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Post by Teena & Siopao on Sept 5, 2022 9:13:38 GMT -7
[Original subject line:HELP pls-Possible to not tolerate Prednisone weaning? ]
Hello. My dog is Siopao Santos. He is an 8 year old Coton De Tulear. He was so healthy. In March 7 i took him for his normal grooming, then that week following, we noticed he was having trouble walking up the stairs and not able to jump up our couch (which he is so good at). Took to Vet March 14, said he had "spine issue". Was put on gabapentin 100 mg, carprofen 75 mg chew for 2 weeks. He recovered 100%. We were told not to take him for walks, and absolutely no stairs and jumping, but not necessarily crate rest.
April 12, 2022- Followup with Vet. Good.
Went back to normal routine except stairs. Can go for his long walks, running...
June 12, 2022- Took him to groomer - with instructions that he had an issue with spine, pls be careful
But sadly, saw a decline with him that week again. If only I knew more, I would have not taken him in for grooming....
June 20, 2022- back to Vet was given Carprofen 75 mg and gabapentin 100 mg. No instructions for crate rest. No walks again.
He felt better after , we limited his stairs, no jumping, but that's it. He was still allowed to roam the house, took him out for short walks , in hindsight, i feel like he was never at 100% but we didn't know to do strict crate rest. Still plays fetch but slower.
July 8, 2022- Went back to Vet emergency appointment, because something is just off . Siopao looked weaker, flailing legs when walking. But can still walk and pee/poop. Vet watched him walk during appointment, not too bad but agreed he is dragging a bit. Placed him in Prednisone 5 mg Schedule of Prednisone, 5 mg 2x/day 7 days, 5 mg 1x/day 7 days, 5 mg every other day on third week. , Gabapentin 100 mg. Got better seems like...
July 21- Called vet and asked if weaning after 7 days of 2x/day is really enough coz i saw him decline with strength, not lifting leg up when peeing as high. He said ok to keep him 2x/day for now. We kept an eye on him Fri and Saturday, (July 22-23) but midnight July 24 he couldn't stand. Gave him Prednisone right away. He was back to 2x/day Prednisone. Started him on Pen rest, with pen attached to his crate, he can still get in and out of his crate. His pen about 5 feet x 3-4 feet size.
July 24 to July 29- Prednisone 2x/day. At that time, we know we are leaving him with a babysitter for two weeks (aug 3-aug 17) bec of a previously planned trip to drop our eldest to college in London.
JUly 29- Vet follow up. We asked if we could keep him at 1x/day the duration of our trip, vet agreed. CBC superchem lab was completed to check blood levels bec of Prednisone. Good results. Siopao now on pen rest, not crate rest. Pen size: 5 ft x 4 ft give or take
[MED LIST/HISTORY- Moderator's Note. Please do not edit
21.6 lbs 8 y.o.
crate rest started 8/3 to heal the disc with limited movement by 9/28
Prednisone as of 8/3: 5mgs 2x/day for 16 days; 8/19 taper test _pain/_neuro
as of 9/2 EOD dose; final dose 9/9
Famotidine 10 mg 1x/day
Gabapentin 100 mg 2x/day]
August 3, 2022 - in the morning hours before our flight, he couldn't stand and walk again in the morning. Prednisone given at 7 am, not able to walk even at 9. Finally walked and peed/pooped at 5 pm using a sling/gait belt, to support his hind legs. Trazodone 100 mg added / 1/2 tab added as needed for anxiety.
Aug3-Aug 18 Siopao was on Prednisone 5 mg 2x/day. Strict crate rest, sling to potty, no walking, no pen. Lots of panting at night, i was told side effect of Prednisone. Sitter gave him Trazodone a few times while we were gone.
Aug 17- night picked him up from sitter. He was happy, tail wags, standing but definitely not back to himself yet.
