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Discussion Starter #1 (Edited)
I have an 11 year old hound that has had some medical problems in the last couple years, such as spine surgery and Hip Dysplasia and a few minor problems.

In the last couple months we’ve had a few new issues arise. About two months ago we had blood work done on her in preparation of her dental surgery she was going to have. The blood was only done as a preventative because she’s 11 and having surgery – she had no signs of anything being wrong at the time it was taken. The blood came back with high level in the liver so we started her on antibiotics to bring it under control. After a couple weeks on them we re-took the blood – number was still higher than normal but they didn’t think it was too high to proceed with the dental surgery since the condition of her teeth could have been the cause of the increased level. She’s always had bad teeth. Poor girl.

Anyway, fast forward I think about a month, and late at night we noticed that she was having a hard time lifting her head off the ground and she was moving even slower than normal. Considering that we refer to her as the sloth – she was hardly able to move and her head wasn’t an inch off the ground. So we ran her over to the vet. They started to do a neurological examination but because of the pain they could see she was in they couldn’t or wouldn’t do much. Because it was so late (by then it was almost midnight) there was no one at the vet to do an MRI. I even called the Veterinary Specialty Center in Buffalo Grove where she had her spinal surgery – no one there either at that time of night – they just said they could make her comfortable till morning when someone was in to do the MRI. So… We decided that she would be most comfortable at home with meds to keep her still and I would bring her to the Veterinary Specialty Center first thing in the morning since they already had a MRI of her for history.

Long story short – her spinal disease has moved up to her neck but because of where it’s located there is 1.) No guarantee on this surgery like there was on the first one she had and… 2.) Because of the location they would have to go in through the throat and with all the nerves she could have a lot of complications. Our only other option is to pray that she takes to the medicine – after three weeks it appears that she is doing well as to her neck – she’s on almost complete puppy bed rest – we carry her up and down the stairs at night and in the am – and only goes out to do her business. Or just to get her afternoon sun bath -

Now on to our current problem. – I’m not exactly sure when it started but to say that it was after the neck problem because she had three different vets checking over every inch of her body and there we’re no enlarged parts anywhere on her.

Friday May 27th – six days ago – I was sitting at the table and looked down at her and saw the right side of her neck was extremely enlarged, and when I felt it – it felt like a tennis ball size – I immediately called her vet and got her right in. When we we’re doing the examination of her we noticed that her right back side was also extremely enlarged. I’ve been so busy looking to see if she’s able to keep her head off the ground that I can’t remember the last time I looked at her back end “cute as it is” – I’m just noting this to say – we have no idea what came first – the back end of the throat.

Samples were taken from both parts – back end was “fatty” the throat pocket was full of a pink puss – my vet was at a loss – never seen anything like it. She took blood and sent it out with the samples she was able to draw and we put her on antibiotics to hold her over the holiday weekend till the results got back. The next day it appeared that the one on the throat was larger so Saturday night I ran her over to the Veterinary Specialty Center in Buffalo Grove where she had been just a few weeks ago and where she had her back surgery – she also took samples – the back was still a fatty substance but now the pocket on her throat was no longer puss – but fatty. No one there had seen anything like this either. I told them the plan that was in place and the results we were waiting to get back – she just recommended that I get the planed scan and X-ray’s on Tuesday – she felt Flash would be fine until then.
Tuesday has come and gone – she had the scans – and X-Rays’ – and most of the samples have come back. The only thing they could tell is she’s had a fractured rib at one time – and she now also has hip dysplasia. Oh, and they were able to rule out lymphoma – but not cancer altogether. Also her liver count is own over 800.

They took more blood and urine are now looking for a mycobacterial infection in her – I’m at a total loss – my brain is mush – and I’m totally drained – has anyone heard or seen anything that is remotely like this?
They said that after the antibiotics are gone and she still has the enlarged parts – they would take larger samples of both and a sample of her liver for more testing.

I'm sorry about such a long post - but I wanted to give as much information as possible.


