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Wednesday, November 7, 2018

Surgery To Remove A Nasty Oral Mass

Comet is my thirteen- and- a- half year old male Lhasa Apso. We noticed an oral mass in his mouth in May 2018. It was probably there for quite a while before that.




The Much Dreaded Event 
Comet's oral mass had grown too big by the end of September. It used to bleed almost every day. It was probably infected too, because he had a mild fever. It also prevented him from eating. Comet had to be fed at this stage. The food had to pushed into his mouth from the side. 

And even though I had hated the idea of putting him through surgery, there seemed no other option left. I had also tried homeopathy, to no avail. 

I dreaded having to put him through the surgery, for the simple reason that he is almost fourteen years old. Apart from that, he's sensitive, delicate, temperamental, nervous, and high-strung. Also, I knew that he would probably lose half his lower jaw and there were no guarantees that the tumour would not grow again. But what option did I have? 

Comet's doctor also convinced me that I had no option but to get the surgery done. He said that they would run all the necessary tests to check if Comet was fit for surgery first. During the surgery, he would be treated as a geriatric patient and given special care. After the surgery, he would receive drip for about three days. He would be given pain killers, but would not be completely pain-free for the first two days after surgery. He would start eating and drinking by the second day, even with part of his jaw missing. Well, my consolation was that Comet would be in good hands. They were being thorough. Everything was explained well to me, in detail, with diagrams. 

A comprehensive blood test was done to ensure that Comet's liver and kidneys were functioning well, and that his hemoglobin was fine, besides other things. An X-ray of his chest was done to see if his lungs were fine since the vet suspected that the tumour in his mouth was cancerous and the cancer might have already spread to his lungs. An X-ray of the skull and throat was also done to see the extent of the tumour and to check how bad his collapsed trachea was. ( An x-ray done a year ago had revealed a collapsed trachea.) Miraculously the collapsed trachea was not collapsed any longer. (The joint supplements must have helped to rectify the problem.) The results of all the tests were obtained in the next two days time. Everything was fine and Comet was cleared for surgery.

The surgery was scheduled for the 23rd morning. I had to keep him fasting for twelve hours before that. Phew!!!!!

The Day Before The Surgery
This was a day full of apprehensions and anxiety for me. I could barely concentrate on anything else. Of course, Comet was oblivious of what was to come. I was on pins because I had to make sure he ate his dinner and drank water before 8 pm, since the surgery was scheduled for 9 am the following morning and we had to take him there by 8 am. I managed that. Then I hid his water bowl. He woke up as usual in the middle of the night and went looking for his water. It broke my heart to watch him search for it. Then, confused, he went back to sleep.

The Nerve-Racking Day of The Surgery
I took Comet for his usual walk at 5.30 am. When he got back home, he went in search of his water bowl again. When he couldn't find it, he pushed his nose into the fan which is always close to where his water bowl is kept. (Maybe the fan took the water away!) He sat down with a sigh, then followed me to the kitchen, and asked for tea since water was not available. He looked for water everywhere. It was so sad to watch him do that.

We reached the hospital at 8.30 am. He was put on drip immediately. He was his normal cheerful self. I had read all about these kinds of surgeries so I expected Comet to be given a sleeping dose first and then wheeled into the operation theater. I didn't mind that. He would fall asleep with us near him. But that is not what happened.

The procedure was explained to me again. I asked the surgeon all the questions that I had written down so carefully, and got all my answers. I was asked to read and sign the consent form.

 In no time, the Elizabethan collar was put around Comet's neck and he was wheeled into the prep room, where he stood on the table and wagged his tail at the attendants. I couldn't bear that for some reason. That's when I began to cry. I stood outside the glass doors of the room and wept. I was asked to go downstairs and sit in the waiting room. The surgery would last about an hour. I didn't want to leave but the nurse convinced me that it would upset him if I stayed close by and he could smell me. So, I reluctantly went downstairs. I looked at every sick dog and cat, and even a sick duck, and cried. I just kept crying till the surgery was done and Comet was in recovery. Then I crept upstairs and peeped at him and ran downstairs again. He was sitting quietly in his cage with the cone around his neck.

The surgery was a success. The surgeon brought the tumor out and stuck it in my face to see. The huge mass with the teeth, was in his hand. He's lucky I didn't faint from the shock. He said he had managed to make a clean cut and take off extra tissue from around the mass. And of course, Comet had lost the front part of his lower jaw bone. The surgeon had inserted screws to keep the two parts of the jaw bone in place. He said it was needed to make Comet's jaw look presentable. He had decided to do a bit of reconstructive surgery for aesthetic purposes. He had also cleaned all the rest of Comet's teeth while he was under anesthesia.
The oral mass was sent for a biopsy.

