What is TPLO surgery?
TPLO stands for Tibial Plateau Leveling Osteotomy. This surgery is performed on dogs suffering from a torn Anterior Cruciate Ligament (ACL). The good news is that well over 95% of dogs regain an active lifestyle with no postop complications.
It’s important to make sure you ask any and all questions you may have to your orthopedic surgeon before the operation. Not to worry, the team at Brodheadsville Veterinary Clinic and Dr. Zeltzman will be here every step of the way.
Once the surgery is complete, we’ll provide you with all of the postop care information you need!
We work with the only board-certified surgeon in the region. He travels to perform complicated orthopedic and “soft tissue” surgeries on cats and dogs at Brodheadsville Veterinary Clinic. Surgeries include:
There is a wide range of orthopedic procedures your pet may undergo. Some of the more common include:
The most common procedure Dr. Zeltzman performs is ACL (anterior cruciate ligament) surgery. The ACL or CCL is a ligament that connects the bone above the knee (femur) to the bone below (tibia). Due to injury, age, or being overweight, the ACL can rupture or tear. When this happens, the knee becomes unstable. Left untreated, the injury causes pain and results in irreversible joint damage and arthritis, as well as lameness. However, with surgery most dogs have a full recovery and can go back to having a happy life.
Procedures Dr. Zeltzman offers, depending on the patient, to address an ACL tear include:
- Nylon sutures (lateral suture or fabello-tibial sutures)
- TPLO (tibial plateau leveling osteotomy)
- CBLO (CORA-based leveling osteotomy)
- TTA (tibial tuberosity advancement)
Dr. Zeltzman has performed thousands of these procedures in dogs (and cats), ranging from less than 5 pounds to more than 250 pounds.
From being hit by a car to suffering a fall, there are multiple reasons your pet may suffer a fractured or broken bone. Most fractures require surgery to be repaired and a full recovery to occur.
Every joint in your dog or cat’s body has the ability to dislocate. Some dislocations are congenital, while others are a result of trauma. The most common joint dislocation for pets is the kneecap, which can actually occur in both knees simultaneously. When this happens, the kneecap slides out of the groove that is supposed to hold it in place at the bottom of the femur. Surgery is required to stop the pain and slow down arthritis.
FHO (HIP SURGERY)
The femoral head ostectomy (FHO) is a surgery of the hip. It is performed for reasons that include hip dysplasia, fractures, dislocations, or deterioration of the bone caused by congenital disease.
Other orthopedic procedures Dr. Zeltzman can help with include:
- ACL surgery (standard or extracapsular repair)
- Kneecap dislocation (patellar luxation)
- Tibial Plateau Leveling Osteotomy (TPLO)
- Cora Based Leveling Osteotomy (CBLO)
HIP SURGERY (HIP DYSPLASIA AND FRACTURES)
- Femoral Head Ostectomy (FHO)
- Hip dislocation (luxation)
- Juvenile Pubic Symphysiodesis (JPS)
- Dislocation (luxation)
- Osteo-Chondritis Dissecans (OCD)
- Fragmented Coronoid Process (FCP)
- Osteo-Chondritis Dissecans (OCD)
- Ununited Anconeal Process (UAP)
- Elbow dysplasia
- Arthrodesis (joint fusion)
- Dislocation repair (luxation)
- Ligament rupture (tear) repair
- Tendon rupture (tear) repair
- External fixator
- Plate and screws
In addition, veterinary medicine itself has come a long way, allowing pets to live longer lives. Like humans, a longer lifespan for pets translates into the potential for various diseases. Advancements in veterinary diagnostic tools have also allowed vets to diagnose cancer in earlier stages, giving their patients a better chance at a full recovery.
None of the above is meant to scare anyone, but rather to motivate you to seek regular veterinary care for your pet. The quality and length of his or her life depends on it.
WHAT TO LOOK FOR
Cancer can be found in any part of a pet’s body. The most common include the mouth, neck, chest, belly, skin, legs, and bones. While each type of cancer has specific symptoms, there are some general warning signs to be aware of, including:
- Sudden weight loss
- Unusual swelling or growths
- Wounds that do not heal
- Disinterest in food
- Abnormal bleeding or discharge
- Foul odor
- Trouble swallowing or breathing
- Persistent stiffness or lameness
- Struggling to urinate or defecate
- Loss of stamina or lethargy
Dr. Phil Zeltzman is a highly skilled surgeon, specializing in various types of pet cancer surgery. He has seen first hand how early detection can extend or even save the life of a beloved pet.
Other cancer procedures Dr. Zeltzman can help with include:
- Cisplatin beads (tiny local chemo pearls that dissolve)
- Feline fibrosarcoma
- Jaw surgery (Mandibulectomy / Maxillectomy)
- Jaw surgery (Mandibulectomy / Maxillectomy)
- Limb-sparing for cancer (osteosarcoma)
- Mastectomy (mammary tumors)
- Nasal tumors (rhinotomy, rhinoplasty)
- Tumors in multiple other locations (mentioned above and below).