Any help that anyone can give would I would be extremely grateful
Jennifer

I attached a few photos of her back end - When hubby gets home I'll get one of her neck - I can't without help because of the ears and extra skin.
 

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Wow Jennifer, sorry to hear about Flash and I wish you a speedy recovery. My boy had a bout of what they called pancreatitis with elevated liver enzymes about a year before he developed lymphoma. His levels I believe were as high as Flash, they prescribed Denamarin (milk thistle). His levels were down in a month or so. Happy this isn't lymphoma, hope not another cancer. Does she have a fever at all? Is she eating OK or any vomiting?
 

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Discussion Starter #3
Thanks for the Reply Kathy - hope your little guy is doing well. I should have mentioned - just a "slight" fever and she's always been a finicky eater - and not a big one at that - she's eating ok for her - nothing to write home about and nothing yet to really worry about if you know what I mean. But I do think she’s drinking a little more than normal.


Jen~
 

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Be prepared .Your girl being 11 this could be the beginning of the end.I don't mean to sound uncaring but she has something going on that they cannot locate and you have had almost everything done that you possibly could have done. Be aware of when you are doing all these things for her or for you.I hope she rallies and she is with you a while longer.You may be upset with me for saying that but I'm only thinking of your best interest as well as hers. Try to know when you've done enough and are doing much for her sake and yours.I pray they find out what the problems are soon.
 

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Discussion Starter #5 (Edited)
No Worries Babbad - I know it sounds hard - but it’s something I do look at. Her quality of life is what's most important to me. I've had Flash talk with a pet physic this weekend - not sure if anyone believes in them - but I've had my kids talk to them a few times and it’s amazing what they tell me about them. The first one I spoke with I asked her why my other hound Lucy would walk around the house and just bark at nothing – just woof – woof – woof – woof moving her head back and forth. She told me that Lucy liked the way her voice sounded because of my high ceiling. Now, this woman would have no idea that I had 20 Foot ceilings. And when we moved to the current house we live in with normal height ceilings – the barking stopped cold.

Anyway, she assured me that she wasn't in pain - just more on the uncomfortable side. I also wanted her to assure Flash they were only going to look inside her when I took her for the scans yesterday. Since her spine surgery she's been a nervous wreck and just shakes and trembles as soon as we walk out the front door. It was amazing – She didn’t shake and no trembles – she sat in the car and looked out the window all the way to the vet and when I got there they couldn’t believe she was the same dog – she was so calm. It was like having my old girl back with me. I’m praying that Flash will tell me when its time. And until she does – I’ll do everything in my power to find out what the heck she has and fix it if there’s a way. She is too special to do anything less.

Jen~
 

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Houndmomma, I'm sorry Flash is having so many issues. I hope the vets are able to help her. I have to tell you, I had an "animal communicator" out to talk to my aged horse a few years ago. I was worried that he would be in a lot of pain but I wouldn't know it. The communicator told me that my horse would tell me "in no uncertain terms" when his time had come. So a couple of years later I walked outside one spring day to find him dead as a doornail in his paddock. As horrible as it was back then, I'm now able to look back and say that he definitely let me know in no uncertain terms that his time had come! :p I don't want you to think that I'm forecasting the same for Flash--I just wanted to let you know that I too believe in pet psychics, or at least some of them. Good luck to you and Flash, and I hope you at least have answers to what's ailing your puppy soon.
 

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So sorry to hear about Flash! I hope they figure out what's going on with her. We'll keep you in our thoughts and Doppler and Virga are slinging lots and lots of healing drool your way.
 

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I wonder if one of these pet psychics could tell us anything about what kind of situation Anabelle spent the first 7 years of her life in. Then again I'm not sure I want to know.

Hoping the best for Flash whatever that may be. I'm glad she is in good hands with you all.
 

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Discussion Starter #10
About 11:00 last night I received and E-mail from one of Flash’s vet. While detailed. We still don’t know what she has. In addition to the message were pages and pages of medical descriptions of different bacteria and everything else that she mentions is the message.


