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> Our Little Quincy Has Auto-immune Disease, Hurts So Much
Aaron
post Apr 1 2013, 10:39 AM
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It was just a few years ago that I came here to lean on this community for support when we lost our car Reggie to hepatic lipidosis (fatty liver disease). It's with great sorrow that I have to return for support for another sick pet. Our sweet dog Quincy, a Maltese, came down with auto immune disease recently and we are trying to suppress the inflammation, but it is proving to be a difficult task so far. We are by no means giving up, but I feel like every day that passes that he does not improve means we are closer to losing him. Back in late December he had his regular annual exam and got his vaccines. We suspect that one of the vaccines triggered his immune system to go into over-drive, for lack of a better phrase. The vaccine was not the cause, as all vets we have spoken with say this is genetic and it takes just one trigger to bring this disease to the surface.

We initially tried steroids which helped some, but it did not completely suppress the inflammation. He slowly got worse so we got an MRI done which revealed considerable fluid on the right side of his brain. So they tried a large does of steroids (prednisone) which had an impact but then he seemed to get worse. So we went to the next treatment which is chemo since we are trying to suppress over-active cell activity. He was having seizures so he is on meds that make him considerably drowsy, so it's hard to tell if the chemo is having an impact since they cannot measure his neurological signs accurately. But the doctor is concerned the chemo might not be having an impact, which means we have fewer treatment options. They have told us that if the chemo does not have an effect, then his prognosis is "poor".

If you are reading this, then you know how difficult this can be. We are stressed both physically and mentally and it would devastate us to lose another pet after just 2.5 years. I can't even imagine how destroyed my wife will be of we lose him, but I am starting to prepare myself for that. I am just typing this to get it off my mind and my chest. We are staying positive and won't go out without trying every viable option. But every day is incredibly difficult.

Thank you in advance for your thoughts and prayers.
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moon_beam
post Apr 1 2013, 02:06 PM
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Hi, Aaron, please permit me to offer you my sincerest condolences on the diagnosis of your precious Quincy. There is a different journey we travel when our precious companions become chronically ill and we are faced with the possibility that their earthly journey is less than what our hearts can manage to comprehend. It is a journey that is called Anticipatory Grief. We try to "prepare" ourselves for the worst case scenario, yet because our precious companion is still physically with us we also find ourselves holding onto the adage that "where there's life, there's hope".

Hope is important to have - - regardless of the circumstances, for without hope the spirit withers and life itself begins to lose all meaning. Hold fast onto your hope, Aaron, for your precious Quincy, for you, and for your wife.

Please let me try to reassure you that you are among friends here who truly do understand what you and your wife are going through, and we are here for you for as long and as often as you need us. And please know that I am holding your precious Quincy and you and your wife close in my thoughts and prayers that he will respond to the chemo treatments and other meds so that he can continue to enjoy a good quality of life with his Forever Mom and Dad.

Thank you so much for sharing your precious Quincy with us, Aaron, and please let us know how he's doing.

Peace and blessings,
moon_beam


--------------------
In heaven's perfect garden there is no grief or pain, and all of God's creation join the angels' sweet refrain.

The most blessed way I have of knowing God's comforting love and grace is to look into the eyes and heart of God's creatures' sweet angelic face.
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LoveMyMickey
post Apr 1 2013, 06:33 PM
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Dear Aaron,

I am so sorry about your little Maltese, Quincy's illness. Please don't give up hope. A few years ago our little Maltese/Pekingese Mickey got an auto-immune disease that attacked his red blood cells. They caught it in a routine test and the young vet didn't give him the right meds. So he almost bled to death through his mouth. We rushed him to another vet, she cleaned him up, gave him shots. She also gave him Predlisone and liquid antibiotics. It took a few weeks for him to get completely well.

He had a heart murmur and died later of congestive heart disease, 2 yrs. ago.

I hope and pray little Quincy will get well. (I love Maltese).

LoveMyMickey


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"Love knows not its own depth until the hour of separation."
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Aaron
post Apr 2 2013, 12:13 PM
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thank you both, your words mean a lot to me.

