Sunday, October 16, 2011

DOGS (PETS) GIVING BACK TO PEOPLE (PT. 2)....


Judging from all the e-mails received following last week's issue, our readers must be well-tuned into the concept of service animals.  Many of you wrote to say how much service animals have meant to you, someone in your family, or a friend of yours.  This week, Helpful Buckeye will be getting into more specific examples of situations in which people have benefited from various kinds of specially-trained service animals.

How often have you walked into a hospital or a nursing facility and noticed a handler with a service/therapy dog walking down the hallway?  I experienced both of those this past summer when my Dad was being transitioned from a hospital to a care center.  The importance of this type of service pet is increasing by leaps and bounds.


Therapy dogs help comfort patients at Salinas-area hospitals



Therapy dogs arrive at Salinas Valley Memorial Hospital with wagging tails and hearts full of love. It's their job to brighten the lives of patients and staff members.


With their masters in tow, they snuggle up to anyone who reaches out for comfort for the sheer joy of it. They have even been known to accelerate healing.


On a Monday morning, Stormy Blue, one of three female Weimaraner therapy dogs owned by Tom Bailey of Salinas, makes her rounds at the hospital's oncology ward and heart center. She wears an orange Therapy Dogs International vest with her name embroidered on it and her official ID tags attached. Her golden colored, empathetic eyes search for and find a nursing center staff member to greet. After hugs, she begins visiting patients.


Bailey calls his dogs his "girls" and together they have completed nearly 1,500 hours of volunteer work at SVMH, visiting Mondays, Wednesdays and Fridays.


Therapy dogs have been part of the hospital's Volunteer Health Career and Spiritual Services program since 1998, said Shannon Graham, assistant director of the program. "We're trying to have at least one team a day," she said. "The dogs brighten up our patients ... and their families too. ... And the staff enjoy it sometimes as much as the patients do."


There are now 18 therapy dogs and volunteers working at the hospital. The dogs include golden retrievers, Chihuahuas, a Pomeranian, a West Highland terrier, a boxer, mixed breeds and a German shepherd named Pirate who comes dressed as a pirate.


The dogs visit most areas of the hospital, except for the ICU, isolation and forensic rooms. Typically, a dog and owner will first visit the nursing station on a floor to see if any patients requested a visit.


"For patients who have been here [before], sometimes they know to ask," Graham said.


Nurses and doctors who know of a patient who would benefit from a dog visit often let the teams know beforehand.


The dogs are known to relieve stress and tension among patients and their families, and the waiting rooms are a regular stop as well.


Bailey, a retired high school math teacher who is one of two certified therapy dog evaluators at SVMH (the other is Kathy Haines), recalled a request from a doctor to visit one of his patients who had undergone open-heart surgery. The man wasn't doing well, so Bailey and his dog stayed with him for 15 to 20 minutes. Afterward the patient's blood pressure had dropped by 10 points and his heart beat had slowed by 10 points. "And it was because of the dog," Bailey said.


Visits can last from five to 90 minutes, depending on the patient, Bailey said. Sometimes the dogs will jump on the bed and snuggle.


Other Monterey County hospitals have therapy dog programs as well. Community Hospital of the Monterey Peninsula has had a program for many years, while Natividad Medical Center has a relatively new program.


The first known therapy dog is believed to have been Smoky, a Yorkshire terrier found abandoned by British army Corp. William Wynne on a battlefield in New Guinea in World War II. When Wynne was hospitalized with a jungle disease, his buddies brought Smoky to visit him and other soldiers in the hospital. Smoky's cheery hospital visits continued for 12 years after the war.


Therapy Dogs International was founded in the United States in 1976 by Elaine Smith, a registered nurse who had worked for a time in England. There she observed how well patients responded to a golden retriever who visited patients with his master, a chaplain.


Bailey began training to be a therapy dog handler in 2003 and started working with them in 2004. His other dogs are Misty Blue and Diamond, all rescued Weimaraners. These dogs were bred as hunters in Germany and taught to snuggle in with their families at night.


"My girls are super important to me and they are my babies," Bailey said. "They're very people oriented."


More therapy dogs are needed at SVMH, Bailey said. The first step in becoming a handler is filling out an application, then the dogs go through a certification process. That includes a placement interview, orientation and on-the-job training with a working pet team.


