Seven Months Post Tumor Removal

May 2019

Seven months have passed and I still have my Comet with me. It's a blessing.

He has his old age problems, no doubt. His collapsed trachea makes him cough on exertion, his slipped disc makes it hard to get up from lying down position, he is almost completely blind and can only see light and shadows now. He is taking his joint supplement every day.

I am enjoying Comet so so much. He is so spoilt that he roams around the house barking at us to give him what he needs. Two months ago, I decided to give him the tasty chicken that I cook for all of us. he loves it so much. Why should I be careful about his diet any more? Let him enjoy the rest of his little life. He will be seated one foot away from the water bowl but will bark for someone to bring it to him. He wants to be fed milk in someone's hand, he will bark at us at midnight if hes uncomfortable and wants the AC on. he gets everything he wants now. I know that his time with us is limited so let him have it all. There are no long walks around the block any more. For the past five months, he only walks around outside the house. Once a month or so he takes me for a longer walk. His sleeping patterns are almost the same. Except that his hearing isn't so good so he doesn't wake up with every little sound. I can sneak out of the house easily because he can't hear me open the cupboard and dress up any longer. He wakes up completely around six or seven pm. After that hes awake and alert till midnight, acting like a young puppy, bouncing around the house and making various demands. He's just so adorable. 

Another Horrible Observation

March 2019
Five months past surgery for tumor removal.

Comet was doing well. He was alert and active, eating well, spoilt as ever, and a happy little old dog.

One day when he was sitting outside, we noticed that the metal brace that had been put in his lower jaw to hold it together during surgery was visible. I got crazy and made a frantic call to the vet. he said that if the brace could be seen it had probably dislodged and he would need to remove it. He told me to fix a date for the surgical removal, make sure Comet fasts for eight hours and bring him for the surgery. I made the appointment.

The night before the surgery, we decided that we should not put him through that unnecessarily. The brace was not troubling him so why put him through anesthesia and all the other problems associated with surgery. I cancelled the appointment. I made the decision to get the surgery done only if it troubles him in some way. In the days that followed, we noticed that it was his lower lip that had moved to expose the brace. The brace was not dislodged at all. I was so happy we had not got the surgery done.

We kept watching it carefully and there seemed to be no problem at all.

April 2019

Comet was due his inoculations so we took him to the hospital. His surgeon was on leave so I spoke to another vet. She said that I should watch the brace carefully. If it causes any bleeding or infection, I need to get it out, otherwise I should not bother him with surgery. I was grateful to her for that advice that put my mind at ease. 

October 2019

It is one year past Comet's surgery. The brace has not troubled him at all. It is more visible to us, but that's it. 

Third Month Check up -Post Tumor Removal

COMET, THE SCHOLAR

Comet's Third Month Check-Up Post Surgery

Comet went to Cessna for his third check-up.

Testing

The x-ray and blood test was done. X-ray showed that his lungs were fine. The cancer had still not spread. His heart was slightly enlarged but not a cause for concern.
When the results of the blood test came in, I was stunned. The anemia had disappeared on its own, lymphocytes were normal again. I had no idea how that happened. Obviously, whatever was wrong had rectified itself. His platelets were low and that worried me even though the vet was not worried. he said that platelets show different values and unless there are external problems, one should not worry about it. But Comet had a history of Tick fever. He had had it about four or five times and it nearly took his life twice. I could not take a chance. So the vet asked me to bring him back for another blood test after a week. I went downstairs to pay the bill, while my son took Comet for a walk outside.

A Horribly Scary Incident

 Suddenly, Comet collapsed. He fell on his side and could not get up. My son thumped his chest. I grabbed him and ran back up the stairs to the vet. The Vet said that his heartbeat was very slow. He gave Comet an injection and said that he would recover slowly. Since I was coming to do the blood test after a week, i could get an ECG done as well. My poor Comet could not even lift his head up. His body was limp. His eyes were dull and glazed. I waited with him on the recovery table till I saw his eyes becoming more alert. Then I knew he was recovering. The doctor said that he did not know why this happened. If it happened again, I should take into account what led to it. The only thing I could think of was that he was probably exhausted with the long journey to the hospital. (45 mins by auto).