Apologies for the delay. Flash's ultrasound report is still pending due to technical difficulties at the radiologist's end.


Upon reviewing all of Flash's information we have the following issues:


1) The mass under the jaw. Aspirates revealed pyogranulomatous inflammation with no organisms seen. There were also some cells that looked atypical i.e. could represent cancer but not definitive.


Things that can cause this type of inflammation:


a) Infections - bacterial - so far the aerobic culture is negative, the anaerobic culture is still pending. There is also an infection called bartonella which is hard to grow so a blood test is pending for this. Some information:


b) Certain forms of cancer such as a histiocytic tumor (I had one of these a few months ago in a similar location that also abscessed) or salivary tumor. I am probably most concerned about this.


2) The other issue we have is the increased liver value (ALT). Some of the above infections can also involve the liver and cancer can obviously spread to the liver although nothing obvious was seen on the ultrasound. There were however some unidentified structures in the abdomen that may be enlarged lymph nodes near the major vessels - we will see what the radiologist thinks of these.


If the culture comes back negative, the blasto and bartonella tests are negative and the mass does not improve then I would recommend biopsy and culture of the mass and possibly an aspirate/biopsy of the liver. We may also consider biopsying the large mass on the back leg.


Flash's urine was also a little dilute with a trace of protein which we will need to watch.


I'm sure most of this did not make much sense to you but I will call you tomorrow - hopefully with some results.


Regards,

Julie
Julie Allen BVMS MS MRCVS DACVIM
 

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Wow, what a nice caring vet to send a detailed email, hopefully you will have some definitive answers soon and Flash on the mend. Take care......
 

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Discussion Starter #12
I just got the call I’ve been waiting for all day. And…. She hasn’t received any of the reports back yet but wanted to check in to see how Flash was doing. I’m taking Flash in tomorrow so they can take more blood to check the liver count as she will have been on the antibiotic for a week by then. Please keep the prayers coming – As comforting as it is to have the great vets that I do – it’s unsettling when I can hear the worry come though in their voice.

Jen~
 

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Flash's Mom: my first disclaimer is that I am no vet.

But I'll share with you what I found based on what you've told us about Flash and also your vet's email. I wonder if they should consider an Actinomyces infection? i believe it causes pyogranulomas in dogs, both in the jaws and in the skin. as i read about it, there is a relationship to dental work (ie. the Actinomyces can be found in the mouths of dogs, and then they are spread to the bloodstream during dental procedures where the bacteria seed different parts of the body, thus causing these abscesses). and when I went back and read your first post, you mentioned that Flash had recently had dental surgery!

anyways, so I definitely wanted to pass this info along to you. Actinomyces is related to Mycobacterium, meaning that it is difficult to culture. I read that your vet actually needs to specifically ask to culture it because it is Anaerobic. (i'm not sure even if a regular anareobic culture is enough-- perhaps it has to be specific to Actinomyces) so if you think this is a possibility, I would definitely let your vet know so she can make sure the right test is ordered.

This link describes Actinomyces causing "lumpy jaw" in cattle. Perhaps "lumpy jaw" in basset?? sounds like the sooner it's treated the better the prognosis. This article says "The laboratory must specifically be instructed to culture for this anaerobic organism."
ACTINOMYCETES

