Is it better to buy a mutt or a purebred?
Once, while hiking, I inadvertently offended a woman by asking her if her dog was a Dalmatian mix. She huffed off, saying that it was an American Bull Dog. I didn’t have the heart to tell her that black and white spots all over the body weren’t typical for Bull dogs, but hey… I’m sure she loved the dog all the same. Likewise, I once made a couple very happy when I corrected them; they told me their vet had identified their dog as a Pit Bull mixed with a terrier. I told them they should be so lucky (I’m a bit partial to Pit Bulls, remember!), but that they instead had a 100% purebred red Australian Cattle Dog. They walked off smiling, like parents whose kid just won the state spelling bee. That mutt (ahem, pure bred) will thank me one day (just kidding!).
In general, I advocate adopting a mixed breed dog (a.k.a., the mutt, the Heinz® 57) unless you are seeking a specific breed for a specific purpose. Don’t get me wrong - I have my personal breed biases and would love to own some purebreds. However, with the growing problem of pet overpopulation, I’d rather rescue a mixed breed from being euthanized in a shelter situation than payout the wazoo or inadvertently support purebred puppy farming. Also, because of hybrid vigor (a fancy way of saying “awesome genetic material”), mixed breed dogs are often healthier and have lower risks for inherited diseases than purebreds. Purebreds are like the old royal families of Europe, lots of pomp and flash, and lots of fainting. Seriously, after seven generations of the “Hapsburg jaw,” didn’t anyone stop to think that intermarrying might not be such a good idea? On the other hand, even Darwin married his first cousin, so maybe there’s something to this “inbreeding” thing. Just think about it: in
Recently, breed-specific rescue groups have evolved, so if you do want to satisfy your desire for a purebred and score points for altruism, this is your solution. Purebred dogs are often surrendered to rescue groups due to owner issues or behavioral or medical problems. Breed-specific foster organizations then find new homes for these purebred pets. Alternatively, many local animal shelters have purebred animals available for adoption. Some shelters are even willing to put you on a breed-specific waiting list. It’s always best to look around to see what options are available.
What’s the difference between having an indoor versus an outdoor dog?
I didn’t believe in having outdoor dogs until I started working with sled dogs and hunting dogs. I was always raised with the idea of keeping your 4-legged friend in the luxury of the indoors, air-conditioning, and well-pampered environment. My dog goes to work with me, sleeps on my bed, watches TV on the sofa with me, sits in the front seat of the car, and eats the rest of my ice cream cone. Granted, he’s a bit spoiled, but hey… his life is 1/7 of ours and he might as well live it up!
Having transitioned from the East Coast to Minnesota, I discovered the world of outdoor Labradors, German Shorthaired Pointers, and Golden Retrievers. Here in the land-o’-lakes, many people hunt with their dogs. These dogs often live outside in a large kennel, and get to go up North to the cabin to hunt each weekend. These working dogs are adapted and used to living outside. Some of these dogs actually prefer to be outside rather than cooped up inside – of course, this varies with how much exercise, attention, and TLC they get. Just like how some people prefer to be outside rather than sitting at a desk job, dogs are the same!
What are some things I should know about before making Hunter an outdoor dog?
Nothing's worse than telling a big, burly, camouflaged-dressed Minnesotan hunter that his best outdoor hunting dog has a devastating disease and watching him break down and cry in the exam room. That said, I no longer doubt the love that owners have for their outdoor dogs. While I used to think outdoor dogs were more neglected, I've come to see dog owners love and care for them just as much – they just prefer to have Hunter outside (or Hunter prefers to be outside). That said, there are key difference between indoor and outdoor dogs.
Outdoor dogs require careful attention to their shelter. Make sure Hunter has a large sheltered area to get out of the rain, hail, snow, or sun. You can consider building a doggy door into your garage so Hunter can escape from the extremes (provided all antifreeze, chemicals, and dangers are out of the way). In cold or hot weather extremes, Hunter should be brought indoors to minimize problems with maggots, heat stroke, biting bugs, hypothermia, frost bite, and lack of water (from frozen water bowls – although this only happens in places like Alaska or Minnesota pre-global warming). Hunter has to have water available at all times. If this means buying a water-bowl heater set up, that's what you will have to do to make sure your outdoor dog is well-cared for outside. Finally, make sure Hunter has clean straw or blankets to sleep on, and that his bed is well padded.
