Kashmir - Cushpup with possible macro adenoma (Kashmir is now free)

[Lori C]

Hello everyone, I'm new here and hoping to benefit from the support and the wealth of collected knowledge I'm finding on this forum. My dog Kashmir is an approximately 12 year old Chow/Heinz 57 mix who was diagnosed with Cushing's in 2017. He was started on Vetoryl and over the next ~18 months the dose was continually reduced based on his ACTH-stim results to avoid over-suppression. He did end up having 2 Addisonian episodes anyway; not full-on crises but stopped eating his food and lost weight (he had extra to lose at this point), yet bounced back quickly with a round of prednisone. After the second episode last fall, he was taken off Vetoryl completely and his February stim test showed him within normal ranges. Even with the constant testing and subsequent adjustments, Kash did well on the Vetoryl and things were good through December 2018.

Early this year Kash seemed to start losing his spark, was more lethargic, slept more, and wagged his tail less and kept it down instead of curled over his back. He also started panting more again and his belly was more distended, and he got tired quickly on our walks. Around mid-April his appetite started to dwindle and has steadily gotten worse, although I keep enticing him with new things and so far I'm able to keep him eating.

In April we went to his regular vet for his annual checkup; blood tests showed a low thyroid but everything else looked good. So he started on 0.4 mg of Levothyroxene twice per day. It seemed to help energize him a little at first but he quickly plateaued and regressed. He has also started drinking more water again although not to the degree he did prior to the Vetoryl. Most of the time he just seems zoned out and blah. He sleeps a lot, can be a bit wobbly, has a little trouble navigating stairs, an occasional stumble here and there...

Because of my gut concern that something was/is wrong, we saw the IMS last week and he ordered a full CBC, thyroid panel, abdominal ultrasound and chest x-rays. Everything looked pretty good other than his Levothyroxine was lowered to 0.4 mg/day. The IMS brought up the possibility of macroadenoma or canine cognitive dysfunction since the tests ruled out other problems. I found this website over the weekend and after reading the macro thread and several dogs' individual stories I am convinced Kash has a macro, even though the IMS tells me I shouldn't jump to conclusions.

We have a consultation with the neuro vet on Monday June 10 where I will learn more about MRI diagnosis, radiation, other treatment options (are there any? steroids perhaps?), cost, prognosis, etc. If anyone has information I should be equipped with when I go in, or knows of questions I should be asking, I'd sure appreciate you sharing those with me. I also learned today that the clinic has a newer generation unit that can perform "stereotactic radiosurgery", that can generally accomplish in 3 treatments what traditionally would require 15-18 treatments. Does anyone have experience with stereotactic radiosurgery? Are the outcomes better, even if the tumor is large in size or in comparison to brain size? To be clear I have not made any decisions yet and if anything I'm leaning towards not putting Kashmir through RT as he has come to dread vet appointments; between Cushing's and rehab for a separate issue, there have been many.

The IMS's remarks are pasted below. I will just add that although the vet describes Kash as "medically stable", that does not mean he is thriving.

Thank you in advance, everyone, for your thoughts and guidance.

"Kashmir's abdominal ultrasound showed mostly changes suggestive of slowly progressive, degenerative processes
as opposed to an obvious new and active process to explain the recent concerns. His thoracic X-rays were essentially
normal.

On labwork, Kashmir has the typical elevations in liver enzymes we've seen previously, but no signs of dysfunction,
and the rest of his organ systems are working fine. His urine analysis was unremarkable. His T4 (thyroid hormone
level) came back slightly higher than the high end of the target range for dogs on supplementation, so we could
consider dropping the dose some (or just going to once daily at the 0.4mg dose). With that said, the typical symptoms
of excessive thyroid hormone supplementation are generally what you would expect from giving too much of a
stimulant - hyperactive, agitation, increased appetite, potentially weight loss due to increased metabolic rate,
irritability/aggression, etc. None of the concerns we discussed sound like thyroid excess to me at all.

