Lager’s Rostral Mandibulectomy

Last picture I took of Lager before his surgery

October 31, 2022

On Halloween, Lager underwent surgery for a rostral mandibulectomy at BluePearl Pet Hospital in Levittown, PA with oral surgeon, Dr. Michael Jennings.

Lager hanging out under the Blue Pearl Dentistry Department’s desk as they caught up on emails and prepared for his surgery

Lager was first anesthetized for an oral exam and dental X-rays. These radiographs confirmed the mass centered on his left lower canine tooth had invaded the underlying bone along the back of canine tooth root. Dr. Jennings called us at that point to inform us of the degree of bone invasion. He recommended removal of the front of Lager’s lower jaw at the level of the left 3rd premolar and right lower 2nd premolar in order to hopefully obtain clean margins of normal tissue along with the oral tumor. Dr. Jennings informed us that this also means Lager’s mandibular symphysis (where jaw meets in “V”) will no longer be connected. We agreed to the new plan in hopes to get clean margins for Lager.

Lager received both systemic pain medication and local nerve blocks to help control any discomfort associated with his procedure. His rostral mandibulectomy was performed, and the sample was submitted for histopathology to confirm the tumor type and clean margins. Dr. Jennings explained that it’s rare, but in some cases he has seen the cancer evolve into a different type/stage, so the biopsy will confirm the tumor type and also will dictate if Lager would need further treatment after he heals from his surgery. Dr. Jennings noted that the biopsy results may take a couple of weeks to come back. Lager’s remaining teeth were also scaled and polished.

Lager also had two dermal sternal masses removed. Those of you who know Lager well and have enjoyed his enthusiasm up close/ in person know that he has had a problem spot on his chest since we adopted him that had to be expressed on a weekly basis. Although it was not easy to manage at times, the problem spot was deemed not to be concerning. However, recently the area had gotten bigger and changed in appearance so it was decided that it would be best to have this removed and biopsied while Lager was undergoing his oral surgery. The two masses on his chest were also removed and submitted for histopathology to confirm the tissue type. The surgery sites were closed with absorbable sutures and he was wrapped in a cross-your-heart chest bandage. The biopsy results for this sample should return in about a week.

Dr. Jennings called after surgery was completed and told us that Lager did well during the surgeries and had recovered smoothly. Lager had to be hospitalized overnight so that pain, anti-inflammatory and antibiotic medications could be monitored and managed. Although we knew it was best for Lager to stay the night, we missed him dearly and called every couple of hours to check on him. The staff assured us that Lager was recovering well and in good spirits.

November 1, 2022

We called to check on Lager first thing in the morning and the staff said that he did well overnight. He ate from someone’s hand and was able to lap-up water. Dr. Jennings called around 12pm and thoroughly reviewed Lager’s recovery plan and confirmed that Lager was doing well enough to come home. The drive to Blue Pearl is about an hour, so my parents drove me to the hospital to pick up Lager so that Brian could monitor Porter and Jägermeister while working from home.

Much anxiety had built up with preparing to see Lager post-surgery. Upon arrival to Blue Pearl, my mother and I were escorted to an exam room to wait for Lager to be brought out. Although I was extremely upset at first sight, Dr. Jennings entered the room with Lager happily prancing by his side. Lager’s eyes were bright and alert, his tail was wagging, and he gave me a heartfelt greeting. My heart and mind were so relieved – but this didn’t stop the tears from flowing – what an absolutely amazingly resilient soldier this warrior is! He was in such great spirits!

Dr. Jennings was amazing… I mean REALLY AMAZING…he was so patient, compassionate, and kind. He took the time to explain everything and also to offer support and reassurance that everything was going to be alright and he could already tell that Lager was going to be back to doing everything he loves to do in no time at all.

Post-Surgery Photos

Believe it or not, it was difficult for me to even get non-blurry pictures on the way home because Lager did not sit down the entire time! He barked the whole way home and actively looked out the window for the duration of the ride. Pictures below to show Lager’s new lower jaw length:

Although alarming in appearance, the large pinkish-red “bubble” you see under Lager’s tongue in the photos below is normal after a surgery like this and should go away on its own in 5-7 days:

Photos below are the best shots I have so far of Lager’s new “chin.”

“Dogs Are a Miracle With Paws” ~ Susan Ariel Rainbow Kennedy

I always say that as humans we have so much to learn from dogs. I am in awe at Lager’s resilience and ability to adapt. As you can see from the photos above, Lager’s tongue was hanging out of his mouth during our car ride home. Dr. Jennings informed us that Lager’s tongue will most likely be hanging out of his mouth for quite some time and that Lager may…or may not… adapt to holding his tongue differently so that it stays inside. Well, by the time our one hour drive home ended, Lager had already learned how to hold his tongue inside of his mouth! When we arrived home, he was able to drink water and was extremely motivated for food.

