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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?

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221 thoughts on “Week 1: Rehab Instructions: Mindset & Expectations
  1. Shirley says:

    Dr. St. Clair my 4 year old Lab just had cruciate surgery 2 days ago, she weights 92 lbs and I am struggling trying to lift her in and outside down 2 sets of 2 stairs. What size harness would she need and how long is a harness required after surgery? Thanks

    • Dr. James St.Clair says:

      Shirley a good support harness will make all the difference for you and make recovery safer for her as well. I would recommend going with the SupportRx harness that we have. For short term use and for girls this is a great value. As for the sizing the 2XL is probably going to be the best fit, but your best bet is to give us a call at 888-504-2220 and speak with Martha. She has the sizing down perfectly and she can help you. As for how long I would say that at least for the first 4 weeks it will be very helpful yet I know many people that continue to use it throughout the entire 3 month recover process just to help their dog get in and out of the car and up stairs etc. Hope this helps and hope her recovery goes really well.

  2. Laura says:

    Kona had a Left TPLO last January, and just had her Right last week. Very different reaction, although last year she had torn her meniscus as well. This time she is trying to be way, way to active. When I picked her up from surgery, she was jumping up and down from excitement, and when they put her in the car, first thing she did was jump in the front seat. HOW do you slow down a 5 1/2 year old Lab???

    • Dr. James St.Clair says:

      Laura this is a great question and really all to common. Unfortunately there is no easy pill solution. It is a bit of discipline training mixed with strategy and confinement. Don’t get me wrong there are many of people who have to utilize pharmaceutical management to keep their dogs slightly sedated because they simply can control their dogs excitement. The most common drug for that is acepromazine and you may want to discuss this with you veterinary surgeon. From there if you are home I often recommend people to tether their dog to themselves ie. attach the leash around your waist so that your dog is calm and with you and is unable to have explosive movements. If this is not viable then a crate or good confinement will allow them to have adequate rest for healing. It is all a matter of finding the best routine that works for you. I wish there was a simple answer to your issue but no doubt it can be very challenging.

  3. Chris says:

    Thank you SO much for your site! IT is so helpful. Miles, my 7yr old Jack Russell Terrier is being operated on tomorrow (TPLO). Thanks to your site, I feel emotionally ready and have studied your manual, seen the videos etc.
    My question is regarding your Glycan Aid supplement. I live in Sweden. Is it available here? Thank you again!

    • Dr. James St.Clair says:

      Chris thanks for the message and good luck with everything. As for GlycanAid being available in Europe it is. Either we can ship it directly to you, though we have to charge the shipping cost, or you can find it through zoomadog.co.uk. Best of luck with Miles recovery and if you need anything we are here to help you.
      All the best, Dr.J

  4. Elizabeth Howell says:

    How come your chondroitin tablets cannot be sent to Australia. I saw somewhere that they cannot be shipped here. Just interested to know

    • Dr. James St.Clair says:

      Elizabeth, the reason for this is solely due to the strict importation regulations of customs in australia. Because GlycanAid uses USA source bovine chondrotin and there are animal protein palatants used it is not acceptable for import to australia. That said, it would not be impossible to get GlycanAid into the country we would just need one of the larger animal health distributors to help us navigate the process. Hope this answers your question.

  5. Terri Moore says:

    I am so happy you have this web site and are willing to help and answer questions. I received none of this info from my surgery or my local vet. My one year old is 2.5 weeks post op. I’ve kept her on short leash for her walks outside and we are up to 10 minutes now. The other day I catch her slowing jogging down the hall which scared me too death because I know running is not allow. She wasn’t racing, but I catch her immediately. I’m so sorry she messed something up. Any advice? She seems fine and looks to be putting her weight on her surgery leg. She has been off pain pills for a week and shows no signs of pain. I also can feel the plate, is this normal?