Recovery

 By the time I left the hospital, he could lift his head. Slowly, in the next hour, he started lifting his upper body. In about three hours time, he was moving around again. But he was very tired and slept extra the next three or four days. the doctor said that it was his way of helping recovery so I should not worry. After that he recovered well and the incident did not happen again, even though the doctor cautioned me that it might. I kept some glucose handy and told everyone at home how to deal with it in case it happened again.

The Next Check-Up

One week later, I took Comet for his blood test and ECG. The platelets were fine and so was the ECG. I was thrilled. He was his alert, normal self by then and the vet said he could not even believe what had happened the previous week. The episode was definitely not caused by a weak heart. We know that now. 

Second Month Check Up Post Surgery

Comet-Enjoying the view !

Comet was fine since his surgery. he ate well, was active, slept well, and didn't seem to have any physical problems.

Comet's lower jaw is visible with the suture line.

Lack Of Appetite
29th December, 2018
Comet was his usual cheerful, active self, except for the fact that he was not as ravenous as he had been every day since the surgery. He did eat his meals, but not with the same amount of enthusiasm. That got me worried.

This continued for a few days. His lack of interest in food kept getting worse, although he was normal in every other way. He still demanded for food and attention, was enthusiastic about his walks, still yelled at everyone for not paying enough attention to him, etc.

Comet Ate Better
4th January, 2019
This was the first day since the 29th of December that Comet showed the normal ravenous interest in his food and ate very well. That took my worry away. I presumed it was an upset stomach or something.

Things Go Wrong
5th January 2019
During his morning nap, I noticed that he was shivering. Although it was a cold day, Comet is a Lhasa Apso with a fair amount of fur to keep him warm so he should not be shivering in the cold. I sat and watched him for awhile. He was sound asleep. In fact, he was in such a deep sleep that he became unresponsive. I tried waking him up but he wouldn't budge. I thought he had passed on. That really worried me. The lack of enthusiasm in his meals for the past few days, his shivering episode and his unresponsive deep sleep forced me to take him for a check up. I needed to know what exactly was going on and decide how to deal with it.

When I managed to wake Comet up, he stared at me for a few seconds, realized that I was dressed up and had my shoes on, and then jumped out of his bed and ran enthusiastically to the front door. His recovery was strange.

Comet Goes To The Vet
Anyway, I took him to the hospital and explained what had happened to the vet.

Comet's Problems
On examination, the vet found that Comet is suffering from cardiac arrhythmia. This means that his heart beat is irregular. The vet said that it is characteristic of old age and if he has no related problems, we should not bother too much about it.

Surprisingly, Comet did not have a temperature so we don't know why he had been shivering.

Swollen and Painful Lymph Node
The vet also found that a lymph node in the right side of his neck is swollen and painful. This was another cause for concern.

Chest X-Ray
A lateral chest X-Ray was done and thankfully Comet's heart and lungs are of normal size. The lungs were clear, which meant that the cancer had not spread yet.

Comet's Chest X-Ray visible on the computer screen

BUN Levels Elevated
A Geriatric blood profile was done to try and figure out why there was a change in Comet's appetite. His BUN levels are slightly elevated so the vet asked me to put him on a kidney diet for some time.

Fear of Anemia
Also, his hemoglobin levels which were borderline low at the time of the surgery are even lower. I am worried that it will lead to anemia. However, the vet feels that this is not really a cause for concern as it's not that low. But I am worried because it has dropped over the past two months in spite of him being on a high protein diet.