After about half an hour we were allowed to meet Comet. He sat in his cage with a clean white towel under him and the cone around his neck. He eyes were half closed and he couldn't keep his head up. We were told that the anesthesia would take another 24 hours to wear off completely. His face and neck area was shaved clean. It would take some time to get used to his new look. When he saw us he began to cry weakly. So the doctor asked us to leave again. It was another hour before he was discharged. He cried that entire hour. We then took him to the terrace and sat there with him. It was around 12 noon. He was to get another session of drip and pain killers at 4 pm. He was groggy from the anesthesia but wanted to get up and walk. He just wanted to go home. He whimpered non-stop.

At 4 pm, he received another 300 ml of saline with B-Complex, pain killers and antibiotics. By 6pm, we were ready to take him home. He was supposed to wear the cone all the time to prevent any damage to the stitches.  He hated it so much. He would walk around with his head bent, whimpering continuously. We were given the pain killers and the injection syringes, and taught how to administer them every eight hours.

That night, Comet would not go to sleep because the cone was on so we took it off him and took turns to stay awake and watch him while he slept.

                                          
                                                   COMET- AFTER SURGERY 
Goodbye Oral Mass
Well, it was such a relief not to see that ugly, horrid oral mass in Comet's mouth any more. 
And now we're hoping he will recover from the surgery quickly. 

On Oral Tumors - Making The Big Decision-

Comet is my thirteen-and-a-half year old male Lhasa Apso, the most adorable creature in the whole wide world!

June 2018- Detecting the Oral Tumor
We noticed a small growth in the front lower portion of Comet's mouth.
                                                                       COMET

July 2018- Investigating the Oral Tumor
The growth seemed much larger in a few weeks so we took him to the hospital for a check up.
The vet wasn't sure what it was.  He asked if we wanted to do a biopsy.  I refused.  He said every growth needs to be removed surgically. Again, I didn't want to put him through any unnecessary procedures in his old age. He is almost fourteen years old.  He is also very sensitive and gets upset easily. 
I asked the vet what would happen if I ignored it.  He said it would keep growing until it filled his whole mouth.  He would not be able to eat any more.
 I thought I could take a chance.  What if the oral tumor stopped growing?  How sure could the vet be that it would keep growing?  And it was not interfering with his normal life activities in any way,  so I decided not to disturb him by doing any surgery.  I also really didn't want to know if it was cancerous. It would be too upsetting. So we left the growth as it was. The vet prescribed Dologel, just in case it was an abscess. 

August 2018-Trying Homeopathy
The Dologel was used for ten days but had no effect so I was convinced that it was not an abscess. The lump just kept growing bigger and bigger. In my desperation, I sought homeopathic treatment. The homeopathic doctor was confident that his medicines would work. So I tried them for two weeks but there seemed to be no improvement. I ran back to the homeopathic doctor. He changed the medicines and asked me to try them for another two weeks. There was still no improvement. 

September 2018-Things Take A Bad Turn
By now I was quite desperate. The oral mass in Comet's mouth had turned so big that he could not close his mouth and eating had become difficult at this stage. I was so upset about it. I hated the thought of putting him through surgery. Yet, it seemed like I was left with no option. I sat and stared at him for hours, wondering what to do. By the end of September, the oral mass began to bleed very often because it kept rubbing against things. His front teeth had lifted with the tumor as it grew upwards. He got fever. I realized that things had taken a bad turn now. The growth was probably infected. I had to act soon.

October 2018-Making The Decision To Remove The Oral Mass
I visited the vet again. He said I had no option but to get the surgery done, even if the growth was cancerous, even if it would reappear soon, the surgery would give him a few months of solace at least. Right now he had begun to suffer due to the oral mass. He would probably lose a part of his lower jaw in the process but it didn't matter as he could not use that part even with the tumor. That was another horrible thought. I was afraid that Comet may not be fit for surgery. He also had a collapsed trachea. The vet said that they would perform all the necessary tests on him first to ensure that he was fit for surgery and only then would they go ahead with the surgery. I was also apprehensive about how fast Comet would recover. The vet convinced me that they would take care of all that.

And so, with no options left, I decided to let Comet have the surgery to remove the disgusting oral mass that had invaded his mouth and our lives!