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Week 1: Rehab Instructions: Mindset & Expectations

Here are your key points for the week.

  • Mindset
  • Timeline
  • Preparing Your Home
  • Rest
  • Icing
  • Walking Slow
  • Support


I know you will agree with me that up to this point, this entire experience has been extremely stressful for both you and your dog. With that being said, take a deep breath because you now have TopDog here to give you guidance on how to best help your dog through this process safely and successfully so that they can return to 100% normal functionality.


You are probably wondering how long this recovery process is going to take. What I can tell you is this: First of all, don’t be shocked or alarmed if you experience minor set backs during the recovery process. It happens all the time and 95% of the time, everything turns out to be alright in the end. Secondly, right off the bat you need to understand what I mean by the concept of FULL RECOVERY. From my years of experience I can tell you that 100% recovery (i.e. full function & full muscle development) will take up to 6 months. Now this does not mean at the end of the 12 weeks your dog is still going to have a limp. To the untrained eye your dog is going to appear 100% normal and yes they are going to feel much better as well, but at the end of the day, it takes a long time for all of the muscle mass and other soft tissue strength in that leg to return to its optimal condition. Remember you are trying to protect the other hind leg from injury. You will hear me time and time again talk about how my veterinary colleagues confidently state the statistic that anywhere for 30-60% of dogs who tear one ACL, will tear that other ACL within one year. What they are saying is true. What they are not telling you is that if you rehab your dog effectively, this statistic is reduced dramatically. We are going to make sure that your dog does not turn into a statistic.


I am not going to go too in depth on this topic because within the Home Rehabilitation Guide we have thoroughly detailed this. Just make sure that you do your best to secure your home for your dog to the best of your ability.


During the first week you really need to focus on allowing your dog the time to rest and relax. Again, the entire experience was very stressful for your dog. The first week is also the time in which they are experiencing the greatest discomfort. 99% of the time they should be resting, relaxing and being nurtured by you. If they won’t let you perform one of the therapies then don’t push them, let them rest.


  • Cold therapy is incredibly effective in so many ways. It is nature’s best anti-inflammatory and it also relieves pain.
  • Rule of Thumb: Ice for the first 72 hours and then use moist heat after, but icing after exercise and therapy is always a good idea.
  • Some dogs are not crazy about the cold on their skin, so I have found that it is best to place a towel or face cloth in between the ice and skin.


For the little bit of time that you will be allowing them to walk around (i.e. for elimination purposes)… I BEG OF YOU… Make sure that they are on a very short leash and are walking at a very slow pace. If you find that your dog needs some extra support or that you need greater control, I encourage you to check out the TopDog Support Rx Total Body Harness System. This harness was developed here at TopDog and is a very affordable and effective solution. Click Here for the SupportRx Total Body Harness Video Good luck this week and make sure you come over and check out our incredible Facebook support community. Feel free to share your dog’s story or ask questions. There are hundreds of dog owners just like you who have already been through the surgery and recovery process and are very willing to offer their guidance.

Have a Question or Comment about Week 1: Rehab Instructions: Mindset & Expectations?

To ask a question or leave a comment for TopDog veterinarian, Dr. James StClair, simply enter your name, email below. (Your email will never be shared or publised)


253 thoughts on “Week 1: Rehab Instructions: Mindset & Expectations
  1. Janelle Fischer says:

    Thank you for your invaluable advice. My 6yo boxer, Raidar had TPLO surgery on both knees. The right cruciate was badly torn of which was removed whilst the left was not as bad hence they left this one. Surgery was 6 weeks ago now but our 6week check up, whilst good in that Raidar is walking well, the surgeon said his bones were not a close as he would like hence advised to continue with the “no exercise at all”. As you can imagine, after 6 weeks of no exercise, my boxer is jumping out of his skin hence I turned to your website. My thought is that if I can exercise him a little he may not be jumping out of his skin as much i.e. less likely to do damage by jumping around with excitement anytime someone goes near the front door. So yesterday I started the short controlled 5min walks and the sitting (of which he does sit really well when applying your video technique – thanks)…….my question is – should I start at the Week 2 recommendations (as per your recommendations of others below) or can I skip ahead a few more weeks?