Based on the fairly thorough information we currently possess, the scenarios that we should be considering most
closely would be age-related change (such as canine cognitive dysfunction, CCD, which is somewhat similar to
Alzheimer's disease in people), or a pituitary macroadenoma. To differentiate between these we would likely need an
MRI performed through our Neurology department. If you do not want to pursue this information, we could consider
some of the supplemental/nutritional approaches that are used for CCD.

Based on how medically stable Kashmir appears to be otherwise, I do not think you need to rush a decision about
how to proceed, but let me know how I can help."

[labblab]

Hello Lori, and welcome to you and Kashmir! Thanks so much for all this detailed information, and I’ll definitely return later today to comment further. However, I want to first take the time to really consider all the info you’ve given us.

In the meantime, though, we’re so glad you’ve found us, and we’ll do our best to help in any way we can.

Marianne

[Lori C]

Thank you for your reply, Marianne.

I feel like we are in a holding pattern until Monday. I've read through the adenoma thread and after searching on stereotactic radiosurgery I found and read several threads including Jed's, Beatrice's and Attila's, as well as others that didn't go the RT route like Pansy and your Barkis. While the threads haven't made me feel very hopeful about Kashmir's long-term future, it's been amazing and heartwarming to see the lengths that so many pet parents have gone through for the love of their dogs, and the guidance and unwavering support offered by forum regulars and members.

I'm trying to spend extra time with Kash, trying out different things to keep him eating, doing research to educate myself, worrying and crying, and then telling myself not to spoil my time with him by worrying and crying. This morning Kash seemed slightly more alert and actually wagged his tail a little. It was a short, sweet surprise, and I wish it would have lasted longer than a few moments, but I'll take it anyway and be grateful for it.

[Squirt's Mom]

Hi and welcome to you and Kashmir!

My Squirt developed doggy dementia. At first she just slowly withdrew, sleeping more and more then she started doing more obvious things like going to the wrong side of the door to go out or come in, getting stuck behind or between furniture, turning in circles for much longer than she used to when laying down like she was stuck in that gear of going 'round and 'round. Then she started pacing in the late afternoons, similar to sun-downers in humans with Altzheimer's, that went on most of the nite. She would walk the same route repeatedly over and over and over until I was sure she would fall over from exhaustion but she never did. My little Fox also developed dementia and exhibited the same signs. In time both of them stopped eating and drinking on their own and Fox lost complete control of her bladder and bowels. Those were their messages to me that they had had enough - when they could no longer eat, drink, or manage voiding normally.

She took a stable SAMe product that is no longer available and it helped her a great deal. Anipryl was also tried but it had little effect on her but has worked for other dogs who had the same problem. There are a variety of other supplements touted online as helping with doggy dementia but I have no first hand knowledge to share with you about them.

I hope you find the answer for your sweet baby boy soon and a viable treatment that brings you both some relief soon.
Hugs
Lesile

[Lori C]

Hi Leslie! Thank you for sharing what you experienced with Squirt and Fox. There is definitely a lot of symptom overlap between CCD and macro adenoma. Were either of them Cushing's dogs and if so, did you have a CT or MRI and that's how you knew they had CCD and not a macro?

[Squirt's Mom]

Squirt was a cush pup, Fox was not. I did not have any testing done on either of them other than maybe an xay on Squirt, I can't remember. I felt I had learned enough thru the cush journey to be able to tell if it was a macro vs dementia as time passed and I wasn't going to take any action if it was a tumor for either regardless so the testing for a tumor would have simply been for info only; that expense could be better put to other uses in my case. Neither developed head pressing which is one of the first signs I saw in a Boston I had who had breast cancer that spread to her brain and is also one of the hallmark signs of any brain tumor in dogs. Neither had signs of failure to thrive (for lack of a better phrase) as time went on until they stopped eating. Until then they enjoyed their food and treats. They were both very confused and withdrawn most of the time but would have moments when they seemed to be present - Squirt more than Fox; both had the pacing, both lost bladder control but only Fox lost bowel control....and that was the extent until their appetites failed. Fox's loss of bowel control happened shortly before her appetite failed.

[Lori C]

Thanks, Leslie, for your response.

