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The "Decision"

Discussion in 'Pre-Veterinary' started by dee vee emm, Dec 1, 2008.

  1. dee vee emm

    dee vee emm Future DVM
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    So here's the thing... among all the stresses of applying and wondering if I'll get in, and then Christmas on the way and a few other things... my mom says the one thing today to me that I've been dreading to hear from her... "Maybe we should start thinking about making a decision..." She is referring to my 15 year old cat. Now after working at a small animal clinic for about 5 years, I've seen lots of people come and go, and the heart ache that comes with putting an animal to sleep. But I've been only the observer, it hasn't happened to me yet.

    SO here's the background... earlier this year I recongized some signs that he might be starting with kidney failure, so I got the tests done, and it was confirmed. So I got the reduced protein food, Epakitin, and there's always fresh water for him. And he's been doing pretty good, except for losing a bunch of weight ( he used to be a big fat cat at 16-17 lbs. and now he's pushing 11- 12 lbs). The thing my mom can't put up with anymore is that he does get consitpated, and after straining so hard, he makes himself vomit, and then there's the occasional peeing (which he never did before) on the carpet. So her and my dad are getting mad that the carpets are getting ruined (but really it's mostly from my dog who is a little Chihuahua and takes advantage of her small size---though that's another story).

    The thing I have with making this "decision" is ok so he's been my buddy for the last 15 years, he sleeps on my bed every night, and he follows me around like a dog sometimes---and I'm going to be totally broken hearted if he's not with me. But the major thing is, his attitude is fine, he's not lethargic or acting sick (besides the constipation), and he still eats (though it's very little bits at a time). So because his quality of life still seems fine, I can't justify losing him over the fact that he's messing up the carpets a little bit. If he was acting sick and wasn't doing well, well then it would be a different story...

    So I was just wondering from one pet lover to another what would be the deciding factor in this case that I should really consider making a decision about him... I mean I'd even buy new carpets if they were that worried about it... I just don't want to lose him when it's not his time to go...:confused::confused:
     
  2. DreamComeTrue09

    DreamComeTrue09 Second time the charm?
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    I'm sorry :( I had a similar situation with my old arthritic dog, it got to the point where he could no longer get up to urinate on his own and he began urinating on the floor. We had to constantly carry him outside with a towel supporting him..When it got to this point it was really sad because he was obviously suffering. He was really restless at night, and the night he began howling because he was in pain, my family agreed to euthanize him =( It was a never ending fight with my parents about how he was ruining our floors, and he certainly did just that. Is it possible you can keep your kitty in your room? That way it's just your room taking the toll?

    Whenever a pet owner is debating whether or not to euthanize, the vets I work with say there's 3 things the pet should be doing and if they aren't then it may be time to start thinking about euthanizing:
    1.) Eating and drinking
    2.)Can get up to urinate / defecate ...should not be lying in their own urine or feces
    3.)Is resting comfortably....should not be restless at night or may be in pain
     
  3. nyanko

    nyanko total trash mammal
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    Oh I am so sorry to read this - it sounds so much like my situation last year.

    I, too, had a childhood cat who had been diagnosed with chronic renal insufficiency at age 13 through my knowing the signs and taking her to the clinic where I worked. Although, I believe she'd been progressing for a little while before I took her in as my mother (not an 'animal person' or a very responsible pet owner, go figure) had her in PA and I'd lived in FL. My mom had been telling me that she was drinking a lot of water, losing weight and urinating outside of the litterbox, so I had a hunch and asked her to get the cat to me somehow before she threw her outside. First thing I did was run bloodwork and sure enough, BUN was elevated, creatinine just at the high boundary of 'normal' and urine was dilute.

    Once I had her on k/d and NF (combination of wet and dry), the condition was managed fairly well. She vomited frequently and also had constipation problems, so I used lactulose, famotidine and a bit of canned pumpkin in her wet food, along with beginning subcutaneous fluids after about a year, in order to manage this. She went through a couple of rough patches over the years, had a number of urinary tract infections that became increasingly resistant to antibiotic treatment, but always managed to bounce back, and she was acting reasonably normal for the most part. It sounds like your cat is in this stage.