    • Dr. James St.Clair says:

      Janelle, of course since I don’t have a personal doctor/patient relationship with your dog I can not give specific advice….what I can tell you is that if I had a dog who was 6 weeks out and starting from scratch I would focus on starting at week 2-3. My reason for this is that being conservative is not a bad thing at all. We all know that FULL recovery takes 6 months whether you are a dog or a person. Therefore starting at week 2-3 and establishing a routine upon which you can build on is the key. The worst thing you could do is to do to much to soon.

  2. Carmen van Leeuwen says:

    Thank you for your incredible guidance! We began Week 3 yesterday. Is there a way to update the email guidance from Week 1 to Week 3? We sooooo appreciate your help!

    • Dr. James St.Clair says:

      Carmen, I sent you over the week three, if you are just getting started late it is best to start around week two and then move on from there. There is no harm in being conservative. Just remember, and you will hear me say it over and over again, FULL recovery takes most dogs a full 6 months total. Make sure you use the videos and information in the online rehab center at http://www.topdoghealth.com/rehabcenter. All the best, Dr.J

  3. Jean says:

    Hi Dr. J, my dog just had her second surgery on the other knee. Her first surgery was in January, and after a few months her other knee started to bother her. It had been weak to begin with so I wasn’t too surprised. I’ll be following your rehab plan again, it helped a lot the first time around! Abby is still on the Glycanaid HA and I was wondering if her dose should be increased due to the recent surgery. She currently takes 2 pills a day. Thanks for all your help!

    • Dr. James St.Clair says:

      Jean it never hurts to go back to the loading dose for a few weeks for a boost, if she tolerates it well. Please keep me informed of her progress. Dr.J

  4. marjon says:

    I have 3 pound yorkie that had fho last week. I was not ready for what my baby and endured in the last week. The doctors made it sound so easy. Anyways we were not prepared. He is an indoor dog. Extremely stubborn. She doesn’t let me touch her leg. She doesn’t want to walk until she wants to. Etc I have been icing the leg for three days every hour for ab 5 minutes. Trying to minimize antiinflammatory drugs since he is so tiny. He takes code in based drug instead. Please help me to help him heal better. We will be forever greayful. Also the joint supplement you offer what would be the safe dosage for him? Does it cause upset stomach? Is it best on full or empty stomach?
    Looking forward hearing from you. Best regards

    • Dr. James St.Clair says:

      Marjon, The first thought that came to mind is that you really need to not be so scared of pain management drugs at this point. This is such a short term period in which he really needs the assistance of proper pain management. He should be given an anti-inflammatory daily or twice daily and also a pain medication like codeine or even better tramadol three times a day. In order for this surgery to be a success for him he needs to be pain free so that he will use the leg and slowly begin to rebuild and strengthen muscle. Please speak with your veterinarian about this. In my FHO patients I use aggressive pain management until they are using the surgery leg near 100% of the time, and then and only then do I start to back off the pain medications. This is vitally important, otherwise you will rob him of the opportunity to recover 100%.

  5. Sheryl says:

    Dear Dr. James
    My older dog (13 years) is not a candidate for surgery for his torn ACL what suggestions do you have for helping him heal without surgery what can I do for him

    • Dr. James St.Clair says:

      Sheryl for the dogs whom are not surgical candidates what I have been telling people is to download the cruciate book from Topdoghealth and follow it exactly as if your dog had surgery starting at week 2. In these case I also STRONGLY encourage people to purchase our GlycanAid-HA supplement. Though we never hard sell anybody on our products..in your dogs case I would be a bit more pushy because I know it would help tremendously. Lastly I would make sure that I discussed with my doctor good comprehensive pain management and make sure that pain is not a part of his recovery equation. Hope this helps and good luck. Dr.J

  6. Nami Jaisinghani says:

    hello Dr. James! my 10 month lab Zach underwent an FHO earlier this week. prior to the surgery I was extremely scared about how we would go about with his rehab since here in India we hardly have any facilities for canine rehabilitation. that’s when I came across your website and it’s really good. we’ve been following your instructions and he seems to be doing fine. we are on day 5 post op and he’s toe touching and intermittently partial weight bearing during the slow leashed walks. thank you so much for the help! Hoping we can go thru the rehab phase more smoothly thanks to your help! :)
    Regards, Nami

    • Dr. James St.Clair says:

      Nami, I always get such joy reading messages from pet owners like you, who are half way across the world. The internet is such an amazing vehicle to spread good and help others who we will never have the opportunity to meet face to face but we can help. My best word of advice Nami for you is to just make sure that you don’t cut the pain medications to short. In my practice I continue with full pain management protocol until the dog is fully weight bearing because I never want pain or any discomfort to inhibit the use of the leg. Just a thought. Thanks for reaching out and we are here if you need us.