Aug 19- Talked to vet, weaning PRednisone again, this time 2.5 mg 2x/day for 7 days, then 2.5 1x/day for 7 days, then 2.5 mg every other day for another 7 days is the current plan. Famotidine 10 mg once a day, continue with Gabapentin 100 mg every 12 hours.
Siopao has a PT vet evaluation scheduled on Thursday 9/8/22 at Veterinary Sports Medicine and Rehab place.
Sept 2 - No prednisone. Gabapentin 100 mg 2x/day
Sept 3- Prednisone 2.5 mg, Gaba and famotidine
Sept 4- No prednisone. Gabapentin 100 mg 2x/day
Sept 5- Prednisone 2.5 mg, Gabapentin 100 mg 2x/day, famotidine.
If we count the day he couldn't walk on 8/3 as our Day 0, he has been on strict crate rest 5 weeks, using sling to potty to support. Prior to that he was on semi strict rest- allowed in pen. No sling (he did not like sling and would not walk if we use it before).
Today Sept 5 Monday, all typical with his day. He ate his breakfast very well as usual. [on the pred taper! ]Gave him Gabapentin 100 mg, famotidine and Pred 2.5 mg this morning at 6:30. He peed before eating. He pooped after eating, but I noticed his legs seem lamer again. Not drinking as well as usual.
Is it ok that he has good and bad days during this strict crate rest process?
Is it possible that he just cannot handle being off Prednisone (even though technically it's so small of an amount by now)?
Help pls.
QUESTIONS
☆ 1currently pain? I Dont think so. No typical signs
☐ slow to move but just looks weak
2 last weighed at 21.6 lbs, was overweight at 24 lbs 8 years
☆ 3 --any red flag signs of stomach damage?
☆ 4 Siopao (pronounced "sho-pow". Teena Santos
☆ 5 Was the diagnosis IVDD (aka: a disc problem, a disc herniation, a bulging disc, slipped disc)?Yes
-- Is the vet a general DVM? Yes
-- or a specialist surgeon: ACVIM neurology or ACVS ortho?
☆ 7 bladder control?YES
☆ 8 Yesterday [9/4], he can definitely wobbly walk with little support, definitely still weak but not worse than he was. No knuckling reflex- i notice his paws stuck a few times and he needs help to correct [knuckling]. Seems to have knee jerk when tapped. Doesn't respond when i mess with his hind paws.Tail definitely still happily wags.
This morning- [9/5] limper tail seems like and lamer legs can still stand on it especially to eat. Still peed and pooped this morning.
Thank you. Sorry for such long post. I am just so worried. Thank you again.
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PaulaM
Moderator. 
Member since 2007: surgery, conservative . Montana, USA
Posts: 19,928
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Post by PaulaM on Sept 5, 2022 9:45:49 GMT -7
Teena, welcome to Dodgerslist forum. Your post has a lot of information to absorb and consider before replying. Refresh your browser to see when it is posted. You've come to the right place to learn about your dog's disease and at-home care. While waiting on my reply: -- Know more about us and comments veterinary professionals make: dodgerslist.com/2020/04/20/education-team-ivdd -- See what owners say about Dodgerslist: dodgerslist.com/2022/08/22/what-owners-say-about-dodgerslist/ EMAIL alerts. Timely communication is important. Thanks for registering. Now you can set up to get an alert whenever someone has posted about your dog. Go to the CONSERVATIVE Board dodgerslist.boards.net/board/6/conservative 1. Look for your dog's thread and checkmark it. 2. Look for the white ACTIONS button towards top. 3. Select “Notification Options" from the pull down menu — check mark “NEW POST” change from never to INSTANT email — press the SAVE button. Click the “x” to close the window 4. Next choose the “Bookmark” See the tiny book symbol now! i.postimg.cc/GhKYTNg7/Bookmarking.jpg |
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PaulaM
Moderator.