    The condition progressed slowly at first. We monitored enzymes and urinary SG every 6 months, then every 3 months when it began to progress more rapidly. Basically, the numbers didn't really tell me it was time - however, there were some signs, to me. A few of them came on gradually - a personality change from aloofness to clinging to me, a decline in appetite, weight and cognitive function, decreased body temparature. Some appeared rapidly over the course of a weekend in March (the weekend before UCD was sending out decisions, incidentally) - staggering, restlessness, severe weakness in her hind limbs. On Monday I had a vet appointment for her to review her antibiotic treatment for the most current, very aggressive UTI.

    On Sunday I made the decision that her time had come at age 17, and on Monday I took her in. Her temperature was 95F, and as soon as the vet came into the room, I told her that I felt it was time. She did not disagree, though she was also emotional about it as we'd been managing the condition together for 7 months (I'd moved to Davis from Orlando, FL in September of 2007 and established contact with a vet immediately). I held off the saphenous vein and she went really quickly, after a very little bit of the pentobarb had gone in.

    Basically, if you don't feel that it's the right time, and you are in tune with the cat's general attitude and demeanor and can look at it objectively, then there's a good chance it isn't. If you can't think about it objectively, you should speak with another person who is familiar with the situation but not as emotionally attached and hash it out. Good luck with the decision, it really is a tough one and it's variable for every situation and animal - but in the end things have a way of working out.
     
  4. Pomona2006

    Pomona2006 UC Davis SVM c/o 2013
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    Well, dee vee emm, this is (as you know) a very personal decision. Losing a pet is never easy and I will give my PERSONAL opinion on euthanasia but will say first and foremost, that you should talk to a vet about your pet's condition before making any decision.

    Watching an animal suffer as it struggles to stay alive is not pleasant for me (and I'm sure many, if not all, of you agree). When what is wrong is not treatable (or simply old age), l am much more comfortable at letting an animal go through euthanasia as I feel like it avoids a lot of pain and suffering. At the same time, putting an animal down is not easy for me - it is extremely hard for me to make the decision to end another creature's life, especially your own! That being said, you really need to talk to a vet to assess the situation.

    From your description of the situation, I personally would not feel comfortable putting the cat down if I was in your shoes. You say, "his attitude is fine, he's not lethargic or acting sick (besides the constipation), and he still eats" I am of the opinion that once quality of life is significantly (and in all likelihood irreparably) compromised, then I start to see euthanasia as an option. As for the carpets...well, I don't think carpets are the biggest deal in the world (we've probably all experienced potty training an animal at one time or another and know that carpets may be at risk at that time - and I believe the same is true in old age) I suggest you try things in the meantime to make it easier for the cat - like putting more litter boxes around the house (1 per room) and make them easy for the cat to get in and out of. See if that helps reduce the number of accidents.

    While I was writing this, I noticed DreamComeTrue09's reply and must say I agree with the suggestions she makes. Every situation is unique, but you have had 15 years of experience with your cat - you'll know when he/she's not doing well. And in the meantime, spoil your kitty like crazy and cherish each and every moment you have with him/her! :)

    Good luck!
     
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  5. HopefulAg

    HopefulAg Texas A&M CVM c/o 2014!
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    I'm kind of going through this same thing. I'm 21 years old and have gone through 3 deaths of animals. Problem is that 3 of them was when I was younger and didn't really 'know' what was going on.

    When I was about 6 or so we got another dog after our other one ran away (he was the third one, we assumed he ran away to die or something). That dog is now 15 years old and has lived a remarkably long time for a larger dog. She's a Golden Retriever/German Shepherd mix and about 60 pounds and is one of the most awesome dogs you'll ever meet.

    Problem is she has been suffering from arthritis for a long time. We've tried things like Rimadyl, steroid shots, and supplements (I.E. glucosamine) but nothing really helped so we stopped giving them and just gave her baby aspirin once a day and that helped for a while. But now she's to the point where she can't even stand up without assistance. We'd love to say that we could just help her up every time, but I don't live at home any more due to college and my parents both work, so it's not practical that someone could lift her up every time she needs to get up for something.

    We've been down the 'maybe we can do X' lane but all roads lead to it being her time. :( So I would say that when the animals quality of life is so deteriorated (she's not to the point of crapping/urinating on herself but that's probably just because someone's been around more lately due to personal reasons) that they can't even take care of their basic needs any more without constant surveilance, then it's best to let them go.
     
