what are the side effects of cerenia for dogs

Comparison of pain response after subcutaneous injection of two maropitant formulations to beagle dogs. While the drug is well tolerated in dogs, a higher dosage may cause side effects. The most . If you have concerns due to a longer, upcoming trip, ask your veterinarian what options you have to prevent motion sickness vomiting. The probability that a dog in this study, prone to motion sickness would NOT vomit during a journey if treated with Cerenia Tablets was 93%, while the probability was 48% if treated with placebo. In people, topical exposure may elicit localized allergic skin reactions, and repeated or prolonged exposure may lead to skin sensitization. . Interpretation of these study results is complicated by the health status of study animals. Therefore, if you give a pet cimetidine and one of these other drugs (theophylline, aminophylline, lidocaine, and diazepam, to name a few), it is more likely that a pet will develop side effects similar to those seen with overdoses of the drug in question. To understand how it accomplishes this feat, you first need a crash course on the vomiting center of the brain. However, a full assessment will help determine what other treatment plans will be most beneficial to your pet. From time to time, your pup may vomit when at home, too. Topical exposure may elicit localized allergic skin reactions in some individuals. Not for use in humans. If this should occur, it will require emergency veterinary attention, which is an important to consider wherever you are traveling. Its not available for over-the-counter purchase. Side Effects and/or Signs of Overdose: Side effects are rare but include diarrhea and decreased appetite. Considerations CERENIA Tablets are recommended for dogs 8 weeks and older for prevention of acute vomiting and for dogs 16 weeks and older for prevention of vomiting due to motion sickness. The empirical formula is C32H40N2O C6H8O7 H2O and the molecular weight 678.81. If vomiting persists despite treatment, the case should be re-evaluated. Cerenia side effects in dogs can be reported directly to the manufacturing company. These work hand-in-hand with other treatment options to help you pet be pain-free and happy. What are the possible side effects of Cerenia? Our nutritional products are available for purchase worldwide. DeckersN, RuigrokCA, VerhoeveHP, etal. Watch for other signs of illness in your pet and changes in appearance or behavior. It's more likely the stress that's causing it - a normal reaction in dogs to any kind of stress. Once you identify allergies, motion sickness, and other pertinent medical information, it should then be shared with anyone who cares for your pet. In laboratory model studies, Cerenia Tablets dosed at a minimum of 2 mg/kg BW reduced the number of emetic events associated with established neural (central) and humoral (peripheral) stimuli. Swelling or pain at the injection site has been seen with the administration of the injectable form. This effect can be reduced by keeping the medication refrigerated. In most cases, your veterinarian may instruct you to not give extra or double doses. Decreased heart rate and prolonged corrected QT intervals were seen in all treatment groups in a dose dependent manner. It's effective for about 24 hours. Administer Cerenia Tablets 2 hours prior to travel. This is transient, though, and should fade within a minute. The risks for Cerenia side effects in dogs are increased when Cerenia is combined with other drugs such asphenobarbital(a medication to control seizures);chloramphenicol(an antibiotic);ketoconazolealong with some other antifungal drugs, certain types of thyroid hormone supplements, behavioral medications andsome cardiac drugs, and non-steroidal anti-inflammatory drugs. The following adverse reactions were reported during a European field study for the prevention of vomiting due to motion sickness in dogs treated with Cerenia Tablets at a minimum of 8 mg/kg orally once daily for 2 consecutive days. Your veterinarian may recommend other antiemetic medications or dietary changes to alleviate your dogs symptoms. What are the side effects of Cerenia? Acute vomiting symptoms include continuous vomiting. Pain at the injection site of Cerenia for dogs may be a temporary side effect. Cerenia (maropitant citrate) is not approved for use in humans. The most common ones are including nausea and lack of appetite. If you accidentally ingest a pet medication, immediately seek medical attention, or call the national Poison Control Center hotline at 800-222-1222. Your veterinarian may want to reevaluate your pet to see if a more serious underlying condition is present. Two dogs out of 106 given the placebo developed hypersalivation as well (almost 2 percent). In puppies 16 weeks and older, bone marrow hypoplasia was not seen (See Animal Safety Section). Your vet may recommend additional tests or procedures to ensure the safe use of Cerenia. Dog Cerenia side effects include