I took Kash to the dog park on Thursday afternoon; he didn't have energy to walk far so we just stayed near the entrance where he enjoyed saying hello to some of the other dogs. He has become much more dog-friendly over the last couple months; when we're walking and we see another dog it really grabs his attention and he likes to go say hi. He was not always like this, but it is sweet to watch. Friday evening we took a half hour walk; we don't go far because he needs to take it very slow, but it was nice and it was a beautiful day weather wise. He had a little stumble where he missed the second step getting down from my bed, but fortunately he was okay and it hasn't stopped him from successfully using the steps since then. I had to fill out some paperwork for the neurologist appointment and they wanted a list of what I feed him, which is not the easiest question to answer since I'm trying all kinds of different dog and human things to keep his interest. He ate reasonably well this weekend in terms of quantity. Perhaps not quality, but I'm just happy he's eating. It's been a good weekend with him being slightly more alert and wagging his tail and me getting him to eat, so I'm not looking forward to the appointment tomorrow which is going to make his illness feel real again.

[labblab]

Hi again, Lori! I'm sorry it's taken me so long to get back to you, especially since I didn't make it back before your appointment today. But the positive part is that now you'll be armed with some more information when we do talk again.

Since you've read our "Macroadenoma" thread, you'll know that I lost my own Cushpup, Barkis, to what we suspect was an enlarging pituitary tumor. So my heart definitely goes out to you as you try to sort out an accurate diagnosis, as well as the best path forward. In answer to one of your questions, we've had dogs here who were treated by conventional multi-part radiation treatment, as well as some who've had much briefer stereotactic procedures. Some dogs have done well with either type of treatment; some not as well. But we'll be happy to talk about that in more detail if it seems warranted. Right now, we'll just be anxious to hear what the neurologist has to say.

So I'll hold off on writing more until we do actually know more. But once again, I'm so glad you've found us, and we'll be watching for your update re: today’s appointment.

Marianne

[Lori C]

Hi Marianne,

Thanks for your kind words. Yes, I definitely am familiar with Barkis and am so glad to have your guidance through this. Is your avatar picture of Barkis?

We saw the neurologist today and she confirmed Kash's symptoms are neurological. Given his Cushing's history, the most likely scenario is his pituitary tumor has grown. Without an MRI she of course cannot rule out that it's some other kind of brain tumor, or even that it could be both the pituitary and another one causing his symptoms (she was just giving me all the possible scenarios). She thinks its unlikely that it's infection or inflammation that is causing them though.

She recommended starting on prednisone to see if it improves his quality of life. He is on 10 mg per day twice a day for 3 days and we are going to see how he responds and then adjust/taper. I gave him his first dose around noon and decided to go to work for a couple of hours since he was worn out from our visit anyway and wanted to sleep. When I got home he wasn't at the door which was really unusual, but I found him on the bed and he walked down the bed stairs more quickly than normal which surprised me; we went for a walk and for the first couple minutes he was holding his tail up and trotting a little. I was thinking 'wow, the prednisone kicked in quickly' but after that little burst of energy he kind of slowed back down. So I don't know if that short spike was related to prednisone or not but it was nice to see. Anyway, since it wasn't overly warm today stayed out for about 45 minutes; we go super slow and stop a lot but that's okay - I cherish every minute with him. We visited some kids and said hi to their dog. Kash is such a cute teddy bear kids just love him and want to pet him. :)

The vet said that if Kash responds well to prednisone it's an indication that the tumor might also respond well to radiation. I'm not convinced I want to go that route but I figure we'll just see what the next few days hold, plus she is going to email me with some studies on stereotactic surgery and outcomes, and outline all the options and information she gave me today since it was a lot of information. I should have the email tomorrow so I will post an update here with that information. I'm happy to say I really liked the neurologist; she was knowledgeable, empathetic, very forthcoming with information, and answered all of my questions without making me feel the least bit rushed. After reading some of the other threads on here I feel so fortunate to have a veterinary specialty clinic 20-25 minutes from my house.