  6. meadow36

    meadow36 UF CVM 2013
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    Obviously quality of life is the determining factor. It sounds like your pet still has decent quality of life. You might have to make some concessions to save the carpets (more litter boxes in the house so he can get to them easier?) and see your regular vet about getting the constipation under control. It sounds like it's related to dehydration - may need to do some SQ fluids daily or EOD. You can try Lactulose or ask your vet about Cisapride.

    His issues as of right now sound managable.
     
  7. OP
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    dee vee emm

    dee vee emm Future DVM
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    Thanks so much you guys for your help. I will definetly take some of your suggestions into consideration, and I'm sorry for those of you that have lost pets or are experiencing the same thing.

    I know when I went to get my cat's blood checked his BUN and creatinine had gone down originally when I started to use the Epakitin, but last time I got it checked it was a little elevated. But still my vet said for him to be really failing the levels would still get a lot higher then they were. So I know he still has some time left. And I am going to try and see what else I can get that will help him.

    And when I finally see that his quality of life is really bad, I know not to be selfish and make the right decision about it. But that's why I'm having such a hard time with it now, because he still seems really fine.

    But thanks again for helping!!! =)
     
  8. cozycleo

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    I'm sorry about your kitty. I lost my childhood cat a few years ago. She was 17 and had kidney failure in the end. She wasn't having urinating issues, but she was on meds the last year.

    It's definitely a personal decision. It comes down to quality of life for me. I think 9 times out of 10, you know when they're suffering enough to put them down. I was very lucky in that Mitzy died in her sleep in her favorite spot in the house. I didn't have to make that decision, but I didn't get to say goodbye either.

    Big hugs to you. I'm sure you'll know what to do when the time is right. In the meantime, enjoy his company!
     
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  9. ImaJerseyGirl

    ImaJerseyGirl WesternU CVM c/o 2014
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    #9 ImaJerseyGirl, Dec 1, 2008
    Last edited: Feb 15, 2010
  10. twelvetigers

    twelvetigers stabby cat
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    We had a cat with FeLV, and my mother (THE crazy cat lady. Yes, that one.) absolutely refused to euthanize. Poor Kitay went so far past that point that she died on her own, alone, curled in the litterbox. Not at all my idea of a good ending.

    You sounds like a good judge of the present situation. Just make sure you are aware when it IS the right time for euth...
     
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  11. 237397

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    I'm so sorry. That's a really tough thing to go through, dee vee emm... and I think the word "humane" draws a very fine line. Since he's been your best friend for so long, I know you'll know when it's time... parents can be inadvertently heartless sometimes, but they just want the best for you and your pet. Make the most out of the time he has left. You know he won't ever be "normal" again, but you'll also know when he's truly suffering... when he's not interested in the daily routine... when he's not acting like himself anymore.... It won't be easy, and you'll learn what it truly means to miss someone, but you won't regret it.

    I know how you're feeling, and you'll be in my thoughts.
     
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  12. DrKsomeday

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    dee vee emm so sorry to hear about your kitty. I'll give you my perspective when my own kitty was diagnosed with lemphosarcoma and what I learned.

    The key I would stress is call your cat's vet. Ask to schedule sometime to discuss "end of life care issues" with them. You don't need to bring your pet to this appointment. Your vet has your pets file and history so they'll be familiar with ways to help.

    He/She will be able to teach you how to balance home care and help to explain what to look for, how to handle this stage of pet ownership, and you maybe surprised how they'll be able to help you come to terms with the unknown. I won't lie its never easy but if you’re like any of us on SDN you’re the type of person who needs all the info and you need to be doing something. We are definitely not a passive bunch.

    For myself I needed as much information as possible and I needed an outside medical professional to help me monitor because it was my first personal case. It's been about a year and although I still miss my kitty I am grateful for the help I asked for, what I learned through the process, and how I will be able to help clients if I get to be a Vet someday.

    Another thing I would recommend is setting up a spot for your kitty that is really personal for them. I picked up a heated window perch for my own cat. I placed it rather low so she didn't have to jump high to get on it. Setup her food bowl close to it and litter box nearby as well. My goal was to make her as comfortable as possible for our remaining time. It was simple thing to-do, but it really helped me probable more than her. My Vet helped with pain management, SQ fluids that I gave at home, and what to look for regarding quality of life. Once again I am very sorry this is occurring.
     
