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13 Signs Your Dog May Need TPLO Surgery

13 Signs Your Dog May Need TPLO Surgery

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Is your dog limping or slowing down? Discover 13 early signs that may indicate your dog needs TPLO surgery for a torn cruciate ligament

By 

Sustainable Vet Group

Updated on

March 25, 2025

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What Is TPLO Surgery and Why Dogs Need It

TPLO (Tibial Plateau Leveling Osteotomy) is a surgical procedure used to treat cranial cruciate ligament (CCL) injuries in dogs. The CCL is one of the key ligaments that stabilizes the knee joint. When it tears—often due to sudden movement or long-term wear—your dog may limp, avoid putting weight on the leg, or show signs of pain and stiffness.

Instead of repairing the torn ligament directly, TPLO works by changing the angle of the tibia (shin bone). This helps stop the femur from sliding forward, restoring stability to the knee. Once the bone is cut, rotated, and secured with a metal plate, your dog can start healing.

TPLO is one of the most effective surgeries for dogs with CCL injuries. It helps reduce pain, improve mobility, and supports long-term joint function, especially in active or large-breed dogs.

Early Signs You Might Miss

CCL injuries often start with small changes in your dog’s behavior. These signs are easy to overlook but may point to early joint pain or instability. Keep an eye out for the following:

  • Reduced activity levels or sudden laziness - Your dog may seem more tired than usual, sleep more, or lose interest in walks. This drop in energy could be due to discomfort in the knee.
  • Unwillingness to play or move as usual - Dogs with early joint pain may avoid games, running, or exploring. If your dog used to be active and suddenly seems withdrawn, it’s a sign something may be wrong.
  • Reluctance to jump, run, or climb stairs - Pain in the knee joint can make jumping or climbing uncomfortable. Hesitating at stairs or avoiding furniture are common signs of a CCL issue.

Noticing these subtle changes early can help you get the right care before the injury worsens.

Moderate Signs That Show Joint Discomfort

As a CCL injury progresses, your dog may begin to show more noticeable signs of discomfort. These signs often appear during movement or rest and are easier to spot than early-stage symptoms. Here’s what to look for:

  • Awkward sitting posture - Dogs with knee pain often sit with one leg stretched out to the side instead of tucking it under their body. This helps avoid pressure on the sore joint.
  • Stiffness and pain in the hind legs, especially after rest - After lying down for a while, your dog may struggle to get up or walk stiffly for the first few steps. This stiffness often improves with movement but returns after rest.
  • Occasional limping - Limping may come and go, especially after exercise or long walks. Some days may seem better than others, but this inconsistency is a sign of joint problems.
  • “Toe-touching” gait - Your dog may lightly place just the toes of the affected leg on the ground while walking, without putting full weight on it. This is a common sign of knee pain.

These symptoms show that the joint is under stress and may need medical attention.

Advanced Signs That May Require Surgery

When a cranial cruciate ligament (CCL) is fully torn or severely damaged, the signs become more serious and harder to ignore. These advanced symptoms often mean the joint is unstable and surgery like TPLO may be needed for proper healing. Watch for the following:

  • Partial weight-bearing on one hind leg - Your dog may keep most of their weight off one back leg, only touching it to the ground when necessary. This helps them avoid pain from an unstable knee.
  • Persistent lameness or limping after rest - Unlike earlier stages, the limping doesn’t improve with movement. Your dog may continue to favor the leg all day, especially after sleeping or lying down.
  • Difficulty rising or sitting - Getting up becomes slow and painful. Your dog may shift their weight awkwardly or need help standing.
  • Clicking or popping sounds in the knee - These noises can come from joint instability or meniscus damage and usually mean the knee is not functioning properly.
  • Swelling around the knee joint - The area may look puffy or feel warm to the touch. This can be a sign of inflammation or joint damage.
  • Muscle atrophy in one leg - You may notice that one thigh appears smaller than the other. This happens when the leg isn’t being used normally over time.

These signs should be evaluated by your vet to decide if surgery is the best option.

When to Visit the Vet

If your dog shows signs like limping, stiffness, difficulty rising, or toe-touching the ground, it’s time to visit the vet. Sudden changes in activity, pain, or leg use shouldn’t be ignored, especially if symptoms don’t improve within a few days. Early treatment can prevent further damage and lead to better recovery.

During the exam, your vet will check your dog’s leg for swelling, pain, range of motion, and joint stability. They may perform a drawer test to assess ligament damage. In some cases, sedation and X-rays are needed to rule out bone issues or confirm a torn cranial cruciate ligament (CCL).

Your vet will then discuss treatment options, which may include rest, medication, or surgery depending on the injury’s severity. Getting the right diagnosis early can make a big difference in your dog’s comfort and long-term mobility.

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Conclusion

CCL injuries in dogs can start with small, subtle signs like reduced play or a change in posture. As the damage worsens, symptoms like limping, stiffness, or toe-touching become more noticeable. In advanced stages, your dog may avoid using one leg, show swelling, or develop muscle loss—all signs that may need surgery.

The good news is that early action can prevent long-term joint damage. Watching for behavior changes and getting a prompt vet check can lead to faster healing and better results. Even if the clicking sound or limp seems mild, it’s always worth asking your vet for advice.

TPLO surgery is often very successful in restoring mobility and comfort. With proper care and follow-up, most dogs return to their normal, active lives. Trust your instincts—if something feels off with your dog’s leg, take action early. It can make all the difference in their recovery.

FAQs

What is the most common sign that a dog needs TPLO surgery?

The most common sign is consistent limping in one of the hind legs, especially after activity or rest. Many dogs also show signs like toe-touching, stiffness, or reluctance to jump or run. These signs often point to a torn cranial cruciate ligament (CCL), which TPLO surgery helps correct.

Can these signs appear suddenly or slowly over time?

Yes, the signs can appear either way. Some dogs show sudden limping after running or jumping, while others develop symptoms gradually. You might first notice reduced activity, hesitation on stairs, or an unusual sitting posture. Both sudden and slow changes can indicate joint problems and should be checked by a vet.

Is limping always a sign of CCL injury?

Not always. Limping can be caused by many things, including sprains, muscle strains, arthritis, or paw injuries. However, long-lasting or recurring limping—especially in large or active dogs—often suggests a CCL tear. A vet exam is the best way to find the exact cause and rule out other issues.

How is a CCL tear diagnosed by a vet?

A vet will perform a physical exam to check joint stability and pain. They may use the "drawer test" or "tibial thrust test" to detect instability. Sedation is sometimes needed for accuracy. X-rays help rule out fractures and confirm swelling or arthritis linked to CCL injuries.

What happens if I delay TPLO surgery?

Delaying TPLO surgery can lead to more joint damage, increased pain, and worsening lameness. The longer the knee stays unstable, the higher the risk of meniscus injury and arthritis. Early surgery gives your dog the best chance for a full recovery and helps prevent long-term complications.

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