Member since 2007: surgery, conservative . Montana, USA
Posts: 19,928
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Post by PaulaM on Sept 5, 2022 10:14:05 GMT -7
Teena, the prednisone taper is to give proof that all inflammation around the nerves is gone. Gabapentin is a pain med and prevents YOU from properly assessing pain on the prednisone taper. What is the final every other day (EOD) prednisone dose?It takes 8 weeks for the disc to heal. Due to no crate rest given until 8/3, one can't be certain the reason for neuro decline on 8/3 while on a pred taper dose 1x/day. It is thus prudent to count the 8 weeks to heal the disc from the date crate rest started. Graduation day would then be Sept 29. Please confirm that we're on the same page as to conservative care of meds and STRICT rest until graduation day of 9/28. The hallmark component of conservative treatment is the very STRICT crate rest part (no PT, little movement). With little blood supply discs are much slower to form good scar tissue than it takes a blood rich broken bone to heal. Those weeks of a cast for a broken arm to heal is similar to the recovery suite being a kind of cast for the disc. 100% STRICT crate rest 24/7 for 8 weeks provides limited movement to allow good strong scar tissue to form. STRICT rest means: ◼︎ no PT for conservative dogs during 8 weeks to heal disc ◼︎no laps ◼︎no couches ◼︎no baths ◼︎no sleeping with you ◼︎no chiro therapy WHYs: dodgerslist.com/2020/04/22/chiropractic/ ◼︎no dragging or meandering at potty times. ◼︎ avoid dangerous detours. Follow the "Roadmap." Tape it to your fridge. D/L and print out: dodgerslist.com/wp-content/uploads/2020/07/Roadmap-for-Fridge.pdf Transports are always a risk to the disc of too much movement. Vet visits must be weighed risk vs. benefit for dogs with little to mild neuro diminishment such as Siopao. Only the most urgent of vet visits can be considered. Otherwise things like med adjustments, updates, can be handled over the phone. POTTY TIME strictness Carry your dog to and from the recovery suite to the potty place and then allow a very, very few limited footsteps. Siopao has been such a lucky dog to have dodged a dangerous bullet of severe neuro diminishment with no crate rest at very first sign of a disc problem on March 7. With urgent vet visits, secure the crate in your vehicle. Transport carefully using a crate padded out with rolled up towels on either side of the dog to prevent movement or jarring the spine when braking or turning corners. Owner knowledge will be key in protecting Siopao for many happy years ahead living with IVDD. Recommend this quick but good intro to IVDD: dodgerslist.com/2020/06/26/time-and-ivdd/ Highly recommended is to reply using the QUICK REPLY area at the bottom of the page. You can scroll up to the post you are replying to and then back down to continue writing. We want to only read your words in your post. It is ok to use 1-2 words or so as reference when writing your sentences to clarify. |
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Post by Teena & Siopao on Sept 5, 2022 12:14:06 GMT -7
The final every other day (EOD) prednisone dose? 2.5 mg on 9/9
STRICT rest until graduation day of 9/28. YES
We were under the impression that we can start laser and/or acupuncture for now while he is on crate rest. That is why we scheduled the PT Vet eval on 9/8.
new development:
This just happened, 1st time ever, he dribbled pee in his stroller.
I just took him out to pee then put him in his stroller. He started moving and whining, and so i took him out again. He peed again. When I came back in, I noticed his stroller was wet, not completely but he definitely dribbled pee.
I then put him in crate while i clean stroller, he was still not relaxed. I took him out again, peed again. I saw a small dribble in his crate.
What does this mean?? UTI (maybe he wasn't emptying bladder all the way like we thought??) or is he progressing to being incontinent?
Will call vet tomorrow.
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PaulaM
Moderator.
Member since 2007: surgery, conservative . Montana, USA
Posts: 19,928
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Post by PaulaM on Sept 5, 2022 14:18:07 GMT -7
Teena, all of life is the weighing of the risk vs. the benefit. It seems from what you write Siopao can walk, although wobbly and only a few times needing help to correct a knuckled under paw. Is that correct for his neuro status?