Outdoor dogs require dedicated monitoring, as it's harder to notice certain clinical signs when Hunter is sick until the signs are more obvious. For example, if Hunter has a large outdoor run, you may not notice that he has had diarrhea for several days, or may not notice him drinking more or less than usual. These signs would potentially be detected earlier for an indoor dog. Likewise, outdoor dogs may need to be on year round preventative flea, tick, and heartworm medication depending on the weather conditions, as they are more exposed to the elements.
Another important consideration is whether or not outdoor Hunter has adequate protection against biting gnats, no-see-ums, flies, and bees. I've seen too many older dogs come in with severe maggot infestations from an underlying skin infection that was neglected. I've also seen some inner city dogs that were tied outside on a short chain only to have their collar slowly embed into the skin of their neck, causing a necrotic, open wound around the circumference of the neck; in the summer, this is maggot bait waiting to happen.
Outdoor dogs also need appropriate socialization and training – if you don't have the time to get a dog, tying Hunter outside with little human interaction, exercise, or care isn't fair. Unfortunately, this is one of the reasons why Rottweilers and pit bulls have such a bad reputation. While these particular breeds are often viewed as "status symbols" or "drug protection dogs," they lack appropriate socialization when chained to a 6 inch chain, and become protective or aggressive to anything coming into "his" area. If you were banished a 6 foot area with no exercise and no one to pet your belly, you'd be grumpy too. Remember, you can make any breed dog mean in these conditions!
Lastly, if Hunter barks constantly while he's outside, it's unfair to your neighbors and is irresponsible as a dog owner. While I do not advocate debarking except in extreme, dire situations, consider using an anti-barking humane collar (like a citronella collar) for your outdoor dog. Your neighbors will appreciate you and Hunter more.
Why am I supposed to fence off my compost pile?
Why do dogs eat dead, decaying vegetable matter? Compost can be toxic to Sherlock, and while you may not think that Sherlock will eat it, he may! Make sure that your compost pile is well fenced off, as it contains mycotoxins that can result in seizuring, tremoring, and secondary hyperthermia. If you notice this, bring Sherlock to a veterinarian immediately, as he should be treated with muscle relaxants, valium, temperature control, and IV fluids. Thankfully, the signs usually resolve after 24 hours. More importantly, remember that Sherlock won’t learn from his mistakes, so he can ingest it again if you don’t remember to fence that compost pile off!
Do dogs get Bell’s palsy (a.k.a. “Why vets shouldn’t treat their own dog!”)?
Just recently, I had the lovely experience of having to play vet to my own dog. Never, ever, treat your own kid/cat/dog/loved one. Remind me of that rule next time...
One day I noticed that JP was slightly squinting in the right eye and that his pupil size was abnormal. I took him to work the next day and was just about to stain his eye with a green/orange dye (fluorescein) to check for corneal ulcers. I’ve treated corneal ulcers hundreds of times in the ER on other people’s pets, so it’d be easy. Then, I remembered the cardinal rule: never treat your own kid/cat/dog/loved one. I decided to capitalize on the fact that I had a doggy ophthalmologist just down the hall. After careful exam, she diagnosed JP with Bell’s palsy, or partial paralysis of his facial nerve (cranial nerve VII). Unfortunately, Bell’s palsy can be either totally benign (and resolve in a few weeks, months, or be permanent) or can be from an underlying brain or chest tumor. While the ophthalmologist was explaining everything to me in scientific terminology (“Well, it’s either pre-ganglionic or post-ganglionic, and we can do this phenylephrine test to see…”), I cut her off, freaked out and said, “What does this mean? Just tell me what to do!” Because it was my own dog, I became the instant client and didn’t comprehend anything she said to me because I was too upset. Nevertheless, we forged ahead. After doing some blood work and chest x-rays, we chalked it up to benign Bell’s palsy.
Bell’s palsy was named after Sir Charles Bell, a human surgeon from Scotland who studied the facial nerve and muscles 200 years ago. Today, he’s credited with this aesthetically disfiguring (albeit temporary) paralysis of your face. Luckily, dogs don’t seem to care what they look like, and don’t seem to mind at all.
Does radon cause cancer in pets?
