OSTEOTOMY TECHNIQUE FOR LEVELING THE TIBIAL PLATEAU
POST ANAESTHETIC CARE
Your pet may be "groggy" during the anaesthetic recovery for up to 48 hours. Confine the animal until fully conscious to prevent misadventure.
Occasionally animals vomit after an anaesthetic so we advise only a small drink of water be given until your pet can walk properly. Because the anaesthetic gas is administered via a tube in the windpipe some animals cough a little for a few days post-operatively.
Minor discomfort is indicated by licking at the stitches. Pain on touching the incision site is to be expected.
We recommend that the animal spends the night after the surgery in the clinic so that we can manage these issues with our trained staff and provide adequate pain relief.
Your dog will receive antibiotic injections prior to and during surgery and may require a course of antibiotic tablets to be completed at home to prevent infection at the surgical site. Often pain relief tablets, or syrup are also prescribed for home use.
HOW MUCH EXERCISE?
- Initially your pet will be reluctant to move much. A short (no more than 5 minutes) walk on the lead 3-4 times a day for going to the toilet is fine. In between times your pet must be confined to a small area (an old playpen is a good option for small dogs or a laundry or bathroom for large dogs) where he/she isn’t able to jump onto beds or sofas. If your pet usually stays outdoors he/she should be safely confined to a pen about the size of an average laundry or tied up on a 2 metre or shorter chain.
A small amount of physiotherapy is recommended if tolerated by your pet. Gently move the knee to flex and extend the joint for about 10 repetitions twice a day, just to the degree of bend your pet will comfortably tolerate.
If applied to the suture site, the post op dressing may be removed after 4-5 days if not peeling off prior to this. The Duogesic (fentanyl) pain control patch and bandage, if applied, can also be removed after 4-5days. If this is being removed at home, ensure the patch is wrapped in newspaper and disposed of in a bin out of reach of children & pets. Skin sutures are removed 10-14 days after surgery. There is usually no extra charge for this consultation unless further treatment or medications are required, although we like to discuss any issues and check the surgery site so please book an appointment with the vet who performed the surgery.
As the surgery technique involves realigning the tibial plateau by cutting a small wedge from the bone and realigning with a plate and screws, these cases need to be treated the same as if they had received surgery for a fracture. This requires a full 8-12 weeks of strict confinement to allow the bone healing to progress without any loosening of the implants. Dogs should be confined to a laundry sized (or smaller) pen for this whole time with short (<5min) walks on a lead to toilet the dog if required. Radiographs (xrays) are taken under general anaesthetic or sedation after 6-10 weeks to assess bone healing at the surgery site, prior to allowing the patient to return to more normal activity. Once radiographs confirm healing, the amount of exercise can now be slowly and steadily increased to 10 minutes walking at a slow, steady pace a couple of times a day. As the patient feels more comfortable you can continue building up the exercise but it should always be on the lead for the first month following the second lot of radiographs. Swimming gently or wading chest deep in still water can be a good activity for restoring movement if weather and pet agreeable.
Sunburn can be a problem on the leg that has had surgery, especially in Summer and with dogs that spend most or all of their time outside. Sunscreen formulated for animals can be purchased from the vets.
Your Veterinarian may discuss with you any arthritic change that may be present in the knee at the times of surgery, and may recommend the use of Synovan ™(one injection under the skin weekly for 4 weeks) to aid the healing of the joint. Good quality omega oil diet supplement or Hills J/D™ diet may also be recommended to aid the healing process & reduce inflammation in joints.
By 6 weeks the patient should be reasonably comfortable on the leg but allow 3 months for full rehabilitation of the injured knee.
GUIDE TO REHABILITATION AFTER KNEE SURGERY
Week 1 to 8
Complete restriction of activity except physiotherapy on knee, toilet breaks 2-4 times per day on a lead
Week 6-8 (or week 10 if older dog)
Xrays to confirm bone healing
5 minute lead walks twice daily, with restriction of activity in between, with toilet breaks as needed
10 minute lead walks twice daily, with restriction of activity in between, with toilet breaks as needed
20 minute lead walks twice daily, can be let out of holding area as long as jumping and excessive running is restricted
Weeks 11 & 12
Finally the expected recuperative period is over! Allow normal activity except for trying to discourage jumping and other forceful motions on the knee. Swimming is an excellent exercise to encourage strengthening of the knee muscles and maximise full range of motion
Walking pace for any of these lead walks should be at a pace that the dog is choosing to use the “sore” leg by taking some weight on the foot. In the first few weeks this may be quite slow, (slow wander), but will increase probably to a brisk walk by the end of week 8-10