 |
[Alimentary Lymphoma]
*Canine malignant lymphoma is a progressive, fatal disease caused by the malignant clonal expansion of lymphoid cells. Although lymphoid cell neoplastic
transformation is not restricted to specific anatomic compartments, lymphoma most commonly arises from organized lymphoid tissues including the bone marrow, thymus, lymph nodes, and
spleen. In addition to these primary and secondary lymphoid organs, common extranodal sites include the skin, eye, CNS, testis, and bone. Lymphoma is reported to be the most common
hematopoietic neoplasm in dogs, with an incidence reported to approach 0.1% in susceptible, older dogs. Despite the prevalence of malignant lymphoma, its etiology
remains poorly characterized. Hypothesized etiologies include retroviral infection, environmental contamination with phenoxyacetic acid herbicides, magnetic field exposure,
chromosomal abnormalities, and immune dysfunction.
Clinical Findings:
Canine lymphoma is a heterogeneous cancer, with variable clinical signs depending in part on the anatomic region involved and extent of disease. In dogs, 4 well recognized anatomic forms
of lymphoma have been described: multicentric, alimentary, mediastinal, and extranodal (renal, CNS, and cutaneous). Multicentric lymphoma is by far the most common form, accounting
for ~ 80% of all diagnosed cases. An early clinical sign of multicentric lymphoma is the rapid and nonpainful development of generalized lymphadenopathy. In addition to dramatic peripheral
lymphadenopathy, malignant lymphocytes may infiltrate internal organs including the spleen, liver, bone marrow, and other extranodal sites. Late in the course of disease, when a significant
tumor burden exists, patients may show constitutional signs of illness, including lethargy, weakness, fever, anorexia, and depression.
Alimentary lymphoma accounts for <10% of all canine lymphomas. Dogs with focal intestinal lesions may exhibit clinical signs consistent with partial
or complete luminal obstruction (eg, vomiting, abdominal pain). With diffuse involvement of the intestinal tract, dogs with alimentary lymphoma may
show significant GI signs, including anorexia, vomiting, diarrhea, and profound weight loss secondary to severe malabsorption and maldigestion.
Mediastinal lymphoma, similar to the alimentary form, comprises only a small fraction of diagnosed cases. It is typically characterized by enlargement of the cranial mediastinal lymph nodes,
thymus, or both. Mediastinal lymphoma arising from the thymus is predominantly comprised of malignant T lymphocytes; with advanced disease, clinical signs may include respiratory
distress associated with pleural fluid accumulation, direct compression of adjacent lung lobes, or superior vena cava syndrome. In addition to respiratory signs, some dogs with mediastinal
lymphoma may exhibit polyuria and polydipsia secondary to the development of hypercalcemia of malignancy, a paraneoplastic syndrome seen in 10-40% of dogs with lymphoma.
The clinical findings associated with extranodal lymphoma (which may involve the skin, lungs, kidneys, eyes, and CNS) can be quite variable and are dictated by the organ infiltrated.
Cutaneous lymphoma may appear as solitary, raised, ulcerative nodules or generalized, diffuse, scaly lesions. Clinical signs of lymphoma at other extranodal sites include respiratory
distress (lungs), renal failure (kidneys), blindness (eyes), and seizures (CNS).
Lesions: Commonly, all superficial and various internal lymph nodes are 3-10 times normal size (multicentric form). Affected nodes are freely movable, firm, and gray-tan; they bulge on cut
surface and have no cortical-medullary demarcation. Frequently, there is hepatosplenomegaly with either diffuse enlargement or multiple, pale nodules of variable size disseminated in the
parenchyma. In the alimentary form, any part of the GI tract or mesenteric lymph nodes may be affected. Involvement of the bone marrow, CNS, kidney,
heart, tonsils, pancreas, and eyes can be seen but is less common.
