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!

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!