We brought Quincy home yesterday afternoon and he slept like a log for most of the time up until bed time (9 pm or so). He began whining, which means he wants food/water, needs to potty or wants to move around. It turns out he wanted to move around. The anti-seizure meds he is on are still making him wobbly, so we helped him walk around for nearly an hour before he was finally pooped. He wanted to do the same this morning, so we helped him walk around for 30 minutes until his meds kicked in and made him drowsy. He is eating, drinking and using the bathroom fine, so those are all good signs. We will consider the fact that he wants to move around (and for pretty long stretches), even though he needs a helping hand at the moment, as a positive. Our primary vet said his anti-seizure med dosages could very well be too high and need to be adjusted, but the next few days will tell us more about that. We will remain positive and take this one day at a time. It's been a roller coaster, physically, mentally and emotionally (as we have all been through, some of us many times).

It's definitely still stressful because you want your baby to be healthy, but we are glad he is home so we can care for and love him like only his parents can.

Thank you again for offering your kind words, they help greatly. Please keep little Quincy in your thoughts and prayers.
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moon_beam
post Apr 3 2013, 03:21 PM
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Hi, Aaron, thank you so very much for sharing with us how your precious Quincy is doing. He is very blessed to have the loving care of his Forever Mom and Dad. Please know your precious Quincy and both you and your wife are in my thoughts and prayers, and please let us know how things are going.

Peace and blessings,
moon_beam


--------------------
In heaven's perfect garden there is no grief or pain, and all of God's creation join the angels' sweet refrain.

The most blessed way I have of knowing God's comforting love and grace is to look into the eyes and heart of God's creatures' sweet angelic face.
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Aaron
post Apr 5 2013, 03:56 PM
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thanks moon_beam. I will never forget how supportive you were (as well as many others) after we lost our Reggie back in 2010. I again thank you for offering kind words.

So yesterday Quincy walked as well as he has since coming home, but then later in the day he was favoring his left side. He is still walking, so we are not going to "freak out" over the change. He got his blood drawn today for his post-chemo testing, so our primary vet checked him out. All things considered she said he is fine and suspects his anti-seizure meds are impacting him to some degree, which was expected. We know auto-immune disease takes months to address, so we are trying to be patient and focus on the long term rather than him taking a step back here or there. It's only been a week since he got his first chemo treatment. He is still eating/drinking/pottying fine and resting well and has the same desire to move around throughout the day, so we will remain positive and continue to provide him the same care and love we always have.

My wife's parents are helping too. They are retired and live close by, so they stayed at our home today and kept an eye on him for us. So we are lucky to have them around to assist.
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Aaron
post Apr 9 2013, 12:36 PM
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I wanted to give an update on Quincy. He has not had any seizures since Saturday evening March 30, so that is good. He is still eating/drinking/pottying fine and continues to have the desire to walk around (when he is not resting). The seizure meds he is on appear to be causing at least some of his side effects, but we won't know for sure until a few more weeks pass. But he is showing steady progress, which is good. We are going to start tapering him off the Phenobarbital he's been taking (his dosage amount was increased a week ago but they want to start SLOWLY reducing the dosage with the idea of completely taking him off PB and utilizing other seizure meds). We are still anxious from the standpoint that we don't know for sure how much of his current condition is from side effects of his seizure meds and how much is from the inflammation. But we are optimistic a good portion are from meds, potassium bromide and Phenobarbital in particular. It takes 2-3 weeks in general for these side effects to subside, so we just have to wait.

He did one small thing that is a positive sign (we take whatever we can get). A few weeks ago when we first took Quincy to the vet, if you flipped his front left paw over in the incorrect position, he would not flip it back over. He has started flipping it back over again. Again, it's small but a positive sign.
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moon_beam
post Apr 9 2013, 03:19 PM
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Hi Aaron, thank you so very much for sharing with us how your precious Quincy, and you, are doing. Progress, however small, is still progress, and it sounds like Quincy is responding to the treatments - - as evidenced in his ability to flip his front left paw back to a normal position. This is a VERY GOOD neurological response, and I am so very glad for your precious boy, and you.

