Tibial Tuberosity Advancement “TTA” Post-Operative Instructions

Following a successful surgery, owner compliance is the most important factor in recovery. Please be careful and patient with your pet during this time. Following these instructions closely will ensure a speedy recovery.

1. Pain Management: Pain management is a necessity following this procedure. Earlier today your pet received an epidural, this is a pain block that does not inhibit motor (muscle) function. Therefore, when the anesthesia has worn off the patient can use his/her legs but will retain some pain relief. Continued pain control is a MUST during your pets’ recovery. The appropriate medications have been sent home after surgery. Be sure to read the labels and give these medications as directed until ALL doses are finished. This will maintain comfort and aid in a speedy recovery. If you feel at any time the pain is not adequately controlled contact the clinic. Some side effects of these medications may include: nausea/upset stomach, constipation or diarrhea. It is best to give these medications with food.
2. Antibiotics: Your pet will be sent home with a course of antibiotics to prevent post-operative infection. Follow the instructions on the label and finish all doses of medications. Give antibiotics with food.
3. Stomach upset: Monitor for any signs of vomiting, diarrhea, lack of appetite or any blood in the stool. If your pet experiences any of these symptoms, please notify the clinic immediately as these symptoms can be a sign of a sensitivity to medications.  Some patients may experience a bout of constipation post-op. It is possible for a pet to not have a bowel movement for up to 7 days after surgery. You may add 1-2 tablespoons of canned pumpkin to their food to aid with the consistency and frequency of bowel movements. DO NOT use canned pumpkin pie filling- ONLY canned pumpkin. HEB typically carries Farmer’s Market Organic Pumpkin in cans on the baking aisle. If the issue does not resolve with the recommendation above please contact the clinic.
4. Confinement and Activity Restriction: STRICT CRATE CONFINEMENT IS CRITICAL during this recovery. Short, leashed potty breaks to the front or back yard are the only “activity” your dog should be participating in. It is best to use a 2 ft.-4ft. leash. DO NOT use a retractable or long line leash. A towel/sling positioned under the belly in front of the back legs can be used for added support to help your pet when standing and walking. Be very mindful of slick surfaces such as wood or tile floors as they can cause your pet to fall/slip resulting in injury. It is okay to carry your pet to a potty spot, be careful not to put their full weight on the recovering leg when setting them down. Your recovering pet will need to be taken out alone for potty breaks, keep housemates separated during recovery. DO NOT allow your pet to use stairs, be off leash, run, jump, play, roughhouse, or be loose in the house. These activities compromise the surgical site and can result in complications including delayed healing, extended recovery time, additional costs and fracturing of the surgical site. The veterinary staff will let you know when your pet is cleared for house confinement.

4. Feeding: Your pet may have an upset stomach the night of surgery as a side effect of the sedation. Offer ¼ to ½ of the normal amount they are fed. If they do not want to eat do not force it. If they eat and vomit, pull the food until tomorrow morning. If they eat and are able to hold down the food for an hour you may offer more in small increments throughout the evening. Unless advised by the veterinary staff to feed a specific diet, use their normal food to reduce the likelihood of an upset stomach.
5. E-collar: Licking at the incision site is NEVER OKAY! It is imperative to keep your pets’ e-collar on at ALL times, even when they are in the kennel. Licking, chewing, scratching or rubbing the incision prevents/slows the healing process and results in opening and infection of the incision site. DO NOT allow housemates to lick or paw at the surgical site either. DO NOT cut the E-collar. The size sent home is appropriate for your pet. The edge of the e-collar should extend 1.5 to 2 inches past your pet’s nose in order to prevent licking or digging at the incision site. If you cut the e-collar shorter you put your pet at risk for infection, opening of the incision site and additional recovery costs as well as prolonged recovery time. The veterinary staff will let you know when it is okay to take the e-collar off.
6. Incision Site Care: You should not need to clean the incision site; it heals best if left alone. Some bleeding and seeping in the first few days is to be expected. Gentle pressure may be applied to the incision site with a clean towel or gauze. If you must clean the incision site use a small amount of warm water, dab DO NOT wipe. DO NOT apply any alcohol, hydrogen peroxide, topical ointments, sprays, salves or bandages as this traps bacteria at the surgical site and can result in infection.
7. Physical Therapy: PT is recommended to aid in your pet’s recovery from surgery. Our in clinic physical therapy program will provide structured exercises and work in the underwater treadmill to promote strength, balance and muscle conditioning. If you have not already scheduled your first physical therapy visit, contact our staff to help you set up that appointment. It’s also recommended to start some simple PROM (passive range of motion) exercises at home the day after surgery. The email with the post-op instructions includes a link to a video that shows how to perform these exercises. We recommend doing this at-home therapy 3-4 times a day. If any of these actions causes your pet stress or to struggle, don’t push it.

• Start by applying heat for 3-5 minutes. Test the compress against your skin before applying it to your pets’ skin to prevent burns.
• Massage for 2-3 minutes.
• Perform PROM exercises – 10 repetitions. This will consist of flexion/extension of the knee joint. Hold extension for 10 seconds or until your pet shows discomfort.
• Ice knee joint for 10-20 minutes.

You can view a video on this exercise on our YouTube page.  Search “Veterinary Surgical Solutions”.

9. Bruising/Swelling: Bruising around the incision site and down the leg is normal and tends to increase for up to 2 days after surgery then slowly resolve. Swelling is not unusual and will commonly occur at the joint below the surgery site, developing 2-3 days post-op. This may feel gelatinous (like Jell-O) and is called edema, it too will resolve over time. Cold and warm compresses applied directly on the incision can help decrease these factors.
10. Medical progress appointments: Your pets’ first re-check will be 14 days after surgery. If the incision site has fully healed sutures/staples will be removed at this appointment and the e-collar will be discontinued. Rechecks are done in conjunction with physical therapy sessions. Through physical examination and X-rays Dr. Lewis will evaluate and make activity recommendations according to the healing and specific needs of your pet.
11. After hours emergency line: During your pet’s discharge you were provided with our after-hours phone number should any questions/complications arise during recovery that need to be addressed immediately. If you call, you will be asked to leave a detailed message and a member of our medical team will return your call. This line also accepts text messages. You can also reach the clinic after hours by phone or email. The after hours line is not checked during regular business hours.

When should I call after hours?

• Appetite has not returned within 24-36 hours after surgery.
• Report ALL vomiting or diarrhea. This could be a sign of medication interaction, sensitivity.
• If your pet gets the e-collar off and has licked and/or caused damage to the incision site.
• Incision site is open and/or showing signs of infection: redness, discharge or swelling.

If your pet is experiencing a medical emergency and you are not able to reach us after hours please take your pet to the nearest emergency clinic.