  13. sumstorm

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    It sounds like the issue is less a question of whether you feel it is time to euthanize as a question of how to make a reasonable compromise with your folks. Are you living at home? If so, it will be much easier to have resonable accomodations in place. Part of living with other people, including parents, is compromising. Carpetings isn't cheap, especially if you have to replace pads and subflooring in multiple rooms. I had the not so great pleasure of doing that in 2 houses now.

    So, while I saw several great suggestions on managing your feline friend's health, my suggestions are on managing the household. Confinement to a few rooms, particularly your own, may make your folks more comfortable with the cat's continued presence. You can then also make the area the cat is confined to more accomodating. If the cat is having accidents, cheap dollar store bathroom rugs are great. The rubber backing helps seal the urine in the upper level, they are easy to clean up, and can be distributed to the most problematic spots. If your really ambitious and have the money, replacing the carpet with FLOR tiles, which are rubber backed, could also help.

    Then offer to do the dirty work. Volunteer a schedule to steam clean the carpets, and stick to it. Check for vomit when you first come home, and clean it up. Most people don't mind living with such issues if they aren't constantly required to tend to the cleaning up.

    If you think the cat is maligned due to the dog, then get a good book on positive housebreaking (Dunbar is generally a good author for the basics) and train the dog.

    I agree that an animal that is comfortably managed medically doesn't need to be euthanized, but I think accomodating those who have to live with the messes will help far more in the discussion than perspectives of what is ethically right orwrong.
     
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  14. OP
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    dee vee emm

    dee vee emm Future DVM
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    So here's an update to this situation...
    He's been peeing around the house for at least the last 2 or 3 month... (not good). And today he's really been doing bad... he's straining to poop (and it's all runny), and then because he's straining so hard he vomits everywhere, and then it continues...
    There even might be something more wrong with him that we don't know about, but all he does is lay all day long and barely moves.

    My mom really thinks it's time, and it's just harder on me cuz I was preparing to take him with me to school (3 hours away... I was waiting for a weekend that I was gonna go up and not come home for a bit so I wouldn't have to keep stressing him out in the car and stuff). So I haven't really been with him the last couple weeks... and it just really upsets me.

    But I don't think that's a good life to live anymore... I've done everything I can think of and I dunno if I can do anymore :(

    I just need some help with making sure it's the right thing to do...
    *sigh* tomorrow's going to be a rough day I think...
     
  15. twelvetigers

    twelvetigers stabby cat
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    I think you know what you need to do. It's never an easy choice to make, but 15+ years is a long and wonderful life for a kitty to have.

    Sad stuff. :(
     
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  16. sunshinevet

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    A beautiful poem you've probably heard before... but never fails to ring true.

    So sorry for you and your kitty :(

    The Last Battle

    If it should be that I grow frail and weak,
    And pain should keep me from my sleep,
    Then will you do what must be done,
    For this, the last battle, can't be won.


    You will be sad I understand,
    But don't let grief then stay your hand,
    For on this day, more than the rest,
    Your love and friendship must stand the test.


    We have had so many happy years,
    You wouldn't want me to suffer so.
    When the time comes, please, let me go.

    Take me to where to my needs they'll tend,
    Only, stay with me till the end


    And hold me firm and speak to me,
    Until my eyes no longer see.
    I know in time you will agree,
    It is a kindness you do to me.

    Although my tail its last has waved,
    From pain and suffering I have been saved.


    Don't grieve that it must be you,
    Who has to decide this thing to do;
    We've been so close,we two, these years,
    Don't let your heart hold any tears.



    Author Unknown ​
     
  17. Angelo84

    Angelo84 Tufts Class of 2011
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    One of the vets I work with asks--would you trade places with him? If so then the extra attention is worth it, if not then it is time.
     
  18. OP
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    dee vee emm

    dee vee emm Future DVM
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    oh man that poem just made me ball my eyes out...

    Honestly I don't really think I'd want to trade places with him...
    But I think my mom made the appt already (at the clinic I used to work at so at least I know everyone there..but I couldn't call and do it), and now he's just sleeping on my bed purring all day so far...
    Apparently yesterday just was a really bad day for him... but frick, why does he have to be so nice now? I couldn't get him to purr at all yesterday....:(
     
  19. rileyroo

    rileyroo Auburn 2014
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    wow that poem gave me chills. thanks for sharing that sunshinevet. dee vee emm, i'm sorry you're going through this. one of my dogs had to be put down in may while i was 5,000 miles away. it was horrible, but i hope you find comfort in having the opportunity to be with your kitty during this situation.
     