Just recently, I had two unrelated, different breed dogs from the same household present for similar signs: inappetance (not eating well), coughing, and hacking. Chest x-rays showed lung nodules suggestive of either cancer or a fungal infection (blastomycoses) in the geriatric dog; just to be on the safe side, the owner wanted x-rays of the younger dog too. Unfortunately, these x-rays also showed the same cancerous nodules. While heartbroken by the double dose of bad news, I bluntly told the owner that she should have the radon level in her house checked as there were no smokers in the household. Either that, or move out of the house…
Cancer, a mutation in a cell's genes, can be caused by random mutation, chemical or toxin exposure, genetics, or for no known cause at all. While there's no distinct link with radon and cancer in pets, previous studies have shown that animals that have more exposure to paints, chemicals, and urban areas have a higher incidence of cancer. Currently, there are research studies being conducted to see if there is a link between second-hand smoke and lung cancer in pets.
Due to the high quality of veterinary medicine now available, pets are living longer than ever. Unfortunately, as a result, we are seeing a higher incidence of cancer. Like humans, cancer is common in animals and the incidence increases with age. Cancer accounts for approximately 50% of the demise of pets over 10 years of age. Signs of cancer include weight loss; inappetance or anorexia; difficulty breathing; fever (with no obvious source of infection); bloody nose; difficulty urinating or defecating; abnormal swellings that continue to grow in size; non-healing sores; lameness that does not resolve; or masses over the mammary area. Some common types of cancer in dogs include skin masses (i.e., mast cell tumor, melanoma, fibrosarcoma), lymph node cancer (i.e., lymphosarcoma), breast cancer (i.e., mammary gland adenocarcinoma), cancer of the head/neck/mouth (i.e., squamous cell carcinoma, melanoma, adenocarcinoma), cancer of the abdominal organs such as the spleen and liver (i.e., hemangiosarcoma, adenocarcinoma), or even bone cancer (i.e., osteosarcoma).
Unfortunately, dogs don't show their signs of illness until it is severe or end-stage, so the prognosis for cancer varies with the type, location, and degree of metastasis (cancer spread). The diagnosis of cancer is made based on physical examination, blood work, x-rays, ultrasound with aspirates, or biopsies. Most types of canine cancer are not "curative" depending on the grade of severity of the cancer. Treatment may include a combination of surgery or surgical debulking (making it smaller via surgery but not curing it), radiation therapy, chemotherapy, or immunotherapy. Your veterinarian may refer you to a board-certified oncologist (cancer specialist) for further workup. Your oncologist can then discuss the overall success rate of treatment options, which again, depends on the type, extent, malignancy, and spread of the cancer. Lastly, remember that while there is a lot of bad or erroneous information on the website, there is some helpful info. Stick with veterinary websites and check out the following websites for more information and support: www.vetcancersociety.org, www.acvim.org, or www.avma.org.
Copyright by Justine Lee Veterinary Consulting, LLC.©
What is “rage” syndrome?
The English springer spaniel, a medium-sized (20-25 kg) hunting dog, is predominantly white with liver (brown) or black markings. They have long, floppy (and something stinky) ears and a silky, long coat that often needs to be groomed. They have a short, docked tail and are highly energetic; hence, they are perfect for bouncing through the fields when out for a hunt.
With “rage” syndrome, older, geriatric English springer spaniels would become acutely and unpredictably aggressive and attack owners or loved ones. This often resulted in humane euthanasia, as “rage” syndrome was highly unpredictable. Unfortunately, we saw a high incidence of “rage” syndrome back in the early 80’s and 90’s that may have been a result of genetic inbreeding. Thankfully, “rage” syndrome is much less commonly seen lately, as responsible breeders have attempted to eliminate this from the breed.
Do dog calming pheromone collars work?
The D.A.P® or “dog appeasing pheromone” collar releases a scent that mimics the natural calming pheromones that dogs release. This is designed to help calm a dog or puppy, and can be used to help Fido through some behavioral situations such as socialization, loud noses, or a new environment. These collars last approximately 4 weeks and also come as a spray and plug-in air diffuser. While there is a cat pheromone out there (i.e., Feliway®), the canine pheromone collar is species specific so it won’t affect your cat, husband, or kids! Because this smell can interfere with citronella spray collars, the company doesn’t recommend combining the use. While I’m not sure if it’s beneficial in Fido, the D.A.P collars likely don’t hurt. Consult your animal behaviorist if you notice that it’s not helping as Fido may need something a wee bit stronger.