diarrhea, excessive drooling, drowsiness, bloody stools, lack of appetite, otitis or inflammation of the ear, endotoxic shock, hematuria, and excoriation. Even in reports of death from Cerenia in dogs,it is difficult to prove the cause of death unless the dog owners elects to have an autopsy done. " Among dogs tested with placebos instead, 1 out of 106 only 1 developed drowsiness which comprises just one percent of placebo researched dogs. The side effects of Cerenia in dogs may be several. # dogs. On top of that, maropitant preserved with benzyl alcohol, offers the advantage of not needing to be refrigerated. Discover how to stop the behavior. or stool, pain, and weakness. The most common side effect of Cerenia in dogs is drowsiness. www.vetstreet.com/pfizer/treat-and-prevent-vomiting-with-once-daily-cerenia. We might not think of dogs getting woozy in the car but it is the case in many pets. It is intended for use in dogs 8 weeks of age or older. Excessive drooling, diarrhea, vomiting, loss of appetite, and mild pain (from injection) are a few common side effects of Cerenia for dogs It is never fun when your dog vomits! Home / Adverse Drug Reactions / Cerenia for Dogs Side Effects. Please note: Cerenia may interact with certain medications and medical conditions, including but not limited to . By blocking it, Cerenia helps prevent these symptoms from occurring. A dose dependent increase in severity of bone marrow hypoplasia was observed histologically. However, its essential to follow your vets instructions carefully and avoid giving your dog too much of the medication. Although Cerenia is claimed to benon-sedating (which makes it a better choice than Benadryl or Dramamine for car sickness) a few dogs may develop drowsiness as a side effect. Back to the U.S field study, out of 206 dogs given Cerenia to prevent acute vomiting, 8 developed diarrhea. How long does it take for Cerenia to work? Urinary recovery of maropitant and its major metabolite was minimal (<1% each). Likewise, dogs with impaired liver function are at higher risk for these side effects. However, long road trips, airplane travel, or other modes of transportation may cause your pet to get motion sickness, which then leads to vomiting. Maropitant is the non-proprietary designation for a substituted quinuclidine. Some other Metoclopramide side effects that occur in dogs who have been treated with Metoclopramide include: Abdominal pain. Cerenia (maropitant citrate) is the first and only FDA-approved veterinary medication to safely and effectively treat vomiting in dogs and cats and prevent vomiting due to motion sickness in dogs. Greater than dose-proportional drug exposure can be expected with an increase in dose (1-16 mg/kg PO). Anorexia (no appetite) Is drowsiness a side effect of Cerenia? Using Cerenia every day eventually risks depleting a dog's reserves of dopamine in their central nervous system leading to tremors (think Parkinsons disease). On top of this, your dog can be lethargic. Cerenia (maropitant citrate) is also an ocular irritant. Where the dogs treated ethically? Of course, not all dogs will develop this. In addition, the use of these antiemetics should be delayed until a clinical examination and abdominal radiographs have ruled out GI obstruction. There are other factors involved with prescription medication. However, let's imagine for a moment the level of damage that may occur if a dog who has ingested toxin is administered Cerenia and the dog fails to vomit. For many, dogs are like another member of the family and rarely are left behind regardless of the destination. Like any drug, Cerenia can have side effects, so its crucial to monitor your dogs behavior and contact your vet if you notice anything unusual. Additional side effects to look out for may be things like changes in behavior (such as lethargy), a lack of coordination, and convulsions. PetMDs medications content was written and reviewed by veterinary professionals to answer your most common questions about how medications function, their side effects, and what species they are prescribed for. Common Side Effects of Cerenia for Dogs Side effects of Cerenia may include drowsiness, lethargy, lack of appetite, and diarrhea. Thanks! "~Clinician's Brief. With a degree in Animal Behaviour and over a decade of practical animal husbandry experience, Hannah's articles cover everything from pet care to wildlife conservation. If you suspect an overdose, immediately seek emergency veterinary care, or contact an animal poison control center. social@canna-pet.com As the name implies, activation of the vomiting center leads to vomiting. When dogs were given Cerenia at a minimum dose of8mg/kg to dogs prone to motion sickness for 2 days, 5 dogs out of 107 developed hypersalivation (almost 5 percent). Most dogs will maintain a normal appetite while taking maropitant citrate, but a loss of appetite is a possible known side effect. What should I do if my pet continues to have acute vomiting? Generic name: maropitant citrate It is therefore important to understand that, while Cerenia is very effective in inhibiting vomiting, it fails to address the underlying cause of the vomiting. Get practical pet health tips, articles, and insights from our veterinary community delivered weekly to your inbox. One specific long term use is to prevent vomiting in cats with renal failure. Hannah Elizabeth is an English animal behavior author, having written for several online publications. Systemic clearance of maropitant following IV administration was 970, 995, and 533 mL/hr/kg at doses of 1, 2 and 8 mg/kg, respectively. Yes, Cerenia can be used to prevent motion sickness in dogs. Other side effects may include vomiting lethargy and loss of appetite. These concerns are not unfounded, considering that the drug information leaflet lists several potential side effects some of which can be quite scary. Administer Cerenia Tablets orally at a minimum dose of 8 mg/kg (3.6 mg/lb) body weight once daily for up to 2 consecutive days. Fifty six Beagle dogs (28 males and 28 females) approximately 16 weeks of age were administered Cerenia Tablets orally once daily for 15 days at 0, 2, 6, and 10 mg/kg. However, there are other ways your pet may have a more comfortable ride when traveling as well. Cerenia Side Effects in Dogs. The side effects of Cerenia in dogs may vary from being mild to serious, although serious side effects are usually quite rare. Cerenia does not target the stomach to decrease nausea. Repeated or prolonged exposure may lead to skin sensitization. The absolute bioavailability of maropitant was much higher following SC injection (91% at 1 mg/kg) than after PO administration (24% at 2 mg/kg). Consultation fees often apply. Acute vomiting may be the result of a change in diet, allergic reactions to food, inflammation, parasites, tumors, liver disease, adrenal gland disease, or heat stroke. Forty Beagle dogs (20 males and 20 females) between 16 18 weeks of age were administered Cerenia Tablets orally once daily for 6 days at 0, 8 and 24 mg/kg. Vomiting Related To Motion Sickness Vomiting that is related to motion sickness is the primary indication of Cerenia. Your dog can face a low appetite after taking a few doses of Cerenia. Subscribe to Drugs.com newsletters for the latest medication news, new drug approvals, alerts and updates. Dogs may also experience vomiting and excessive salivation when higher doses are used to prevent motion sickness. The fact that dogs on the placebo salivated as well makes one wonder whether the simple fact of being in a study caused dogs enough stress to cause drooling. It also may act as a mild pain control medication. Cerenia is only available through a veterinarians prescription. In US field studies in veterinary patients, Cerenia Tablets and Injectable Solution were well tolerated in dogs presenting with various conditions including parvovirus, gastroenteritis, and renal disease. Plasma protein binding of maropitant was high (99.5%). This will help you determine if its an ongoing problem or a one-time event. If you're interested in the Havanese dog breed, then you'll need to learn more about this breed's coat. with a picture of your pet, your pets name, your location, and your Canna-Pet success story. Behavioral changes. Aside from pain at the injection site, Cerenia can cause nausea, vomiting, and diarrhea. Keep the tablets in the supplied blister packs until use to protect from moisture and light. If your dog is suffering from acute vomiting, it may not always happen indoors, which means you may not always be privy to it right away. Dogs given a placebo though apparently were not free from being affected. Take into account what makes your dog comfortable at home and translate that as much as possible when on the road. To make the trips enjoyable for all, find out what your dog needs to have a safe and comfortable ride. Oral maropitant citrate can be used in cats over 16 weeks and older for either vomiting or motion sickness. The following Adverse Reactions were reported during the conduct of a US clinical field trial where CERENIA Tablets were administered once daily for 28 consecutive days to 32 dogs: lethargy, vomiting, inappetence, corneal edema, and enlarged lymph nodes. Side effects included sporadic episodes of salivating, vomiting, weight loss and lower serum albumin levels. Cerenia is also used to treat acute nausea and vomiting in dogs and can alleviate nausea associated with chemotherapy. Its possible your dog will always need to take medication for motion sickness. How long do side effects of Cerenia last? This can be a serious concern, especially if your dog is already prone to dehydration or has kidney problems. The rare side effects of Cerenia can include: Diarrhea Anorexia (no appetite) Hematuria (blood in the urine) Hypersalivation (excessive drooling) According to a published study, oral maropitant is commonly used off label in cats at the same dose (1 mg/kg q24h), which differs from the labeled dose