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Getting Back to Normal After TPLO Surgery: A Guide to Healing, Strength, and Recovery

Your dog has just had successful knee surgery with a TPLO. The surgery has stabilized the knee, but the next 12 weeks are critical for healing and a return to normal.

After surgery, it is completely normal for some muscle mass and strength to be lost in the operated leg, especially in the thigh muscles that help stabilize the knee. This happens because your dog naturally favors the “good” leg and must stay on activity restriction while the injured leg heals.

Rebuilding muscle mass and strength with exercise and nutrition are the top goals after surgery. Here is a complete, easy-to-follow recovery guide to help your dog heal with less pain and build back strength for the best possible outcome.

Build Back Muscle and Strength

Nutrition supports recovery and helps your dog get back to their normal activities sooner.

  • Feed moderate to high levels of highly digestible animal-source protein. Aim for about 75 grams of protein per 1,000 calories per day.
  • Support muscle with supplements. Fortetropin® is a proprietary advanced food-based nutrition product developed and owned by MYOS Corp.
    • In a randomized, double-blinded, placebo-controlled study of dogs after tibial plateau leveling osteotomy (TPLO), those receiving Fortetropin showed no significant loss of thigh circumference, while the placebo group had significant muscle loss during the post-operative restricted activity period.
  • Include healthy fats such as omega-3 fatty acids from cold-water fish to reduce inflammation and support joint health.
  • Consider dog- or cat-specific probiotics to help rebalance the gut after surgery and anesthesia.
  • Use fiber sources such as psyllium husk or canned pumpkin if your dog has soft stools during recovery.

Pain and Inflammation Control Beyond Medication

Comfort is essential for healing. Always follow your surgeon’s instructions for prescribed medications. In addition, these gentle, non-drug options can make your dog feel better:

  • tPEMF therapy, or targeted pulsed electromagnetic field therapy, may help ease inflammation and discomfort.
  • Massage, myofascial release, and gentle active stretching
  • Ice and heat therapy

Recovery-Friendly Home Modifications

Small changes at home make a big difference in keeping your dog safe and comfortable while they heal:

  • Place non-slip rugs or runners on slippery floors.
  • Use ramps instead of stairs or jumping; choose a non-slip surface such as artificial turf or thick carpet.
  • Raise food and water bowls to just below elbow height.
  • Provide supportive, low-entry bedding.
  • Place an anti-fatigue mat where your dog stands to eat or drink.

Building Strength with Exercise

Too much activity too soon can delay healing or cause setbacks. Working with a canine physical rehabilitation certified therapist or a sports-medicine boarded veterinarian is one of the best ways to create a custom plan that fits your dog perfectly. A structured rehabilitation program can significantly speed recovery and help your dog regain confidence and strength.

This guide is an example of a rehabilitation plan for an uncomplicated TPLO surgery in a dog. It is meant to be used in addition to your surgeon’s instructions for incision care, activity restriction, medications, and follow-up visits. The very best results come from one-on-one care with a veterinarian certified in canine rehabilitation or boarded in sports medicine. Follow all of your vet’s recommendations for activity limits, walks, incision care, e-collar use, and medications.

Building Strength Safely: An Example Step-by-Step Exercise Guide for TPLO Recovery

Days 1–7: Protect the Surgery Site and Allow Initial Healing

  • Exercise: Gentle passive range-of-motion movements for the operated knee and hip on the same side.
  • Comfort care: Ice the knee, apply heat, and use light massage on the low back.
  • Keep the incision clean and protected with a lick sleeve or e-collar.

Days 7–14: Encourage Light Use of the Leg and Gentle Weight Bearing

  • Exercise: Cookie stretches and simple weight shifts onto the operated leg.
  • Comfort care: Ice the knee, heat and massage the low back, and gently massage the hip flexors, hamstrings, and gluteal muscles.
  • Begin working with a rehabilitation therapist for underwater treadmill sessions when your surgeon gives the go-ahead.

Weeks 2–6: Build Confidence and Restore a Normal Walking Pattern

  • Exercise: Front-leg-elevated weight shifts, walking over cavaletti poles, and sit-to-stand exercises.
  • Comfort care: Ice the knee only if needed after activity; continue heat and low-back massage as helpful, plus hip flexor, hamstring, and gluteal massage.

Weeks 6–12: Improve Strength and Endurance

  • Exercise: Backward walking, side steps, cross-body stands, and incline walks. Increase the challenge of sit-to-stand and cavaletti exercises.
  • Comfort care: Use ice, heat, or massage only when your dog shows signs of limping.

Weeks 13–16: Return to Normal Activity

  • Exercise: Continue and advance all previous exercises. Add rolling a peanut/balance ball, low jumps onto a box, pivots with front legs elevated, and progress cavaletti poles to light trotting.
  • Comfort care: Ice, heat, or massage only as needed.

Your dog is on a journey back to strength doing the activities they love best. By combining rehabilitation exercises, smart nutrition, including Fortetropin, and your care, your dog will heal well and may even be stronger than before.

References

  1. Repac, J. A., Alvarez, L. X., & Amstutz, K. L. (Eds.). (2026). Handbook of Canine Exercise Therapy. Wiley-Blackwell.
  2. Hetrick, Katie, et al. “Evaluation of Fortetropin in Geriatric and Senior Dogs with Reduced Mobility.” The Canadian Veterinary Journal, vol. 63, no. 10, Oct. 2022, pp. 1057–1060. PubMed: https://pubmed.ncbi.nlm.nih.gov/36185794/
  3. Freeman, L. M. “Cachexia and Sarcopenia: Emerging Syndromes of Importance in Dogs and Cats.” Journal of Veterinary Internal Medicine, vol. 26, no. 1, 2012, pp. 3–17. Wiley Online Library: https://doi.org/10.1111/j.1939-1676.2011.00838.x
  4. Ogilvie, Gregory K. “Interventional Nutrition for the Cancer Patient.” Clinical Techniques in Small Animal Practice, vol. 13, no. 4, Nov. 1998, pp. 224–231. ScienceDirect: https://doi.org/10.1016/S1096-2867(98)80007-8
  5. White, Dana A., et al. “Fortetropin Inhibits Disuse Muscle Atrophy in Dogs after Tibial Plateau Leveling Osteotomy.” PLOS ONE, vol. 15, no. 4, 9 Apr. 2020, e0231306. PLOS ONE: https://doi.org/10.1371/journal.pone.0231306