, in severe cases, surgical intervention to remove infected tissue or implants.

Prompt veterinary care ensures a smoother recovery and reduces the risk of long-term complications.

Preventing TPLO Incision Infections

Preventing infection after TPLO surgery is crucial for ensuring a smooth recovery and avoiding complications. Proper post-operative care significantly reduces the risk of infection and promotes faster healing.

Proper At-Home Wound Care Routine

A clean and well-maintained incision site is essential for preventing bacterial growth. Follow these steps to ensure proper wound care:

• Inspect the incision daily for redness, swelling, or discharge.
• Use vet-approved antiseptic solutions if cleaning is necessary.
• Avoid touching the wound with unclean hands to prevent contamination.
• Follow the prescribed antibiotic regimen to eliminate any potential bacterial infections.

Importance of E-Collars to Prevent Licking

Dogs instinctively lick wounds, but their mouths contain bacteria that can introduce infection.

• An Elizabethan collar (E-collar) or medical pet shirt should be used at all times until the incision fully heals.
• Even brief periods of licking can introduce bacteria, delaying healing and increasing infection risk.

Keeping the Incision Dry and Clean

Moisture creates an ideal environment for bacterial growth, so it’s important to:

• Prevent the incision from getting wet—no bathing or swimming until cleared by the vet.
• Keep the bedding clean and dry to avoid contamination.
• If the incision gets wet, gently pat it dry with a clean, soft cloth.

Following Post-Op Care Instructions Strictly

Veterinary post-op guidelines should be followed precisely, including:

• Restricted activity to prevent excessive movement that could stress the incision.
• Proper medication schedules, including antibiotics and pain relievers.
• Scheduled follow-up visits to monitor healing progress.

Monitoring for Any Early Signs of Infection

Even with proper care, infections can still develop. Watch for:

• Redness, swelling, or discharge from the incision.
• Excessive licking or signs of discomfort around the area.
• Changes in behavior, such as lethargy or reluctance to move.

By taking proactive steps in at-home care, pet owners can significantly reduce the chances of post-operative infections and support a successful TPLO recovery.

‍

Read more about:

• TPLO Failure Symptoms
• TPLO Surgery Cost Guide
• Long-Term Outcomes of TPLO Surgery
• Common Causes of Limping in Dogs Post-TPLO Surgery

‍

Conclusion

A TPLO incision infection can slow down healing and cause serious problems if not treated. It's important to notice early signs of infection, like redness, swelling, discharge, or increased pain, to prevent further issues. Quick veterinary care can greatly improve recovery results.

Proper post-operative wound care, such as keeping the incision clean and dry, using an E-collar to prevent licking, and following all prescribed medications, helps reduce the risk of infection. Watching for any changes in the incision site or behavior allows for early action if needed.

If an infection happens, quick diagnosis and treatment with antibiotics, wound care, or surgery ensure the best recovery possible. By being watchful and proactive in post-op care, pet owners can support a smooth healing process and help their dog regain mobility safely.

FAQs

How do I know if my TPLO incision is infected?

A TPLO incision infection may show signs such as redness, swelling, warmth, and abnormal discharge (yellow, pus-like, or foul-smelling fluid). The incision may become painful, and your dog might show increased licking, lethargy, fever, or reluctance to walk. If you notice any of these symptoms, contact your veterinarian immediately for evaluation and treatment.

How do you treat a TPLO infection?

Treatment depends on the severity of the infection. Mild cases may be managed with oral antibiotics and wound cleaning, while severe infections might require intravenous antibiotics, wound flushing, or even implant removal if bacteria form a biofilm. Pain management and restricted movement are also essential for recovery. Early treatment ensures the best outcomes and prevents complications like deep bone infections or implant failure.

What to do if my dog's incision is infected?

If you suspect an infection, contact your veterinarian immediately. Avoid cleaning the wound with unapproved solutions, and prevent your dog from licking the incision by using an E-collar or protective covering. The vet may prescribe antibiotics, pain relief, or wound debridement depending on the infection's severity. Delaying treatment can worsen the infection and lead to complications.

How common is infection after TPLO surgery?

Infections after TPLO surgery are relatively uncommon, occurring in about 3-10% of cases. The risk increases with factors like poor post-op care, excessive licking, moisture exposure, or underlying health issues such as diabetes or immune suppression. Following strict wound care protocols and monitoring for early signs of infection significantly reduces the risk.

What is the infection rate for TPLO?

The infection rate for TPLO surgery ranges from 3-10%, depending on factors such as surgical technique, sterility, and post-operative care. Using advanced infection prevention methods, such as Simini Protect Lavage, proper antibiotic use, and strict wound monitoring, can help minimize infection risks. Prompt intervention at the first sign of infection is essential.

What does the start of an infected incision look like?

The early signs of an infected TPLO incision include increased redness, mild swelling, warmth, and clear to yellow discharge. The area may become more painful than expected during normal healing, and your dog may lick or chew the incision excessively. If left untreated, symptoms can worsen, leading to pus formation, odor, and systemic illness. Any suspicious changes should be evaluated by a veterinarian immediately.

Tibial Plateau Leveling Osteotomy (TPLO) is a surgery used to treat cranial cruciate ligament (CCL) injuries in dogs. Instead of replacing the damaged ligament, TPLO changes the knee's mechanics by cutting and rotating the tibia to stabilize the joint. This procedure greatly improves mobility and reduces pain, making it one of the most effective treatments for CCL injuries.

While TPLO is often successful, complications can occur. Problems may arise from surgical errors, implant issues, infections, or improper post-operative care. These issues can cause severe pain, lameness, and reduced mobility, requiring immediate attention.

Recognizing symptoms of TPLO failure early is crucial. Pet owners and veterinarians must closely monitor recovery to spot signs of complications. Identifying problems early can prevent further damage, improve treatment outcomes, and sometimes avoid the need for corrective surgery. Being aware ensures a better quality of life for the dog.

Early Warning Signs of TPLO Failure

Recognizing early symptoms of TPLO failure is crucial for timely intervention. While mild discomfort and swelling are normal during the initial recovery period, persistent or worsening symptoms may indicate complications.

Persistent Lameness or Limping

Mild lameness is expected for the first few weeks after TPLO surgery. Most dogs show significant improvement within 8–12 weeks. However, if limping persists beyond this period or worsens, it may signal poor bone healing, implant failure, or an underlying infection.