His medical care providers are correct in slowly decreasing his meds, particularly the Phenobarbital. It is a fine line in determining the absolute minimum maintenance dosage to help control the seizures, and the only way to do this is to slowly decrease it. Hopefully he will be able to be completely weaned from the Pheno while maintaining control of the seizures with other meds.

It is so special that your wife's parents are able to help supervise Quincy when you and your wife are at work, etc.. I know this helps you to know that your precious Quincy is in loving care when you can't be there with him, and it also gives special time for Quincy to be with his "grandparents."

I hope today is treating your precious Quincy, and you and your wife kindly, Aaron. Please know your precious boy and you and your wife are in my thoughts and prayers, and that I look forward to knowing how things are going.

Peace and blessings,
moon_beam


--------------------
In heaven's perfect garden there is no grief or pain, and all of God's creation join the angels' sweet refrain.

The most blessed way I have of knowing God's comforting love and grace is to look into the eyes and heart of God's creatures' sweet angelic face.
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Aaron
post Apr 11 2013, 01:48 PM
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thanks moon_beam, we keep reminding ourselves that progress, slow or otherwise, is progress. I know these meds, especially when given in the manner Quincy received them, can have stronger temporary side effects that take time to subside. It's definitely a "team effort" in getting Quincy back on his feet (figuratively and literally). My wife and I, her parents, my parents and her sister and her husband have all layed a role in helping Quincy. The last few days he has shown improved ability to get himself up after he stumbles, which is an indication that his hind leg strength is getting back to normal. My wife sent me a video of him waking in the backyard and he is walking "taller" and in a more controlled manner. So it appears that the side effects of his meds are slowly waning. We have someone on duty for each day over the next 2.5 weeks, so we're hopeful he will be back to his more normal self after that time so he can hang out next door with his cousins or at his grandparents' house. It's been a challenge on many fronts, but we told ourselves we would not give up on him.
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moon_beam
post Apr 12 2013, 02:17 PM
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Hi, Aaron, thank you so very much for sharing with us the very good news as to how your precious Quincy and you are doing. I am soooo happy that he is becoming stronger with every day. It is so heartwarming to share with you the progress your precious Quincy is making with the loving care and attention of all of his family. He is definitely blessed to have so many loving family members taking care of him.

I hope today is treating your precious Quincy, and you and your wife and all your family kindly, Aaron. Please know your precious boy and you and your wife are in my thoughts and prayers, and that I look forward to knowing how things are going.

Peace and blessings,
moon_beam


--------------------
In heaven's perfect garden there is no grief or pain, and all of God's creation join the angels' sweet refrain.

The most blessed way I have of knowing God's comforting love and grace is to look into the eyes and heart of God's creatures' sweet angelic face.
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Aaron
post Apr 12 2013, 03:33 PM
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Thank you moon_beam smile.gif Quincy's follow-up appt is Monday afternoon, which I am anxious about because I don't know what to expect. I have to remind myself that in less than 2 weeks he has made great strides, going from not being able to walk on his own on April 2 to being able to walk and get up on his own today. While it has not even been 2 weeks since he came back home, it feels like it has been so much longer.

There is still a long road ahead of Quincy for his recovery, but I feel like he is headed the right direction. It's nerve racking not knowing how much of his condition is being caused by the combination of potassium bromide + phenobarbital. Everything I have read indicates the side effects Quincy is experiencing now are consistent with the separate and combined side effects of these two meds and it can take several weeks for those side effects to subside, at least to the point of him being back to a more normal state. So we have to continue to be patient and take each day at a time.

I'll let you know how his appt goes on Monday and what the game plan is.
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Aaron
post Apr 15 2013, 03:36 PM
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So Quincy had his appt today. The vet expressed concern over Quincy, particularly his mental/neurological state, but it was more from the standpoint that we just have to continue with the plan we have in place and look for continued progress, even if that progress is slow. His physical progress over the last two weeks has certainly better than his neurological progress, but it's hard to say how much of that is from the potassium bromide (or other meds) and how much is from the inflammation. Only time will tell but we also know neurological injuries take time to heal. He's only been on cyclosporin for a week and that takes at least two weeks to reach therapuetic levels, if not more. The vet stressed that he might have good days and bad days and some mornings might be good and some mornings might be bad and we can't beat ourselves up if he hits some bumps in the road, but instead we want to measure progress over weeks at a time. His next appt is scheduled for 2 weeks.

