Stifle(knee) surgery weeks 1-2 post-op

1. Activity:
No running, jumping, free access to stairs, no dog doors, or rough playing with other pets or children.

Do not allow any unsupervised, or off-leash, activity for the next 8-12 weeks to allow for complete healing of the surgical site.

Activity must be limited to supervised walking about the house, and very short leash walks (100-200ft), three times daily for the purpose of going outside to the bathroom only.

Confine your pet to an enclosed area such as a small room, or dog pen, when not supervised.

2. Incision: 
Monitor the incision daily for signs of infection such as increased redness, swelling, or discharge. Some minor swelling is normal.

Sometimes fluid from the joint will settle around the hock due to gravity. This is normal and will resolve itself.

If the surgical site suddenly becomes painful, or warm to the touch, please call us immediately.

Your pet must wear an E-collar until the 2 week re-check as licking can provide a source of infection.

Keep the incision clean and dry (do not apply anything to the incision). No bathing or swimming for 14 days.

3. Medications:
Give all medications as directed and call us if you believe your pet is having an adverse reaction to any of the prescriptions.

It is very important that you complete your pet’s entire prescribed medication regimen when you go home.

The medications help with inflammation, pain relief, and aids in preventing infection.

If your pet loses his/her appetite, begins vomiting, develops diarrhea, or dark/tarry stools please call us immediately.

4. Food:
During the 6-8-week confinement period, it is recommended that your pet be given 2/3 the portion of their normal food amount to prevent weight gain.

5. Recovery:
Your pet should show steady, continual improvement.  Sharp yelps, cries, or sudden changes in the way they use the limb may all be signs of a problem. If your pet suddenly becomes painful, please contact us.

It is Important to note that most pets will begin to use the affected limb within 2-3 days of surgery. In spite of this increase in comfort and use, you must continue to enforce the exercise restriction. Explosive, off-leash behavior can be devastating to the surgical procedure!

We may prescribe sedatives for your pet’s safety and to assist you in enforcing exercise restriction.

6. Recheck:
An appointment, 14 day’s after surgery, will be scheduled with us to examine the incision and remove sutures.

There will also be an 8 week recheck. At this appointment radiographs will be taken to check the healing progress of the bone cut.

7. Questions:
Our foremost interest is achieving as rapid, and as complete, a recovery as possible for your friend. Do not hesitate to call if you have any questions or concerns.

Home Rehab Guidelines

Before you start:
1) If your pet is on medication for pain, plan your rehabilitation session at least an hour after medication has been given.
2) It will be helpful if there is someone that your pet trusts that can assist you in the rehab process. You can perform the exercises while the other soothes him/her and gives minimal restraint. Please note that rehabilitation can be difficult and slightly painful at times. If you think your pet might bite, please use a muzzle!
3) Pick a quiet, comfortable place where your pet can easily lie down and relax. This will allow him/her to be more calm and receptive to therapy.

The following rehabilitation treatments are intended for the first 2 weeks after surgery. Additional exercises and instructions will be given at the 2 week recheck appointment.

Gentle massage can rehabilitate physically as well as mentally. What could be more wonderful for your pet than a massage from their most favorite person in the world? Massage is meant to loosen and relax otherwise tight, tense muscles. The key is to be gentle. Firm, smooth motion in the same pattern is ideal. It is important to concentrate not only on the surgical site, but the entire limb. Be cautious around the incision, as it could still be tender and uncomfortable. Some animals have been known to doze off during their massage; just try not to startle them when you begin the range of motion exercises. Massage for 5-10 minutes.

Range of Motion (ROM):
Place your pet on their side with the injured limb up. After a gentle massage, place one hand above the affected joint of the injured limb (for example, the knee) and the other below the joint. Make sure that you support the entire limb with your hands. A series of FLEXION and EXTENSION exercises should follow.
Flexion (Bending of the joint): Begin by slowly flexing the joint of the affected limb. Avoid moving other joints while you are working on this one. VERY SLOWLY continue to flex the limb until you are getting marked resistance or your pet shows signs of discomfort (moving, crying, tensing up the leg, etc).

Then go into extension (Straightening the joint): Keeping your hands in the same position as for flexion, gently and slowly begin to extend the leg. As before, only go until your pet shows discomfort. Repeat these movements for 35-40 repetitions, it should take about 5 minutes.

Once completed you will perform stretches. With your pet laying in the same position keep the surgical leg in a neutral position. Then bring the leg forward towards the head until some resistance is felt. Hold for 10 seconds then slowly bring the leg back towards the tail and hold for 10 seconds. Repeat these movements 10 times.

Icing your pet’s knee after ROM exercises and stretches is recommended. This can be a little uncomfortable, especially at first, so your reassurance is important. A frozen bag of peas or moldable ice pack works best. Simply place a thick towel between their legs for support, then place a small cloth over the knee and lay the ice pack over the cloth. Ice for 5-10 minutes.

Walking can be a very effective tool during rehabilitation. It is important to allow and sometimes push your pet to begin using the injured limb. The biggest mistake owners make is letting their pet walk too fast, allowing them to hold the injured limb up. Many animals are happy to go out for a walk, but it is important for them and you to understand that this is an important rehabilitation component that needs to be worked on intently. Walking your pet too fast and allowing them to hold the leg up is easiest for everyone involved, but it negates the entire purpose.
Use a short leash to maintain control of your pet at all times. A slow and short walk (100-200ft) for the first 2 weeks will help with blood flow and the overall healing process. At the 2 week appointment you will receive a new set of exercise instructions.

Weeks 3-(8-12) Post-op Stifle Rehabilitation Instructions

  1. Daily Walks: exercise walk once daily, short leash walking with a purpose, starting at ¼ mile and working up to 2 miles over 6 to 10 weeks. Put a mild to moderate incline up at the beginning if convenient.
  2. Curb Weaves: during the walk, in a safe area, weave on and off of a curb for about 50 to 100 yards at a pace that makes the patient carefully place each paw down and avoid bunny hopping.
  3. Cavaletti Course: step over 5 beams ankle to knee height before and after each walk.  Easiest thing is 10’ foot 4X4 cut into 5 pieces, set horizontally on the ground, have patient walk through it and can elevate it over time.
  4. Cookie Stretch: anytime the patient is given a treat or toy etc., 90 degrees towards the surgery leg.
  5. Once weekly water walking. Walk patient in calm water just touching the bottom of the chest for 15 to 20 minutes at the end of the week.  See map on the other side.
  6. E-Collar should remain on for the next several days, when you’re not home and at bedtime.
  7. A shower bath is okay. Do not submerge in water for at least one week.
  8. No grooming appointments until cleared/released at your follow up appointment.
  9.  0-7 years at 8 weeks, 7-10 years at 10 weeks, 10+ years at 12 weeks.