  20. OP
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    dee vee emm

    dee vee emm Future DVM
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    Thanks guys for all the support and encouragement.

    I don't know if it's me trying to make myself feel better (since I'm so upset today), but maybe him being all calm and peaceful and purring today is his way of telling me it's okay....That we are doing the right thing...
     
  21. pawprints

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    Heyyy...Just checking to make sure if you're doing ok if you made the 'big decision'...We're here if you need to talk!
     
  22. ckgilabert

    ckgilabert CSU PVM c/o 2014!!!!
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    hey. just wanted to say that im sorry about the situation that you're in. i hope to be as strong as you are when i need to make decisions. good luck
     
  23. OP
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    dee vee emm

    dee vee emm Future DVM
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    Hey....
    yeah the decision was made...
    My mom and I brought him in for a consult to make sure, and in the last month he's lost another 2 lbs... he used to be almost 17 and in the almost 2 years I've cared for his kidney failure now he was about 10 lbs...
    So I don't think he would have lasted a whole lot longer.

    I came home from school Wednesday night (rushed the whole 3 hours it took to drive) and he wasn't too goo that night. But I spent the whole night with him, and all day Thursday till we brought him in... he was just laying there sleeping and purring so I'm glad he ended on a good note rather then if he would have went down hill really fast and then there would have been no other choice.

    It was a really hard decision (the vet I worked for, my mom and the one tech were pretty much all waiting for me to say the ok), but I think it was for the best. I mean it was almost 2 years since I first noticed the signs and that's how long I cared for him. Some ppl would have done it way sooner. But at 16 years I think he had a great life.

    So that's where I'm at now.
    I was a bit better yesterday till we did the whole funeral thing... but it's all part of life I guess...
     
  24. bunnity

    bunnity Penn 2014
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    Really sorry dee vee emm, just know that you gave him a great, long life and that you let him end it painlessly. Sounds like a lucky kitty to me. Hope you feel better and talk to us if you need to.
     
  25. Angelo84

    Angelo84 Tufts Class of 2011
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    It sounds like you made the right decision. My condolances.
     
  26. flyhi

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    wow. unbelievably sorry for your loss. i am so glad kitty was purring for you and gave you that comfort. it sounds like you did all that you absolutely could and that is was time for kit kat to turn into an angel. good for you for allowing kitty to go in peace. take care.
     
  27. eventualeventer

    eventualeventer Medical Tire Fire
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    Oh, I'm so sorry.

    A little over a year ago, I had to make the same decision for my Meatbag cat. To top things off, the night before she was scheduled to be PTS, I injured my ankle (had to have surgery the next week) and was hobbling around in pain. She often slept on my bed, but she was usually curled up by my feet. That night, she stretched out against my chest between my arms and it seemed like she purred the whole night. It was like she was trying to comfort me, when the reason I needed comforting was that I had to let her go.
     
  28. DVMDream

    DVMDream Don't disturb the snowflakes
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    I am so very sorry. You gave him a great life and it sounds like you made the right decision. My deepest sympathy to you.
     
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  29. OP
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    dee vee emm

    dee vee emm Future DVM
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    Thanks everyone for everything... all the support and encouraging words.
    It was a rough weekend, but I'm getting better a bit at a time thinking he's in a better place now.
     
  30. Minnerbelle

    Moderator Emeritus Verified Expert 7+ Year Member

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    Status:
    Veterinary Student
    I am so sorry for your loss. I've only lost one long-term pet in my lifetime, and that was my little dog who lived till she was 16. That happened during the fall semester of my Junior year. It was during finals, and my family didn't want me to become a trainwreck about it, since there was no way I would make it home in time to say goodbye... so I didn't find out until I got home. It was really difficult for me to deal with for a while, but I found this poem really helpful... so I thought I might post it here:

    Do not stand at my grave and weep,
    I am not there, I do not sleep.
    I am in a thousand winds that blow,
    I am the softly falling snow.
    I am the gentle showers of rain,
    I am the fields of ripening grain.
    I am in the morning hush,
    I am in the graceful rush
    Of beautiful birds in circling flight,
    I am the starshine of the night.
    I am in the flowers that bloom,
    I am in a quiet room.
    I am in the birds that sing,
    I am in each lovely thing.
    Do not stand at my grave and cry,
    I am not there. I do not die.

    -Mary Frye
     

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