Gabbar – Osteofighter!

It has been just over a month since Gabbar’s surgery. I have been meaning to write about this for a while. I finally find myself and Gabbar in a place where I feel I can share his story, and perhaps, doing so will help other pet parents who may find themselves and their furry kid in a similar situation. This is a long post, so please bare with me. Some of you may have followed his story and my updates from a month ago.

Who?

We live in Mumbai, India. Gabbar is our 8-year-young Labrador Retriever. For me, he is the epitome of innocence. Most people don’t believe he is a Labrador because of how thin he is, how active he is, and how fast he runs. He isn’t gluttonous, he sure as hell isn’t lazy, and he isn’t chubby. But yes, he’s a Labrador. He’s full of life and love.

How it began.

About a month and half ago, as many of you would know from my earlier post, Gabbar started limping. It was sudden. There was no physical trauma, or accident. My wife took him and his sister Suzy for their morning walk at 6am. It was an uneventful walk. He peed. He pooped. And when they came back home, Gabbar began limping, holding his front-left leg up, finding it painful to put any weight on it.

Now this is something that tends to happen with dogs, especially overactive ones like Gabbar. Either they exert themselves. They jump off the couch or the bed. Usually, these things sort themselves out in 2-3 days without any medication or any measures taken. Kind of like a muscle pull or soreness that humans experience. When it didn’t seem to get better, we took him to the vet. The vet said he would be fine. That he probably injured himself, and that it would sort itself out in a few days. She prescribe a painkiller (Meloxicam) for 3 days. Over the three days, Gabbar seemed to be getting better. He was able to put some weight on his leg. He seemed to be walking fine too.

And then, one morning, he spotted his favourite toy that had been out of his sight for a few days. He ran, jumped, got hold of the toy, and started limping again. Little did I know at that moment that this toy, that made him limp again and put him in a lot of pain, could have possibly saved his life.

We felt that Gabbar probably exerted himself before getting fully healed. So we gave it a couple of days. When the limp didn’t get any better, we took him to a different, reputed vet with a very resourceful clinic. They vet took a few X-Rays to check for a fracture. There was nothing alarming in them. Some light degradation of the bone was visible, which we were told was possibly due to the fact that Gabbar was now a senior dog. Gabapentin was prescribed for the pain, albeit low dosage, and a spray to be applied with warm fermentation. We were told to give it 4-5 days and if it didn’t improve, to come back.

5 days passed, and Gabbar’s limp got progressively worse. He was in pain. He could no longer rest any weight on the front left leg. He would drag it along as he hopped on three legs. He particularly had pain at a specific point on his front-left shoulder. He would wince and squeal in pain when touched there. Below is a video of Gabbar’s condition and inability to walk during that period.

https://youtu.be/bGil7a2nmdU

This is a picture of the spot (marked by X) where the pain was.

The Diagnosis

It was then that when a friend and I were sharing stories about our unwell dogs that she recommended we see Dr. Chousalkar. We took Gabbar to him. He took another round of X-Rays of the leg and shoulder from different positions and angles. Other than age-related degradation, the X-Rays showed nothing wrong. He suspected a nerve-related issue, and referred us to Dr. Deshmukh, who is a neuro-specialist. Dr. Deshmukh suspected that it may be an issue with the cervical spine and arranged for an MRI to be taken the same evening. When taking an MRI, there is a preliminary scan, which is followed by a more detailed one. During the preliminary scan itself, he was able to see that the spine was fine, and decided not to proceed with the rest of the MRI. He instead took Gabbar into the next room for a CT scan of his affected shoulder.

The following evening, the CT Scan results came in. Calcification of the bone was detected. The report said that the results were suggestive of Osteogenic Sarcoma (known more commonly as Osteosarcoma). I had no idea what that was. And then came google. And then a feeling like someone had just shot me in the chest and stabbed me in the gut.

Osteosarcoma is a type of bone cancer. One that is excruciatingly painful, and spreads very fast. This is unlike other cancers where you may physically spot a tumor, which then gets detected as cancerous, and you have some time to act before it can do more damage. Here, you don’t notice any symptoms because the tumor is inside the bone. It eats away at the bone slowly until the bone is so weak, that a very minor trauma (in Gabbar’s case, a simple run and jump) can suddenly turn very painful. Dr. Deshmukh in fact explained the pain by asking me to imagine a tiny explosion inside the bone at multiple intervals. Osteosarcoma usually can be detected in basic X-Rays itself. Usually, you do not need to go to an CT Scan level to detect it. In Gabbar’s case, the X-Rays did not show anything.

Gabbar was not Gabbar anymore. Let alone jump or run, he was barely moving. He would sleep on his mattress, and barely lift his head up. His shoulder had fallen. Tears would roll down his eyes. A wrong move in even lying down would result in pain so bad, he would let out an extended series of squeals that would last 30-40 seconds. He had by now, lost all function of that leg. But felt every iota of pain that cancer was causing in that leg.