Here's some info too:
Actinomyces sp. are gram-positive, acid-fast–negative filamentous bacteria that cause pyogranulomatous infections in dogs, cats, cattle, goats, swine, horses, foxes and human beings.5 These anaerobic or microaerophilic commensal organisms are found in the oral cavity of animals and humans.3 Cutaneous actinomycosis is the most common manifestation in dogs, especially in large breed male dogs, and Actinomyces viscosus is the most frequent isolate.3–5 These infections are usually secondary to perforating injuries caused by bite wounds or foreign bodies. In the most common forms of clinical disease in the dog, the cervicofacial, abdominal, and thoracic regions are involved.47 In humans, central nervous system (CNS) infection with Actinomyces is rare and usually results from extension of an adjacent focus or from hematogenous seeding from a distant site.7 Risk factors include dental caries or infections, recent tooth extraction, head trauma, gastrointestinal tract surgery, chronic otitis, mastoiditis or sinusitis, chronic osteomyelitis, tetralogy of Fallot, and Actinomyces infection of an intrauterine device.7 A cerebral abscess is the most common manifestation of human CNS actinomycosis. Other infrequent presentations are meningitis or meningoencephalitis, actinomycomas, subdural empyema, and epidural abscesses.7 There are two unconfirmed reports of Actinomyces causing CNS disease in animals: spinal meningitis in an Arctic fox and encephalitis associated with hydrocephalus in a dog.16 In both cases, the diagnosis of actinomycosis was assumed based on morphologic characteristics and staining properties of the bacteria on histologic examination. Culture of Actinomyces from the CNS and a definitive diagnosis has not been previously reported in domestic animals.

Anyways... just a thought, but definitely wanted to share it with you.

Please keep us posted and we are all thinking of Flash here.
 

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Found a few more things about it:

--Another interesting factoid about Actinomycosis: "Distribution - Occurrence is probably worldwide. A moderately common infection; seen most often in hunting dogs."

--Here is a conclusion from an article on Actinomycosis in humans:
"The diagnosis of actinomycosis is problematic because it is an uncommon infection and microbiological identification is often difficult and delayed. It should be considered when clinical presentation suggests malignant disease but there is no histological confirmation."

--Actually, I believe that looking for "sulfur granules" are one of the best ways to diagnose (need to look at tissue under microscope), since cultures can be low-yield (ie. infection may be there, but cultures are often negative, because of how difficult it is to culture). "Microscopic examination of the fluid draining from the sinuses shows the characteristic "sulfur Granules" (small yellow colored material in the fluid) produced by Actinomyces israelii."

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This is from a 2006 article in Scotland re: how difficult to obtain a culture of Actinomycosis in humans. I'm going to guess it's similarly difficult in dogs.
SMJ

Good news is if for some reason this is it, antibiotics are very helpful...

ps. remember the below is for humans, when they discuss the treatment

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Diagnosis is difficult and positive cultures are very difficult to obtain, with only a 10 to 20% recovery rate.6, 7 This is often due to the fastidious nature of the organism, lack of proper culture conditions, prior use of antibiotics and culture overgrowth from other organisms.6, 7

To increase the probability of a positive culture, certain requirements must be fulfilled. The organism should be cultured on brain-heart or blood agar in anaerobic conditions with a 5% CO2 atmosphere for 4 to 6 days.8 Even when these requirements are strictly followed, culture results are still poor.

As the diagnosis is difficult to make, surgery is an important tool in both treatment and diagnosis, although recurrence is high without concurrent antibiotic therapy. Oral penicillin, for at least 6 months, is the first line of treatment, with tetracycline as an alternative.
 

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Sorry to post so many times-- I guess I'm hoping it's this (then treatable by antibiotics) than histiocytosis....

"Samples were taken from both parts – back end was “fatty” the throat pocket was full of a pink puss – my vet was at a loss – never seen anything like it. She took blood and sent it out with the samples she was able to draw and we put her on antibiotics to hold her over the holiday weekend till the results got back. The next day it appeared that the one on the throat was larger so Saturday night I ran her over to the Veterinary Specialty Center in Buffalo Grove where she had been just a few weeks ago and where she had her back surgery – she also took samples – the back was still a fatty substance but now the pocket on her throat was no longer puss – but fatty. No one there had seen anything like this either. I told them the plan that was in place and the results we were waiting to get back – she just recommended that I get the planed scan and X-ray’s on Tuesday – she felt Flash would be fine until then. "

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Flash's Mom, it also occurs to me to wonder if in fact the lesions from Flash were "fatty" or if they were actually the "sulfur granules" characteristic of Actinomyces. The reason they are called "sulfur" is because of the yellow color, which I imagine could also look like fat. More info below from one of the links i gave you. Might ask the vet if they diagnosed the "fatty" substance by chemical means (to confirm it is actually fat), or if it was only by visual determination. If only visually, it is possible to mistake the "sulfur granules" for fat, I would think.