Diagnosis:
The definitive diagnosis of lymphoma is often uncomplicated and can be obtained by either cytologic or histopathologic evaluation of the affected
organ system. In dogs with multicentric lymphoma, fine-needle aspiration of enlarged peripheral lymph nodes usually provides specimens of adequate cellular content and detail to make
a definitive diagnosis. Cytologically, lymph node aspirates may identify a monomorphic population of lymphoid cells, either of large (lymphoblastic),
intermediate, or small size. Despite the ease of diagnosis, cytology is unable to differentiate or categorize the wide spectrum of lymphomas with
regard to morphologic pattern (diffuse versus follicular) and histologic grade (high versus low). Due to these constraints, histopathologic tissue evaluation
remains the gold standard for the diagnosis of lymphoma, providing additional morphologic information required for definitive classification.
In rare situations where cytology or histology fails to confirm the diagnosis, new molecular techniques may allow for its identification. The use of PCR allows for the amplification of DNA
sequences that confirms the presence of malignant lymphocytes. Although PCR methods are highly sensitive, the methodology should be reserved for cases where conventional cytologic
and histologic diagnostic techniques have failed.
Treatment:
Treatment of multicentric canine lymphoma with aggressive, multi-agent chemotherapy protocols is often rewarding, with >90% of all dogs achieving some clinical response. The most
common chemotherapeutic agents used in combination protocols are vincristine, adriamycin, cyclophosphamide, L-asparaginase, and prednisone. Individual treatment protocols vary with
respect to dosage, frequency, and duration of treatment; advantages and disadvantages of each treatment protocol can be found in medical oncology textbooks. With combination
chemotherapy, the expected survival time for dogs with B-cell lymphoma is ~9-12 mo. For dogs with T-cell lymphoma, expected survival times are shorter (6 mo). Dogs
that fail to respond to traditional combination chemotherapy or that relapse may achieve disease remission, added survival times, or both with the use of various rescue protocols (eg,
lomustine, half-body radiation).
Although systemic chemotherapy remains the cornerstone for treating lymphoma, the idea that both induction and maintenance phases of chemotherapy are necessary for achieving durable
remission times has recently changed. Short but dose-intense chemotherapy protocols (eg, Madison Wisconsin protocol) without maintenance provide disease-free intervals and survival
times equivalent to protocols that include chronic maintenance therapy. Additionally, the use of half-body radiation in replacement of maintenance chemotherapy has demonstrated clinical
efficacy and provides another option for maintaining durable remission times without the need for chronic chemotherapy.
Despite the favorable outcomes expected in treating multicentric lymphoma, the successful management of other anatomic forms of lymphoma is
often more difficult and less rewarding. Alimentary lymphoma, if focal, can be treated effectively with surgical resection and combination
chemotherapy. However, with diffuse involvement of the intestinal tract, low constitutional reserve and severe malabsorption of nutrients and loss
of proteins often results in poor clinical responses and short survival times (ie, <3 mo). The use of combination chemotherapy with or without palliative radiation
therapy can afford dogs with mediastinal lymphoma considerable improvement in survival times and quality-of-life scores, but the expected median duration of remission is <6 mo for T-cell
lymphoma. Dogs with hypercalcemia of malignancy, often associated with mediastinal lymphoma, are also less likely to achieve prolonged survival times, due to the multi-organ damage
associated with chronic elevations in ionized calcium. Lymphoma involving other extranodal sites such as the skin, can be managed with combination therapies including surgery, radiation,
and systemic chemotherapy; however, the development of refractory and progressive disease is common.
*Canine malignant lymphoma is a progressive, fatal disease caused by the malignant clonal expansion of lymphoid cells. Although lymphoid cell neoplastic
transformation is not restricted to specific anatomic compartments, lymphoma most commonly arises from organized lymphoid tissues including the bone marrow, thymus, lymph nodes, and
spleen. In addition to these primary and secondary lymphoid organs, common extranodal sites include the skin, eye, CNS, testis, and bone. Lymphoma is reported to be the most common
hematopoietic neoplasm in dogs, with an incidence reported to approach 0.1% in susceptible, older dogs. Despite the prevalence of malignant lymphoma, its etiology
remains poorly characterized. Hypothesized etiologies include retroviral infection, environmental contamination with phenoxyacetic acid herbicides, magnetic field exposure,
chromosomal abnormalities, and immune dysfunction.