Signs of concern include the dog favoring the other leg, difficulty bearing weight, or sudden regression in mobility. If the leg does not seem to be healing as expected or if there is no gradual improvement, further veterinary evaluation is necessary. X-rays can help determine if the bone is healing correctly or if complications exist.

Read more about: Common Causes of Limping in Dogs Post-TPLO Surgery

Pain During Movement or Reluctance to Use the Affected Leg

Some discomfort is normal post-surgery, but persistent pain when walking, climbing stairs, or standing up may indicate a problem. If a dog avoids using the leg weeks after surgery or shows hesitation in movement, it could be due to implant irritation, improper bone healing, or inflammation. Pain when touching the leg, vocalization, or a stiff gait are red flags.

A dog that initially improves but later develops increased pain needs urgent assessment. A vet may perform imaging and physical exams to check for implant loosening, joint infections, or soft tissue complications affecting recovery.

Swelling Around the Surgical Site

Mild swelling is expected for a few days post-op but should gradually decrease. If swelling persists, worsens, or becomes firm and painful, it may indicate a complication. Excessive swelling could result from implant irritation, fluid buildup, or infection. If the area feels warm or if swelling is accompanied by lameness, immediate veterinary attention is necessary.

A seroma (fluid accumulation) may require drainage, while severe swelling linked to infection or implant rejection may necessitate medical intervention or revision surgery. Monitoring the surgical site daily helps detect abnormal swelling before it leads to more serious issues.

Signs of Infection (Redness, Discharge, Heat)

Post-surgical infections can occur around the incision or deep within the joint, though they are less common when Simini Protect Lavage is used, as it helps reduce bacterial contamination during surgery. However, infections can still develop due to improper wound care, immune response issues, or implant-related complications.

Early symptoms include redness, swelling, heat, and discharge from the incision site. A foul odor, increased pain, or excessive licking are also concerning. If untreated, infections can spread, leading to implant instability, fever, lethargy, and appetite loss. In severe cases, infection may require implant removal and surgical intervention.

Prompt antibiotic therapy is essential to control bacterial growth. Regular wound monitoring, proper hygiene, and early veterinary attention help prevent minor infections from escalating.

Structural and Mechanical Failures

These complications indicate that the surgical repair is not functioning correctly, leading to ongoing instability and pain. Unlike early post-op discomfort, structural failures can cause long-term mobility issues and may require corrective surgery.

Recurrent Knee Joint Instability

After TPLO, the knee joint should be stable due to the new tibial alignment. However, if a dog shows difficulty walking, wobbling, or an unstable gait, it may signal failed bone healing or implant issues. Instability can result from improper fusion of the cut tibia, loose screws, or excessive strain on the joint.

A dog may shift weight frequently or show reluctance to move, indicating mechanical failure. X-rays and physical exams help confirm whether the joint is unstable. Left untreated, instability can lead to severe arthritis, chronic pain, and reduced mobility, making early intervention critical.

Meniscal Injury or Tear

Meniscal damage is a common complication following TPLO surgery, as this cartilage helps cushion the knee joint. A torn meniscus can occur due to improper knee mechanics or residual instability. Symptoms include a sudden return of lameness, difficulty bearing weight, or a clicking or popping sound when the knee moves.

Dogs may yelp when standing or walking and may become more inactive due to pain. A torn meniscus may require surgical removal or repair to restore function. Without treatment, the condition can worsen, leading to chronic discomfort and long-term joint deterioration.

Post-Operative Meniscal Tear

A meniscal tear can occur at the time of surgery (primary tear) or develop later due to knee instability (secondary tear). A secondary meniscus tear is particularly concerning, as it often happens weeks or months after the initial procedure. This results in immediate pain, limping, and reluctance to move.

Dogs with a new meniscus tear may suddenly regress in their recovery, refusing to put weight on the leg despite previous improvements. Surgical intervention is often required to remove the damaged cartilage and restore comfort. Regular post-op checkups help detect meniscal issues before they become severe.

Implant Loosening, Bending, or Breakage

TPLO implants, including plates and screws, must remain secure for proper healing. If an implant loosens, bends, or breaks, the bone may fail to stabilize, causing pain and mobility loss. Signs include swelling, limping, reluctance to use the leg, or a clicking sensation in the joint. Implant failure can result from improper post-op care, excessive activity, or underlying bone weakness.

Overweight dogs and those resuming activity too soon are at higher risk. X-rays are necessary to confirm implant damage. Severe cases may require revision surgery to replace or secure the implants and restore knee stability.

Advanced TPLO Failure Symptoms

These symptoms indicate severe complications requiring medical intervention. If TPLO failure progresses, a dog may experience chronic pain, loss of function, or permanent joint damage. Early detection is key to preventing irreversible issues.

Delayed Bone Healing or Nonunion

Bone healing after TPLO typically takes 8–12 weeks. However, some dogs experience delayed healing or nonunion, where the bone fails to fuse properly. Causes include poor nutrition, excessive movement, infections, or improper plate positioning.

Dogs with nonunion may show persistent limping, pain, or swelling at the surgical site. X-rays can confirm if the bone is healing correctly. Nonunion requires intervention, such as adjusting activity levels, improving diet, or, in severe cases, revision surgery. If left untreated, it can lead to chronic instability and increased risk of implant failure.

Muscle Atrophy Around the Thigh

Muscle atrophy occurs when a dog avoids using the affected leg, leading to gradual muscle loss in the thigh. Mild atrophy is normal post-surgery but should improve with rehabilitation. However, progressive muscle loss suggests long-term mobility issues, improper healing, or ongoing pain. Dogs with severe atrophy may struggle with balance, fatigue quickly, or rely heavily on the other leg.

Physical therapy, controlled exercise, and pain management help restore muscle strength. If left unaddressed, muscle atrophy can make recovery difficult and reduce overall limb function, leading to permanent weakness.

Recurrent or Persistent Mobility Issues

Most dogs regain near-normal function within a few months after TPLO. However, if mobility issues persist beyond this period, it could indicate implant failure, arthritis, or joint instability. Some dogs may continue limping, struggle with stairs, or hesitate to run and jump. Persistent dysfunction suggests that TPLO did not fully correct the knee mechanics, leading to long-term discomfort.