Bailey said he likes to get down on the floor with a therapy dog applicant and play with them. Potential therapy dogs must be 2 years old to work at SVMH. They must be well socialized with other dogs (no growling or barking), good on a leash and calm. They must not be bothered by unusual smells or loud noises and they also must be bathed the day before each visit….


…Bailey's girls have visited most areas of SVMH, but he specializes in the oncology ward and the heart center. The dogs have even worked in the emergency room.


"ER is very interesting and the girls are very effective," he said. "They quiet the patients down and put them at ease…."


…Stormy Blue, who is 3 1/2 years old and weighs 88 pounds, was eight months old when Bailey adopted her. She has been working as a therapy dog since she was 13 months old. He said Stormy Blue is frisky and playful before a hospital visit but calms down and is ready to go to work the minute he puts the vest on her.


On their way out of the hospital they pass a first floor room where family members are visiting a patient. A young mom and her smiling dark-haired daughter come into the hall and ask questions about Stormy Blue and therapy dogs. They pet her silky silver coat and play with her floppy ears as she sits beside Bailey, relishing the attention.


Master and canine leave the family with smiles on their faces. Then they walk into the lobby to say goodbye to the staff, another day of brightening the lives of others under his belt and her collar.

Adapted from: http://www.thecalifornian.com/article/20111011/NEWS01/110110310

Sometimes, dogs can be very helpful to humans without even being with them.  As this article points out, research on dog diseases frequently leads to new pharmaceuticals for human diseases.

Curing cancer in dogs helps humans too



If you or someone you know has been diagnosed with cancer, there’s another reason to call a dog “man’s best friend": curing cancer in canines could help save human lives too.


According to the National Cancer Institute, a dog is diagnosed with cancer every five seconds in the United States — about the time it took you to read this sentence — and affects roughly 6 million dogs each year. While the diagnosis is never easy to hear, there is hope. Bear, a former cancer patient, is a happy and, finally, healthy Australian Shepherd. After his initial diagnosis, Bear’s family enrolled him in a unique research program at Ohio State’s Comprehensive Cancer Center, where vets and cancer researchers are working together to develop cancer cures for dogs and humans. These clinical trials are often run at no cost or limited cost to owners. As a result of Bear’s treatment, he is now cancer-free.


As cancer research continues to evolve, scientists are discovering that certain types of cancer in dogs are remarkably similar to those in humans, in both how they develop and behave in response to treatment. At the Comprehensive Cancer Center, researchers treat canine cancer patients and share their findings, including drug activity and potential side-effects, with doctors who then apply this information to human studies.


“About 80% of clinical trials fail in the early stages, and a little less than half fail in the later stages,” says Cheryl London, a veterinarian and cancer researcher at Ohio State University’s Veterinary Medical Center. “There’s obviously not enough information going forward when human clinical trials start. So, we want to help that process become more efficient and more accurate.”


It’s an approach that has already proven to be effective. Over a decade ago, Dr. London helped test a cancer drug called Palladia. It was so effective in treating dogs with cancer, that scientists developed a nearly identical drug for humans called Sutent.


In 2006 Sutent became the first drug ever simultaneously approved by the FDA for use in two different types of human cancer, and in 2009, Palladia became the first drug ever approved specifically for treating dogs with cancer. Its success, London says, is due in part because researchers were able to treat dogs first, which greatly helped to inform the design of human studies.

Adapted from: http://blog.sfgate.com/pets/2011/07/18/curing-cancer-in-dogs-helps-humans-too/

Moreover, some disease processes in dogs can be very similar to those in humans and the correlation of successful treatments can result from looking further into that relationship.

Researchers Look to Dogs to Better Understand Intricacies of Bone Cancer



A new University of Minnesota discovery may help bone cancer patients fight their disease more effectively, according to new research published in the September issue of Bone.


Bone cancer typically affects children; the course and aggressiveness of the disease can vary from patient to patient and is very difficult to predict. Some patients respond remarkably well to conventional therapies. Their disease shows less aggressive behavior and they can survive for decades without recurrence. Others respond poorly to treatment or their disease comes back rapidly. Often, these patients survive less than five years.


Recently, a team led by Dr. Jaime Modiano, a College of Veterinary Medicine and Masonic Cancer Center expert in comparative medicine, discovered a gene pattern that distinguishes the more severe form of bone cancer from a less aggressive form in dogs. Dogs are the only other species besides humans that develops this disease spontaneously with any frequency.