[labblab]

Lori, thanks so much for your quick update. I surely do hope that you’ll see continued improvement with the prednisone, regardless of whether or not you decide to proceed with invasive treatment. As I mentioned above, we’ve had dogs here who have been treated for their macrotumors using differing modalities and the results have been variable across the board. Some have done well and enjoyed improvement in their quality of life for multiple months; others have not seen a great deal of improvement or suffered from various complications associated with the procedure. For this reason, I’m not going to try to identify any specific stories for you to review, since there really is no single outcome that has been “typical” here. Probably the research info that the neurologist will supply to you will carry the most updated prognostic info.

One point that I assume she’s already mentioned is that the radiation is hoped to resolve or at least improve the neurological symptoms for a period of time. However, the tumors are not removed in their entirety, and eventually regrow for most all dogs. Also, the conventional Cushing’s symptoms are usually not helped by the procedures, so ongoing Cushing’s medication is typically required. I don’t mention this to dissuade you from considering radiation, but just to let you know that, unfortunately, the procedure does not yet offer a complete permanent cure.

No matter what you decide, I am so touched by your calm acceptance of, and sweet responsiveness to, Kashi’s current situation. Since you read Barkis’ story on the Macroadenoma thread, you’ll know that one of the biggest sorrows and regrets that I still carry with me was my inability to just be “present” with him during our last days together. I was so frantically trying to search for solutions that my focus was on treatments instead of cherishing our time together. So no matter what you end up deciding, I believe you’re offering him the most important and valuable treatment of all — your undivided love.

And yep, my avatar is indeed Barkis. Every time I see his face on this forum, I feel as though I’m still honoring his sweetness and his bravery. He’s what brought me to this family so many years ago, and he’s the reason why I remain. He will always truly be “my bestest boy.”

Please do continue to update us as often as you can. And please give sweet Kashi a big hug for us, OK?

Marianne

[Lori C]

Hi Marianne, any appearance of calm acceptance of Kash's situation on my part is just that - an appearance. Or perhaps I come across as calm because I'm worn out and tired. I sat in my car in my garage this afternoon and wailed and cried my eyes out. I suppose the other thing I've felt is a sense of [defeated] resignation. From all the reading I did immediately after the IMS mentioned adenoma, I was positive I knew what we were facing (although I was holding out hope I'd be wrong) and I knew what the treatment options were going to be - except for the radiosurgery instead of the longer regimen; that one I missed. I think though, that it's a testament to how articulately and accurately so many people on this website described their dogs' symptoms and journeys that I could see the same things in my own dog. Thanks to the wealth of information here, I can now do my best to focus on spending time in the present with Kashmir instead of frantically researching my options. You didn't have that option with Barkis, but thanks to you and all the other people who have contributed to K9C, people like me who come after you have that gift. I am very, very grateful.

[Lori C]

We have finished day 2 of prednisone and it has definitely bumped up Kashmir's appetite. In addition to his chicken pate dog food (the only thing he was willing to eat recently), today he had some treats, chicken breast pieces and I gave him some of my vanilla ice cream - baby boy gets whatever he wants (except chocolate, etc. of course!) We went for a short walk this morning but it's been too rainy to go out again since. I saw a little more kind-of-tail-wagging, a tiny bit more pep for the first couple minutes of a walk today - so this is all good. We're not talking drastic improvement here but it is something. I should add too, that fortunately Kash doesn't give any signs of being in discomfort or pain. I feel fortunate that he doesn't pace and hasn't had tremors or seizures and I hope those things continue to STAY AWAY because right now he has good quality of life, even if he's much more subdued than the perky guy he used to be.

The estimate for an MRI is $3000, and the estimate for CT (needed to guide RT) and 3 sessions of stereotactic radiosurgery is $7000, assuming no overnight visits. I got a copy of a 2018 study from the vet that I began reviewing. Overall survival outcomes are not very long and definitely shorter for hormone-producing tumors than non-producing ones. It's just not a great picture, unfortunately. How I wish I would've known about the potential for pituitary tumor growth when we were dealing with "just" Cushings; I would have gotten Kashmir into the neurologist immediately when the symptoms started and maybe RT would feel like more of an option than it does now.