Chronic instability may also cause secondary joint problems. Veterinary evaluation, including X-rays and orthopedic exams, is needed to determine if additional treatment or revision surgery is required. Without intervention, mobility may decline further, affecting quality of life.

Signs of Implant Failure (Mild Discomfort to Acute Pain)

Implant failure can range from mild discomfort to severe pain. Early signs include persistent limping, swelling, and difficulty bearing weight. If an implant loosens or breaks, symptoms can suddenly worsen, causing acute distress, refusal to move, or vocalization when walking. Clicking or grinding noises may also indicate implant instability.

Severe cases require urgent veterinary care, as implant failure can lead to bone fractures or infection. X-rays confirm implant integrity, and treatment may involve pain management, restricted movement, or surgical revision. Delayed care increases the risk of complications, making early detection crucial.

Potential Need for Revision Surgery

Revision TPLO surgery is necessary when the original procedure fails due to nonunion, implant failure, or chronic instability. This involves replacing damaged implants, repositioning the tibial cut, or addressing infections. Revision surgery is often more complex than the initial procedure and requires strict post-op management.

Recovery may take longer, but successful revision can restore knee stability and improve function. If left untreated, TPLO failure can result in chronic pain, severe arthritis, or loss of mobility. A thorough veterinary evaluation determines if revision surgery is the best option for improving the dog’s quality of life.

When to See a Veterinarian

Pet owners should contact a veterinarian if their dog shows signs of worsening pain, persistent lameness beyond 12 weeks, or sudden regression in mobility after initial improvement.

Other concerning symptoms include swelling that does not subside, redness or discharge from the surgical site, difficulty bearing weight, or signs of infection like fever and lethargy. Any clicking or grinding sounds from the knee may indicate meniscal damage or implant instability, requiring immediate attention.

To confirm TPLO failure, veterinarians use diagnostic tests such as X-rays to assess bone healing and implant positioning, CT scans for detailed imaging of the knee structure, and joint fluid analysis to detect infections or inflammation. In severe cases, additional tests may be needed to evaluate soft tissue damage.

Early veterinary intervention can prevent further complications, reducing the need for complex revision surgery and ensuring a better long-term outcome for the dog.

Preventing TPLO Failure

Proper post-operative care is essential for preventing TPLO failure and ensuring a smooth recovery. Strict activity restriction is crucial in the first 8–12 weeks—dogs should avoid running, jumping, or using stairs. A knee brace may provide additional joint support, especially for highly active dogs. Physical therapy helps restore strength and mobility while minimizing the risk of complications.

To promote proper healing, a nutrient-rich diet with adequate protein, calcium, and joint supplements (such as glucosamine) supports bone repair. Regular follow-up vet visits allow for X-ray monitoring to confirm bone fusion and implant stability.

Recognizing early red flags—such as persistent limping, swelling, or signs of infection—can prevent serious complications. Pet owners should check the incision site daily and report any unusual symptoms.

By following post-op guidelines and addressing concerns promptly, the risk of TPLO failure can be significantly reduced, leading to a successful recovery and long-term joint stability.

‍

Read more about:

• Long-term outcomes of TPLO surgery
• Common myths about TPLO surgery explained
• Long-term effects of TPLO surgery on dogs
• Post-surgery recovery after TPLO in dogs
• TPLO surgery for older dogs: Is it a worthwhile option?

‍

Conclusion

TPLO surgery is usually successful, but failures can happen due to improper healing, implant problems, or post-operative complications. Key symptoms of TPLO failure include:

• persistent lameness
• swelling
• pain during movement
• joint instability
• signs of infection

Structural issues like implant loosening, meniscal tears, or delayed bone healing can further hinder recovery.

Early detection is crucial—addressing warning signs quickly can prevent serious complications and reduce the need for additional surgery. Regular vet checkups, diagnostic imaging, and close monitoring of mobility help catch problems before they worsen.

Strict adherence to post-op care is essential in preventing TPLO failure. Pet owners should limit activity, ensure proper nutrition, and follow rehabilitation plans as advised by their veterinarian. By recognizing symptoms early and sticking to recovery guidelines, pet owners can improve their dog’s chances of a successful TPLO outcome and long-term mobility.

‍

FAQs

What happens if TPLO fails in dogs?

If TPLO fails, the affected leg may remain unstable, leading to chronic pain, persistent lameness, and arthritis. The knee joint may not heal properly, causing difficulty in movement. In severe cases, implant failure or bone nonunion may require revision surgery to correct the issue. If left untreated, TPLO failure can significantly impact a dog’s mobility and overall quality of life.

What percent of TPLO surgeries fail?

TPLO has a high success rate, with over 90-95% of dogs recovering well. However, failure can occur in 5-10% of cases due to infections, implant loosening, meniscal injuries, or delayed bone healing. Factors like improper post-op care, excessive activity, or underlying health conditions increase the risk. Early detection and proper recovery management can reduce complications and improve surgical outcomes.

How to tell if a dog's ACL surgery failed?

Signs of TPLO failure include persistent limping, swelling, pain, and reluctance to use the affected leg beyond the expected recovery period. Clicking sounds in the joint, excessive stiffness, or visible implant issues may also indicate failure. If a dog’s condition worsens instead of improving, a vet should perform X-rays or CT scans to assess healing and detect complications.

Why is my dog limping 2 years after TPLO surgery?

Limping two years post-TPLO may result from arthritis, implant irritation, meniscal damage, or muscle atrophy. Some dogs develop scar tissue or secondary joint issues that cause discomfort. If limping is sudden, it could indicate a late meniscus tear or implant problem. A veterinary exam, including imaging, can determine the cause and guide appropriate treatment, such as pain management or revision surgery.

What does a failed TPLO look like?

A failed TPLO often presents as persistent pain, joint instability, swelling, or difficulty bearing weight on the affected leg. Dogs may show progressive lameness, reluctance to move, or audible joint clicking. Severe cases may involve implant loosening, infection, or nonunion of the bone, which can be confirmed through X-rays or CT scans. Early intervention is crucial to prevent worsening complications.

Can TPLO surgery be redone?

Yes, revision TPLO surgery can be performed if the initial procedure fails. This may involve removing or replacing implants, repositioning the tibial cut, or addressing infections. Revision surgery is often more complex and requires strict post-op care. In some cases, alternative treatments like custom knee braces or joint fusion procedures may be considered if TPLO cannot be successfully redone.

What is the alternative to TPLO on dogs?