In fact, dogs are much more likely to develop bone cancer than humans, but according to Modiano -- who specializes in the relationship between animal and human disease -- human and canine forms of bone cancer are very similar and the gene pattern is an exact match. The discovery of this key differentiating signature may be beneficial in the treatment planning of human bone cancer patients.


"Our findings pave the way to develop laboratory tests that can predict the behavior of this tumor in dogs and children at the time of diagnosis," said Modiano. "This allows us to tailor individualized therapy to meet the patient's needs."


The downstream impact of the findings


University of Minnesota researchers hope to use their findings to develop practical and useful lab tests for humans and for companion animals that will help clinical care providers determine the type of cancer a patient faces, and how aggressive that cancer may be.


Then, depending on which type of cancer a patient has, clinicians could adjust interventions and treatment plans accordingly.


"Patients with less aggressive disease could be treated conservatively, reducing the side effects and the risks associated with treatment, while patients with more aggressive disease could be treated with more intense therapy," said Modiano.


The study was funded by the National Cancer Institute, the AKC Canine Health Foundation and the Kate Koogler Canine Cancer Fund.

Adapted from: http://www.sciencedaily.com/releases/2011/07/110728103146.htm

Going beyond the idea of dogs providing comfort for human patients, it is now possible for medical researchers and clinicians to utilize the extremely well-tuned sense of smell that dogs have.

Dogs Sniff Out Lung Cancer

Specially trained dogs can identify most patients with lung cancer by smelling their breath, researchers said.  Sniffing 100 breath samples from patients with biopsy-confirmed lung cancer, the dogs failed to flag only 29, reported Thorsten Walles, MD, of Schillerhoehe Hospital in Gerlingen, Germany, and colleagues online in the European Respiratory Journal.


Among 400 other samples from individuals without lung cancer, the canine sniff test gave false positives for just 28, the researchers found.  However, Walles and colleagues suggested that the findings were most important for confirming that human exhalations contain markers for lung cancer, which eventually may be detectable by more conventional means.


"This is a big step forward in the diagnosis of lung cancer, but we still need to precisely identify the compounds observed in the exhaled breath of patients," said Walles in a press release.


Several earlier studies have found that dogs, with their keen sense of smell, can identify patients with various forms of cancer, including tumors of the breast, colon, and lung merely by sniffing. The proposition originated in 1989 with a case report of a man whose melanoma was diagnosed because his dog kept sniffing the lesion.


The dogs used in the current study were young family pets -- two German shepherds, one Labrador retriever, and one Australian shepherd. Using test tubes containing exhalations from 35 lung cancer patients and 60 healthy controls, a professional dog trainer taught the animals to lie down in front of tubes with samples from the patients.


During both the training and the subsequent testing phase, each sample was given to the dogs only once so that they would not simply learn to recognize individual participants' characteristic odors….


…Whether dogs will ultimately be better than machines for breath analysis remains to be determined, they indicated.


"Electronic nose technologies" are not yet practical because of their complicated sampling procedures and vulnerability interference, the researchers commented.


Dogs, on the other hand, are "virtually on the verge of respectability" for disease detection. Yet without better understanding of what they are responding to, it will be impossible to develop a reliable screening test for lung cancer based on their abilities, Walles and colleagues suggested.


"Unfortunately, dogs cannot communicate the biochemistry of the scent of cancer," they lamented.

Adapted from: http://www.medpagetoday.com/HematologyOncology/LungCancer/28096

Therapy animals also frequently work with human heart patients.

Vineland hospital's canine assisted therapy is a doggone success for heart patients

Gypsy, a retired racing greyhound, was on the track for four and a half years, chasing rabbits as fast as her long legs could go.


The dog has slowed down since retirement. Now, she’s taking more leisurely steps alongside heart failure patients at South Jersey Healthcare’s Regional Medical Center at Vineland, where recovering cardiac patients are making their own strides toward wellness.  The therapy dog, who works with her owner nurse Sami Abate, sees about six to 10 heart failure patients a day, coaxing them to get up and walk.


“Walking your dog is actually good for your heart,” said Abate, of Millville, whose recent research study found clear evidence that therapy dogs lead to big-time favorable outcomes for heart failure patients.


