If your dog ruptured their anterior cruciate ligament (ACL), they may need surgery (and you want the run-down on what recovery will look like). Proper post-operative care is critical for a successful recovery from ACL surgery. Understanding the timeline and recovery requirements will help ensure that success. The veterinarian who does the surgery will give you specific recommendations on recovery – be sure to follow what they say.

What Is ACL Surgery for Dogs?

ACL surgery is performed on dogs who have torn their ACL, to stabilize the knee joint, lessen pain, and restore the function and mobility of the joint. Different surgical procedures can be used to accomplish this.

Your dog will have a similar post-operative care routine and timeline regardless of the method used to repair their ACL tear. The recovery process is critical to the success of the procedure. So, follow your veterinarian’s post-operative instructions to the letter.

Full recovery will take at least three months and can continue for as long as six months or longer. They may also develop osteoarthritis (OA) in the joint.

Weeks One and Two of Your Dog’s Recovery From ACL Surgery

Medications and Food

It’s critical that all medications (antibiotics, sedatives, pain meds, etc.) are given as directed for the recommended time. Monitor your dog for signs of nausea, vomiting, diarrhea, or change in appetite. Don’t adjust or stop any medications without prior approval from your veterinarian. If you think your dog is having an issue with the medications, contact your veterinarian.

Your dog should be eating and drinking normally. If they have a loss of appetite, contact your veterinarian.

Incision Care

Your veterinarian will instruct you on how to care for the surgical site. Ensure your dog wears their Elizabethan collar (or other collar to prevent them getting to the incision) continuously so they can’t lick or chew at the incision. Also, monitor that they are not trying to rub it against anything. Keep other pets from licking at the site as well.

Evaluate the incision several times a day for any redness, heat, swelling, or discharge. If any changes are noted, contact your veterinarian immediately.

Activity

Your dog must have restricted activity during this time. They must not run, jump, or play, especially with other pets. No jumping or climbing on furniture and avoid stairs, if possible, or assist your dog by using a sling at their hind end.

When they can’t be supervised, confinement to a small area or crate is important.

Since it may take up to two weeks for your dog to bear weight on their leg, you may need to use a sling to help them balance and walk. When walked, which should only be for potty breaks at this point, they must be on a short leash at all times. Walks should be three to four times daily for no longer than five to ten minutes.

You’ll get passive range of motion (PROM) exercises from your veterinarian that you must do with your dog two to three times a day. Your veterinarian may also recommend rehab or physical therapy. This can help improve your dog’s return to normal and their long-term health outcome.

Pain and Swelling

Mild knee swelling is common in the first week and can progress down the leg to the ankle.

To help with pain and swelling, your veterinarian may instruct you to apply cold and heat therapy. Cold therapy usually starts immediately following surgery, whereas heat therapy is delayed for about 72 hours after surgery.

Approximately two weeks after surgery, your veterinarian will have you come in for a follow-up visit. Sutures or staples may be removed at this time. Keep all follow-up visits even if you think your dog is doing well.

Weeks Three and Four of Your Dog’s Recovery From ACL Surgery

At this point, the incision should be healed, and sutures removed. The Elizabethan collar can usually be taken off and your dog may begin to toe-tap their affected leg down as added support.

Your dog still needs activity restrictions, but you can gradually increase their walk time on a short leash for up to 20 minutes three times each day. Go at a comfortable pace and stick to flat areas where they have good footing. Continue to avoid running, jumping, and playing.

Continue with the PROM exercises as directed. Before and after these sessions, your veterinarian may recommend you massage the thigh muscles.

During the fourth week, your veterinarian may advise you to start standing weight exercises, like three-legged standing using the affected leg, sit-to-stand, and exercises that require them to shift weight to the affected leg.

Following walks, use cold therapy for up to 20 minutes (or as directed by your veterinarian) to help minimize swelling and discomfort. Icing the knee for 10 to 15 minutes following the PROM session will help control swelling and muscle spasms.

At the end of four weeks, your veterinarian may want to take radiographs.

Weeks Five and Six of Your Dog’s Recovery From ACL Surgery

Your dog will continue activity restrictions but will be allowed longer leash walks. Walks can be 20 to 30 minutes up to three times daily on flat ground. Gradually increase to about 35 minutes during the sixth week. Slight inclines can be slowly introduced during the sixth week.

Continue to avoid stairs if possible or offer support to the backend.

Continue with the weight-bearing exercises and incorporate the following:

• Standing on their hind legs by picking up their front legs
• Walking them in a figure 8 pattern
• Walking them in a serpentine or zigzag pattern

Weeks Seven and Eight of Your Dog’s Recovery From ACL Surgery

Leash walks can be extended up to 40 minutes. You can also start going up and down stairs slowly.

Gradually increase the PROM exercise repetitions. You can introduce the following on-leash movements:

• Slow trots when on walks
• Incline and decline surfaces that have good footing

Weeks Nine and Ten of Your Dog’s Recovery From ACL Surgery

Continue leash walking until week ten. This helps ensure that the bone has adequate time to heal and is stable before your dog can move freely. Starting in the tenth week, with your veterinarian’s approval, allow your dog off-leash in a small area while supervised. You don’t want them running, jumping, or making sudden turns.

Swimming is a good exercise to introduce at this time as long as they have easy access in and out of the water and the ground is even.

Your veterinarian may add additional weight-bearing exercises at this time.

Week 11 and Beyond of Your Dog’s Recovery From ACL Surgery

While your dog’s leg may be healed, they likely have muscle weakness. Their muscles may take several months to return to their pre-surgery strength. Increase the length of leash walks until they’re at their pre-surgery activity level. It’s recommended that aggressive play or strenuous exercise is avoided until they hit the four-month mark. Keep in mind when a dog tears their ACL, it is common for them to tear the other side, as well. Consider putting your dog on a diet if they are overweight as this can help with prevention of this type of problem.