The death of a pet is extremely difficult and painful. For some, it takes a very long time before the sadness goes away.

Betty Kamida's dog Sweetie was very special to her.

Sweetie's story is quite miraculous. She was a stray on the grounds of Tripler Army Medical Center for many years. In 2002, when Kamida brought her therapy dog Moses for a hospital visit, she first saw Sweetie. With the help of Tripler staff, Sweetie was finally caught after six weeks of perseverance.

She was in poor condition, living off scraps all those years. She had skin infections, her fur was missing in several spots and she had a broken hip that healed improperly. Sweetie couldn't sit without falling over. After $4,000 in surgeries and one foster family, Sweetie went on to live a very happy and full life with the Kamida family in June 2003.

The wheat-colored terrier mix was distrustful at first, but eventually learned what it was like to be a dog with a loving family. She enjoyed the creature comforts of home, such as resting on the softest pillows, going to the beach, enjoying car rides and playing with her doggie brother, Moses.

No one knows Sweetie's exact age, but her estimated age was about 9 years when she came to live with Kamida.

In August 2008, Sweetie had a cough that wouldn't go away. After many tests and a second opinion, she was diagnosed with esophageal cancer. A mass in her throat prevented her from eating and drinking.

Kamida had to decide what was best for Sweetie. A week later, Sweetie was euthanized at home with her family around her. "She became my closest companion, and we were very attached to each other. It was really hard to make that decision, but nothing else could be done," says Kamida.

After Sweetie had passed, Kamida still missed her very much. Everywhere she looked, she expected Sweetie to be there. Kamida contacted Renee Rokero, a licensed clinical social worker and founder of the Hawaii Pet Grief Center.

"It was a completely traumatic experience. I read an article about the Hawaii Pet Grief Center just a couple of months before my Sweetie got sick. Renee was a great source of comfort, wisdom and understanding during a very difficult time," says Kamida.

Rokero says, "Seventy-five percent of the general population will grieve the loss of their pets, but only a very small subset of this population will actually seek out professional help.

"Grief is a normal response to the loss of a loved one. I provide services that deal with complicated grief. When sadness and helplessness doesn't pass over a period a time and actually worsen, such as a person can't eat or sleep, that's when my services will be helpful."

One of the first things Rokero recommends to help with grieving is a book by Dr. Wallace Sife, "The Loss of a Pet." Sife is a licensed psychologist who has a Web site and support group through the Association for Pet Loss and Bereavement.

Secondly, Rokero encourages talking to other people who understand what it's like to lose a pet. Sharing will also help to lessen the grief.

Kamida says, "I'm so thankful that the Hawaii Pet Grief Center exists. It was a safe place I could go to and cry as much as I needed to, and for as many weeks as necessary, to start moving forward. Renee understands the role pets have in our emotional and spiritual lives and why losing them can be so devastating."

It's been a year since Sweetie has passed. Looking at Sweetie's photos and talking about her is still hard for Kamida, but little by little, the pain has lessened over time.

"Throwaway dogs are the best dogs. I wouldn't have traded Sweetie for a million dollars," says Kamida.

Animal lover Leslie Kawamoto has been with the Advertiser for 19 years, or 133 dog years. Check out her blog at www.HonoluluAdvertiser.com/Blogs.