Tenotomy and Tenectomy in Dogs

Tenotomy and tenectomy are surgical procedures used to treat conditions which cause inflammation of the tendon. Tenotomy involves detaching the affected tendon from the bone. Over time, the tendon will heal on top of the bone. Tenectomy involves removing all or part of a tendon due to disease. Tendon inflammation most commonly occurs in the tendons of the biceps. This condition is then known as bicipital tenosynovitis. However, tendon inflammation may occur in many tendons in the body. Large, athletic dogs have a higher chance of developing tendon inflammation.

The procedure steps for both tenotomy and tenectomy are described below.

Tenotomy

This procedure may be performed with a scalpel or with an arthroscope. The chosen instrument will vary based on the surgeon’s expertise and preferences, as well as the equipment available at the veterinary hospital.

1. Prior to surgery, a veterinarian will conduct an arthroscopic examination of the affected tendon to confirm the diagnosis and determine if it needs to be treated surgically.
2. Blood work will be conducted to make sure it is safe for the dog to undergo anesthesia.
3. The dog will be anesthetized. The operative area is shaved and cleaned.
4. An incision is made into the skin and subcutaneous tissues near the torn tendon.
5. The affected tendon is detached from the bone. Diseased tissue will be removed at this time.
6. Over time, the tendon will heal on top of the bone.
7. The incision site is sutured.

Tenectomy

1. Steps 1-4 from the tenotomy procedure are repeated for tenectomy.
2. The surgeon will determine which portion of the tendon to remove.
3. The selected portion of tendon, or the entire tendon, is removed.
4. The incision site is sutured.

Tenotomy is usually very effective, particularly for treating bicipital tenosynovitis. Surgery is usually more effective in resolving chronic tendon injury and other conditions compared to conservative methods. Although it is more effective than conservative treatment, the recovery process will take much longer and usually requires physical therapy.

Dogs will need to rest following surgery according to surgeon instructions to avoid injuring the tendon. Leash walks may be suitable for elimination purposes. Dogs will be given pain medications, and may need to wear an Elizabethan collar to avoid aggravating the stitches. Physical therapy is typically required to restore full function to the tendon. A follow-up appointment will be made within two weeks following surgery to remove the sutures. Additional appointments will be scheduled on an as-needed basis to assess healing and administer physical therapy and other treatments.

The cost of tenotomy and tenectomy will vary based on standards of living and additional costs incurred. The cost of tenotomy and tenectomy typically ranges from $500 to $5,000.

Dogs may walk abnormally during the first few weeks of the recovery period, and may not bear weight on the affected limb. This is normal, and usually resolves on its own.

Tenotomy and tenectomy may not resolve the underlying condition on their own. Additional treatments which may aid the healing process include:

• Electrical stimulation therapy
• Exercise therapy
• Ice pack therapy
• Medication
• Nutritional changes

The surgeon may recommend any of these in conjunction with tenotomy or tenectomy to relieve the dog’s discomfort and restore function to the tendon.

Complications with tenotomy and tenectomy, although rare, are possible. These include postoperative infection, tissue damage, and anesthetic death. When the procedure is performed with an arthroscope, infection is considered extremely rare, and the risk of tissue damage is decreased. Anesthetic death is rare in animals that have been evaluated for anesthetization prior to surgery.

Owners should monitor their dog’s outdoor activity carefully, and prevent them from engaging in activities that may result in tendon injury. These include falling from heights and overstretching the tendon. Even with close monitoring, the condition may still occur, especially in large dogs that are highly athletic. Tendon inflammation that is secondary to congenital defect is difficult to prevent. Dogs diagnosed with congenital conditions should not be bred.