How do I avoid a bad veterinarian?
This “Top 10 signs you’ve gone to a bad veterinarian” list was from David Letterman’s 101 Top 10 list back in September 2002. Tis’ true…
10. When you hand him your cat, he asks uncomfortably, "Monkey?"
9. Two weeks later your dog coughs up a rubber glove.
8. Big sign in waiting room: "No pets allowed."
7. Diploma looks a lot like menu from Chinese restaurant.
6. Always saying, "I've got a tick bomb in my pants!"
5. Sends you card every spring: "Time for your dog's annual neutering."
4. First question: "What ails your varmint?"
3. He has a lot of posters up advertising cockfights.
2. He himself wears one of those big funnel-shaped dog collars.
1. He bites.
Do dogs get “growing pains?”
Believe it or not, dogs do go through growing pains. The two most frequent causes are panosteitis and hypertrophic osteodystrophy (HOD). These two diseases are seen in rapidly growing, medium to large-breed dogs and may result in a shifting leg lameness or lameness in one particular limb. Certain breeds such as Great Danes, Weimaraners, Irish wolfhounds, Labrador retrievers, Saint Bernards, Boxers, and German shepherds seem to be more predisposed. While there is no known cause for these “growing pains,” speculation includes a genetic component or rapid growth from a high protein puppy diet.
With panosteitis, the ulna (where your funny bone is) is the most commonly affected bone, while the radius (the other side of the ulna or your forearm), humerus (upper arm), and femur are the next most affected limbs. HOD is most commonly seen in the front legs in dogs, and results in widened, inflamed, warm, painful joints.
These “growing pain” diseases can be identified on x-rays of the affected limb. If you notice these signs in Fido, make sure to take him to a vet for x-rays. This will help rule out other orthopedic diseases we can see in young or juvenile dogs such as hip dysplasia, osteochondritis dissecans (OCD), ununited anconeal process, and fragmented medial coronoid process which require surgery.
While there’s no “cure” for panosteitis or HOD, treatment is supportive care – in other words, using anti-inflammatory pain medications (such as Rimadyl, Deramaxx, etc), doing physical therapy, using appropriate nursing care (such as soft beds), restricting exercise, tempting them to eat, and changing their diet (to a lower protein diet) may be beneficial. Old wives’ tales include the use of Vitamin C as a supplement, but this has not been scientifically validated. Nevertheless, the use of Vitamin C is relatively benign as it is a water-soluble vitamin – in other words, Fido will just pee out all that extra supplementation.
Can I throw a birthday party for my dog?
Yes, you can. Often times, humane societies or doggy daycares will sponsor birthday parties which run anywhere between a few hundred… and up to a few thou’. In fact, you can spend as much as a bar mitzvah or a wedding if you really want to. Not only will certain places provide a cake for the pooches, games, supervised playtime, a dog-proof play area, and a photographer, but they may even include snacks for human companions and a gift bag to boot. It doesn’t matter if you don’t know the exact date of Fido’s birthday; pick a date and celebrate it from that day on!
I’m hypothyroid and want to help Fat Fido lose weight. Can I give him my thyroid medication to speed up his metabolism?
While rotating through the dermatology service as a 4th year veterinary student, I remember discussing one case where an overweight dog had a bad hair coat due to hypothyroidism (which is when an under-active thyroid gland results in a slower metabolism). The owner had just started thyroid supplementation and hadn’t noticed an effect yet. That’s when my classmate told me that she took thyroid medication to lose weight and (shock!) it didn’t work. The attending dermatologist and I just stared at her, wondering why someone with medical knowledge would try something so asinine. That said, please don’t try that on Fido (or yourself!).
Thyroid medication toxicity is the 7th most common reported drug overdose. Whether or not Fido accidentally got into your meds or his meds, no, you should not be dosing this inappropriately! Because thyroid medication is actually poorly absorbed, toxicity is usually very rare. Signs of toxicity include hyperactivity and a fast heart rate (seen at 0.2 mg/kg to 1.0 mg/kg). When in doubt, keep your thyroid medication out of reach and don’t use it as a weight loss attempt for Fido.
Who’s the world’s biggest loser?