Post-Surgical Veterinary Care
Dr. Zeltzman takes a holistic approach to post-surgical care, keeping in mind his patients’ wellbeing far beyond their recovery from surgery. He begins this process by considering the whole patient, as opposed to just the surgery site. This starts with a consultation provided to every owner and a discussion about the appropriate food for their pet, depending on their condition.
Regardless of the procedure your pet undergoes, you as the owner will receive discharge instructions specifically tailored to his or her needs. This includes instructions for incision care, exercise restrictions, physical therapy, medications, follow-up appointments, X-ray schedule, and bandage changes.
No matter if your pet undergoes a simple soft tissue procedure or a more complex neurologic surgery, he or she needs proper and compassionate follow-up care.
Help for Overweight Pets
Vets across the country are reporting more and more incidence of overweight and obese pets. While the reason for this is unclear, what is certain is a greater number of pets will be susceptible to joint injuries such as ACL tears, heart disease, diabetes, cancer, and more.
Dr. Zeltzman is so concerned about the rise in overweight pets that he includes food recommendations in all of his discharge instructions, in order to ensure his patients maintain a healthy weight during their recovery from surgery. In addition, he is the co-author of Walk a Hound, Lose a Pound, a practical and easy-to-read book about helping dogs and their owners lose weight and stay fit together.
Soft Tissue Surgery
Also known as exploratory laparotomy, belly surgery is performed for several reasons. They include the removal of diseased organs, removing bladder stones, taking biopsies, and removing foreign bodies. Yes, pets have been known to swallow a number of inedible items, including socks, locks, and rocks.
Dr. Zeltzman performs a preventive operation known as a prophylactic gastropexy. Meant for dogs at risk for GDV or “stomach twisting,” the surgery attaches the stomach to the inside of the belly, keeping it from twisting and possibly taking the animal’s life.
Cysts and tumors can appear anywhere on or inside an animal’s body. They typically require removal. They may also be biopsied in order to first determine if the mass is either malignant (cancerous) or benign (non-cancerous).
BLADDER AND URINARY SURGERY
The most common bladder surgery for dogs is the removal of bladder stones. For cats, it’s a procedure known as a perineal urethrostomy (PU). Male cats have a tendency to experience blockages in their urethra. When this happens several times, a PU is performed to widen the exit route.
Oftentimes, cats experience ear polyps, which are removed with various surgeries. Certain breeds of dogs, most often Cocker Spaniels, can have issues with ear infections. If the infection is bad enough, it may require a total ear canal ablation (TECA), or removal of the ear canal. As invasive as it sounds, the procedure yields terrific results, allowing pets to live ear infection and pain-free.
Dogs, mostly Labs, can have a condition that paralyzes their larynx, or voice box. While it is a stressful condition, the “tie back” surgery widens the airway and is the difference between suffocating and breathing comfortably. In good hands, the complication rate is low.
OTHER SOFT TISSUE PROCEDURES DR. ZELTZMAN CAN HELP WITH INCLUDE:
- Abdominal surgery
- Abdominal port placement for chronic effusions
- Adrenal gland removal
- Bladder (stone removal, masses)
- Colon surgery
- Diaphragmatic hernia
- Ectopic ureter
- Exploratory laparotomy
- Gallbladder (removal vs. re-routing)
- Hemoabdomen (internal bleeding)
- Incontinence treatment
- Intestinal obstruction (foreign bodies)
- Intestinal surgery
- Kidney surgery
- Liver biopsy, including “keyhole” liver biopsy
- Liver surgery
- Pancreas surgery
- Pleuro-Peritoneal Diaphragmatic Hernia (PPDH)
- Prophylactic gastropexy (“twisted stomach” or bloat or GDV prevention)
- Prostate surgery
- Spleen removal (splenectomy, bleeding masses)
- Stomach surgery (foreign bodies)
- Urethra surgery
- Uterus infection (pyometra)
THORACIC SURGERY (THORACOTOMY)
- Esophagus surgery
- Patent Ductus Arteriosus (PDA)
- Persistent Right Aortic Arch (PRAA)
- Pleural port placement for fluid buildup
- Lung surgery, including “keyhole” lung biopsy
HEAD AND NECK SURGERY
- Cheiloplasty (for excessive drooling)
- Cleft palate
- Ear and throat polyps in cats
- Ear hematoma
- Elongated soft palate
- Everted laryngeal saccules
- Eye and eyelid surgery
- Facial fold removal
- Laryngeal paralysis (“Tie back”)
- Lateral Bulla Osteotomy (LBO)
- Lateral ear resection
- Oro-nasal fistula
- Para-thyroid gland removal
- Salivary gland surgery (mucocele, sialocele)
- Stenotic nares (narrow nostrils)
- Thyroid gland removal (cat or dog)
- Total Ear Canal Ablation (TECA)
- Ventral Bulla Osteotomy (VBO)
“BACK END” SURGERY
- Anal sac surgery
- “Corkscrew” tail removal
- Perianal fistula management
- Perineal hernia
- Prepubic urethrostomy (P/U salvage or revision, urethral tear or stenosis)
- Urethrostomy (perineal or P/U in cats, scrotal in dogs)
- Redundant vulvar fold (vulvoplasty, episioplasty)
- Scrotal ablation
- Open wound management (trauma)
- Skin flaps
- Skin grafts
- Vacuum-Assisted Closure (VAC) of open wounds
- Blocked urethra (cat or dog)
- Foreign bodies
- Gastric Dilatation-Volvulus (GDV)
- Spleen removal (splenectomy)
Other soft tissue procedures include other types of hernias, soft tissue biopsies, elbow hygroma, lymph node removal or biopsy, feeding tube placement etc.