The vet stressed that Quincy may never return to the old Quincy we have always known, but that does not mean he cannot have an enjoyable quality of life. It just seems so strange that he went from being in a certain mental state on March 27/8 to how he is now and the cause completely being the inflammation. But that is also the optimist in me talking and knowing that K Br side effects can be strong and can take more time to subside based on our extensive research. I have to prepare myself for the possibility that we may never get Quincy back to his old self. I don't even want to think about losing Quincy and instead will continue helping him make progress in any way I can (as my wife will too). I know it is going to be a difficult road but we are not giving up on him, not as long as he is making progress.

Thanks for listening to me ramble, it helps to get things off my mind. It's just a tough road to travel, mainly because we hate seeing him not at his fullest. I would take a reduced Quincy and love him all the same.
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moon_beam
post Apr 16 2013, 10:50 AM
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Hi, Aaron, thank you so very, very much for sharing with us how your precious Quincy, and you and your wife are doing. From what you share with us, it sounds like Quincy's recovery is moving in the right direction - - slowly but surely. There is no doubt in our minds that you and your family love your precious Qunicy "in sickness and in health". Of course our prayers are with your precious boy and you that your precious Quincy will recover as close to 100 percent as possible, but I also know that whatever level of improvement he makes will be greatly appreciated, and celebrated. Quincy is so blessed to have the supportive care of his Forever Mom and Dad, and all of his family, to encourage him as he continues with his recovery.

Thank you again for sharing with us how your precious Qunicy's appointment went yesterday, Aaron. I was thinking about it this morning, and am so glad to share your news. I hope today is treating your precious Quincy, you and your wife, and all your family kindly. Please know your precious Quincy and you and your wife are in my thoughts and prayers, and that I look forward to knowing how your precious boy and you are doing, and will look forward to knowing how his next check up in 2 weeks goes.

Peace and blessings,
moon_beam


--------------------
In heaven's perfect garden there is no grief or pain, and all of God's creation join the angels' sweet refrain.

The most blessed way I have of knowing God's comforting love and grace is to look into the eyes and heart of God's creatures' sweet angelic face.
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LoveMyMickey
post Apr 16 2013, 05:46 PM
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Dear Aaron,

That sounds good that little Quincy has some improvment. Like you said some of his problems could be side effects from the meds. Little Quincy will always be in my thoughts and prayers to get completely well.....Give him a special pat for me....God bless...

LoveMyMickey


--------------------
"Love knows not its own depth until the hour of separation."
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Aaron
post Apr 17 2013, 10:11 AM
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thank you both for the kind words. This is so incredibly difficult now, as we just don't know if Quincy is going to improve or this is as good as he is going to get. I know for sure I will have his K Br dosage decreased to see how he responds as I have read other dog owners state their dogs could not handle the side effects. Perhaps it's the optimist in me, but I still think some of his condition is from the meds' side effects, as he is on three seizure meds right now. Only time will tell, which is the difficult part. As he is now, Quincy needs a baby sitter pretty much all the time. While my wife's parents have been very supportive, we cannot expect them to watch him multiple times a week. And we can only take off so much time from work to be with Quincy. What haunts me is if he does not improve beyond his current state, then we are going to be faced with some very difficult decisions. It literally makes me want to vomit thinking about that.

What makes it more difficult is that he eats/drinks/potties fine and still walks around and get exercise, albeit with less coordination. So he is not on his death bed or anything like that. If he could just turn the corner a little bit, then it would make a huge difference.
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moon_beam
post Apr 17 2013, 10:39 AM
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Hi, Aaron, thank you so much for sharing with us how your precious Quincy and you are doing. I know how your heart is hurting for your precious little boy - - just wanting to make everything "right" for him again. This is a testimony to your devoted love for him.