Alternatives to TPLO include Lateral Suture Stabilization (Extracapsular Repair), Tibial Tuberosity Advancement (TTA), and CBLO (Cora-Based Leveling Osteotomy). These procedures also stabilize the knee but may be better suited for smaller dogs or specific cases. Non-surgical options like custom braces, weight management, and physical therapy may help in mild or inoperable cases, though they do not provide the same level of stability as TPLO.

How long can a dog go without TPLO surgery?

Dogs with a torn CCL can survive without TPLO, but untreated ligament injuries lead to chronic pain, arthritis, and joint deterioration. Some small or inactive dogs may adapt with braces, weight control, and pain management, but larger, active dogs usually require surgery for long-term stability. Without intervention, progressive joint damage can severely impact mobility, making walking difficult or painful over time.

‍

TPLO (Tibial Plateau Leveling Osteotomy) is a special surgery used to treat cranial cruciate ligament (CCL) injuries in dogs. By adjusting the tibial plateau angle, TPLO stabilizes the knee joint, allowing for better weight distribution, reducing pain, and improving mobility. It is considered one of the most effective treatments for CCL tears, especially in large or active dogs.

The cost of TPLO surgery can vary widely, usually ranging from $3,500 to $7,000 (or even more). Several factors affect the price, including:

• the location of the veterinary clinic
• the surgeon's expertise
• preoperative diagnostics
• hospitalization
• anesthesia
• post-surgical care

Additional costs may include medications, follow-up visits, rehabilitation, and potential complications.

Specialist hospitals and board-certified surgeons often charge more due to their advanced training and high success rates. Additionally, regional differences in veterinary care costs can affect pricing, making TPLO surgery more expensive in urban areas than in smaller towns.

Factors That Influence TPLO Surgery Costs

Dog’s Size and Weight

Larger dogs need stronger, more durable implants, which raises material costs. They also require higher doses of anesthesia, longer surgeries, and more monitoring during recovery. The complexity of handling a large dog's knee joint makes the surgery more technically challenging, leading to higher fees.

Smaller dogs, while still needing precise surgery, usually have lower implant costs and reduced medication expenses. Veterinary clinics adjust their pricing based on the dog's weight, as it directly impacts the surgery's difficulty, recovery time, and post-operative care, causing variations in overall TPLO surgery costs.

Geographic Location

TPLO surgery costs can vary greatly depending on the clinic's location. In urban areas, prices are usually higher because of increased overhead costs, like facility expenses, staff salaries, and the demand for specialized services. Rural clinics might offer lower prices, but they may not have access to board-certified surgeons or advanced surgical equipment.

Costs also vary between states and countries, affected by regional economic conditions, veterinary licensing fees, and medical supply costs. Pet owners in areas with a high cost of living should expect to pay more, while those in smaller towns might find more affordable options.

Veterinary Clinic’s Pricing Strategy

The type of veterinary clinic also affects TPLO surgery costs. Corporate-owned clinics often have set prices, which may be higher due to overhead and administrative expenses. Private practices might offer more flexible pricing but can also charge higher rates if they have a strong reputation.

Clinics with high demand, advanced equipment, and top-notch facilities usually charge more. Some hospitals include follow-up care in their pricing, while others list these costs separately, impacting the total amount pet owners need to pay. Choosing between different clinic types can significantly influence the final surgery bill.

Severity of the Injury

The extent of ligament damage directly impacts TPLO surgery costs. A partial tear might need less surgical work and result in lower costs, while a complete rupture usually requires more complex reconstruction.

Additional issues like meniscus tears, osteoarthritis, or joint inflammation make the surgery more difficult and increase post-operative care, raising overall expenses.

In severe cases, longer hospital stays, extra imaging, and specialized rehabilitation may be necessary, further increasing costs. Veterinary surgeons evaluate each dog's condition individually, deciding on the level of intervention needed and adjusting the treatment plan as necessary.

Necessary Implants and Materials Used

The type and quality of implants, plates, and screws used in TPLO surgery can greatly affect costs. High-grade titanium or stainless steel implants are more expensive but offer better durability and a lower risk of complications. Customized implants, made for larger or more active dogs, also increase costs due to their specialized design.

Some clinics might use generic implants to keep costs down, while others choose premium, brand-name materials for better long-term results. The choice of implants impacts not only the price but also post-surgery stability, healing time, and overall success rates.

Surgeon’s Expertise and Qualifications

Board-certified veterinary surgeons usually charge more than general veterinarians because of their specialized training and higher success rates. These experts have a lot of experience in orthopedic procedures, which leads to better surgical results.

While general veterinarians can perform TPLO surgery at a lower cost, they might not have the same level of expertise, which could affect recovery and complication rates.

Some pet owners choose experienced surgeons despite the higher cost, focusing on safety, precision, and long-term joint health for their dogs. Selecting a skilled surgeon often results in faster recovery and fewer post-surgical problems.

Regional Cost Comparison

The cost of TPLO surgery varies significantly by country and location due to differences in veterinary fees, cost of living, and availability of specialized surgeons. Below is a general comparison of TPLO surgery costs in different regions:

‍

‍

Urban clinics usually charge more because of higher operating costs and greater demand for specialist services. In contrast, rural clinics often have lower prices but may not have board-certified surgeons.

Additionally, pet insurance can greatly affect out-of-pocket costs, as some policies cover part or all of the TPLO surgery expenses, depending on the region and the plan.

Cost Variations by Dog Size

The cost of TPLO surgery varies based on the size of the dog, mainly because of differences in implant needs, anesthesia dosage, and surgical complexity. Here's a breakdown of approximate costs by weight category:

• Small Dogs (<40 lbs) – Approximately $4,450
  Smaller dogs need smaller implants and less anesthesia, making their surgery a bit less complex. However, the cost is similar to larger dogs because specialized skills and equipment are still necessary.
• Medium Dogs (40–70 lbs) – Approximately $4,450
  Dogs in this weight range usually need standard-sized TPLO plates, keeping costs similar to small dogs. The surgical method and recovery care are also similar.
• Large Dogs (70–100 lbs) – Varies Based on Plate Size
  Costs increase for larger dogs due to the need for stronger, larger TPLO plates. Some clinics charge extra for custom implants that offer better durability and long-term joint support.
• Extra-Large Dogs (>100 lbs) – $4,450 to $5,950
  Giant breeds require reinforced implants, more anesthesia, and longer surgery time, which raises the overall cost. Post-surgical care and rehabilitation may also be more intensive, further affecting expenses.