    • Dr. James St.Clair says:

      Terri, it is totally normal to be able to feel the plate because there is not a lot of muscle cover this. Also the episode you described is ok, we really are focused on avoiding big situations where they are exploding/running. Don’t stress, as long as she is doing well and was ok after that episode you are fine. Just continue doing the great job that you are already doing. All the best. Dr.J

  6. Lee says:

    My dog had TPLO surgery on Tuesday. Today he is 5 days post-op. He would let me do the passive ROM the first two days. Now he is not willing. Incission looks great. Swelling is at a minimal. Things look good. Should I be concerned? Should I continue to try?

    • Dr. James St.Clair says:

      Lee great question and my answer would be to always not push the therapy if your dog seems uncomfortable. You optimal time to do such therapies would be 1-2 hours post pain medications but that said again if he does not want you to do it…don’t do it. They key is in the slow controlled leash walking. If he is putting the leg down and putting weight on it then the passive range of motion is not necessary because he is engaging that joint.

  7. Vickie says:

    Our 22 month old pit bull had TPLO surgery 3 days ago and is doing really good but he has lot of brusing. It started appearing the day after surgery in a couple spots but now it has spread to almost his whole leg. Is this common? If so, how long does it usually take to clear up?

    • Dr. James St.Clair says:

      Vickie, yes that is totally normal and common. No doubt it can get to look pretty gruesome. I would say that this can last for a good week. The key is slow improvement and resolution of the bruising with no excessive swelling noted.

  8. SHIRLEY says:


    • Dr. James St.Clair says:

      Shirley currently we so not have the x-Large T.U.S.H. harness available which would be ideal for your boy. I am very sorry for that. We do though have the SupportRx harness which is our original support harness which allows for front control and hind end support through the belly wrap. It is very affordably priced and still a great option to consider.

  9. Mark Kornfein says:

    TPLO surgery and stairs
    Read your guide and it is a wonderful help! One question to get our dog outside to go requires going down 2 or 3 steps to get outside (house level, 2 steps, outside level). Our dog is about 70lbs and we have gotten SupportRx harness (mostly for the car), Can we just use the back part to help him up/ down the stairs? Does he need the support going up and down?, he is kind of heavy to lift

    thank you,


    • Dr. James St.Clair says:

      Mark the answer is yes. You can totally just use it to help him go up and down the stairs. You should not have to carry him, you can simply use the harness to provide a little bit of support to the hind and that would be perfect.

  10. Eva says:

    Uli, my 7 year old Staffie had TTA 3 days ago.His medications are:Meloxican once daily, Amoxyclav 500 1tbl twice daily. He is still in pain, can I give him Tramadol left from pre -surgery? Uli’s weight is 27kg, quite heavy for my low back. I ordered yesterday TTA Complete Package Guide, The support harnessRX and GlycanAid-HA. The second question is ; my other staffie is 6 year old, should I put her on Glycan tablet for prevention to avoid another surgery?

    • Dr. James St.Clair says:

      Eva, I have to apologize for my delay. The holidays seemed to have set me back and I am sorry for that. As for you question about pain meds I am sure by this point that you got that figured out by calling your veterinarian. All of my post-ortho cases go home with NSAID’s and tramadol for pain at a minimum but your surgeon is the key determinant on that. As for your other dog and the need for preventative joint health supplements, again this really is up to your and your doctor. If we all live by the motto; An ounce of prevention is worth a pound of cure…then if the supplement can cause no harm and only potentially help in the long run then I would say yes. That being said..if a dog has perfect joint health from the start then there really in no need for additional supplementation. It is best to discuss this with her doctor and see what they think about her overall joint health situation. Again I am sorry that I was not here for you immediately but I hope you are both well. All the best, Dr.J

  11. Kris says:

    My dog bully has had surgery four days ago now I don’t have him crated. Generally he’s been sleeping and resting for about 23+ hours a day. He’s a bullmastiff boxer cross and generally quite the lazy fellow. The downstairs area is relatively small (about 30m2 and the outside area only about 20m2). He’s mostly inside at the moment but does love to sunbathe outside for parts of the day. Is he allowed to walk around the house freely on the odd occasion that he gets up to move around a little or should he be more confined to not move at all?? He’s on Tramal and metacam as well. What’s the sort of maximum that they’re usually allowed to be on their feet during a 24 he period. Also when doing his business (#2) obviously there’s some minor bending of the back legs going on. Is that ok?