The hot new reality TV series The World’s Biggest Loser teams up overweight Americans who, with the help of dietitians, personal trainers, and support of their teammates, attempt to lose the most weight to gain $100,000. Did you know you can enroll Fido into the World’s Biggest Loser for dogs? Recently, a miniature pinscher named Milo was hailed the “Grand Champion” in the Hill’s 2006 National PetFit Challenge after losing a whopping 12.2 pounds. Not only did he get crowned at the Tavern on the Green in Central Park, but his mom also received roundtrip tickets and complimentary hotel accommodations at a resort in Telluride, Colorado! Check out PetFit.com to help track Fluffy’s weight loss program, and find helpful hints on how to help “extra-fluffy” Fluffy lose weight! You too can register for an opportunity to win!
Do sled dogs have transmitters in them while they are running?
Just like how Fido has a microchip under his skin to identify when he is lost, so do sled dogs. In order to ensure that dogs are healthy and running in ethical, appropriate racing conditions and guidelines, certain sled dog races such as the Iditarod Trail Sled Dog Race require that each individual dog be microchipped. For the Iditarod, each team is allowed to start with 16 dogs, but they must finish with a minimum of 5 of their original 16 dogs. Since dogs can’t carry their driver’s license on them as proof of identification, they all have to have a microchip ID; this is checked at the start of the race and at the finish line (to make sure no swapping of dogs goes on). This also helps veterinarians identify appropriate dogs with their teams and to also ensure that they are returned to the appropriate homes if they ever run off. These microchips don’t have global positioning satellites in them, but each Iditarod sled dog team does run with a GPS in case of emergency for rescue reasons; this can only be turned on in the event of an emergency, however.
My vet shaved my dog, and now his hair hasn’t grown back. Wassup?
Recently, I had a Chow/Australian Shepherd named “Kia” that had been attacked by two other dogs in her own yard. When the owner brought her in to me in the emergency room, he profusely apologized for Kia looking so poorly groomed as she was due to go to the doggy beauty shop next week. Being that she was long haired, I had to shave Kia quite closely to look for bite wounds. To make her look more “smooth” and since the owner was planning on having her groomed anyway, we decided to save the owner a trip to the groomer; we shaved Kia down to a “puppy cut.” A few months later, the owner called me back to report that the hair hadn’t grown back yet. After examining her, running a few thyroid tests, and having a veterinary dermatologist evaluate her, I discovered that Kia had succumbed to my first case ever of “post-clipper alopecia” – a fancy way of saying that after clipping her hair, it was never going to grow back for some unknown reason.
Unfortunately, post-clipper alopecia is a very rare symptom that veterinarians dread. While it’s extremely rare, it’s very hard to explain to the poor owners that Fido’s hair will never grow back, especially when there’s no medical explanation. The good news is that it helps prevent Fido from shedding!
My dog likes to chew on those plastic ant traps. Are they toxic?
While ant and roach baits do have toxic components in them, there are usually in such small doses that they are not usually toxic. They contain boric acid, fipronil, sulfuramid, avermectin, hydramethylon, and propoxur. When in doubt, don’t put them in places where Fido can chew on them.
Can I use baking soda instead of toothpaste for Fido?
While we are proud of you for prioritizing Fido’s dental care and breath, baking soda probably isn’t ideal for brushing his teeth. Just like for humans, baking soda can be quite abrasive and can potentially wear away at the enamel surface of the teeth. Also, because baking soda contains a lot of sodium (salt), Fido may inadvertently swallow too much. This may become a problem if Fido has heart or kidney problems and can even irritate the stomach enough to cause vomiting. The bland, salty taste, along with the idea of a human sticking an abnormal object in to his mouth may not be viewed as very pleasant by Fido. Stick to the liver or chicken dog toothpaste flavors instead.
Does Fido really like liver-flavored toothpaste?
Using a flavored veterinary-prescribed toothpaste may make the whole “I’m about to jam a toothbrush into your mouth while you bite me” experience more enjoyable. Just like humans who prefer the mint flavor of toothpaste or dental floss, Fido likes the liver, chicken or beef flavor of toothpaste. In addition, some of these veterinary toothpastes also have anti-plaque properties. So yes, Fido prefers liver or poultry-flavored toothpaste to mint-flavored or baking soda.
Do dogs get strokes?