Larger dogs often have higher long-term care costs, including pain management and physical therapy, making post-operative planning crucial for their recovery.

What’s Included in the TPLO Surgery Cost?

The total cost of TPLO surgery usually includes several components to ensure a safe procedure, proper recovery, and post-operative care. Here is a breakdown of what is typically included:

• Pre-Surgical Bloodwork: Before surgery, veterinarians perform blood tests to check the dog’s overall health, making sure they can safely handle anesthesia and recover without issues.

• X-Rays for Diagnosis and Surgical Planning: Preoperative X-rays are needed to confirm the severity of the CCL tear and determine the exact tibial angle for surgical correction. Post-surgical X-rays may also be taken to ensure the implant is properly placed.
• Anesthesia and Surgical Monitoring: TPLO surgery requires general anesthesia, which is carefully given and monitored throughout the procedure. The cost includes oxygen support, IV fluids, and continuous tracking of vital signs to ensure the dog's safety.
• Actual TPLO Surgical Procedure: This includes the orthopedic surgery itself, where the surgeon makes a precise bone cut, repositions the tibial plateau, and secures it with plates and screws.
• Post-Operative Pain Medications: Pain management is crucial for recovery. The cost typically includes anti-inflammatory drugs, antibiotics, and pain relievers to prevent infection and discomfort.
• Follow-Up Visits and Check-Ups: Most clinics include at least one or two post-surgery appointments to monitor healing and assess the dog's progress. Additional visits may be needed if there are complications.
• Physical Therapy or Rehabilitation Sessions (If Included): Some veterinary clinics offer rehabilitation programs like hydrotherapy or therapeutic exercises to help improve recovery. However, not all clinics include these services in the base surgery cost.

Each clinic has its own pricing structure, so it's important to check what is included to avoid unexpected costs during recovery.

Hidden or Unexpected Costs of TPLO Surgery

While TPLO surgery is highly effective, some additional expenses may arise depending on the dog's recovery process and the clinic’s pricing structure.

• Emergency Care for Complications: Although rare, complications such as implant loosening, poor bone healing, or excessive swelling may require extra treatment. Even with lower infection risks using Simini Protect Lavage, issues like implant irritation or allergic reactions might still occur, needing additional veterinary care.
• Additional Pain Management Medications: While most TPLO surgery packages include standard pain medications, some dogs might need stronger or longer-term pain relief, especially if they have pre-existing joint issues or heal slowly.
• Post-Surgery X-Rays for Recovery Monitoring: Some veterinary clinics charge separately for follow-up X-rays at 6-8 weeks post-surgery to confirm proper bone healing. If not included, these can cost $150 to $300 per session.
• Rehabilitation and Therapy (If Not Included in Base Cost): Hydrotherapy, laser therapy, or guided rehabilitation exercises can enhance recovery but may add $50 to $100 per session.

With advanced infection control measures like Simini Protect Lavage, unexpected costs related to post-operative infections are minimized, making TPLO recovery more predictable and reducing financial uncertainties.

Payment and Financing Options for TPLO Surgery

TPLO surgery is a significant financial commitment, but various payment and financing options can help manage the cost. Pet owners should explore different ways to reduce financial strain while ensuring their dog gets the necessary treatment.

• Flexible Payment Plans Offered by Some Clinics: Many veterinary clinics offer in-house payment plans, allowing owners to pay in installments instead of a lump sum. These plans typically require a deposit upfront, with the remaining balance spread over several months.
• Discounts for Upfront Payments: Some clinics provide discounts for paying in full before the surgery. This option can help save money, as interest fees from financing plans are avoided. It's worth asking if a prepayment discount is available.
• Third-Party Financing or Personal Loans: Veterinary financing companies like CareCredit and Scratchpay offer low-interest or interest-free short-term loans for pet medical expenses. Personal loans or credit cards can also be an option, but they may come with higher interest rates.
• Pet Insurance Coverage Considerations: Not all pet insurance plans cover TPLO surgery. Policies that include orthopedic conditions or CCL injuries may reimburse a portion of the cost. Companies like Trupanion, Healthy Paws, and Embrace often cover TPLO surgery, but pre-existing conditions are typically excluded. Pet owners should check waiting periods and coverage limits before proceeding.

Discussing these options with the veterinary clinic can help find the best financial solution for your dog’s surgery.

Additional Considerations Before Committing to TPLO

Before proceeding with TPLO surgery, it’s important to consider potential risks, unexpected costs, and pricing differences between clinics to ensure you are fully prepared for the financial and medical aspects of the procedure.

Risks of Unexpected Complications and Added Cost

While TPLO surgery has a high success rate, complications such as implant failure, delayed bone healing, or improper post-operative care can lead to additional expenses. Some dogs may require extended rehabilitation, extra pain management, or revision surgery, increasing costs beyond the initial estimate.

While infection risks are lower when using Simini Protect Lavage, other factors like poor post-op care or underlying health conditions may still affect recovery.

Comparing Quotes from Different Veterinary Clinics

Prices for TPLO surgery can vary significantly between clinics based on location, surgeon expertise, and included services. It’s recommended to get multiple quotes, ensuring you compare what’s included, such as pre-op tests, X-rays, follow-up visits, and rehabilitation. Some clinics offer payment plans or discounts, making it essential to explore all financial options before committing.

Taking the time to understand potential costs and evaluate different providers can help ensure the best possible care for your dog while managing expenses effectively.

Is TPLO Worth the Cost? Long-Term Financial Benefits

While TPLO surgery is expensive, it is often a cost-effective investment in a dog’s long-term health. Choosing not to proceed with TPLO can lead to chronic pain, progressive arthritis, and long-term medical expenses that may exceed the cost of surgery.

Cost of Not Doing TPLO

Without surgical intervention, a torn cranial cruciate ligament (CCL) leads to joint instability, inflammation, and arthritis progression. Managing these issues requires lifelong pain medications, anti-inflammatory drugs, physical therapy, and joint supplements—costs that add up over time. Many dogs that do not undergo TPLO eventually experience injury in the opposite knee, further increasing medical expenses.

TPLO as an Investment in Mobility and Health

TPLO surgery restores knee stability, reduces pain, and allows for full weight-bearing movement, enabling dogs to return to normal activity levels. Unlike conservative management, TPLO prevents further joint deterioration, reducing the need for ongoing medical intervention.