    • Dr. James St.Clair says:

      Kris normal walking around the house would be totally fine. What we are trying to avoid is any jumping, running, going up stairs etc. The initial days after surgery should be focused on resting with only breaks to go outside to use the bathroom. The reality is that they will tell you what they can and can not do, we just need to protect them form doing to much to soon. Good luck with Bullies recovery.

  12. Jeanie creger says:

    I came across your site looking for help after my dog had Acl surgery. There just isn’t a lot of information for canine rehab at home. So this is wonderful! My question is why dog is two weeks and three days post surgery…I would like to know where do I start in your program? Also if I can receive newsletters for week two and week three.
    Thank you so very much!

    • Dr. James St.Clair says:

      Jeanie that is a great question in terms of what to do when you find us a few weeks into recovery. My suggestion would be to start around week two. The reason I say this is it is about the long haul/the big picture. Full recovery takes a full 6 months at the end of the day. The first week is all about reducing the inflammation and discomfort related to the surgery itself. Being that you are now 2.5 weeks out that initial surgery pain is resolved or resolving and you are ready to focus on healing and building strength. I wish you the best of luck with your dogs surgery. Dr.J

  13. Victoria Leitner says:

    In order to avoid stairs, is it okay for a dog to use a ramp immediately after ACL surgery? My ramp is one side of an agility A Frame. I cannot lift a 40# dog to get in and out for pottying, etc. Also, do you advise cold laser treatments? If so, how many and for how long?

    • Dr. James St.Clair says:

      Victoria our T.U.S.H harness would be a great option for your dog. It makes supporting the helping them in and out of cars or up and down stairs much easier and safer. I have no problem with the A frame as long as it is slow and in full control. As for the cold laser, of course I am a big fan. Typically for my patients I will do this 2-3 times a week.

  14. Beverley says:

    My 17mth boxer had her TTA op on 17/11/14 she is going stir crazy been crated 24hrs a day!!is she ok to walk around small room for short periods at a time? There’s no furniture in there so she cannot climb onto anything! My other worry is we have another boxer who is 7 mths old and at the moment they are completely seperate so that’s not helping her stress levels!! When can we introduce them I’m just worried about them getting giddy!! Thank you look forward to your reply. Beverley

    • Dr. James St.Clair says:

      Beverley, there is no doubt that the first few weeks of recovery are stressful, especially when you have a playmate in the house. Here is what you need to remember though. #1 This painful period for both of you is temporary in the grand scheme of things. #2 It takes a good 6-8 weeks to form good scar tissue and callus formation where the bone was cut and plated. That being said you have to use your best judgement. The best thing to do is have your dog on a short leash even when you are in the house and our want them to be together, this way you have some form of control. To help with the stir crazy you need to simply spend more time with her playing mental games (with good treats of course) and doing your short control leash walking. Again you know your dogs best so just be careful.

  15. Lisa says:

    Hi and Thanks for the great website! Just got my 71lb Golden home from TPLO so how soon should I start the Glycandaid-HA I’m about to order? Also, really stupid question, but what side of the leg do I ice? I assume the outside part where there are no sutures. 11-7-14

    • Dr. James St.Clair says:

      Lisa first of all good luck with your dogs recovery. I totally understand how stressful it is especially in the early days after surgery. Second you can start GlycanAid HA right away. Third as for where to ice, this is not at all a stupid question. In the case of the TPLO I would have a tendency to provide cold therapy on both the front and the inside of the knee where the surgery was. That being said make sure you have a cloth in-between the ice and the leg. Hope this helps. Dr.J

  16. Gladys says:

    I rescue a female lab mix and was hit by a car, vet perform a femur surgery to cut bone head since then she does not put the leg down, he told us that this will take up to 6 weeks. Time is almost up and nothing is seen. The muscle is very thin in the area. Help!

