by Dr. Rodrigo Roca
As a veterinarian who is passionate about diagnosing and treating lameness, I’ve found that one of the most difficult parts of the process isn’t the diagnosis or even the treatment—it’s managing owner expectations. Pet owners, like any paying clients, naturally expect results. In many cases, they expect full recovery. But the reality is, 100% recovery is not always possible. Sometimes, it’s not even close.
Yes, there are situations where a pet can return to full function. A straightforward transverse radius and ulna fracture, for example, might heal beautifully with the right care. But outcomes depend heavily on the nature of the injury and the skill of the surgeon. Even a good prognosis can be derailed by complications—imagine a case where the fracture is repaired, but the limb is rotated improperly. That pet may walk, but never normally.
More commonly, we face chronic or complex conditions that simply don’t have perfect solutions. Consider the middle-aged Labrador with elbow dysplasia, the one-year-old German Shepherd with hip dysplasia, or the expensive French Bulldog puppy with a lateral condylar fracture. Despite advances in surgical techniques—custom elbow implants, total hip replacements, intraoperative imaging—these patients often still face lifelong issues: arthritis, implant failure, infection, or the possibility of amputation.
The greatest risk, in my experience, isn’t the procedure itself—it’s promising too much. When we understate the risks or oversell the outcome, we set ourselves and our clients up for disappointment. And few things are more difficult than dealing with an owner who is upset—not just about the outcome, but about feeling misled.
I’ve often said a TPLO will restore a dog to 99% function. But is that really true? Research by Tingas et al. shows that up to 30% of TPLO patients still experience instability. Pozzi et al. found that all TPLO patients retain some tibial thrust during internal rotation testing. These aren’t failures, but they’re far from perfection.
We should be transparent with owners: musculoskeletal disease is often debilitating, and interventions, while helpful, aren’t magic. Still, most of us would agree that doing something—whether that’s a TPLO, a fracture repair, or a coronoidectomy—is better than doing nothing.
Or is it?
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