I am happy to share the study with this forum - is there a recommended place to post it, perhaps in the adenoma thread?

[labblab]

That would be great if you’ll post the study on the Macroadenoma thread. The more information we can consolidate there, the better!

In that vein, in looking back at that thread, I realize we’ve never extensively referenced there the possibility of surgery as a treatment option. This is largely because it’s so rarely performed here in the U.S. But one of our members, Lucy, was actually the first patient in a pilot surgical project conducted in L.A. as a joint venture between UCLA and Cedars Sinai Hospital. Lucy did have a successful outcome. However, I can only think of one other member who’s had similar surgery, and that’s Macy, whose mom started the Macroadenoma thread. Unfortunately, as you saw, Macy did not survive to recover. Anyway, now that I’m thinking about it, I do want to add a “surgical” post to that thread, too, even though it’s a possibility that’s seldom discussed or considered.

Meanwhile, I’m so glad to hear that the prednisone may be helping Kashi, if only a little bit. We’ll always take “better” in any form we can get it, that’s for sure!!

Marianne

[Lori C]

We have had a tough few days but things are a little better now. On Thursday I tapered Kashmir down from 10 mg prednisone twice a day to 5 mg twice a day per the vet's instructions, the idea being to find out the lowest possible dose he can be on. He started to seem a little off on Thursday night and by Friday morning he had really nosedived, with no interest in water or food, going for a walk...he just laid down and didn't want to move. He was trembling ever so slightly, and his breathing also seemed a little different. Not like he was in distress exactly but more labored than usual. Neither the neurologist nor IMS was in the office Friday, but a different person there suggested I try bumping his prednisone back up to the 20 mg/day to see if it helped him. So I did that and he does seem better. He was doing poorly enough that I had contacted an in-home vet about euthanasia but I ended up not scheduling it in order to give the prednisone time to do its thing. Thankfully he was a little better yesterday and today he seems close to where he was back on Wednesday before we tapered. His appetite is better and he's drinking water, and I took him on a walk today.

I can tell things are changing. One of Kash's symptoms is that he favors his right side. When the vet did his neurological exam she noted how he prefers to always make right turns, even if a left turn makes more sense. I had also noticed how he would stand but have his head facing to the right; I noticed this mostly on walks when he'd take a break (I used to say these were because he was tired but I think it's a combination of that plus he's having a moment where he's in a bit of an altered state (obtundation)). Yesterday and today I've noticed how his tail is actually hanging a little more to the right side too. He also is a little more jumpy when I put the harness over his head or generally when something unexpected comes in his line of sight it's like he momentarily thinks it might hit him.

I hope I'm doing the right thing by Kashmir. Friday I was sure the right thing was to let him go, and I don't think it would have been the wrong thing - but I'm glad to have a little more time with him as long as he's not suffering. It makes me sad that he's not the happy boy I once knew, but he's not in pain and he definitely still enjoys getting petted and especially having his ears scratched. It's really hard though to live in the present when you are dreading the future.

[labblab]

It's really hard though to live in the present when you are dreading the future.

Boy, truer words were never spoken! But if it brings you any comfort to know, I do believe you’re taking all the appropriate actions right now. And during those really tough moments, I surely hope you’ll feel your family here, standing right alongside you every step of the way.

Huge hugs flowing to both you and your precious boy, today and every day.
Marianne

[Harley PoMMom]

Huge hugs from me too.

[Lori C]