Dr. Zeltzman commonly performs surgery of the neck and back. The majority of the procedures he performs involve dogs with slipped discs in the back. While the condition can affect any dog, the breed that suffers from it the most is the Dachshund. Slipped discs in the neck can also occur. Cats can occasionally suffer from slipped discs. If your pet is suffering from a slipped disc, surgery is often necessary. Without the procedure, the pet may become partially or completely paralyzed.
Other neurological procedures or tests Dr. Zeltzman can help with include:
- Atlanto-axial (sub)luxation
- “Bulging” disc (back and neck)
- Cauda equina (L/S syndrome)
- CSF tap (spinal tap)
- Degenerative myelopathy
- Spinal tap (CSF tap)
- Spinal tumor
- Vertebral fracture and/or dislocation (luxation)
- Wobbler syndrome (cervical vertebral instability syndrome)
- Muscle and nerve biopsies
- Chiari-like malformation
- Syringomyelia workup
Pet Pain Management
For some surgeries, depending on the patient, pain medication may be administered before surgery. This could include an epidural, medication within an IV, or drugs placed directly into a joint. Regardless, the goal for Dr. Zeltzman is to keep your pet as comfortable and safe as possible.
Once your pet’s surgery has been completed, he or she will be sent home with anti-inflammatory and/or morphine-like drugs. The former is to reduce the swelling associated with surgery, while the latter is meant to manage the accompanying pain. In addition, your pet may also receive antibiotics or other necessary medications.
MEET OUR ORTHOPEDIC SURGEON, DR. ZELTZMAN!
Phil Zeltzman, DVM, DACVS, CVJ, Fear Free Certified
Phil Zeltzman is our traveling surgeon. He comes to Brodheadsville Vet Clinic when needed to perform specialized surgeries.
Why did you become a veterinarian?
Very simply, to help animals. I’ve wanted to be a vet since the age of 5. Little did I know then what I know now: being a vet is just as much about helping people. My favorite TV shows were Flipper, Daktari, Skippy the kangaroo and Lassie. Becoming a vet (and later a surgeon), has been a dream come true, and I am as passionate about my profession today as I was when I first started. When I was a kid, I read countless books about all kinds of animals, including ants, bees and German shepherds.
Do you have pets?
I only adopt rescued cats, although when I was a surgery intern, I also rescued Valentine, a bunny, after fixing her broken leg. My cats are named after delicacies: Caramel, Nougat, Praline.
What training did you go through to become a surgeon?
After 8 years in vet school, I completed a 1-year internship at the University of Georgia, followed by a 3-year surgery residency at Surgical Referral Service in Buffalo Grove, Illinois. So that’s 12 years of schooling, and I consider myself a life-long learner, so I’m not quite done! After fulfilling multiple requirements, including passing a difficult exam, I became a board-certified surgeon.
What’s your philosophy?
I don’t use fancy words to try to impress you. I prefer to use simple words so you understand me. I don’t sugarcoat things. We will talk about possible complications, not to scare you, but to educate you. The rules are strict postop, but that’s how we achieve good results. I don’t just treat a knee, or a hip, or a body part. I like to treat the entire pet, so I will also make recommendations for physical therapy, supplements, special food, and even doggy or kitty psychology, as needed. So I see myself as a “holistic” surgeon.
What is your most common surgery?
By far, my most common surgery is the TPLO (Tibial Plateau Leveling Osteotomy), a surgery to address a torn ACL. I’ve performed thousands of them, in dogs from less than 5 pounds to more than 250 pounds! The results have been very impressive. I am actually certified to perform TPLOs – not everybody is. I am also certified (and an instructor) for the TTA Rapid (Tibial Tuberosity Advancement), also to treat a torn ACL.
What other types of surgeries do you perform?
I enjoy all aspects of soft tissue, orthopedic, cancer, reconstructive, and neuro-surgery. I also have a strong interest in physical therapy, open wound management, and emergency cases. I enjoy helping with the prevention and treatment of overweight and obesity, as well as pain management and arthritis management.
Tell us something surprising about yourself
I love writing. I’m a blogger, columnist, award-winning writer and book author. I write a blog, which pet lovers can subscribe to on my website. I’ve written hundreds of articles in all kinds of magazines over the years: human medicine, science, general interest, and of course veterinary medicine.
What are some of the nicest compliments you’ve received from pet owners?
. “I wish my physician would treat me as well as you treated my dog.”
. “You would never know she had surgery.”
. “My 10-year-old acts like a puppy again.”
For more information about Dr. Zeltzman, please visit his web site: www.drphilzeltzman.com.