for dogs (2 mg/kg), probably due to the difference in . If you or one of your travel companions also get motion sickness, talk to your doctor about potential remedies. Vomiting is a complex process coordinated centrally by the emetic center which consists of several brainstem nuclei (area postrema, nucleus tractus solitarius, dorsal motor nucleus of the vagus) that receive and integrate sensory stimuli from central and peripheral sources and chemical stimuli from the circulation and the cerebro-spinal fluid. Keep in mind, most dogs take Cerenia with no adverse reactions, but the most common reported side effects are as follows: Lethargy Drowsiness Excessive drooling Lack of appetite Diarrhea Is there an alternative I can turn to? When dog owners report side effects of Cerenia in dogs, it may be therefore difficult to prove whether the dog is truly suffering from side effects from this drug or from complications deriving from the underlying cause of the vomiting itself. Yes, there are several alternatives to Cerenia for treating nausea and vomiting in dogs. Cerenia Tablets may be used interchangeably with Cerenia Injectable Solution for once daily dosing for the prevention of acute vomiting. There are no known long-term side effects associated with the use of Cerenia in dogs. According to veterinarian Dr. Jennifer Coates, giving Cerenia on a schedule of five days ontwo days off, or every other day, helps prevents this side effect. Dont feed your dog up to one hour before giving him Cerenia and plan to give it to him approximately two hours before disembarking. Does cerenia make dogs lose their appetite? Complications may occur as well insmall dog vomiting because of an intestinal obstruction from ingesting sharp pieces of plastic. Your email address will not be published. Make sure your vet knows whether your dog is on other medications while taking Cerenia. Placebo dogs though were also affected with 5 dogs developing bloody stools, ultimately comprising 7.2 percent of the 69 tested. Although hepatic first-pass metabolism contributed to the relatively low bioavailability after an oral dose, prandial status does not significantly affect the extent of oral bioavailability. Other potential side effects include dry mouth, constipation, and diarrhea. Many different medications use CYP as part of the process of being cleared from the body. Side effects of Cerenia may include drowsiness, lethargy, lack of appetite, and diarrhea. For other uses of this medication, please follow the directions on the drug label or as provided by your veterinarian. Side effects of Cerenia may include drowsiness, lethargy, lack of appetite, and diarrhea. Cerenia will take effect quickly, and improvement signs in your dog . Theyre easy on the digestive system and can also potentially help with other disorders like anxiety in dogs. See also Tramadol Dosage for Dogs With Cancer Toxicity: And, you want to take extra precautions if your dog has liver problems. Cerenia (Maropitant Citrate) tablets are indicated for the prevention of acute vomiting and the prevention of vomiting due to motion sickness in dogs. As with most medications, Cerenia can cause side effects in dogs. Drug & Food Interactions Cerenia side effects for dogs are usually temporary, mild and not serious. The leaflet mentions 10 dogs dying out of 206 receiving Cerenia, which is 4.9 percent. It is a medication that can help increase antioxidants in the body that assist with liver function. Dogs allocated to the placebo group were treated using either an injectable placebo solution or placebo tablets once daily at the discretion of the clinician. Hypersalivation simply means that the dog's salivary glands produce excess saliva. Do not attempt to give your dog Cerenia without a prescription or without consulting a veterinarian. Cerenia has a wide margin of safety. If your dog has been prescribed Cerenia for acute vomiting and continues to vomit or is unable to take the medication because of it, then call your veterinarian right away. For those who travel frequently with their pets, you most likely already have a routine down. Always monitor your dogs behavior after administering Cerenia and contact your veterinarian if you notice any adverse reactions. Always confirm storage requirements by reviewing the label. It may act as a mild pain control medication. In studies, Cerenia has proven to be so effective, that even dogs who were given powerful emetics (substances known to cause vomiting) such as syrup of ipecac or apomorphine, failed to vomit courtesy of this drug. Think about implementing other wellness practices that can help promote overall comfort as well. An accumulation ratio of 1.5 was observed following once-daily use of maropitant for five consecutive days at 1 mg/kg (SC) or 2 mg/kg (PO). The most common side effects of Cerenia include drowsiness, lethargy, and diarrhea. Well follow up with a 25% off coupon code! Rarely, dogs may experience loss of appetite, diarrhea, or constipation. If this