Raised Lymphocyte Count
 His lymphocytes were high two months ago and are even higher now. It does make sense since his lymph node is swollen, but I'm worried about what is wrong. The vet said that we have to wait for another month to see what changes there are in his blood profile. Then we'll decide what needs to be done.

Well, apart from all our findings, Comet is doing very well. He's eating very well again and everything else is also fine. So, I'm not too worried about his kidney functions. The elevated BUN levels could have been due to his high protein diet.

The vet had asked us to put Comet on a high protein diet after the surgery and he should not be given any carbohydrates at all.

Back Home
So we're back to enjoying the little spoilt brat, with his whims and fancies. His next check up will be next month, unless something happens before that!

First Month Check Up

1st December, 2018

We took Comet for an X-Ray of his lungs, as we were asked to do. This would show if the cancer had spread to his lungs or not.

As usual, he was excited about the ride to the hospital in the auto rickshaw. He screamed and shouted and jumped all over until the collar and leash was put on and we carried him down the stairs.

We have been carrying him up and down the stairs for the past six years ever since we discovered that he had a slip disc and some mild spondilitis. He also has arthritis.

The X-Ray was done and the vet informed us that his lungs were fine.

He had been fine all through the past month after the initial few days during his recovery from the surgery. He was eating very well. He was enthusiastic about his walks, and had enough energy. He barked and yelled at us when he wanted to demand for attention or food. He yelled when he wanted milk, or a biscuit, he yelled at me when I returned from school every afternoon. He got all the attention he needed. He got fatter and more spoilt than ever and that made me very happy!

The Nasty Results- 'Malignant Tumor...Ameloblastic Carcinoma or Pleomorphic Adenoma'

Comet's fur is growing back around his muzzle.

Results of the Biopsy
The results of the biopsy came in on the 28th of October.  It was sad news. The tumour was malignant. The possibilities considered were carcinoma ex pleomorphic adenoma or ameloblastic carcinoma.

Carcinoma ex Pleomorphic Adenoma
This is also called a malignant mixed tumor, carcinosarcoma or metastacizing PA. It is an uncommon tumor with aggressive biological behaviour. It is a carcinoma of the salivary glands.

Ameloblastic Carcinoma

Ameloblastic Carcinoma is also rare. It is an aggressive malignant epithelial odontogenic tumor that arises in the maxillofacial skeleton.

 So, Alas! My Comet developed a rare kind of cancer that is aggressive and will surely spread.

The Vet's Prognosis

The vet said that there was a possibility that another oral tumour would come up and if and when it did, Comet could not have another surgery. Also, there was a possibility that the cancer cells would travel to the lungs so he should have a chest x-ray done once a month. We could try to give him Ocoxyn syrup to delay the cancer from spreading as much as possible. But Comet will not take syrups.

My Thoughts

I just don't want him to suffer at all. I know he's old and he must go one way or another, but it's just so hard to accept. I decided not to worry about the future and to enjoy every day I have left with him. I decided to spoil him even more than I already do. 

Comet's Recovery After Surgery To Remove His Oral Mass

Celebrating Christmas With Comet

( Never Thought He'd Make It)

Comet is my thirteen-and-a-half year old male Lhasa Apso who delights me round the clock!
He had surgery to remove an oral mass on the 23rd of October, 2018.

The Day After The Surgery 

24th October, 2018

We took him to the hospital for a check up and his drip. He had not even tried to eat or drink water. He was given 300 ml of saline again, with B-Complex, pain killers and antibiotics. He had no interest in going for his walk either. He walked around with his tail between his legs and a confused look in his eyes. The vet said that he would have a certain amount of pain in spite of being on pain killers. So that was understandable. He was sedated for ten minutes and his mouth was examined and cleaned thoroughly. The sedation was a scary experience for me because of the way he became unconscious in a second. 