      All the best, Dr.J

  7. Mike says:

    My wire haired griffon of 6 years just had the TPLO surgery on her right rear leg two days ago. I started the PROM exercises and notice when I move the repaired joint, there is a distinctive click. Is this normal and will it go away with time/continued therapy? Thank you.

    • Dr. James St.Clair says:

      Mike this is a tough call. You are only just out of surgery so it makes this evaluation slightly difficult. I would probably not focus on this at this point and focus on whether she is weight bearing on that leg and continuing to improve over time. Wish I could give you definitive answer so help ease your fear.

  8. Anna says:

    My dog just tore her ligament, not completely but about a 75% tear, however the vet thinks it may not be the ACL and instead be the rare one that only happens in 1% of cases, i think he said it was the PCL. Because she can walk normally and i do not have the funds to pay for it, we are trying to avoid getting the surgery, but the vet recommended following your rehabilitation guide anyways. Would you have any other suggestions or do you know anything about this type of tear? Do you suggest following the 12 week program for trying to rehabilitate without the surgery? Again she is walking completely normal with no limp or showing pain, stairs are the only thing she refuses to do and i carry her up. Thank you so much!

    • Dr. James St.Clair says:

      Anna, in this situation I would absolutely follow the advice of your veterinarian and treat her as if she had surgery. This will give a conservative approach and allow time for healing. Since I have no way of examining her myself I can’t really give specific advice but from the sound of it your veterinarian is a realist and smart doctor. The only thing I would say is make sure you also incorporate a really good joint supplement into the mix. I recommend you take a close look at TopDog’s GlycanAid HA. It is available on our site or on amazon which ever works best for you. Good luck and be conservative to avoid further damage and interrupt healing.

  9. Linda Horne says:

    Hi, I have a 2 year Husky who ruptured her cruciate ligament in her right knee. We tried to keep her quite and calm as our vet said to give her a week to decide on the surgery or not. 4 days later she ruptured the left leg. Left was more unstable than right so they did a TPLO surgery on Tuesday. We fetch her tomorrow. Advice for week 1?? We have got her a leg brace from Orthdog her her right leg (ordered before she damaged the left) will this really help her? We need to get her strong as she will have other surgery in eight weeks.

    • Dr. James St.Clair says:

      Linda the key is going to be good pain management and conservative therapy. If you have access to a local canine rehab facility in your area I would strongly recommend that you seek out their expertise. Also if you have not already you may want to pick up one of TopDog’s SupportRx total body harness. These are extremely affordable and great for female dogs. In terms of your post-op instructions they would be the same along with apply some therapy to the right (ie. massage). Again best bet is find a local canine rehab specialist and if this is not available then just follow along with the guidelines we sent and the individual advice of your surgeon. Good luck and she will be fine, it is just going to take a little longer.

  10. Natasha says:

    Hi. I purchased the harness and belly support. I am having difficulty with it in two ways: 1. my lab is almost 80 pounds, kind of long and wiggles no end so I find it hard to control his front end. 2. How much do I lift for stairs. Yes, there is no way around a few stairs to get out of the house and into the yard. He is on week three, looking good and feeling strong and he is pulling me down the stairs.

    Thank you.

    • Dr. James St.Clair says:

      Hey Natasha, I wish we had video so that I could see real time what you are experiencing. That said I am not sure about you question #2 but what I can tell you is this….That harness is always meant to be two hands on the leash…kind of thing. The reason for this is that you want to control the speed of the dogs front end while you are also supporting them in the hind end. As for question #2 and how much you lift his hind end…it is also about control and supporting them as much as they need. When if comes to stair I just hold the hind and and take a bit of the weigh off just to help them navigate. From the sound of it he is a big boy with a lot of strength and doing well at 3 weeks post-op…so every day and every week he is getting stronger and feeling better. You have your work cut out for you in the coming weeks…just do you best to slow him down. Hope this helps. Dr.J

  11. Carol Wilson says:

    My dog Cora will have her surgery on Monday morning (3/30/15). On what day do I start the PROM?

    • Dr. James St.Clair says:

      Carol PROM is ideally started immediately provided that they are comfortable and will tolerate the exercise.