Abate’s second therapy dog, Gypsy, was already at work in the hospital the day after completing six months of obedience training, which was required before she could begin volunteering.


Walking can be difficult for those who suffer from heart failure. Their feet and ankles are often swollen, and just getting out of bed or treading to the bathroom causes them to breathe like they’ve sprinted a 100-meter dash.


Even though the greyhound looks fast, Gypsy never won a race on the track. At the hospital, she takes slow steps between Abate and the patient holding her leash.


“This is more her speed,” said Abate, who found that Gypsy’s sleek good looks could often charm patients into a stroll around the unit.


The observation encouraged Abate — and research partner Michele Zucconi, SJH’s clinical nurse manager — to study patient-pup interaction to see if heart failure patients could be encouraged to get out of bed with the gentle coaxing of a four-legged friend.


Until now, there had been no evidence-based research on the books supporting Canine Assisted Therapy — a term the research team coined.


Between June 2009 and March 2010, the nurses — and Gypsy — got down to work.


They recorded patient responses when they were asked to get up and walk with a nurse. The initial answer was usually “no.”


After a few screening questions — “Are you allergic to animals or afraid of dogs?” — Gypsy was offered as an escort.


Compared to a hospital ambulation data base of 400 previous heart failure cases, Gypsy’s patients were four times less likely to refuse walking when she was by their side.


“People didn’t think they walked any farther, but they walked twice as far,” Abate said. “We discovered that patients who had walked were released one day sooner.”


An early release could mean a savings near $6,000 for the hospital, according to Bruce Boxer, Director of Nursing Quality and the hospital’s Magnet Program.


The study “does have true physiological meaning,” said Boxer, noting that other studies conducted on pet therapies focused on effects that could not be easily measured, like whether a pet’s visit was responsible for lowering blood pressure or decreasing stress levels.


“We realized that walking was evidence-based,” Zucconi said, who was able to track the positive responses to walking with Gypsy….


…Abate’s study was accepted by a medical journal on the first draft, something nearly unheard of in the world of clinical research. It recently won the Research Poster Award given by the National Teaching Institute and American Association of Critical Care Nursing….


…In addition to the clinical application, Boxer said Gypsy has had other effects on patients — and staff.


“She really facilitates communication,” he said.


The race dog often serves as an ice breaker between nervous patients and clinicians. Abate said quiet patients will start to open up when the conversation turns to pets. Then, more important talks can bloom.


And on tough days, even the staff members have been overheard saying, “I could really use a Gypsy moment,” Abate said.

Adapted from: http://www.nj.com/gloucester-county/index.ssf/2011/06/vineland_hospitals_canine_assi.html

It has now been well-established that regular exercise with a dog contributes to a more healthy heart.  Click through the pictures on this site that depict:

The Dog Lover's Guide to Heart Health

Studies show that people with dogs are more active, and activity is good for your heart. Here are 9 easy ways to get heart-healthy exercise and play with your pooch at the same time.


The results are in: According to a study in the Journal of Physical Activity & Health, dog lovers are more active and more likely to get exercise than non-dog owners. Statistics from the study reveal that dog owners are 34 percent more likely to walk 150 minutes a week than non-dog owners, and 69 percent more likely to get at least some leisure-time physical activity. This means that spending time with Fido can also be a great way to fit in heart-healthy exercise. Try these fun activities with your four-legged friend.


1. Walking

2. Jogging

3. Hiking

4. Agility Courses

5. Canoeing

6. Fetch

7. In-Line Skating

8. Hide & Seek

9. Hunting

Adapted from:

Researchers and clinicians can sometimes be a little direct in their zeal to get someone's attention, as in this headline:

Walk the dog, drop the pounds--Researchers look to put a leash on obesity


Taking Fido for a walk can keep people from getting husky, say University of Massachusetts researchers who are trying to get couch potatoes up and out by appealing to their love of dogs.


The first-in-the-nation clinical study at the University of Massachusetts Medical School aims to see if Rover has the power to unleash new levels of human motivation and combat the nation’s obesity epidemic. Researchers are launching a study that will use social networking and other methods to encourage test subjects to walk their dogs — and measure how much walking they do.


“I’ve never had such a great response about a research study. So many people are dog lovers,” said Kristin Schneider, an assistant professor of preventive and behavioral medicine at UMass Medical School.