With tears in my eyes and a giant lump in my throat I am writing to tell you I set Kashmir free yesterday evening, June 18th. He was just getting so tired. The neurologist bumped up his prednisone on Monday morning to 50 mg and I know Kash well enough that if it was going to do anything I would have seen some slight sign of improvement within the next 24 hours, certainly within the next 36. But there wasn't any improvement; he just became more and more tired, rarely moving or showing interest in anything going on around him. Monday night and Tuesday he didn't want food and drank very little water...although Tuesday afternoon he really surprised me by eating two chicken breasts I had baked in the oven and cut in small pieces for him. I put the bowl under his nose on the bed and after he ate one, I got a second half, and then another, and he ate nearly all of it! We sat outside on the back stoop much of the day and I petted him and talked to him while he dozed. It was an incredibly hard decision and I second-guessed myself during the day, especially after he ate the chicken, but deep down I knew if I had had him stay longer he could probably only handle a day or two, and I would be doing it for myself, not him. And though we had a beautiful day together and he had a nice last meal, I don't think I could have handled another torturous day like last Friday or yesterday either, deciding whether to do it and then watching the clock tick by once the appointment was made. And neither could Sarena, my niece who lived with me and grew up with Kashmir but moved across the country last fall after her college graduation. She took it very hard that she hadn't seen Kash since Christmas and couldn't be here other than via FaceTime to say goodbye. She's coming into town in 10 days but that was too far away. It's going to be hard for her at first when she arrives and he's not here, but we will get through it.

A bright spot is was the vet I found - she was so kind and caring, and assured me she believes I found the "window" we all hope for that isn't too early but avoids lingering and suffering. I do feel I made the right decision, but I miss him. My other dog Roxy and I just keep looking for him around the house because it feels so foreign that he's not here. And today I experienced many of the "firsts" -- or perhaps they are "not firsts" - not saying good morning, petting him, feeding him, scratching his ears, etc. But I know where he is now he has energy again, there are no more pills or pokes or vet trips, and he's free and happy, and someday I'll get to be with him again.

I never thought when I first posted here that this conclusion would come so soon. I have a hard time believing it was only a week and a day ago that we saw the neurologist because so much has happened since then. But I feel fortunate that if this had to happen that it was relatively quick, and that his symptoms of sleeping all the time and altered mental state were easier to take than the seizures, pacing, crying, and other harrowing manifestations other people have experienced and written about in this forum. My heart, broken as it is, goes out to them for having to experience that with their dogs. I regret that I didn't know about the possibility of a (likely) macro tumor earlier because if I had maybe treatment would have been an option as he was in good health otherwise. But it was not meant to be.

I am still going to post his symptoms and the study I received in the adenoma thread where hopefully they will be helpful to others, but it may be a few days before I do it, as it's emotionally very tough right now.

I also learned about a website, https://www.aplb.org/ (association for pet loss and bereavement) that has some great resources: counselors, chat room, and a list of vets who practice in-home euthanasia. This is how I found the wonderful vet who helped make Kashmir's passing peaceful and dignified.

Thank you to everyone here, especially Marianne, Lori and Leslie for your thoughtful replies to my posts. I hope I never have to create a new thread on this site, but I definitely will tell others about it because it provides an important source of support and resources for those of us who face this difficult Cushings journey with our beloved dogs.

~ Lori

[Joan2517]

I'm so sorry, Lori. I've been following and hoping that things would improve. He sounded like a lovely boy and we all know how much he will be missed. All the "firsts" are so hard and dreaded. My first year without Lena, I couldn't wait for each of them to be over, but waited for them just the same. When a memory pops up on Facebook back to when she was still alive, I always hope it's one of her, or at least she might be in a picture with whatever we were doing that day.

You gave Kash a great life. He was beloved and loved you back. I think that is one of the greatest gifts in life...the unconditional love of a pet.

Hugs to all of you...
Joan

[labblab]

Dear Lori, I am so deeply sorry, too. This news is hard to hear, yet we’re so very grateful to be included in your journey, every step of the way. We’re especially touched to be able to honor Kashi’s sweetness and his bravery. He’ll be forever remembered here on our special thread:

https://www.k9cushings.com/forum/showthread.php?9161-Remembering-All-Who-Have-Left-Us-(2019)

If you would ever wish for us to add a photo link to his memorial line, you can email us a photo at any time — now, or at any point in the future: k9cushings@gmail.com.

We know that there are really no words that can make any of this feel better. But if there is any comfort at all in knowing that we’re always hear and ready to talk, that is the truth. I often say to folks that “we stand ready to walk alongside you,” and that is truly the case. I know the continuation of this journey will be painful in so many ways, but please know you’re never alone if you’d welcome some company. And whenever the time comes that you would want to add onto our Macroadenoma thread, that will be a gift you’ll be passing on to others who are also seeking help and direction.