What is the last date you observed he was knuckling under his back leg paw?  Every time Siopao is out of his recovery suite is a danger to his still healing disc to tear, to cause increased damage to the spinal cord. With mild neuro damage one must weigh the risk of too much movement to the disc during a transport vs the benefit. Nerves self heal. If you want acupuncture or laser find a mobile vet who will come to your home in order to avoid transporting Siopao. Monitoring neuro decline at home
Where is Siopao on the list? As damage to the spinal cord increases, there is a predictable stepwise deterioration of functions. Paralyzed legs happen before there is loss of bladder control for example. With any neuro diminishment, update and alert your vet! The body self heals nerves in reverse order of the damage. 1. Pain caused by the intial disc tear & inflammation in the spinal cord 2. 8/3 Wobbly walking, legs cross 3. 8/3 Nails/toes scuffing floor 4. 8/3 Paws knuckle under sometimes 5. _?_ Little leg movement ability to reposition in the suite. _?_ can't move up into a stand 6. Legs do not work at all (paralysis, dog is down) 7. Bladder control is lost. Leaks on you when lifted. Can no longer sniff and then pee on that old urine spot outdoors. 8. Tail wagging with joy is lost 9. Deep pain sensation, the last neuro function, a critical indicator for nerves to be able to self heal with conservative treatment or a surgery. SNIFF and PEE TEST to prove bladder control Let us know what you observe:
1) The only way for humans to know if there is bladder control is with the “sniff and pee test.” Carry outdoors, set them on an old pee spot to sniff. Make sure the sling or your hands are not on the tummy area as that can press on the bladder. See if Siopao will release urine on the old urine area. If urine comes out after sniffing, he has bladder control. 2) If Siopao leaks on you when lifted that is a sign he has lost bladder control. |
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Post by Teena & Siopao on Sept 5, 2022 14:49:58 GMT -7
YES [can wobbly walk sometimes knuckles]
this morning [9/5 knuckles] he did [knuckle under] a bit
wobby walking-yes ,
nails/toes scuffing- yes,
paws knuckle under- yes sometimes when he goes too fast
, no. 6-8 he is not exhibiting, he is able to reposition, he can get up and tail wags. no. 9, i don't know how to test, when i touch his toes he doesnt respond. but vet never told me he lost dps
Sniff and pee test: definitely has this. he sniffs and pees on old spots. the problem today was just he peed so much and he had accident /dribble.
does this mean i have to consider possibly stopping Gabapentin as well?
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PaulaM
Moderator.
Member since 2007: surgery, conservative . Montana, USA
Posts: 19,928
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Post by PaulaM on Sept 5, 2022 18:00:39 GMT -7
Teena, quoted sentences have been removed from each of your posts. Please do not quote us, it is confusing as to which are your words.
Simply write a full sentence that includes what you are writing about. Avoid "it" "yes" in sentences that do not include what you are writing about.
We only want to read your words not ours.
Thank you for helping us.
Avoid touching his toes.
Most general vets would not be able to correctly identify deep pain sensation (DPS). HOWEVER, it in Siopao's situation, clearly if he can walk, can sniff & pee, wag his tail he has not lost the very last neuro function DPS according to the list.
You are giving gabapentin every other day and gabapentin only lasts for 8 hrs. It is likely you could stop gabapentin in order to be able to really tell what is going on regarding pain during the pred taper. Call your vet to confirm stopping gabapentin tomorrow.
Make sure you are using a sling and harness to prevent Siopao "⚠️from going too fast". Use sling if wobbly to prevent his backend twisting and falling over. When he is out of the suite, then he must only be taking the very fewest of footsteps and going slowly at potty times.
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Post by Teena & Siopao on Sept 5, 2022 18:55:40 GMT -7
Thank you Paula. We appreciate your help so much.
He is Still on Gabapentin 100 mg every 12 hours (2x/day ) now.
[MED LIST/HISTORY- Moderator's Note. Please do not edit
21.6 lbs 8 y.o.
crate rest started 8/3 to heal the disc with limited movement by 9/28
Prednisone as of 8/3: 5mgs 2x/day for 16 days; 8/19 taper test: ? pain/ ? neuro
as of 9/2 EOD dose; final dose 9/9
Gabapentin 100 mg 2x/day every day during a pred taper!