How TPLO Saves Money in the Long Run

While conservative treatments like bracing, pain management, and therapy may seem cheaper initially, they often require years of continuous care.

TPLO, on the other hand, is a one-time surgical cost that provides a permanent solution, minimizing future expenses and improving a dog’s quality of life.

‍

Read more about:

TPLO Surgery for Older Dogs: Is It a Worthwhile Option?

Post-Surgery Recovery After TPLO in Dogs

Common Myths About TPLO Surgery Explained

Long-Term Outcomes of TPLO Surgery

What is Bilateral TPLO Surgery?

‍

‍

Conclusion

TPLO surgery is a major financial commitment, with costs usually ranging from $3,500 to $10,000 per knee. This price covers pre-surgery diagnostics, anesthesia, the surgery itself, post-operative care, and follow-up visits. However, there may be extra costs for rehabilitation, post-surgery X-rays, and emergency care for any complications.

Before deciding on TPLO, pet owners should think about their dog's size, the severity of the injury, the surgeon's expertise, and their location, as these factors significantly affect the total cost. Comparing quotes from different clinics, checking pet insurance coverage, and looking into financing options can help manage expenses.

Although the initial cost is high, TPLO offers a long-term solution, lowering the risk of arthritis and removing the need for lifelong pain management. In the long run, it is often more cost-effective than conservative treatments. Investing in TPLO means better mobility, pain relief, and an improved quality of life for your dog.

FAQs

How much does TPLO surgery cost on average?

The average cost of TPLO surgery ranges from $3,500 to $10,000 per knee, depending on clinic location, surgeon expertise, diagnostic tests, anesthesia, and post-operative care. Urban clinics and specialty hospitals tend to charge more. Additional costs may arise from follow-up visits, rehabilitation, and pain management, which are sometimes not included in the base price.

How much does it cost to remove a TPLO plate?

The cost of TPLO plate removal varies depending on factors such as the veterinary clinic, location, and the complexity of the procedure. On average, the cost ranges from $800 to $2,500. This typically includes anesthesia, surgical fees, and post-operative care. Plate removal is usually recommended only if complications arise, such as infection, irritation, or persistent pain. Some clinics may offer a lower cost if the removal is performed at the same facility where the TPLO surgery was originally done. Always consult your veterinarian for an accurate estimate based on your dog's specific case.

Why is TPLO surgery so expensive?

TPLO surgery is costly due to its complex nature and specialized equipment. It requires advanced surgical skills, high-quality implants, general anesthesia, and extensive post-operative care. Additionally, board-certified veterinary surgeons charge more due to their expertise and success rates. Factors like pre-surgical diagnostics, follow-up X-rays, and rehabilitation therapy further increase the total cost.

Can pet insurance cover TPLO surgery?

Yes, some pet insurance plans cover TPLO surgery, but coverage depends on the policy terms and pre-existing condition exclusions. Companies like Trupanion, Healthy Paws, and Embrace often reimburse part of the cost if the injury was not diagnosed before the policy started. Owners should check waiting periods, deductibles, and reimbursement limits before relying on insurance.

Are there cheaper alternatives to TPLO surgery?

Alternatives include lateral suture stabilization (Extracapsular Repair) and TTA (Tibial Tuberosity Advancement), which may be cheaper but are less effective for larger, active dogs. Conservative management with medications, weight control, and bracing can temporarily relieve symptoms but does not fully restore joint function and may lead to long-term arthritis.

What are the hidden costs of TPLO?

Hidden costs may include post-surgical X-rays ($150–$300 per session), extended pain management, rehabilitation therapy ($50–$100 per session), and emergency care for complications. While infection risks are lower with Simini Protect Lavage, some dogs may still require additional medications or follow-up procedures, adding to the overall cost.

How can I save money on TPLO surgery?

Pet owners can save money by comparing quotes from different clinics, asking about payment plans, checking pet insurance coverage, and looking for upfront payment discounts. Some veterinary schools offer lower-cost surgeries performed by supervised students. Financing options like CareCredit and Scratchpay also help spread out payments.

Does the cost of TPLO include physical therapy?

Not always. Some veterinary clinics bundle rehabilitation sessions in the total cost, but many charge separately. Physical therapy, including hydrotherapy, laser therapy, and therapeutic exercises, can cost $50 to $100 per session. It is essential to confirm with the clinic whether post-operative rehab is included.

Is TPLO surgery a one-time cost, or will my dog need additional procedures?

TPLO surgery is generally a one-time procedure, but additional costs may arise for post-surgery check-ups, pain management, and rehabilitation. In rare cases, complications like implant failure or infections may require revision surgery, adding to the expenses. However, with proper post-operative care, most dogs recover well without further surgical intervention.

‍

Tibial Plateau Leveling Osteotomy (TPLO) is a surgery used to treat cranial cruciate ligament (CCL) tears in dogs. Unlike traditional methods that try to replace or mimic the damaged ligament, TPLO changes how the knee joint works to restore stability.

The procedure involves cutting the top part of the tibia (shin bone) and rotating it to a flatter position. This change reduces the natural forward sliding motion of the femur over the tibia, removing the need for the CCL. A special bone plate and screws hold the new position, allowing the bone to heal over time.

TPLO is considered better than traditional extracapsular repairs, which use artificial sutures to mimic the ligament’s function. Those methods can fail in active or large dogs. TPLO offers better long-term stability, faster recovery, and a lower risk of complications, making it the preferred choice for many veterinarians treating CCL injuries.

‍

Function of the Cranial Cruciate Ligament (CCL)

The Cranial Cruciate Ligament (CCL) is a key stabilizing part of a dog's knee (stifle) joint. It connects the femur (thigh bone) to the tibia (shin bone) and prevents excessive forward movement (tibial thrust) and rotation of the tibia when the dog walks, runs, or jumps. The CCL also helps distribute weight evenly across the joint, reducing stress on cartilage and minimizing wear over time.

When the CCL ruptures, the knee joint becomes unstable. Without this ligament, the femur slides abnormally over the tibia, causing pain, inflammation, and lameness. Dogs with a CCL tear may limp, have trouble bearing weight on the affected leg, and avoid activities like running or jumping. Over time, instability leads to arthritis, worsening discomfort and mobility.