Clinical Findings:
Canine lymphoma is a heterogeneous cancer, with variable clinical signs depending in part on the anatomic region involved and extent of disease. In dogs, 4 well recognized anatomic forms
of lymphoma have been described: multicentric, alimentary, mediastinal, and extranodal (renal, CNS, and cutaneous). Multicentric lymphoma is by far the most common form, accounting
for ~ 80% of all diagnosed cases. An early clinical sign of multicentric lymphoma is the rapid and nonpainful development of generalized lymphadenopathy. In addition to dramatic peripheral
lymphadenopathy, malignant lymphocytes may infiltrate internal organs including the spleen, liver, bone marrow, and other extranodal sites. Late in the course of disease, when a significant
tumor burden exists, patients may show constitutional signs of illness, including lethargy, weakness, fever, anorexia, and depression.
Alimentary lymphoma accounts for <10% of all canine lymphomas. Dogs with focal intestinal lesions may exhibit clinical signs consistent with partial
or complete luminal obstruction (eg, vomiting, abdominal pain). With diffuse involvement of the intestinal tract, dogs with alimentary lymphoma may
show significant GI signs, including anorexia, vomiting, diarrhea, and profound weight loss secondary to severe malabsorption and maldigestion.
Mediastinal lymphoma, similar to the alimentary form, comprises only a small fraction of diagnosed cases. It is typically characterized by enlargement of the cranial mediastinal lymph nodes,
thymus, or both. Mediastinal lymphoma arising from the thymus is predominantly comprised of malignant T lymphocytes; with advanced disease, clinical signs may include respiratory
distress associated with pleural fluid accumulation, direct compression of adjacent lung lobes, or superior vena cava syndrome. In addition to respiratory signs, some dogs with mediastinal
lymphoma may exhibit polyuria and polydipsia secondary to the development of hypercalcemia of malignancy, a paraneoplastic syndrome seen in 10-40% of dogs with lymphoma.
The clinical findings associated with extranodal lymphoma (which may involve the skin, lungs, kidneys, eyes, and CNS) can be quite variable and are dictated by the organ infiltrated.
Cutaneous lymphoma may appear as solitary, raised, ulcerative nodules or generalized, diffuse, scaly lesions. Clinical signs of lymphoma at other extranodal sites include respiratory
distress (lungs), renal failure (kidneys), blindness (eyes), and seizures (CNS).
Lesions: Commonly, all superficial and various internal lymph nodes are 3-10 times normal size (multicentric form). Affected nodes are freely movable, firm, and gray-tan; they bulge on cut
surface and have no cortical-medullary demarcation. Frequently, there is hepatosplenomegaly with either diffuse enlargement or multiple, pale nodules of variable size disseminated in the
parenchyma. In the alimentary form, any part of the GI tract or mesenteric lymph nodes may be affected. Involvement of the bone marrow, CNS, kidney,
heart, tonsils, pancreas, and eyes can be seen but is less common.
Diagnosis:
The definitive diagnosis of lymphoma is often uncomplicated and can be obtained by either cytologic or histopathologic evaluation of the affected
organ system. In dogs with multicentric lymphoma, fine-needle aspiration of enlarged peripheral lymph nodes usually provides specimens of adequate cellular content and detail to make
a definitive diagnosis. Cytologically, lymph node aspirates may identify a monomorphic population of lymphoid cells, either of large (lymphoblastic),
intermediate, or small size. Despite the ease of diagnosis, cytology is unable to differentiate or categorize the wide spectrum of lymphomas with
regard to morphologic pattern (diffuse versus follicular) and histologic grade (high versus low). Due to these constraints, histopathologic tissue evaluation
remains the gold standard for the diagnosis of lymphoma, providing additional morphologic information required for definitive classification.
In rare situations where cytology or histology fails to confirm the diagnosis, new molecular techniques may allow for its identification. The use of PCR allows for the amplification of DNA
sequences that confirms the presence of malignant lymphocytes. Although PCR methods are highly sensitive, the methodology should be reserved for cases where conventional cytologic
and histologic diagnostic techniques have failed.