Back home, he still kept whimpering when the cone was on so we kept it off as much as possible, and watched him. We noticed that he became restless about four to five hours after the painkiller injection was given. The effect was probably wearing off. As soon as the next injection was given, he would calm down and go into a deep sleep for a few hours. He did not eat all day. He did go to his water bowl and stand there, put his head down as if he wanted to drink some, but then lifted his head again.

 The vet informed us that he would need to get used to his new mouth. Now that the oral mass was removed, and he had lost half his lower jaw in the process, his mouth probably felt very different. He had also lost about ten teeth. 

The grogginess from the anesthesia wore off by the evening. He looked a little more alert and less disoriented. 

Again, we took turns watching him while he slept because he didn't want the cone on. 

Comet Has Not Started Eating and Drinking Yet

25th October, 2018

Comet had his regular drip session in the morning. He kept whimpering all the time. Even if the hospital waiting room, he would cry softly, non-stop. The vet examined his suture line from the outside and said it seemed to be healing well. Comet should start eating and drinking by this evening. I was asked to grind his food from now on because his teeth were not aligned properly any more so he would not be able to bite and chew.

However, Comet is not like any other dog. His recovery is taking longer than it would in any other dog. He did try to drink a little water but ran miles from food. He still did not feel like walking. But he looked more alert. The vet said that by now the pain would have gone completely so we were to give the injection only if required. But we gave it because he seemed to need it. He kept whimpering when the previous dose wore off. 

Comet Finally Drank Some Water and Ate a Little

26th October, 2018

Comet had his regular drip again. He was still whimpering the entire time. The only time he would be calm and not crying would be when he was at home. He would sleep peacefully until the pain killer wore off. Then he would become restless.

The vet was now concerned that Comet had not yet started eating and drinking on his own. He did a blood test to check if there was anything else wrong and preventing him from eating and drinking. His blood work was normal so that was ruled out. He was given a shot of prednisolone (a steroid) to stimulate his appetite.

By evening, Comet was much calmer and happier. He did not whimper at all and did not need the pain killers. He showed more interest in his walk.

At night, he began to drink water on his own and even ate some food. We were very happy but just hoped that it would continue after the effect of the steroid wore off.

Comet Is Eating and Drinking Again

27th October, 2018

The vet was not satisfied with the amount that Comet had eaten the previous day so he was given drip again, with all his medication. No more pain killers were given. The suture line was cleaned from the outside, without sedation.

Comet was more himself today. The whimpering stopped completely. He drank water in excess and ate very well

He's back to his old self, wagging his tail, running around the house, eating and drinking very well, walking well. 

Comet Is More Himself

28th October, 2018

Now that Comet is eating and drinking normally, he was given only 100 ml of drip and his last dose of antibiotics. His sutures were examined and he was sent home quickly.

Comet took time adjusting to his new mouth and non-aligned set of teeth and I took time adjusting to how best to feed him.

Apart from that, he's back to normal but hasn't asked for his normal long half a kilometer walk around the block in the morning. 

Comet's Checkup

November 1st, 2018

Comet went for his checkup. Everything seems fine and the sutures will come off in two days time. The vet is happy with Comet's recovery. 

Time To Get The Sutures Removed

November 3rd, 2018

Since Comet would be given anesthesia, he had to be fasting again since the previous night. Again he went looking for his water bowl all over. It was so sad. We reached the hospital at 8.30 am. He was put on drip and wheeled off into the operation theater. This time he was angry and wanted to kill everyone around him. We had to wait for about fifteen minutes.

We were allowed to see him in the recovery room so we were with him when he came around. He had the cone on and an oxygen mask on, which he wanted to push off. Within half an hour, he had recovered from anesthesia and the nurse told us to take him home as being in the hospital would just raise his stress levels.

His next checkup will be in a month's time. That would be the 3rd of December. 

At Last, Comet is His Old Self

November 6th, 2018

Comet demanded for his favourite long walk around the block. He walked well and didn't get tired.

He is eating and drinking very well. He's alert, active and happy again.

Comet has made an excellent recovery!