  12. Shelley says:

    Hi! Our 11 year old shitzhu has tight rope ACL surgery Wednesday. She is on predinzone due to an auto immune issue and is taking tramodol and gabepentin. She seems to be taking these Meds fine with minimal side effect thank goodness!! My question is about Passive Range of Motion excercises. We’ve attempted very softly to do this but she appears to be in so much pain! It only has been 48 hours post surgery and we are terrified to hurt her…is this something that has to happen right away or can we wait a few more days to start this. She also gets quite annoyed with icing…we are doing this every 3 hours right now..when can we slow this down? We feel so heart broken she is going through all of this pain!

    • Dr. James St.Clair says:

      Shelley my rule of thumb with at home care is to do only what they tolerate. You really don’t want to push them. If it were in our facility I may have a tendency to push them more, but only because of our experience working with these patients. Don’t stress about it…once it seems that she is more comfortable then go ahead and do the exercises. Good luck. Dr.J

  13. Elizabeth Baird says:

    My dog is having the TPLO procedure done in early April. She is an amputee (left hind leg), surgery on right hind leg. Wondered what kind of help she will need since she won’t have another leg to help her get around, but also won’t have to worry about injuring other leg. Thanks.

    • Dr. James St.Clair says:

      Elizabeth I think it would be a really good idea for you to get a support harness. Our SupportRx would be perfect for a female three legged dog because the hind end support is via a belly band. I am sure she is going to do great you just need to do your best to keep her moving slow and protected until you get some good primary bone healing. Good luck and we are here if you need us.

  14. Jeanette Shade says:

    What is the best way to clean our black lab’s sutures? There is just a little clear discharge. Our daughter has been wiping it with a dry paper towel since when he is taken outside to urinate or poop the lawn is wet.

    • Dr. James St.Clair says:

      Jeanette that is fine. This clear discharge is called serosanguinous fluid and it totally normal.

  15. Paul little says:

    7 year old Beagle a little heavy, had TPLO mon. Pm this is we’d morning. Has not put weight on it except for potty. Also does NOT want me to move it. Will let me ice but that is all.
    3 legs it up and down 3 stairs for potty. How long before she should kinda sue it. Should I take her back in?
    Thx Paul

    • Dr. James St.Clair says:

      Paul I am sorry that I am catching you a bit late and I am hoping that by now you have seen improvement from where you were only 3 days post-op. All dogs are different post-op though with the TPLO most do have a tendency to use the surgery leg quicker than some of the other procedures. If at any point you are concerned or question how she is progressing, I would most definitely call the surgeon directly since they are the ones responsible and know she particular situation best. All the best, DR.J

  16. Susan says:

    hi there. I just connected with your organization yesterday. My 2 3/4 year old, 116 lb. Bouvier had TPLO Jan. 12 so we are starting week 8 next week. the email I received today was for week 1. I don’t mind having a reminder for the exercise though. We are walking 30 minutes twice a day on a leash now. she is coping very well but has a limp and hold her paw about 3 inches off the ground when standing still – indoors and outdoors. is this normal? also wanted to know if I could start taking her to a heated indoor salt water pool for a swim with me a couple of times a week – for maybe a 15 minute swim? at what point can I have her off leash and doing a slower pace run – sometimes when walking she speeds up the pace on leash to a little jog for a few feet – thank you for your help

    • Dr. James St.Clair says:

      Hi Susan, what beautiful dogs Bouvier’s are. If I understand you correctly while on walks she still has a noticeable limp and then when she stops he holds the leg up slightly. So I would say that yes this could be perceived as normal even at 8 weeks but with a TPLO at 8 weeks post-op I would expect any limping to be minimal. You best bet is to have a recheck evaluation with the surgeon just to make sure all is healing well. Second I would then just want to make sure that you have her on a good supportive joint health supplement that is packed with everything that joint and all others need for optimal health. As for the swimming 8 weeks post-op I don’t have a huge problem with that as long as the process of getting her into and out of that pool is very safe and avoids any struggling. I would rather see her in an underwater treadmill at a local canine rehab facility though. As for the off leash and slower paced running my answer would be no way. She is not ready for that. She first has to master or achieve a level of perfect gait walking and weight bearing before she could ever be ready for increased speed. Once she is walking perfectly without a limp, then you can start to test increasing her speed and definitely always on leash. Hope this helps and answers some of your concerns. All the best, Dr.J

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