Upon looking at the CT Scan results, Dr. Chousalkar mentioned that we had to confirm that it was cancer. Sometimes, certain infections, caused by tick fever can show similar symptoms. Usually, when the weather changes, Suzy and Gabbar have a tendency to pick up ticks. It’s usually a yearly routine. The Mumbai monsoons had just ended. I had done my round of tick removal from their coats.

A biopsy was scheduled to confirm or rule out cancer. We hoped against hope that it was just an infection. By now, I had done extensive research on Osteosarcoma. It was evident that the first step would be to put Gabbar out of pain. And to do so, the affected leg would have to be amputated.

It isn’t easy facing that option. Here is an innocent being that you’ve raised since he fit on your hand. You’ve raised him like your own kid. He means the world to you. And to be faced with the fact that the best thing you can do for him is to hack off his leg is a situation I wouldn’t want to see my worst enemy in. It was then that I found the online forum www.tripawds.com. Tripawds is a forum where pet parents, primarily from the USA have formed a phenomenal support group for parents of pets affected by cancer, mainly Osteosarcoma. My wife and I were an emotional mess. Had it not been for the amazing people at Tripawds that helped me realize I am not alone in this, that my pooch wasn’t the only one to face this issue, I would never have got through this. The people at Tripawds helped me make my decision, by giving me the confidence, with their own stories, that Gabbar would be pain-free with amputation. Doctors would not commit to how long he would live. But I learnt that he also “doesn’t have a timeframe stamped on his butt”.

It was a Saturday when the biopsy results came in and it was confirmed that Gabbar had Osteosarcoma. We spoke with Dr. Chousalkar, who asked us to evaluate the situation. When doing the biopsy a couple of days back, he had also taken an X-Ray of Gabbar’s lungs. Because the shoulder is so close to the lungs, the cancer can easily spread to them, which can be fatal. Thankfully, the lungs were clear. Dr. Chousalkar informed us that if the cancer had spread to the lungs, he would have advised us to take a couple of weeks, put Gabbar on heavy painkillers, spend some quality time, and then put him out of his misery by helping him cross the rainbow bridge. However, because the lungs were clear, amputation was an option. That we had a chance to give him a chance. We scheduled the surgery for the following Thursday and left with a heavy heart.

The Fight

Till Tuesday morning, my wife and I spent every minute wondering whether we were making the right decision. During these days prior to surgery, Gabbar was prescribed a heavy dose of pain medicine. He wouldn’t eat himself, and I had to hand-feed him and on some days, literally force the food down his throat so that I could give him his medication. Below is a picture of how he was during these days:

Then on Monday, there was a moment when the pain got unbearable. He wailed. I cried. I called Dr. Chousalkar who immediately asked me to put him on a heavier dose of Meloxicam. The Meloxicam dosage took away all the pain. We had rented a human wheelchair by then. I would place Gabbar on the wheelchair, wheel him downstairs to his pee/poop spot, and carry him off it. He would slowly do his business and I would carry him back onto the wheelchair and wheel him home. It was a bit of an ego issue for Gabbar. You see, he is a proud old man. He won’t pee in diapers. He won’t pee in the house. I even tried taking him into the bathroom, but he wouldn’t pee there either. Below is a video of Gabbar sitting on his human wheelchair:

https://youtu.be/U8rrgZNFTEE

So that morning, after the Meloxicam took the pain away, Gabbar, still unable to use that leg (it was dead by now, except the pain part) was helped off his wheelchair. I let him down in his spot. I didn’t put him on a leash, thinking, “Where’s he going to run in this condition?” He looked left. He looked right. And then started running. I had to go catch him. Then made him pee. Then he sniffed around, and then jetted! Started running again. He was telling me something.

He was telling me loud and clear that it isn’t over yet. He was telling me, “Take my pain away, and I will fight!” And that was when I realized how important that amputation was going to be.

The Amputation

Thursday came. We took Gabbar in for his surgery. Dr. Deshmukh, who had been managing Gabbar’s pain in the days prior to surgery had asked us to take Suzy along as well. In case there would be blood loss during the surgery, Suzy could be an on-call donor. I placed Gabbar on the operating table. I kissed him, asking him to be strong. But I was asking myself to be strong. I knew he was beyond strong. Dr. Barry, the specialist surgeon who works with Dr. Chousalkar administered the anesthesia. Gabbar slowly got drowsy and as he fell asleep, I was asked to leave. It was a nervous few hours as my wife, Suzy and I waited outside. After 3 hours, Dr. Barry came out and told us Gabbar was doing fine and that we could see him in about half an hour. As my wife waited at the clinic, I drove Suzy back home. By the time we reached him, my wife called me and said she was with Gabbar and that he was fine. He was drugged, almost unconscious, but wagging his tail on hearing her voice.

I drove back to the clinic. I entered the room where my wife was waiting with him. He was wrapped in a towel, almost unconscious, heavily drugged, as can be seen in the picture below:

And then the towel was removed. I broke down. To have taken the decision to amputate his leg, and then to sit there and see the results of that decision, to see that leg gone was probably the most gut-wrenching moment of my life. It took me a while to get myself back together. But my wife told me, that if Gabbar was going to fight this, we have to help him believe that everything is normal. We cannot cry in front of him.