Yes, dogs can get strokes, but thankfully it’s not common. Human strokes are often due to lack of blood flow or acute blood vessel abnormalities. Dogs don’t typically develop these. The two most common reasons for “strokes” in veterinary medicine include a fibrocartilagenous emboli (FCE) or old dog vestibular disease. Fibrocartilagenous emboli are when microscopic pieces of cartilage and fibrous tissue develop and break off, blocking blood flow to the spinal cord by occluding the spinal cord arteries or veins. Signs of FCE are acute and usually more unilateral (worse on one side than both sides), and are seen more commonly in certain breeds such as Miniature Schnauzers, Shetland sheepdogs, and Labrador retrievers. Unfortunately, there is no cure for a FCE, and nursing care and supportive care are necessary to help Falling Fido improve, as recovery from paralysis may be gradual and slow. Just like humans with strokes, sometimes dogs can have permanent neurologic deficits. But on the up-and-up, his family will have been tremendously affected by the close call and Fido will never have to get up and fetch the remote ever again.
Old dog vestibular disease is an acute inflammation of the vestibular nerve, which is the nerve that runs through the inner and middle ear and stems from the brain. There may be many causes for this, such as you sticking a Q-tip in your dog’s ear (bad owner!), putting in ear medication, ear infections, trauma, thyroid problems, or just geriatric reasons. This nerve is what helps dogs stay balanced and the same nerve that makes you car or sea sick. It’s the doggy equivalent to your tinnitus. Signs of old dog vestibular disease include sudden imbalance, falling over to the side, not being able to walk, vomiting, nausea, rolling or circling to one side, and abnormal sudden eye movement (called a nystagmus). In other words, your dog looks drunk. Old dog vestibular disease usually resolves in 2-3 days with marked, sudden improvement – as soon as it came, it’ll go away! Unfortunately, the more serious differential for this acute “stroke” is a brain tumor, so if signs don’t resolve shortly, Falling Fido will need an MRI or CT to rule out otherwise. With old dog vestibular disease, your dog can be left with a mild head tilt, making him look eternally curious and perplexed. You’d think this’d be cute after a couple of weeks, but…
Do EMTs know to rescue my dog?
I have a neurotic sticker on my front door that tells the firefighters how many cats and dogs inside my house might need to be rescued. Firefights and EMT will typically try to save the humans first, followed by animals later. Unfortunately, the stickers don’t have a priority order like “save the dog first, husband second, tabby cat third, middle child next, black cat fourth, and so on.” Nevertheless, rest assured in knowing that EMTs will do what they can to help save your dog.
In Appleton, Wisconsin, animal lovers donated several animal oxygen masks to the local fire department after seeing a newspaper photo of a Wisconsin firefighter giving mouth-to-mouth to a cat that had succumbed to smoke inhalation. Also, the Twin Cities is proud to boast “BART” which is “Basic Animal Rescue Training.” This is a non-profit organization that was established by veterinarian Janet Olson in 2004 after a local firefighter’s German shorthaired pointer (named Bart) died after being trapped in a fire. Since then, BART has trained over a thousand EMT and firefights about how to safely handle, assess, and perform CPR on dogs and cats. So, depending on the training of your EMT or your local donations, you may be lucky enough to have a pet-loving EMT or firefighter in your neighborhood!
Do dogs have heart attacks? Can I use those airport defibrillators (AEDs) on my dog?
Unlike humans, dogs rarely have heart attacks. Heart attacks are usually due to a specific type of arrhythmia (abnormal rhythm of the heart), when one chamber of the heart has abnormal, inefficient contractions. In humans, the #1 arrhythmia causing heart attacks is typically ventricular fibrillation, but this is only the #3 cause of cardiopulmonary arrest (death) in dogs. Humans usually develop ventricular fibrillation as a result of a myocardial infarction, which is extremely rare in dogs. While it has been reported in dogs before, the #1 arrhythmia resulting in death is dogs is asystole, which is when the heart just stops beating – in other words – literally – a broken heart.
If your dog collapses or gets weak, don’t rush and grab that AED (automated external defibrillator) that you see hanging on the wall of the airport or mall. This is only for the use with ventricular fibrillation, not asystole. Remember, it’s not like what you see on Pulp Fiction. Once an animal undergoes cardiopulmonary arrest, the likelihood we’ll get him back is unfortunately
very low.
Copyright by Justine Lee Veterinary Consulting, LLC.©
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