should occur, it will require emergency veterinary attention, which is an important to consider wherever you are traveling. This leads to us pondering whether dogs may just die during studies. When prescribed, your dogs doctor will review all the side effects and potential risks to look out for. Fortunately, not many dogs appear to have been affected though when looking at the study. Pain/vocalization upon injection is a common side effect. Will my dog have to take Cerenia for the rest of his life? The most common side effects of Cerenia in dogs are drowsiness and lethargy. Cerenia is not recommended for use in dogs less than 16 weeks old. The study shows that out of 69 dogs 2 developed a lack of appetite which is 2.9 of the total placebo-tested dogs. This may include massage therapy, acupuncture, aromatherapy, or a change in diet and exercise. This appears to happen when Cerenia is preserved with a preservative known as metacresol. Twenty-four 7-month-old dogs were given Cerenia once daily for 93 days. However, its important to administer Cerenia at least an hour before the motion sickness-inducing activity to ensure its effectiveness. No, Cerenia is a prescription medication that can only be obtained through a licensed veterinarian. For a copy of the Material Safety Data Sheet (MSDS) or to report adverse reactions call Pfizer Animal Health at 1-800-366-5288. If youre introducing your pet to the medication for the first time, its wise to set out on a test drive before hitting the road for the real trip. This can be concerning, especially if your dog is already underweight or has a history of poor appetite. In vivo model studies in dogs have shown that maropitant has antiemetic effectiveness against both central and peripheral emetogens including apomorphine, and syrup of ipecac. You should monitor your pet carefully while they are receiving this medication to ensure they do not have any negative side effects from it. However, its essential to consult with your veterinarian before giving your dog any new medication or supplements. 1-800-PetMeds explains the medication comes in four different sizes to accommodate dogs of all sizes, and it is a once daily medication that can be administered for up to five days. The following adverse reactions were reported during the course of a US field study for the prevention of acute vomiting in dogs treated with Cerenia Tablets at a minimum of 2 mg/kg orally and/or Injectable Solution at 1.0 mg/kg subcutaneously once daily for up to 5 consecutive days: Other clinical signs were reported but were <0.5% of dogs. Can cerenia for dogs cause loss of appetite? The vestibular system is found in the inner ear and is responsible for gathering information about balance and motion. We have to warn you, Cerenia comes with common side effects, as does every other medication on the market today. And other side effects such as a watery movement. For personalized dosage instructions, talk to your veterinarian. Fortunately, Cerenia helps prevent acute vomiting by blocking substance P (which triggers vomiting) in the brain. This way you can monitor how well your dog is responding to the medication and if its a suitable option long-term. Dogs used in the study were weaned early, minimally acclimated to the test facility, and many of the dogs in the study tested positive for coccidia. Rather than leave your dog at home when you hit the road, Cerenia may be prescribed by your veterinarian to help avoid this problem. Frequently reported side-effects of this drug include hyperactivity, muscle restlessness, or drowsiness, as well as constipation in dogs. Where any steps take to reduce stress in dogs if housed in a laboratory? Uses of Maropitant Citrate (Cerenia) for Dogs and Cats; Maropitant citrate is used to treat vomiting and prevent vomiting associated with motion sickness in dogs. If any of these symptoms occur, stop using Cerenia and consult your veterinarian right away. Double check that theres enough space in his crate and enough air getting to him while riding. The drug also works to control nausea and vomiting due to the relationship between the eyes and vestibular system. Cerenia is a medication that has been used for many years in veterinary medicine to treat nausea and vomiting in dogs and cats. Cerenia works quickly, and you may notice an improvement in your dogs symptoms within a few hours of taking the medication. Make sure there is good ventilation for your pet, as this can help him feel better when in the car. If he is 14lbs he could be dosed as high as 60mgs to help with motion sickness, although most veterinarians would probably start at 24mgs to see if that is effective. Cerenia Tablets caused decreases in food consumption and body weight that were not dose-dependent and did not persist after cessation of treatment. There are certain conditions your dog may grow out of as years go on and conversely, there are conditions that may affect him worse as he gets older. Possible Side Effects of Cerenia Consult