Lager after arriving home has already learned to hold his tongue differently so that it remains inside his mouth.

Lager has not even skipped a beat. He’s happy, alert, and prancing around the house – handsome as ever! Dogs truly are amazing, aren’t they? They don’t look in the mirror or focus on their appearance, and they don’t care what others think either. Dogs remind us to focus on the important parts of others – HEART and SOUL… not physical characteristics or imperfections. They teach us that you shine from WITHIN and that imperfection can impact the world in a positive way….to use your difference to make a difference. Dogs adapt, overcome, and continue to enjoy their journey despite the obstacles that may develop in their path. They don’t worry about challenges – they conquer them. Lager is living proof of this. In my eyes, Lager is an inspiration. I am grateful for the lessons he has taught me, and for the experience he has shared with me. His journey will equip me with the ability to pay it forward when someone else is faced with seeing their dog through the same operation.

Lager has to be hand fed soft food until he heals completely and adapts to eating / drinking with his shorter lower jaw. On November 1st, his first night home, I used a blender to make his kibble into a powder and mixed in some wet food and water to make it “meatball” consistency. I made little meatballs and although I was proud of how well the prep went, I’m not going to lie … our first attempt at properly delivering the “meatballs” to Lager’s mouth was quite a messy situation! The morning of November 2nd, I did a better job of creating the meatballs, and Brian figured out that it was easier to “deliver” the meatballs to Lager while standing behind him and using gravity to help Lager get the meatball in his mouth.

Grateful…Thankful…Blessed!

We very much appreciate the continued support, prayers, and positivity sent to our family! The overwhelming outpour of post comments, private messages, and kind gestures have filled our hearts with hope, love and courage during a very emotional time. We appreciate ALL of you beyond what words can express.

Below is a picture of the beautiful Belle…Her wonderful Mama posted this adorable photo in support of our boy:

The pack’s amazing Aunt Jackie sent a care package that arrived on Halloween day… some really cool Halloween dog toys, and an awesome mug displaying Lord Byron’s quote, “The poor dog, in life the firmest friend, the first to welcome, foremost to defend” and featuring her dog, Freya (who we refer to as Whiskey’s sista-from-anotha-mista)! I certainly will need extra caffeine and will get good use of this mug… and once things settle, the dogs will enjoy these toys !

A good friend who I met while her pug, Axl and our girl, Margarita, were battling cancer simultaneously, sent Lager some pre-surgery treats and a Comfy Cone for his recovery!

What’s Next?

Lager will have his chest site and bandage changed on Saturday November 5th as long as the bandage holds up. If we see anything seeping through the bandage, or if the bandage is failing, we will have to bring him in sooner. He will then see Dr. Jennings on November 11th for a re-check of his jaw.

Lager taking a break from the E-collar and resting comfortably during the World Series

16 thoughts on “Lager’s Rostral Mandibulectomy

  1. he is still a most handsome boy! I would love to get a kiss from him. I am so happy he is doing well so far and I hope he continues to improve. Dogs do teach us how to overcome don’t they!

  2. Lager you are such an inspiration! And you and your family are loved by many. Sending love and prayers for quick healing!

  3. Jenn, I can’t believe him eating like it’s no big deal!! He had bounced back and looks like he will adapt quickly!! He is an amazing sweetheart! Jeff & I continue to send our love and prayers!! We love & miss you guys!!!💖💖💖💖❤️‍🩹🐾

  4. Thank you so much for sharing this journey with Lager and helping us understand the procedure. First, I did shed some tears in the beginning because I could feel your anxiety of this journey. You write so incredibly well and answered all the questions I had and then some. Dogs are incredibly resilient, and you put it so well. By the end of you writing this I was smiling and felt the incredible love and overcoming our own fear. Your strength and love shines through and so true that our dogs teach us so much. Sounds like Lager has some awesome Dr.’s. Praying that they got it all and pathology and margins comes back negative. Sending you all big hugs, lots of love and healing light.

    • Thank you so much – – I cried a lot too! I tried to record every detail in hopes that one day I can help someone else who finds themselves seeing their dog through the same journey. I truly appreciate your prayers, love, hugs, and healing light!!

  5. Crying along with you, reading his story. Then I get to the end and I’m crying tears of joy. SO much admiration for him, and for you. Sending joyful hugs!

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