Treatment:
Treatment of multicentric canine lymphoma with aggressive, multi-agent chemotherapy protocols is often rewarding, with >90% of all dogs achieving some clinical response. The most
common chemotherapeutic agents used in combination protocols are vincristine, adriamycin, cyclophosphamide, L-asparaginase, and prednisone. Individual treatment protocols vary with
respect to dosage, frequency, and duration of treatment; advantages and disadvantages of each treatment protocol can be found in medical oncology textbooks. With combination
chemotherapy, the expected survival time for dogs with B-cell lymphoma is ~9-12 mo. For dogs with T-cell lymphoma, expected survival times are shorter (6 mo). Dogs
that fail to respond to traditional combination chemotherapy or that relapse may achieve disease remission, added survival times, or both with the use of various rescue protocols (eg,
lomustine, half-body radiation).
Although systemic chemotherapy remains the cornerstone for treating lymphoma, the idea that both induction and maintenance phases of chemotherapy are necessary for achieving durable
remission times has recently changed. Short but dose-intense chemotherapy protocols (eg, Madison Wisconsin protocol) without maintenance provide disease-free intervals and survival
times equivalent to protocols that include chronic maintenance therapy. Additionally, the use of half-body radiation in replacement of maintenance chemotherapy has demonstrated clinical
efficacy and provides another option for maintaining durable remission times without the need for chronic chemotherapy.
Despite the favorable outcomes expected in treating multicentric lymphoma, the successful management of other anatomic forms of lymphoma is
often more difficult and less rewarding. Alimentary lymphoma, if focal, can be treated effectively with surgical resection and combination
chemotherapy. However, with diffuse involvement of the intestinal tract, low constitutional reserve and severe malabsorption of nutrients and loss
of proteins often results in poor clinical responses and short survival times (ie, <3 mo). The use of combination chemotherapy with or without palliative radiation
therapy can afford dogs with mediastinal lymphoma considerable improvement in survival times and quality-of-life scores, but the expected median duration of remission is <6 mo for T-cell
lymphoma. Dogs with hypercalcemia of malignancy, often associated with mediastinal lymphoma, are also less likely to achieve prolonged survival times, due to the multi-organ damage
associated with chronic elevations in ionized calcium. Lymphoma involving other extranodal sites such as the skin, can be managed with combination therapies including surgery, radiation,
and systemic chemotherapy; however, the development of refractory and progressive disease is common.
| Mid October 2009 Logan began showing an occasional gag reflex, having a difficult time swallowing, what appeared to be inflamation in the glandular area of the neck, etc. After seeing her veterinarian, and seeing specialists, going through multiple barium x-ray series, ultrasound's, needle aspirations, and blood labs ... ALL with unremarkable results ... it was tentatively diagnosed as an idiopathic neurological disorder. Logan had a great appetite, no fever, lots of energy. Late October 2009 Logan was always athletic and in good shape. When she was a pup, she had a tendency to get pudgy, but that was my fault - too many training treats maybe :). Nevertheless, she was the AVID fence runner and never let anyone else jump higher than she could. Did not particularly like to be road worked next to the bike ... but would run that fence until she literally made a trench. At her last dog show, in Salem, OR, she looked suddenly VERY thin to me. Her handler even said to me that one more pound and she would be "Skinny". She was right. After the dog show, I took the dogs back to the hotel, cleaned them up and took them out to potty - noticing Logan was very soft-stooled and it looked dark. She was eating fine and her temp was normal ... She showed no signs of fatigue ... maybe she got too much bait?!?! A benign conclusion, but ... not likely. Later that weekend, she had a bad bout of diarrhea and it appeared to have dark bloody appearance. As soon as I got home that day, I got a sample which was taken to the emergency vet for analysis, results: no parasites, no foreign matter, minute amounts of blood - possibly from straining or an ulcer; normal levels of everything else. Treated for diarrhea & had more blood labs run: all within normal limits except red blood cell count was low - I knew this was not good - we HAD to find the bleed. Sent out for further evaluation; otherwise