As you know the decrease in any medications needs to be gradual, so it's going to take time for the side effects to ease and for Quincy to be able to exhibit changes in his behaviors - - be they positive that he can do without the medication - - or positive that he needs the medication. Adjusting the dosage for seizures is like walking a tightrope - - there is no "one dosage fits all" prescription - - it is totally dependent upon the patient's ability to handle the specific medication and adjusting the dosage to control the symptoms - - which may require adjusting periodically - - like insulin for diabetes.

It sounds like Quincy is holding his own. He also knows that you love him and will provide for him according to his needs. Unless something drastic changes for Quincy that indicates his quality of life no longer exists, it is important to try to stay focused on the progress your precious boy IS making. You and your wife may want to consider purchasing / building an inside pen for him - - or perhaps gating him in a bedroom - - so that you can safely leave him alone at home while you are at work, and when other family members cannot be with him. This way you will know he is safe until you get home.

I hope today is treating your precious Quincy, you and your wife, and all your family kindly. Please know your precious Quincy and you and your wife are in my thoughts and prayers, and that I look forward to knowing how your precious boy and you are doing.

Peace and blessings,
moon_beam


--------------------
In heaven's perfect garden there is no grief or pain, and all of God's creation join the angels' sweet refrain.

The most blessed way I have of knowing God's comforting love and grace is to look into the eyes and heart of God's creatures' sweet angelic face.
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Aaron
post Apr 17 2013, 11:37 AM
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Thank you moon beam, you are right. He has been on his current seizure med regimen for almost 3 weeks now and the only change has been to reduce his PB dosage. He is on 125 mg/day of K Br (after being on a loading dose), which is near the upper end of the recommended daily dosage of 20-40 mg/kg. It's hard to say if that is too high a K Br dosage for Quincy or not, but I will make it a point that this dosage needs to be reduced to see if it has any impact on his condition. Considering he is also on PB, it might be too much for him to handle. Like humans, animals' tolerance for drugs varies from animal to animal. And I don't even know how the Keppra factors in since side effects of that med are not well known, especially when used in conjunction with other meds.

I have to remind myself that he has been home for only since 4/1, so we need to let the new medication regimen do its job. I have to work extra hard to stay positive and not allow negative thoughts to enter my mind. I won't lie, I have thought numerous times about having to say goodbye and what life would be life afterward, but I simply cannot do that right now. I have to focus my energy on his recovery.

I have thought about making a spare room into a space for Quincy in the event nobody can watch him. We have such a room we could prepare for him. Currently we have converted our living room into such a space, but it would not be adequate for Quincy if he was alone since it's lined with pillows and dog beds, which he can potentially "break through". Someone will be watching him through at least next Friday, so we have time to prepare. Kristy and I will use all our vacation time to stay with him if we think it will help him progress. I know my in-laws and my parents will help as needed. I just don't want to give up on him until we have exhausted every possible angle. He is that important to us.
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moon_beam
post Apr 17 2013, 02:15 PM
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Hi, Aaron, thank you so much for sharing with us how your precious Quincy and you are doing. When our precious companions are experiencing a medical crisis it is perfectly normal for us to think about having to say goodbye and what life would be like without their sweet precious physical presence with us. I have experienced this many times with each of my companions, and as recently as 6.5 months ago when my I came so very close to losing my precious Noah with what turned out to be a twisted intestine. Because the surgery was expected to be very intensive, I put a "Do Not Resusitate" order on Noah's chart, and instructions for the surgeon to call me during surgery so that I could decide to have him peacefully transition home to the angels if that turned out to be the best for him. It is hard not to let our fears and sorrows find a place in our thoughts and grieve for them even though they are still physically with us yet so very ill. Thankfully, the surgeon was able to restore my precious Noah's health to him - - this time, and he is doing well to this day.

And so it is with your precious Quincy - - because of the deep enduring love you have for him you do not want him to suffer - - yet he is still showing you that your love for him is giving him the strength and courage to endure through this medical challenge. It sounds like your precious Quincy isn't ready to "throw in the towel" yet - - so let this be your guide. You are doing the absolute RIGHT thing when you share with us: "I just don't want to give up on him until we have exhausted every possible angle. He is that important to us."