It is also very helpful to know what a fine resource the Association for Pet Loss and Bereavement has been for you. We have listed them for many years on our Grief Resources thread (https://www.k9cushings.com/forum/showthread.php?171-Where-to-Find-Help-When-You-re-Hurting), but I’ve never had direct contact with them myself. So this information is also a gift that you’re passing on, as well.

On this first sad morning without your precious boy alongside you, my heart is aching for you and Sarena and Roxy — for all who miss him and love him so dearly. But you did the right thing for your boy, Lori. You did the right thing.

Always in loving memory, and always here for you.
Marianne

[Squirt's Mom]

Dear Lori,

My heart is shattered to hear your news. We come to love our babies here almost as if they were our own and it is never easy to read such loving posts as yours about the most difficult decision so many of us have to face. But I know without doubt that Kashmir holds that last day in his heart as a treasured gift he will carry with him until that day when your job here is done and he can be by your side once again. You gave him the best life possible his whole life with you and in the end, gave him freedom from his failing shell. It is my belief that our babies remain with us always, just in a different form. Sometimes in the dark of night I can smell my Squirt and I know she is beside me or I feel a tickle on my ear and know that Trinket is laying by my head or hear the rapid clicking of nails on the hall floor and know Brick is running in to say hi or so many other tiny almost insignificant things that tell me my babies are still with me and always will be. I still grieve for them all and will til my final day.

Grief is a personal thing; there are no rules, no time limits, no guidelines. For me, grieving is a way to honor the love we shared so I hope I will always find myself with tears on my cheeks and a sob catching in my throat from time to time for all those precious Souls who shared their lives with me. For you, it is new and raw and I remember those days, too. We are here for you if you need to talk, to scream, to cry, whatever - we understand because we have walked in your shoes, most more than once or twice. So please know you can come here and we will listen any time you need or want. We also have a memorial thread in the In Loving Memory section when, IF, you wish to write a tribute to your precious boy; we would be honored to help celebrate his life with you.

The works of John O'Donohue have brought much comfort to me over the years so I leave you today with these words from "Eternal Echoes":


A Blessing For Absence
John O’Donohue

May you know that absence is full of tender presence
and that nothing is ever lost or forgotten.

May the absences in your life be full of eternal echo.

May you sense around you the secret Elsewhere which holds
the presences that have left your life.

May you be generous in your embrace of loss.

May the sore of your grief turn into a well of seamless presence.

May your compassion reach out to the ones we never hear
from and may you have the courage to speak out for the
excluded ones.

May you become the gracious and passionate subject of your own life.

May you not disrespect your mystery through brittle words or false belonging.

May you be embraced by God in whom dawn and twilight
are one and may your longing inhabit its deepest dreams
within the shelter of the Great Belonging.

[Lori C]

Joan, Marianne and Leslie, I so appreciate your kind words more than I can describe. I know I'll be coming back to reread them in the future, and I will most definitely write a tribute to Kashmir too. Marianne, I will send some photos tonight. I have a favor to ask though, and that's if the special thread could be updated with Kash's actual date of passing which was June 18, not 19.

I had some other firsts today - going in to work and seeing his picture on my monitor background; coming home and not finding him here, stopping at the grocery store and not buying the Cesar's chicken and liver dog food which was the only thing he would eat over most of the last couple weeks. I'm having the same feeling as I did after my mom died, where I didn't want time to pass because she felt further away, even though my rational mind knows that time is what will help me heal to where I can fully function again as a whole, but changed person.

Leslie, I think I'm a lot like you in that I still grieve for my other angel pets, even those who left me long ago. I asked Kashmir to tell them all hello for me and remind them that I love them, and to be nicer to my kitties than he was here on earth.

Thank you again for your kindness and support.

[Harley PoMMom]

I am so sorry for the loss of your precious Kashmir, he sure was a beautiful boy. We are here for you, always.

With Heartfelt Sympathy,
Lori