unremarkable. Findings: inconclusive; watch for a temperature rise, behavior changes, etc. Mid November 2009 Logan was now under the watchful eye of everyone involved in her health. I had to go to Texas to take a puppy home, and she was left here with Todd, the family and given GREAT care by Dog-Sitter-Deb while I was gone. Upon my returning home, Logan was failing. She was thin - even though has a solid reliable appetite ... and she had experienced loss of control of her bowels with bloody stool one while I was gone, but appeared fine. I tried to think of anything I may have been remiss about in her regular care ~ great diet, great exercise, lots of affection, consistent vet care; she was given HeartGuard regularly; she was wormed (Nemex-2), on schedule, (I recommend this especially since all of the Katoba Dobermans eat a healthy raw and fresh foods diet), she was cleared through titers of needing any vaccinations; we don't use ANY pesticides or fertilizers outside, nor herbicides or pesticides inside the house ... but, I did hire Terminix to spray outside last summer (they guaranteed 100% pet safe products); then I considered the recent MUSHROOM colonies that have developed with the wet weather... I was looking for any answer to the bloody stool - I do not care WHO or WHAT you are - THAT is NOT "okay". Logan's grand-sire, Taylor, died from eating poisoned mushrooms, so, I immediately found every nasty shroom on the back property and dug them up. I took the different species in for analysis - and they started 'toxicology labs', the results of which, apparently, can take quite some time to get back. A local professional gardener was able to positively identify each of the mushroom species, in the meantime, and found none of them to be in a family of those fatally damaging to humans or animals ... although, she admitted, she would not eat them herself :). Labs were sent out on Logan again ~ all within normal limits except the presence of the blood. That said, Logan kept losing weight, was drinking excessive amounts of water, and suddenly had bouts of little control over her bodily functions and we 'lived' at the vets office. Sunday, November 22, 2009 Up all night with Logan - taking her out as each time she wakes up she potties and is embarrassed if she does not make it to the door. No need to let her feel humiliated - so, it will just be an on-going slumber party until we can fix this problem! During her mid-night massage tonight, I felt a small lump in her belly. I could move it around & it was hard. Could she have a blockage that SOMEHOW we had missed in all the xrays and ultrasounds?? That was a more comforting thought than a possible tumor ... cancer. Monday came and went with Logan appearing a bit happier, albeit her energy level was limited to 5 seconds of fence run then hours of rest ... and a lot of moaning while she slept. She had terrible gas, so I figured that was the reason for the moaning. I was thinking myself full circle - my head said she had cancer ... my heart said I was "thinking the zebra when this was just a horse" . The lab results should show SOMETHING soon, and for now, I needed to just be comforting to Logan. I had already scheduled for another ultrasound for Tuesday, I told the vet office I really thought I felt a tumor and it had come on literally THAT day. Tuesday, November 23, 2009 I had to work this morning, so Todd was the "doc on duty" until I returned. By that afternoon, Logan's gums were not as pink as I like. It seemed there was just 'nobody home' when I looked in her eyes. She was frightened by everything - could this be a sign of severe pain or is she having trouble seeing? While she's not a big bitch, her perfect, lean, "show" weight was always 68.5# ~ she was down to 62#. And, that tennis ball sized "lump" I felt in her belly had now quadrupled in size - in ONE day. My "false hope" of a blockage went out the window ... that was now smothered by knowledge and common sense. Things that a dog could swallow, do not "grow" when they hit the gut. Upon examination, Dr. Nottingham was shocked by this large mass that had not been felt in ANY previous exam. He decided immediately upon another needle aspiration, during ultrasound. Logan laid on her back in the form on the table ~ with me, Bethany-the-assistant, and Kathy-the-Surgical-tech, (Logan loves them both), holding and comforting her through the procedure. Her belly was shaved & cells were aspirated. Within minutes, the results showed overwhelming presence of lymphocytes, possible lymphoblasts. High-grade intestinal lymphoma is not curable, and in Logan's case, is not remotely operable. Extensive chemotherapy treatments would provide limited improvement on quality of