Please know we are here for you, Aaron, to share with you whatever is in your heart and on your mind - - and to offer you encouragement, comfort, and hope as your precious Quincy, you and your wife, and your family travel this journey in your precious boy's medical crisis. Please know your precious Quincy and you and your wife are in my thoughts and prayers, and that I look forward to knowing how your precious boy and you are doing.

Peace and blessings,
moon_beam


--------------------
In heaven's perfect garden there is no grief or pain, and all of God's creation join the angels' sweet refrain.

The most blessed way I have of knowing God's comforting love and grace is to look into the eyes and heart of God's creatures' sweet angelic face.
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Aaron
post Apr 18 2013, 10:52 AM
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thank you moon beam. The last few days have been more difficult for whatever reason. The last few days Quincy has not been walking or getting up as well as in prior days, which could be the meds or could be an indication that the inflammation is getting worse. It's hard to tell right now. I have been out of the office all this week and came in this morning and had to leave because I was crying. I am a physical and emotional wreck right now.

Each day that passes it gets more difficult to see Quincy like this. He's a shell of his former self right now and that is so painful to see. One of the things that makes it so much more difficult is that we got Quincy a few months after we lost Reggie, so there is that connection. Quincy helped us manage our loss of Reggie and it hurts to think we may now lose Quincy. We just have to hope that these new meds kick in and help him. But it's getting more difficult with each passing day.

I don't have to explain to you the wonderful memories and all the ways in which Quincy is engrained in our lives and our home that make this ordeal even more difficult. You have been there before numerous times. I don't know if it helps me any, but I'd like to share some of my fondest memories of Quincy with you, if not to put a smile on someone's face.

One thing he did but hasn't since the auto immune disease set in was to greet anyone who walked into a room with a special "hello" bark. It wasn't his normal bark, but a more quiet, more reserved bark. You could tell he was doing it specifically to say hello. When he was excited to see you and he was laying on the couch or the floor, he would "swim" for you....he would put his front legs forward and his back legs straight back and make this cute little swimming motion. I would be sitting on the couch at night watching TV and he would come sit on my chest and lick my hand until I started giving him a back and ear massage. He loved his back and ear massages so much. While we never liked him barking at people through our back fence (we have a metal fence so our dogs are able to see people through it), he had this cute little howling bark that made me laugh every time I heard it. What I wouldn't do to hear that bark again. Quincy and his brother Woodrow love to chew on bully sticks and Quincy would always steal Woodrow's bully stick, even if the one he just had was the one he stole before.

Those are just a handful of the precious memories I have of Quincy. I don't mean to share them in a way that makes it look like he is gone, but I wanted you to know what kind of a special dog he is since I have not really shared any of that with you.

I will continue to update you on Quincy's progress. Thank you for reading and providing support in this time of need.
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moon_beam
post Apr 18 2013, 02:27 PM
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Hi, Aaron, thank you so very much for sharing with us how your precious Quincy and you are doing, - - and for sharing your wonderful memories that you and your precious Quincy share in your earthly journey. He is a very special boy indeed. Even though he is going through a major medical trauma right now, this only endears him closer to you.

Aaron, your precious Quincy will let you know beyond all shadow of doubt when you will need to ease his journey home to the angels. He has his next check up in about 10 days or so, and hopefully in that period of time both you and your precious Quincy will be seeing more positive results with his meds regimen. If you have not already considered it, you and your wife may want to think about obtaining a second opinion if you think it might be appropriate and helpful for your precious Quincy. Whatever you and your wife decide on behalf of your precious Quincy will be the RIGHT decision for him.

I hope today is treating your precious Quincy, you and your wife, and all your family kindly. Please know your precious Quincy and you and your wife are in my thoughts and prayers, and that I look forward to knowing how your precious boy and you are doing.

Peace and blessings,
moon_beam


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In heaven's perfect garden there is no grief or pain, and all of God's creation join the angels' sweet refrain.

The most blessed way I have of knowing God's comforting love and grace is to look into the eyes and heart of God's creatures' sweet angelic face.
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