"The patient usually presents with a pus-draining lesion, so the pus will be the clinical material sent to the laboratory. This diagnosis can be made on the hospital floor. When the vial of pus is rotated, the yellow sulfur granules, characteristic of this organism, can be seen with the naked eye. These granules can also be seen by running sterile water over the gauze used to cover the lesion. The water washes away the purulent material leaving the golden granules on the gauze. This organism, which occurs worldwide, can be seen histologically as "sulfur granules" (figure 3 and 4) surrounded by polymorphonuclear cells (PMN) forming the purulent tissue reaction."
 

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Discussion Starter #16
Thanks so much Wworm for all the information. I've printed out everyting to take with me today when I take Flash for more blood work. They want to check the liver count again since it's been a week today that she's been on the meds for it. I think her count was 870 something.

This is too funny and gave me a laugh I needed - the only hunting Flash ever has done is drag her sorry ass to the kitchen and turn on drool machine so I’ll give her something to turn it off.
--Another interesting factoid about Actinomycosis: "Distribution - Occurrence is probably worldwide. A moderately common infection; seen most often in hunting dogs."
What we thought was really strange was that when I took her to the vet on Friday the back end was fatty (which they did send out for testing) but the neck pocket was pus – then the next night when I ran her over to the specialty clinic – the neck pocket had turned to fatty. The only thing I’m getting out of that is I missed when her back end enlarged because as I previously mentioned I was so busy watching to make sure she was still able to hold her head up that I didn’t pay attention to any other part of her body. And maybe because I was so busy watching her neck – I caught it as soon as it grew.
Flash's Mom, it also occurs to me to wonder if in fact the lesions from Flash were "fatty" or if they were actually the "sulfur granules" characteristic of Actinomyces. The reason they are called "sulfur" is because of the yellow color, which I imagine could also look like fat. More info below from one of the links i gave you. Might ask the vet if they diagnosed the "fatty" substance by chemical means (to confirm it is actually fat), or if it was only by visual determination. If only visually, it is possible to mistake the "sulfur granules" for fat, I would think.
When I spoke with my vet last night she was going to be calling everywhere they have Flash’s samples to see what the delay is. And I guess the Ultrasound hasn’t even been uploaded due to the site being down – so she’ll be calling support about that also. I guess they’ve had a message on their site about technical issues – but enough is enough. Technology – gota love it.

Thanks so much for your prayers for Flash – I’m a big believer of the power of prayer.

Jen
 

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Hello,

I have never posted before, but I wanted to reiterate bassetmom26003's post regarding milk thistle. After extremely high ALT levels, our vet put our 13yr old basset on Vetri-Liver Support Soft Chews, which contains milk thistle. Within two weeks his numbers were down significantly and continued to decrease and stabilize over the next ten months until we lost him to congestive heart failure. I know when it comes to health issues that all situations and circumstances vary for each animal, but I wanted to say that this is a product that worked wonders for our Pooh. I will be thinking about you and Flash. Here is a link to the specific product in case you want to research.

Vetri-Liver Support Soft Chews for Dog's Liver Function
 

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Discussion Starter #19
OMG – Wworm – thanks so much – we still don’t know anything yet but while I’m waiting for my phone to ring, (like watching a pot to boil, never does) I’m researching everything I can and one of the thing you had listed said something about the nose.
On the right side, same side as the other two growths, she’s had what looks to the naked eye a scratch or dry skin. I remember even asking one of my vets about it when she was at the office (prior to all the current problems) they thought it was nothing and should go away and just keep an eye on it. Shortly after that all hell has broken loose with medical issues with both my hounds.
First Lucy with a growth by her eye, and pressure on her eye. It was almost in a closed state. As soon as we got that under control we’ve had all these issues with Flash and I’ve been so busy with everything else going on I didn’t put two and two together to think if it could be related. I just to an extreme close-up of her nose and send it to my vet. Because of the size of the image it might be blocked – I’m waiting to hear back if her server blocked it due to size and if so I’ll have to upload it to one of my sites for her to download. But I know they’re busy today so I’m not even sure when she’ll get a chance to see my email.