    • Dr. James St.Clair says:

      Gladys my best advice would be #1 your dog should have a hip X-ray to make sure there is not a bone spur that formed and #2 get your dog back on pain meds ASAP. I truly feel as if we do not give these FHO dogs the benefit of the doubt and continue with pain meds long enough, at least until they are using the leg 100% consistently. In my mind if a dog is not using the leg, then I always make sure first that pain is not a part of the equation. You need to discuss this with your veterinarian.

  17. June Goritz says:

    Surgery was last Saturday. When will she be able to at least walk without the Lift Me Up Harness. It is starting to leave her contact areas a bit raw. The medications indicate that a side affect is not being able to control bladder. After doing a full load of soiled urine bedding, There isn’t ANY DOUBT this is true. Her fur wreaks of urine and am not sure of the best method to protect her from being saturated, then cleaned/dried – without fussing with her too much. She loves her massages, as she is a Cushings and Thyroid dog.

    • Dr. James St.Clair says:

      June unfortunately they are really all different in there recovery speed so it is impossible for me to say when she will not need the assistance. If possible it would be great to get her into a professional rehab program to accelerate her healing process.

  18. Wendy says:

    Bailey my 33lbs 10yr old shepard/terrier mix just had surgery last Tuesday cruciate and luxating patella so week one is almost behind us. Your Web site is great thanks for all of the great info and I just ordered the Glycanaid-HA. She is also a cushings dog and I understand that because of the steroids she is on that it could slow down recovery but she does seem to be doing well. She seems to have her same energy but hates the crate so the vet gave me acepromezine to keep her calm and sleeping during the day when I’m at work. Anything you can share about her recovery as a cushings dog would be great. I’m hoping she doesn’t injure the other leg.

    • Dr. James St.Clair says:

      Wendy it is true that her recovery may be slowed due to this disease but my biggest advice would be to understand that full recovery no matter cushiness or not, takes a FULL 6 months. This is the amount of time that I have seen that it takes to get everything balanced again. That said I strongly strongly encourage pet owners to not allow their dogs to be off leash until they are 100% positive that both hind legs are the same size and the dog is walking 100%, jogging 100% and running 100% while on leash before ever allowing them to be off-leash. Make sure you get used to feeling the comparing the muscle size and strength of both hind legs. I have a video on this at http://www.topdoghealth.com/rehabcenter. Best of luck, Dr.J

  19. Theresa says:

    Another question. How much pain meds should my dog have. The vet only prescribed Meticam and I actually made her give me some tramadol. She gave me only 5 pills 50 mg each and said I can only give her 1/6 of a pill twice a day. I don’t think that is enough. I do have some liquid tramadol that one of my dogs had to take at a different time. It says to give 1/2 ml every 8 hours. It is 25mg. I don’t have a ml applicator only one by lbs. would I give that I her by weight? She is 15lbs. I really don’t want her to be in pain.

    • Dr. James St.Clair says:

      Theresa the typical dose of tramadol is 1mg/lb body weight 3-4 times a day. You can check with your veterinarian about this. The Metacam is only an anti-inflammatory and not a true pain medication. It controls the discomfort related to inflammation. I am a fan of long term pain management so check with your vet about this. All the best, Dr.J

  20. Theresa says:

    Angelica had surgery on Tuesday and its two days later. When I take her out to potty she won’t use her leg at all to walk. She will use it to potty though and if she is standing still she will toe tap. Should she be using that hind leg to walk already?

    • Dr. James St.Clair says:

      Theresa they truly are all different in the initial post operative phase. First off I would just want to make sure that her pain management drugs are correct and she is being covered pain wise. If she is then I would just focus on the guidelines of the 1st week of post op care outlines in our Free Home Rehab Guide. Recover is a slow progression and as long as you are seeing small improvements on a daily basis then I would be happy. All the best, Dr.J

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