One-third of adults in the United States are obese, according to the Centers for Disease Control. Just as appalling, 60 percent of dog owners never take their mutts out meandering, Schneider said.


It’s precisely the emotional investment people place in their pooches — and the time they spend social networking on their computers — that Schneider is counting on to coax 120 sedentary Worcester and Lowell residents off their couches and out the door for a minimum of 2 1⁄2 hours of dog walking each week.


In collaboration with physical therapy professors Cynthia Ferrara and Deirdra Murphy at UMass Lowell, Schneider and co-investigator Stephenie Lemon will create a six-month, self-governing community of dog walkers on Meetup.com and provide them pedometers, newsletters, information on walking routes and dog parks — even locations of waste bins.


Over six months, the researchers’ plan is for participants to reach out to each other for doggy play dates and exchange tips on dog-friendly routes and pet-gear sales.


“We can learn so much from dogs,” Schneider said. “They’ll go up to (most) anyone and be so positive and friendly. People need to do more of that in their day-to-day lives.”


“A lot of people have this idea that just letting the dog out in the back yard is enough,” she said.


But the howl-worthy excuses don’t end there. Dozens of dog owners Schneider and Lemon met with this year also griped about weather and the social stigma of Fido relieving himself on a neighbor’s lawn as reasons for begging off breaking a sweat.

Adapted from: http://bostonherald.com.nyud.net/news/regional/view.bg?articleid=1369074&srvc=home&position=emailed

The other very common human disease that lends itself to being detectable by a dog is diabetes.  Dogs are being trained to be able to smell a diabetic's breath for signs of either a high or low blood sugar.

Canines trained to help people with diabetes



Chloe was so rambunctious, her owner didn't want her anymore.


Now the chocolate Labradoodle not only has a home, she also has a job, all thanks to Mark Hackathorn and Scott Smith, who turn homeless and surrendered dogs into service dogs.  Later this month, Chloe will be Seattle-bound, where she will be a diabetic alert dog for Mark Hagen.


Hackathorn, owner of Tidewater K9 Academy for nearly 30 years, and his longtime assistant Smith, are behind CARES, or Canine Assisted Rehabilitation and Education Services. The recently formed nonprofit operates out of a pre-Civil War house in Brentwood that also serves as a boarding and behavior training facility. Initially, CARES was started to rehabilitate dogs to give to the elderly, but Smith read about diabetic alert dogs online and brought the idea to Hackathorn.


"We looked into it and thought, 'Oh, my God. We can help,' " Hackathorn said.


Diabetic alert dogs are trained to give a signal to warn their partners about low or high blood sugar levels. While generally a diabetic can feel the warning signs of low blood sugar, which include sweating, shaking, nausea and confusion, a hypoglycemic-unaware patient cannot.


A diabetic alert dog "can smell when your blood sugar drops too low or goes too high," Smith said. "We teach dogs how to smell that scent and when it gets to a particular point, how to alert us."


Hagen, a diabetic for 32 years, used to be aware of his sugar lows until three years ago, when his health began to deteriorate. Last summer, he went in for a dental cleaning and woke up stunned to see his wife and emergency medical technicians in the room. His dramatic drop in insulin resulted in a visit to the emergency room that evening.


Currently, Hagen relies on a continuous glucose monitor that is about 70 percent accurate in detecting low levels, he said.


"That leaves a lot to fall through the cracks," he said. "My problem is when I get low enough that I can't help myself anymore."


Hagen did some online research and was impressed by the training methods Hackathorn and Smith use. Many trainers rely on dabs of sweat as the scent sample, which can lead to a false positive. Hackathorn and Smith use saliva, an indicator they say is accurate 98 percent of the time.


Hagen flew to Norfolk earlier this year and bonded with Chloe instantly. He will return to the area in the middle of August to spend the week with her under the guidance of Hackathorn and Smith. Then she will ride with him in the passenger cabin back to Seattle and join his family, which includes a pug and Lab mix.


"She's an easy dog to like and work with," Hagen said. "She's extremely smart. I think she'll be a good fit."


Many organizations take years to train diabetic alert dogs; Hackathorn and Smith can do it in as little as eight months. Chloe's training is nearly complete. Hackathorn demonstrates by placing the scent on his body, which causes her to become animated, touching him with her paw. If Smith does not immediately respond, she becomes more persistent.