with your veterinarian or seek immediate veterinary medical attention if vomiting continues despite treatment with Cerenia. In a study of 275 canine patients presented to veterinary hospitals with a history of acute vomiting, dogs were initially administered Cerenia Injectable Solution or placebo on Day 0. But when dogs are sick, they generally like to be calm as there is a lack of energy. How long does it take for cerenia to work? Each peach-colored oval tablet is scored and contains 16, 24, 60 or 160 mg of maropitant as maropitant citrate per tablet. Find out which foods your pet is allergic to and what works best. While Cerenia is often used to treat vomiting, it can sometimes cause diarrhea or vomiting as a side effect. document.getElementById( "ak_js_1" ).setAttribute( "value", ( new Date() ).getTime() ); Enter your name and email to get exclusive offers and updates from Canna-Pet! Cerenia is primarily used to control nausea and vomiting in cats, including motion sickness. Track all medical history, medications, and dietary changes in your pet to find what works. Cerenia works on average within one hour of administration. 2008;31(6):528-532. Placebo (n=106 ) Cerenia (n=107 ) # dogs. But if youre new to taking your pet with you on trips, it can be a bit of trial and error. Does cerenia stimulate appetite? The most common side effects seen in dogs and cats administered CERENIA are pain/vocalization (injectable), depression/lethargy, anorexia, anaphylaxis, ataxia, convulsions, hypersalivation, and vomiting. Discover what type of coat the Havanese dog breed has and its main characteristics. If your puppy is chewing walls, rest assured your are not alone. The medication needs a change to become fully absorbed and start working before your dog gets into a moving vehicle. To reduce the risk of these side effects occurring, dog owners should talk to their veterinarians about the correct dosage for their pets. More serious effects that are less frequent include increased body temperature, changes in behavior, seizures, and excessive drooling. In case of accidental ingestion, seek medical advice. ASPCA Animal Poison Control (888) 426-4435. Can Cerenia be used with other medications? However, its essential to give the medication time to work, and your dog may need to take Cerenia for several days to see the full benefits. The only common side effect of Cerenia includes pain on injection, which resolves within seconds. The chemical name is (2S,3S)-2-benzhydryl-N-(5-tert-butyl-2-methoxybenzyl) quinuclidin-3-amine citrate monohydrate. Cerenia is given orally. Some dogs may also experience loss of appetite, vomiting, or abdominal pain. Travel is no exception. Well answer some of the most frequently asked questions about Cerenia and how it can benefit your dog. J Vet Pharmacol Ther. Frequently Asked Questions. Cerenia, Accessed 17 Nov. 2017. There is limited information available on the use of Cerenia in pregnant or nursing dogs. Giving Cerenia to a dog with a blockage may temporarily stop the vomiting, while the plastic may cause intestinal perforationand life threatening peritonitis. This may include increased anxiety, restlessness, or even aggression. Most veterinarians believe Cerenia injectable stings less if kept in the refrigerator. Can Cerenia cause any long-term side effects in dogs? Conclusion. Cerenia may interact with certain drugs, including antibiotics and pain medications, so its important to disclose any medication your dog is taking to prevent any potential adverse reactions. Post-Approval Experience (Revised May 2019) Are there any potential side effects? The following adverse reactions were reported during US studies for the prevention of vomiting due to motion sickness in dogs treated with Cerenia Tablets at a minimum of 8 mg/kg orally one time. References doi:10.1136/vetreco-2017-000262. There are reports of dogs feeling a sensation of pain at the injection site when injected with Cerenia. Cerenia is the first and only FDA-approved medication prescribed by veterinarians for dogs to help treat and help prevent vomiting caused by motion sickness. . This receptor plays a crucial role in triggering vomiting and nausea. One of the most common side effects of Cerenia is drowsiness or lethargy. Even if you have one dog that uses Cerenia for vomiting due to motion sickness, consult with your veterinarian first before using it for another pet. ; Hypersalivation, drowsiness, lethargy, anorexia and diarrhea are possible side effects from Maropitant . Acute vomiting in dogs is more extreme and often requires the care of a veterinarian for effective treatment. Another appetite stimulant is Cerenia (Maropitant Citrate), a common anti vomiting medication for both dogs and cats. Cerenia is generally safe for use in puppies over the age of eight weeks. Try to keep your pets diet as all-natural as possible. Treat and Prevent Vomiting With Once-Daily CERENIA. Vetstreet, Accessed 17 Nov. 2017.

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