Famotidine 10 mg 1x/day]
Prednisone 2.5 mg is the one that is every other day.
I am using sling every time he is outside to potty (we carry him in and out)he just goes potty on our old wood deck..
it [regarding: moving too fast] happens sometimes when i put him down, but mostly ok.
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Post by Romy & Frankie on Sept 6, 2022 13:16:07 GMT -7
Good job carrying Siopao out to potty and then using a sling. The fewest footsteps, the minimal amount of movement is what will allow the disc to heal.
During a pred taper, pain emerging means that there is still swelling in the spinal cord. If there is still swelling in the spinal cord, more time on the anti-inflammatory and pain meds is needed. When a dog is on pain meds during the pred taper, the emergence of pain may be masked by the pain meds. This makes it more difficult to determine if all the swelling is gone. That is why we commonly see vets cut back or stop the pain meds, in this case gabapentin, during the taper
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Post by Teena & Siopao on Sept 7, 2022 9:24:00 GMT -7
Thank you.Still waiting for our vet to call me back for instructions on how to stop Gabapentin, but I do 100% get what you are saying. So with him on prednisone only until 9/9 friday i should really take him off.
Did you just stop Gabapentin? or do I also need to be gradual like 1x a day instead of 2x/day?
Is it normal to see a difference with my dog during day and night? Legs just seems "lamer" at night [muscle fatigue?], then perks back up the next day.
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Post by Romy & Frankie on Sept 7, 2022 13:05:44 GMT -7
Some vets prefer to taper gabapentin, but many prefer just stopping. You can ask your vet what he prefers.
When my dog went off gabapentin, we just stopped it without any problems.
It is not unusual for a dog to seem lamer at night. He may just be tired. It takes more effort for him to do things at this point. As long as Siopao perks up again the next day, I don't see a cause for concern. Healing is not completely linear. There may be good and bad days along the way.
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Post by Teena & Siopao on Oct 6, 2022 14:12:05 GMT -7
Sorry for such long hiatus,wanted to give update. Siopao f inished 8 weeks 9/28/22. He started PT - laser/acupuncture and hydrotherapy. He has been walking. Finally off prednisone, gaba. However, he has been sickly- UTI, nausea/ vomiting then last week day after he was done with strict crate rest, he was admitted in critical care for 3 days, 2 nights for pneumonia. Currently on 2 antibiotics, anti nausea and famotidine still...He used to be such a healthy pup. But we are GRATEFUL that he has started walking and seem to be more like his usual self. Thank you to you all for the education and support. |
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Post by Romy & Frankie on Oct 6, 2022 14:33:51 GMT -7
I am sorry to hear that Siopao has been sick with pneumonia as well as having stomach issues. Hopefully the meds he is on will quickly take care of this.
Good news that he is more like his old self again and walking. Hydrotherapy, walking on an underwater treadmill, has been helpful to many dogs on this list. My dog benefited a lot from it. Is that the type of hydrotherapy Siopao is doing? Underwater treadmill seems to benefit IVDD more than swimming exercises. Moving the legs in a walking movement under the water seems to help the brain remember how to do it.
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PaulaM
Moderator.