life, BUT, only for a VERY short period of time. Her life would probably end before the treatments did. This tumor was taking over her precious body. She was not able to absorb ANY nutrients through diet and was starving to death. Her red blood cell count was way too low and she was literally bleeding out slowly through the bowel. She had bouts of visible discomfort which means she was in terrible pain - Doberman are so stoic you rarely know if they hurt. I decided against Chemotherapy, but was too shocked and sad to make "that" decision yet. Dr. Nottingham pointed out that with no therapy at all, she would go very quickly ... days maybe. He prescribed Metronidozole for the diarrhea, and "Tramadol hcl" for pain control. I took Logan home and decided to watch her, love her as usual, sleep with her, try to keep her pain free and let her call the shots. She wants to eat each meal - and in between - she slept most of the evening and did not get up but twice during the night to go out. This cannot be happening - and now, I am pretending I will wake up and this will be a bad dream ... a night-terror of sorts. We are sending this latest la work out to forensics ... i DO trust Dr. Not's diagnosis ... I am looking for a different one though ... just to satisfy my selfish, un-accepting heart. If that weren't enough ... much to my horror ~ it is the EXACT day, (2 days before Thanksgiving), 2 years ago - when Piper was diagnosed with Hemangiosarcoma, dieing 5 days later. It is a gravely sad time in our home. Wednesday, November 25, 2009 Lab work came back consistent with advanced intestinal lymphoma ... Official diagnosis: Alimentary Lymphoma, (*see below). I had to go to the McLaughlin house today, where Angie was kind enough to take some pictures of Logan and I - a spur of the moment thought, realizing I had no candids of my girlie and I. Angie worked her magic and brought some life to Logan's now very thin, but still lovely, face. Poor Ronin, (Int'l CH Katoba's Emerald Warrior CGC TDI) ... he just could not understand why Logan - his usually playful, teasing, tough-romping, overly rambunctious sister - did not want anything to do with him. Being the proper therapy dog that he is, he waited quietly on his bed until we were done. Then, Logan gave a few quick wags of her tail at Ronin, at the girls, and at Angie. Then, she had to rest on their floor - it was wearing her out just being away from home. I felt terrible, although I treasure Angie's generosity, the children's patience, and Ronin's understanding while we stayed to have pictures taken ~ I am glad we did it and will treasure the photos forever, (above). Thank you, Angie. The 20 minute drive and 10 minute photo session exhausted Logan ... she is now home and resting on her bed with her woobie. Didn't want food until late tonight & was very sick all night. |
| My precious Logan ~ "Right now, I'm too sad and bitter to know what I should say. I'm sorry if that's selfish, but, I desperately want you to stay. Just another woobie-snuggle, or some puddle-stomping play. Even an argument with your sister where you always get your say. You are still a baby ... ... why would God take you away? I can't find words of joy right now, my tears are in the way. Maybe a note of remembrance ... ... on another day." ~ Mom |
| Can Int'l CH Katoba's Emerald Classic |
| March 4, 2007 ~ November 27, 2009 |
November 26, 2009 ~ Thanksgiving
Today is a day to give thanks. Part of me wants to rejoice over ALL my dogs especially the sweet silly girl that Logan has always been. The other part of me wants
to scream and throw things and ask WHY ... why HER ?!? She is so delicate and funny and caring and perfect and ... dieing? What is there to be thankful for in
THAT? Watching this evolve ... well, it just SUCKS !!! I had decided there would be no THANKSgiving dinner. My heart was aching so badly, KNOWING we were
just 'waiting' as the end was inevitable ... her body was frail and failing her, but, her beautiful face glowed ... and with every slow wag of her tail, I was given false
hope of turning this around. I had NO reason reason to celebrate with a feast today ... did I ?
Then, Todd and I went to the grocery store - yes ON Thanksgiving morning. We got each of the dogs a big fresh marrow bone ... and also ... we bought everything
I would need to make the 'Traditional Turkey Dinner'. What was I thinking? I wasn't. I began cooking and cooking and cooking. Logan made the occasional walk
through the kitchen and was handed a tasty morsel of whatever it was I had in my hand at that moment. Then she would retreat back to the living room to sleep,
eventually taking over the couch, whereas Todd was happy to take a seat on the floor in front of her :).