CCL injuries greatly affect a dog's ability to move comfortably. Many dogs compensate by shifting weight to the opposite leg, increasing the risk of injuring the other knee. If left untreated, a torn CCL can cause chronic pain, muscle loss, and permanent joint damage. Surgical intervention, such as TPLO, is often the best option to restore knee function, relieve pain, and help dogs regain an active lifestyle.

Indications for TPLO Surgery: Which Dogs Need It?

TPLO surgery is most commonly recommended for large and active dog breeds, as they are more prone to cranial cruciate ligament (CCL) injuries due to their weight and activity levels.

Breeds like Labrador Retrievers, Golden Retrievers, Rottweilers, German Shepherds, and Boxers are at higher risk. However, TPLO can also be beneficial for medium-sized and small dogs, especially those with persistent knee instability.

Common Symptoms of a Torn CCL

• Limping or favoring one leg, especially after exercise
• Stiffness after resting, particularly in the morning
• Swelling and pain around the knee joint
• Difficulty rising, jumping, or using stairs
• Progressive worsening of lameness over time

When Is TPLO Surgery Necessary?

A veterinary evaluation is essential to determine the best treatment approach. TPLO is typically recommended if:

• The dog is large or highly active, where other repairs may fail
• There is significant knee instability affecting mobility
• Conservative management (rest, pain medication, and physiotherapy) has not improved symptoms

When Conservative Management May Work

For small dogs (under 30 lbs) or older, less active dogs, non-surgical options such as joint supplements, anti-inflammatory medications, weight management, and physical therapy may be considered. However, these methods do not fix the underlying instability, and arthritis will progress over time.

For high-energy or large dogs, TPLO remains the gold standard because it restores stability, allowing them to regain normal movement and minimize arthritis risk.

Mechanism of TPLO Surgery

Tibial Plateau Leveling Osteotomy (TPLO) is a surgery that aims to stabilize the knee joint by changing how the tibia (shin bone) works. Normally, when a dog walks, the femur (thigh bone) slides down the tibia because of the natural slope of the tibial plateau. The cranial cruciate ligament (CCL) stops this forward movement, keeping the knee stable.

‍

‍

How TPLO Alters the Tibial Plateau Angle

In TPLO, a curved cut (osteotomy) is made in the top portion of the tibia, allowing the surgeon to rotate the bone and reduce the tibial plateau angle (TPA) to nearly level (5-7 degrees from 20-30 degrees in most dogs). This new position eliminates the forward sliding motion (cranial tibial thrust) that occurs when the CCL is torn.

Why the CCL Is No Longer Needed

After TPLO, the knee no longer relies on the CCL for stability because the new bone alignment prevents abnormal movement. The femur rests in a neutral position, and weight-bearing forces are transferred evenly across the joint. The cut bone is then stabilized with a metal plate and screws, allowing it to heal in its new position.

Biomechanics in Simple Terms

Before TPLO, a torn CCL allows the tibia to slide forward with each step, causing pain and instability. After TPLO, the adjusted bone alignment prevents this sliding motion, making the knee function normally even without the ligament. This technique is particularly effective in large, active dogs, offering long-term stability and reducing the risk of arthritis progression.

TPLO Surgical Procedure Steps

Pre-Surgical Preparations

Before TPLO surgery, a veterinarian performs a thorough examination, including:

• X-rays of the knee to assess the tibial plateau angle and confirm CCL rupture.
• Blood tests to ensure the dog is healthy for anesthesia.
• Fasting for 8-12 hours before surgery to prevent complications.
• General anesthesia is administered, and the leg is shaved and disinfected.

Step-by-Step Breakdown

1. Making the Curved Cut in the Tibia
   
   • A semi-circular osteotomy (bone cut) is made in the upper tibia using a specialized saw. This allows the surgeon to reposition the tibial plateau.
2. Rotating the Tibial Plateau
   
   • The cut bone is rotated to reduce the tibial plateau angle from its natural slope (20-30 degrees) to a nearly level position (5-7 degrees).
   • This prevents the femur from sliding forward, eliminating the need for the CCL.
3. Fixing the New Position
   
   • A metal plate and screws secure the rotated tibial plateau in place. These implants provide stability while the bone heals.

TPLO Surgical Duration and Hospital Stay

• TPLO surgery usually takes 60-90 minutes, depending on the dog's size and the complexity of the procedure.
• Most dogs stay in the hospital for 12-24 hours after surgery for pain management and monitoring.
• Full recovery takes 8-12 weeks, with limited activity and follow-up X-rays to ensure proper healing.

Why TPLO Surgery is Preferred Over Other Methods

TPLO surgery is considered the gold standard for treating cranial cruciate ligament (CCL) injuries, especially in large and active dogs. It provides superior joint stability and long-term success compared to other methods like Tibial Tuberosity Advancement (TTA), lateral suture stabilization, and conservative management.

Comparison with Other Techniques

1. Tibial Tuberosity Advancement (TTA)
   
   • Like TPLO, TTA alters knee mechanics but focuses on shifting the patellar tendon’s force rather than leveling the tibial plateau.
   • Less effective for severe arthritis or extreme tibial slopes.
   • Similar recovery time, but TPLO is often preferred for better long-term stability.
2. Lateral Suture Stabilization (Extracapsular Repair)
   
   • Uses an artificial suture outside the joint to mimic the CCL.
   • Less reliable in large, active dogs, as the suture can stretch or break over time.
   • Suitable for small dogs (<30 lbs) but not ideal for high-energy breeds.
3. Conservative Management (Rest, Medication, Therapy)
   
   • Does not restore knee stability, leading to progressive arthritis.
   • May be an option for very small or senior dogs, but often results in chronic pain and reduced mobility.

Why TPLO is Preferred

• Higher success rate (~90-95%) with long-term joint stability.
• Faster recovery (dogs can bear weight within days, full recovery in ~12 weeks).
• Best suited for large and active dogs, as it withstands high physical demands better than other methods.

Benefits of TPLO Surgery

Restores Joint Stability for Normal Movement: TPLO surgery eliminates the instability caused by a torn cranial cruciate ligament (CCL) by changing the biomechanics of the knee. By leveling the tibial plateau, the femur no longer slides forward, allowing smooth, pain-free movement. This lets dogs return to normal activities like running, jumping, and playing after recovery.