Henley, Thank you so much for caring about Flash enough to make your first posting. I’m aggressively looking into everything, thank you for the link. I’m so sorry to hear you lost your Pooh to heart failure – I also lost a cat to that about ten years ago – I feel your loss.


Thank you again for all your help and prayers for Flash.

Here is the extreme close-up of Flash’s nose – amazing what you can see with a close up that you can’t with the eye.
 

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Discussion Starter #20
Appears my Vet has the same insomnia that I do – I just received her email and the report from the ultrasound.

Message from my Vet:
I noticed the nose the other day. Please ask the tech to check tear production in the eyes (or we can check it next week). We sometimes see a dry nose (and dry eye) if there is damage to the facial nerve. It's possible the mass is impinging on the nerve or it could be unrelated.

The ultrasound report came back and the radiologist concurred with my findings (see attached). The biggest things were the spherical structures near the vena cava that he wondered whether were granulomas. I think they would be really risky to aspirate due to their proximity to the vessel but we could look again when she was anesthetized. I do think we should proceed with the biopsy and liver aspirate depending upon the lab work results. I'll look at the schedule and see when might work.

Regards,

Julie

Julie Allen BVMS MS MRCVS DACVIM

Text from the report:
HISTORY: The areas of concern and clinical signs include the following:. Presented approximately 1 week ago with 6x6cm submandibular mass. FNA yielded 30mls of purulent material. Cytology revealed pyogranulomatous inflammation with no organisms, some of the epithelial cells displayed signs of atypia but pathologist felt predominant finding was inflammation however underlying neoplasia could not be fully ruled out. Aerobic culture negative. Anerobic still pending. Blasto Ag negative. Bartonella pending. Lab work revealed markedly elevated ALT 817 (5-107), ALP 387 (10-150). On clavamox and metronidazole with no change. Planning biopsy of mass, checking for mycobacterium and possible FNA of liver next week.


ABDOMINAL ULTRASOUND 6/3/11: Eighty one static images, 3 video loops are provided. The liver is diffusely =hyperechoic, no regions of nodules or masses identified. The gallbladder is normal. The splenic parenchyma is normal with hyperechoic regions surrounding blood vessels, likely adipose tissue. The kidneys are normal with intact corticomedullary definition. There is a 1.1 echogenic structure in the dependent portion of the urinary bladder, no shadowing seen. The GI is normal with intact wall layering and thickness.

The adrenal glands are normal, the right measuring 6.5mm thick and the left measures 5.8mm thick. There is a 1.9cm x 2.1cm echogenic structure present associated with the caudal vena cava. This appears adjacent to the cava, not confirmed to be within.

CONCLUSIONS: Hyperechoic liver. Differentials could included fatty infiltrates, steroid hepatopathy, cholangiohepatitis, hepatitis or less likely neoplasia.

The echogenic structure near the caudal vena cava could represent a granuloma, hematoma or less likely a neoplasm.

Small urinary bladder crystal.

RECOMMENDATIONS: Consider needle aspirates of the liver and if possible the echogenic structure. Color flow evaluation of this structure should be utilized to ensure no caval involvement.

Well, this is all I know for now – Tomorrow when I’m hopefully thinking clear this will all make a little more sense to me. I’m drained in every way.

I think one of the most difficult aspects of going through this is not know what to pray more for. To find out what the problem is so I can get it fixed. Or knowing when enough is enough. Right now she doesn’t appear to be in any pain, still likes to eat, still loves her treats & cookies and enjoys her little walks around the cul-de-sac. She can no longer go on her mile long walks but she’s walking so slow smelling everything within reach of her nose – which I think the walks might even take us longer now.

Jen~
 
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