Once dinner was ready, all the dogs got their bones. Logan decided to come to the dinner table ... and was THRILLED to see our forks coming her way without
even the hint of begging needed on her part. Her enthusiasm is weak, but her appetite is voracious because nothing stays with her - there is no absorption of
nutrients, so she gets no value from anything she eats, other than "smelling & tasting" pleasure. And it did not hurt that she was now able to override all table-side
rules :). She stood waiting for the next taste of turkey, mashed potatoes and gravy, candied yams, stuffing, and even a bite of roll with cranberries. Why not,
right?!?!! The Pi Esta Resistance, though, was later in the evening when she enjoyed s bit of pumpkin pie and whipped cream. I think she even "smiled" as she
went back and forth slowly between Todd and I until our plates were clean.
After said and done, I am glad we had a Thanksgiving dinner ... and I AM "thankful" ~ "thankful" for another day ... THIS day.
It is late, now ... Logan wants to lay in front of the extra heater ~ she can't stay warm very well and no longer wants to be under the blanket on the sofa with me.
So, I am going to go melt myself into Logan's dog bed, along side her ... and take in every second of life Logan is willing to give me - awake or asleep.
Today is a day to give thanks. Part of me wants to rejoice over ALL my dogs especially the sweet silly girl that Logan has always been. The other part of me wants
to scream and throw things and ask WHY ... why HER ?!? She is so delicate and funny and caring and perfect and ... dieing? What is there to be thankful for in
THAT? Watching this evolve ... well, it just SUCKS !!! I had decided there would be no THANKSgiving dinner. My heart was aching so badly, KNOWING we were
just 'waiting' as the end was inevitable ... her body was frail and failing her, but, her beautiful face glowed ... and with every slow wag of her tail, I was given false
hope of turning this around. I had NO reason reason to celebrate with a feast today ... did I ?
Then, Todd and I went to the grocery store - yes ON Thanksgiving morning. We got each of the dogs a big fresh marrow bone ... and also ... we bought everything
I would need to make the 'Traditional Turkey Dinner'. What was I thinking? I wasn't. I began cooking and cooking and cooking. Logan made the occasional walk
through the kitchen and was handed a tasty morsel of whatever it was I had in my hand at that moment. Then she would retreat back to the living room to sleep,
eventually taking over the couch, whereas Todd was happy to take a seat on the floor in front of her :).
Once dinner was ready, all the dogs got their bones. Logan decided to come to the dinner table ... and was THRILLED to see our forks coming her way without
even the hint of begging needed on her part. Her enthusiasm is weak, but her appetite is voracious because nothing stays with her - there is no absorption of
nutrients, so she gets no value from anything she eats, other than "smelling & tasting" pleasure. And it did not hurt that she was now able to override all table-side
rules :). She stood waiting for the next taste of turkey, mashed potatoes and gravy, candied yams, stuffing, and even a bite of roll with cranberries. Why not,
right?!?!! The Pi Esta Resistance, though, was later in the evening when she enjoyed s bit of pumpkin pie and whipped cream. I think she even "smiled" as she
went back and forth slowly between Todd and I until our plates were clean.
After said and done, I am glad we had a Thanksgiving dinner ... and I AM "thankful" ~ "thankful" for another day ... THIS day.
It is late, now ... Logan wants to lay in front of the extra heater ~ she can't stay warm very well and no longer wants to be under the blanket on the sofa with me.
So, I am going to go melt myself into Logan's dog bed, along side her ... and take in every second of life Logan is willing to give me - awake or asleep.
| THIS is how I want to remember my Lovely-Lavendar-Lollipop |
| ____________________________________________________________________________________________________________________________ |
| Copyright2009KBabbitt. All Rights Reserved. use of ANY materials on this site or its linked pages is explicitly prohibited. |
| "... leaves me wishing, still, for one more day with you ..." ~ Diamond Rio |
| "... how can I live without you, I want to know ... how can I breath ... without you ?" ~ Trisha Yearwood |
November 27, 2009
Logan has died.
Two years, 8 months, 23 days, 1 hour ...................................................................................................................................................................... a blink of an eye.
Logan has died.
Two years, 8 months, 23 days, 1 hour ...................................................................................................................................................................... a blink of an eye.
| ________________________________________________________________________________________________________________________________ |
| ________________________________________________________________________________________________________________________________ |