Reduces Long-Term Arthritis Risk: A torn CCL leads to chronic joint instability, which accelerates cartilage damage and arthritis. TPLO provides permanent knee stability, significantly slowing down the degenerative changes that cause pain and stiffness. While arthritis can still develop, it progresses much slower compared to untreated or poorly repaired injuries.

Faster Recovery Compared to Traditional Repairs: Unlike lateral suture techniques, which rely on an artificial ligament that can weaken or break, TPLO stabilizes the knee through bone healing. Dogs start bearing weight within days after surgery, and most regain normal mobility within 8-12 weeks. This is faster and more reliable than other surgical methods, especially for large, active dogs.

Higher Success Rates and Better Long-Term Outcomes: Studies show TPLO has a 90-95% success rate, with fewer complications and a longer-lasting solution than alternative techniques. Dogs undergoing TPLO generally have a higher chance of returning to full activity, making it the preferred option for high-energy or working dogs.

Potential Risks and Complications of TPLO Surgery

While TPLO surgery has a high success rate, complications can still occur, including:

• Implant Failure (Plate or Screw Loosening) – If a dog is too active too soon, the metal implants can shift or break.
• Bone Fractures – The tibia is weakened during surgery, and excessive strain may cause small fractures, especially in high-energy dogs.
• Delayed Bone Healing – Some dogs, particularly older ones or those with underlying conditions, may take longer to recover.

Post-surgical infections are one of the biggest concerns in orthopedic surgeries, but many veterinary surgeons now use Simini Protect Lavage, a non-antibiotic surgical lavage solution. Simini reduces bacterial contamination and biofilms, lowering infection risks significantly. This makes TPLO surgery safer and helps prevent complications that could delay recovery.

How to Minimize Risks with Proper Post-Op Care

• Strict activity restriction for 8-12 weeks to prevent implant damage.
• Regular vet check-ups and follow-up X-rays to monitor healing.
• Wound care and infection prevention – Keeping the incision clean and using solutions like Simini helps reduce infection risk.
• Controlled physical therapy – Gentle exercises, under veterinary guidance, help regain mobility without stressing the joint.

With the right precautions and the use of advanced infection control methods like Simini Protect Lavage, most dogs recover successfully with minimal complications.

Success Rates and Long-Term Outcomes of TPLO Surgery

High Success Rate and Improved Mobility: TPLO surgery has a 90-95% success rate, making it one of the most reliable treatments for cranial cruciate ligament (CCL) injuries in dogs. Most dogs experience significant pain relief and restored joint stability within weeks. Studies show that 85-90% of dogs regain near-normal function, allowing them to walk, run, and play without limping or discomfort.

Long-Term Prognosis: Can Dogs Return to Normal Activity? For most dogs, TPLO provides a permanent solution, allowing them to return to normal activity levels once fully healed. Large, active, and working dogs particularly benefit from TPLO, as it withstands high-impact movement better than other surgical options. With proper post-op care, arthritis progression is slowed, and joint function remains strong for years.

Cases Where Additional Treatment May Be Needed

While TPLO is highly effective, some dogs may require further treatment, such as:

• Severe pre-existing arthritis – Some dogs may need joint supplements, weight management, or physical therapy for long-term comfort.
• Implant-related complications – Rare cases of plate or screw loosening may require revision surgery.
• Bilateral CCL injuries – If both knees are affected, a second TPLO may be needed once the first knee has healed.

With proper rehabilitation and veterinary follow-ups, TPLO surgery allows dogs to live pain-free, active lives with minimal long-term issues.

‍

Also read more about:

Before and After TPLO Surgery: Dog Health Recovery Timeline

Common Myths About TPLO Surgery Explained

Post-Operative Infection in Dogs: Symptoms and Solutions

‍

Conclusion

In conclusion, Tibial Plateau Leveling Osteotomy (TPLO) surgery is a highly effective treatment for cranial cruciate ligament (CCL) injuries in dogs, especially for large and active breeds. By changing the knee joint's biomechanics, TPLO offers better stability, lowers the risk of arthritis, and allows for quicker recovery compared to traditional repair methods.

Although there are possible risks and complications, proper post-operative care and advanced infection control can reduce these issues. With a high success rate and the ability to restore normal activity levels, TPLO remains the top choice for veterinarians looking to improve the quality of life for dogs with CCL injuries.

‍

FAQs

How long does it take for a dog to recover from TPLO surgery?

Full recovery from TPLO surgery takes about 8-12 weeks. Most dogs start bearing weight within a few days, but strict activity restriction is necessary for proper healing. By 6-8 weeks, follow-up X-rays check bone healing. Gradual return to normal activity happens after 12 weeks, with complete muscle recovery taking up to 6 months in some cases.

Can a dog walk immediately after TPLO surgery?

Yes, most dogs can bear weight on the leg within 24-72 hours after TPLO surgery. However, their movement should be strictly limited to prevent complications. Short, controlled leash walks for bathroom breaks are allowed, but running, jumping, and stairs must be avoided for at least 8-12 weeks to ensure proper healing.

Does TPLO surgery prevent arthritis in dogs?

TPLO surgery does not completely prevent arthritis but significantly slows its progression. By stabilizing the knee joint, TPLO reduces abnormal wear on cartilage, which helps minimize long-term joint damage. However, some arthritis may still develop, especially if the injury was untreated for a long time before surgery.

Will my dog need physical therapy after TPLO surgery?

Yes, physical therapy helps speed recovery and improves mobility. Controlled range-of-motion exercises, underwater treadmill therapy, and strength training can reduce stiffness and rebuild muscle. While not always required, veterinary-supervised rehab improves outcomes, especially in large or highly active dogs.

Can a dog tear the CCL in the other leg after TPLO?

Yes, dogs that rupture one CCL have a 40-60% chance of tearing the other within two years. TPLO surgery helps restore stability in the operated leg, but increased weight-bearing on the opposite limb can strain the remaining CCL. Weight management, joint supplements, and controlled activity can help reduce this risk.

Is Bruising Normal After TPLO Surgery?

Yes, bruising after TPLO surgery is common and occurs due to tissue manipulation, blood vessel disruption, and surgical trauma. Mild to moderate bruising around the incision site typically fades within 1–2 weeks. However, excessive bruising, swelling, or warmth may indicate infection or complications. If bruising worsens or persists beyond two weeks, consult your veterinarian for further evaluation.

‍

‍