The first dog the men trained to be a diabetic alert dog is Max, a surrendered yellow Lab, who has since found a home assisting Robert Anderson in Roanoke. Anderson suffers from a seizure disorder that has compromised his ability to deal with his diabetes.


"His memory got so bad, he forgot to test his blood sugar," said his wife, Kimberly. Max came to the family in December and has been a godsend, Kimberly said.


"His being able to keep his independence makes me able to keep mine," she said.


Costs can be inhibiting. Hagen considers himself fortunate to be able to pay the $20,000 for Chloe out-of-pocket. Hackathorn is working to locate corporate sponsors that can subsidize what would be prohibitive expenses to many.


Hackathorn finds rescues via Craigslist, typically seeking Labs or golden retrievers, though he is most partial to the "doodles," because they are hypoallergenic. Once the dogs are trained, they are on alert around the clock, as it isn't unusual for diabetics to suffer highs or lows in the middle of the night.


"These dogs don't have any down time," Hackathorn said.


Giving back motivates Hackathorn, who said he has trained more than 20,000 dogs, largely in obedience. Now his primary focus is service dogs.


"We wanted to do more," he said. "And we wanted to rescue dogs. I like to say, 'Save a dog; save a human.' "

Adapted from: http://hamptonroads.com/2011/08/canines-trained-help-people-diabetes

An appropriate way to finish this week's issue of dogs helping humans with some of their problems is this story of one dog helping another dog--which happens to be deaf.

Deaf Black Lab Fetched By Dog Friend (Great Video)



Teamwork has never been more adorable.


Benson, a cute black lab, is hearing impaired, so when it's time to come inside after playing in the yard, his buddy Buffy has to fetch him.


Despite being "awwww-inspiring," it seems doggy cooperation isn't that uncommon. Earlier this year, Rowdy, a rat terrier, went on a walk with his owner and discovered Casper, a 15-year old miniature schnauzer, stuck in a drain pipe.


Authorities estimated Casper had been in trapped in the pipe for around three days. Firefighters rescued the imprisoned pup with a "unique plan involving a hose and a teddy bear."


Watch as Buffy happily prances over to his roommate, grabs his collar, and ushers him back towards the house. It's even better if you listen to "The Best Of Friends" song from the Fox and the Hound at the same time.

Watch the short video at: http://www.huffingtonpost.com/2011/10/10/buffy-fetches-benson-deaf-black-lab_n_1003670.html?icid=maing-grid10%7Chtmlws-main-bb%7Cdl7%7Csec3_lnk3%7C103391

That's it for health and disease-related situations that make good use of our canine friends.  Next week's issue of Questions On Dogs and Cats will present the conclusion of this topic with some very interesting examples of other ways in which pets have become important in making humans' lives more fulfilling.

SPORTS NEWS
The Pittsburgh Steelers beat JAX today, although the score was closer than it needed to be. We travel to Phoenix (Glendale) next week to play the AZ Cardinals.



PERSONAL STUFF

Hallelujah!!!!!  That's all I can say after being able to finally get back on my bike this weekend...rode 10 miles Saturday and 15 miles Sunday.  That doesn't seem like much, compared to my normal distances, but coming off a serious injury, it was a thrilling jolt of happiness for Helpful Buckeye!  I had been anticipating these days for a while but the actual realization of doing it was even greater than I had anticipated.  The chances of making the Tour de Tucson have improved considerably....

I also saw the first tarantula of the Fall today while on my bike ride.  The male tarantulas are out looking for a mate during October at our altitude.


Lastly, the riddle has finally been solved...about the chicken and the egg...and which came first.  As the geneticist J. B. S. Haldane remarked, "The most frequently asked question is: 'Which came first, the chicken or the egg?' The fact that it is still asked proves either that many people have never been taught the theory of evolution or that they don't believe it."  With that in mind, the answer becomes obvious. Birds, as we now know, evolved from reptiles, so the first bird must have come out of an egg--laid by a reptile. From “The Second Book of General Ignorance” by John Lloyd and John Mitchinson.


Now, you won't have to lose anymore sleep over that one....

~~The goal of this blog is to provide general information and advice to help you be a better pet owner and to have a more rewarding relationship with your pet. This blog does not intend to replace the professional one-on-one care your pet receives from a practicing veterinarian. When in doubt about your pet's health, always visit a veterinarian.~~

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