Dr. Barry came in, said Gabbar was doing great, and that he deserved a little ice-cream treat. And that’s what he got. Some things never change, like the love of ice-cream. Here is Gabbar lapping up a cup of ice cream literally a couple of hours after surgery:

https://youtu.be/iYN6cKbJD7s

The Recovery

We were told that Gabbar would take a couple of days to get back up on his feet and moving around. He would take some time to adjust to his new life on three legs. I couldn’t tell if he was in pain or not. He was heavily drugged. I carried him to the car. We drove home. His mattress had been set up. I carried him in all the way from the car. He was barely able to hold his head up. We placed him on the mattress. Made him comfortable. Suzy came in, sniffed around. She knew something was different. She didn’t bother Gabbar. She just lay down near him quietly. He was drowsy. He slept on my lap for a while.

My wife and I came to our room. It had been a long, exhausting day. I cracked open a beer and just wanted to lie down for a while.

And then suddenly I heard tail slapping against door. At first I thought it was Suzy. And then I heard what sounded like two tails slapping against a door. I got up and walked out of the room.

There he was. 7 hours post surgery. Gabbar was up on his feet and Suzy seemed like she was whispering something in his ear. One has to see it, to believe it:

https://youtu.be/NCTg3SSpFnc

and this:

https://youtu.be/zPbD7s2pb3U

Sure he had some surgical pains. But that horrible pain that was exploding in him repeatedly was now gone.

The Road Ahead

During the surgery, Dr. Chousalkar had harvested a lymph node to check it for any malignancy. Fortunately, the lymph nodes were cleared of malignancy, which means the cancer has not spread much into his body. Yes, there will be some spread on a micro level. Usually, this metastasis, depending on severity is combated by Chemotherapy. Chemotherapy has been a debatable topic. Some studies have shown that in cancer-affected dogs, those receiving chemotherapy did not have a significantly more prolonged life than dogs not receiving it. In some individual cases, chemo has worked. In many, it had only lead to a series on unfavourable side effects.

My wife and I made a decision that day. We don’t know how much longer Gabbar will live. But however long he lives, he will live pain-free, and we will make sure he is happy and comfortable. We made a decision that we would not put him through the ordeal of chemotherapy and would pursue a holistic, natural approach to keep residual cancer cells in check.

Gabbar’s diet has now changed drastically. He is now on a carb-free, grain-free, protein-high diet. We are pursuing natural options such as turmeric golden paste and raw garlic. Cancer cells feed off carbs and sugar. So the most effective way to keep them in check is to starve them by curtailing carb and sugar from the diet. You can read more about the benefits of turmeric and raw garlic for cancer-affected dogs in the following links:

http://www.turmericforhealth.com/turmeric-for-pets/7-benefits-of-turmeric-in-dog-osteosarcoma

http://www.dogsnaturallymagazine.com/garlic-for-dogs-poison-or-medicine/

We are now 16-days post amputation. Gabbar is healing better and we are healing with him. He gets excited about walks. When he goes for a walk, he doesn’t want to come back home and throws a tantrum every single time because he wants sniff around and chase cats. And every time he throws a tantrum, it only makes me happier. We’re focusing on cherishing every minute we spend with him. And he in turn has realized that he can get away with anything. My parents are visiting. If anyone is sitting around. he will ask us to sit on the floor so he can lie down with his head on our lap. He wakes his grandparents up at odd hours. And they give in to his demands. He’s abusing his situation, and is getting away with it. And we are more than happy to let him get away with anything.

Suzy has been a rockstar through all this. When he was in pain, she would lie down protectively next to him. She wouldn’t steal his food, or his toys. After surgery, she would do the same. An accomodative, sympathetic distance. And when Gabbar started to get better, and adapting to his new lifestyle, well, she decided enough was enough. Now we’re back to normal. It’s all fair game. She’s bullying him again, stealing his food, his toys, his bed. No mercy! And I think Gabbar prefers it this way.

Below is a video of Gabbar as of this evening. 16 days after surgery. Smile back on his face. Taking life head-on.

https://youtu.be/rzxvI-fQaV0

Gabbar is the bravest pup I’ve ever known. All his life, we would make fun of him for being a “darpok” or sissy. A slight rumble of thunder would scare the wits out of him. A little growl from Suzy would cause him to run and hide. But he’s braved, is braving, is fighting what none of us would have the courage to. He doesn’t harp about the past where he had four legs. He’s not worried about the future. Today, he’s got three legs, and he’s going to figure out how to run, hop, jump, get his toys, get his treats on them. There’s a lesson here for all of us. Here is a dog who was always healthy, always active, barely ever ate packaged commercial dog food, was fed freshly cooked food everyday, diet in control, had his share of exercise, a loving household, and yet was hit with cancer. It makes no sense. But it doesn’t matter to him. From Gabbar we can learn that no matter what crap life throws at you, you just have to live in the moment, you just have to keep moving forward.