Member since 2007: surgery, conservative . Montana, USA
Posts: 19,928
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Post by PaulaM on Oct 6, 2022 17:36:50 GMT -7
Teena, sorry to hear about this bad break of pneumonia and a UTI to interfere with Siopao's graduation. It is always a good idea to take it slow with graduation's increased physical exercise and introduction back to family life at home. This way have a better sense if there were to be soreness it was not likely from overdoing exercise, but something to get checked out at the vet. Does Siopao still knuckle under his back paw or can he now right it quickly or no longer knuckles under at all? GRADUATION, A SLOW RE-INTRODUCTION His muslces are soft and out of shape after the rest period and the setback of pneumonia/UTI. Gradually build up his muscles and their lungs. Take a look at our information. Gradually building your dogs muscles over a month's time will have your dog safely running and having fun again! SAMPLE SCHEDULE Here is a sample schedule to safely and slowly introduce your dog back to family life and physical activity: dodgerslist.com/2020/06/15/back-friendly/?highlight=sample%20scheduleDIY back PROTECTION around the house  ** 1) Good ideas for making your home back friendly: dodgerslist.com/2020/07/09/home-protect-ivdd-backs/2) Lots more ideas and tips in living with an IVDD dog such as dentals, nail trims, harness fit and having fun with him: dodgerslist.com/living-with-ivdd-tips-2 3) Teach Siopao to be safe from jumping up or down, but to use a ramp whether over steps leading outdoors or to furniture in the house.
PT at HOME Safety first. You should always consult with a veterinarian before starting any exercise program with your dog. For example, although senior dogs need to stay limber, severe arthritis might make certain movements inappropriate. - Strengthening core muscles. Core exercises don't require specialized equipment. Core muscles are important in supporting the spine. Here are 5 exercises you can do at home: totofit.com/five-basic-exercises-essential-to-building-core-strength/May we turn the tables and ask YOU for help? Did you know there are less than a handful who volunteer daily to help dogs and their owners? We need helping hands from other Forum members in educating. Education about disc disease is our number one mission! We invite you to hop on to our educational bandwagon team. Too many dogs are put to sleep because owners lack education about IVDD treatment. STRICT crate rest and proper medication have helped many dogs recover. We depend on all members to pay it forward for the help they have received with their dog by helping us educate! Pick what suits you....
We depend on you. Here are some ways to help.. i.postimg.cc/R0y7zpGx/IVDD-survior-gallery.jpg ** -- Please celebrate Siopao's graduation! Add a graduation photo and a short caption to our Gallery to give other members inspiration about your IVDD Survivor! dodgerslist.boards.net/thread/2262/add-dog-dodgerslist-photo-gallery-- "Share" our FB posts www.facebook.com/Dodgerslist-- When in conversation at the grocery store line or wherever you may meet breeds most prone to IVDD (Dachshunds, Beagles, Poodles, Spaniels, Shih Tzus, Pekingese, and Chihuahuas, Frenchies) give out our free little wallet cards. Hand carry our literature and print out our letter of introduction for your vet. Teena, don't be a stranger! Stop in periodically. We really do LOVE to hear how your dog is doing. We'd love a short video clip to see Siopao in action at home, at PT and living & loving life in spite of IVDD! if you see a new member in a tough spot, give them hope. A brief paragraph about your dog can be insanely supportive and inspiring in a time of need! i.postimg.cc/8P5FkBYy/living-laugh-love-in-spite.png |
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Post by Teena & Siopao on Oct 6, 2022 18:07:44 GMT -7
Thank you for all the after graduation information.
Siopao has been consistently correcting his back paws both R and L when we check it (Does not knuckle on his own at all.)
And he is walking on underwater treadmill during hydro therapy (not swimming).
Do you recommend still using pen/crate when he's not supervised at home? We are taking it easy though we have been letting him walk around more, we take turns watching him.
We cancelled his previously scheduled PT this week because of this past weekend. We are a bit hesitant to restart hydrotherapy next week because of his pneumonia...But we will call PT vet and ask. I will look into all the information you sent.thank you. I am a pediatric physical therapist, i have been working with babies for 26 years and have been trying to translate some of my baby exercises and doing some with him. I did do his weight shifting exercises and weightbearing and massage /ROM.
I will post a video once things have settled down a bit from the scare over the weekend.
And i will also look into info about paying it forward and helping someone else.
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Post by Romy & Frankie on Oct 7, 2022 13:04:42 GMT -7
We do recommend crating IVDD dogs when they are left alone, especially so soon after graduation. By being cautious, we may be able to avoid another episode.
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