1. Cut the sausage into 1?4 inch thick rounds.
2. Melt the butter in a large pot over medium heat. Add the flour and cook, stirring often, for about 2 minutes, or until it begins to brown.
3. Add the tomatoes, okra, onions, garlic, cayenne pepper, and water, and stir until well mixed. Cook uncovered for 15 minutes.
4. Add the sausage and shrimp to the pot and cook another 10 minutes.
5. Spoon the piping hot gumbo into bowls as is or over rice.
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