Cat very sick and dehydrated

Merry Prankster · 22-01-2014 8:10pm #1

Hi,

Our cat started getting sick on Thursday night and was sick a few times the following day. He also stopped eating and drinking. We took him to the vet on Saturday who, after feeling his stomach, diagnosed gastritis and gave us some liquid antibiotics and a syringe.

We gave him the antibiotics on the Sunday but he quickly vomited them up and kept vomiting throughout the day but, because he hadn't eaten in days, all that was coming up was yellow bile.

At this stage he had become very lethargic and weak. His coordination and eyes are greatly diminished and he keeps wanting to lie in odd places like the middle of the hall facing the wall or on top of the stairs. His ordinary personality has completely vanished and he is now like a zombie.

I brought him back to the vet on Monday who advised that we increase the antibiotics to thrice daily. I expressed concern about the cat's refusal to eat or drink but the vet said not to worry. He asked me to bring the cat in the following day (yesterday) which I did. The vet checked him and again said not to worry about the food but maybe try to give him some water and Dioralyte using the syringe. He requested that I bring the cat in tomorrow morning.

I have managed to get a little water down his throat using the syringe but not very much. Surely he must be close to dying from dehydration at this stage? He's only voluntarily drank once in the past six days and eaten nothing. He's urinated once (into his water bowl) in the past three days and the colour was unbelievably concentrated.

Should I insist on a drip and blood tests at this stage? Apart from stopping vomiting, there has been no improvement in his condition. The little fella is in an awful state. Cheers for any help.

SillyMangoX · 22-01-2014 8:13pm

I would suggest finding a new vet and calling their emergency number tonight! From the sounds of it a drip is badly needed at this stage, or else as you said the cat could easily die from dehydration, especially if this has been going on for nearly a week with not a lot of fluid intake. Where are you located? I'm sure someone could PM details of a vet that would help you tonight!

VonVix · 22-01-2014 8:14pm

I'm no vet, but I would have thought if your cat hasn't been drinking for that long a drip would be needed at this point?

Definitely get a second opinion I think.

Merry Prankster · 22-01-2014 8:40pm

Cheers for the replies. I might not be able to get to a vet tonight but, if not, I'll go to a different one first thing in the morning.

VonVix · 22-01-2014 8:45pm

In the meantime have you tried wetting your cat's paw? Your cat should be encouraged to lick its paw if you try to wet it with some water.

Merry Prankster · 22-01-2014 8:55pm

VonVix wrote: »

In the meantime have you tried wetting your cat's paw? Your cat should be encouraged to lick its paw if you try to wet it with some water.

I tried that earlier but he wouldn't lick his paw. He really does not want to do anything at all. The only way seems to be with the syringe but he hates it and I'm not sure I manage to get much water down each time. I'm beginning to suspect that the original ailment might have cleared up and that he's actually suffering from chronic dehydration now.

SillyMangoX · 22-01-2014 9:05pm

Merry Prankster wrote: »

I tried that earlier but he wouldn't lick his paw. He really does not want to do anything at all. The only way seems to be with the syringe but he hates it and I'm not sure I manage to get much water down each time. I'm beginning to suspect that the original ailment might have cleared up and that he's actually suffering from chronic dehydration now.

That's quite possible, often the dehydration makes them feel worse than whatever was wrong in the first place. My cat was a bit sickly a few days ago, not eating or drinking and she ended up getting weak by the end of the day. Once I got a bit of water into her she started eating again. Really all you can do is persevere with the syringing till you can get to a vet. What I do is put the cat somewhere level with me, like on a counter, I put my right arm behind them and hold their back end between my elbow and ribs, hold their head with my right hand and have the syringe in my left hand, put it between their back teeth and slowly drip it in. They will struggle as they don't like it at all, but it's for the best. Alternatively if you can get someone else to hold the cat it makes things much easier!

Terry Wogans Inner Thigh · 22-01-2014 9:10pm

My cat was like this a couple of years ago. I put golden syrup on her paw and around her mouth as a last resort and she licked it off. The sugar must have given her some energy and she started drinking water again. I read it on a few forums and thought it must have been worth a shot. Hope yours gets well soon.

Merry Prankster · 22-01-2014 9:14pm

SillyMangoX wrote: »

I put my right arm behind them and hold their back end between my elbow and ribs, hold their head with my right hand and have the syringe in my left hand, put it between their back teeth and slowly drip it in.

That's what I've been doing, although I squirt it in faster. He really hates it but there's so little fight left in him that he offers little resistance. I've tried placing the water bowl in front of him a couple of times but he seems a little confused about it. He just puts his head in the bowl but does nothing. Two days ago he urinated into it which is worrying because he was looking at the litter tray while doing it.

VonVix · 22-01-2014 9:19pm

Merry Prankster wrote: »

That's what I've been doing, although I squirt it in faster. He really hates it but there's so little fight left in him that he offers little resistance. I've tried placing the water bowl in front of him a couple of times but he seems a little confused about it. He just puts his head in the bowl but does nothing. Two days ago he urinated into it which is worrying because he was looking at the litter tray while doing it.

Make sure that the bowl isn't plastic, some cats won't drink from those (for some odd reason!)

Merry Prankster · 22-01-2014 9:22pm

Terry Wogans Inner Thigh wrote: »

My cat was like this a couple of years ago. I put golden syrup on her paw and around her mouth as a last resort and she licked it off. The sugar must have given her some energy and she started drinking water again. I read it on a few forums and thought it must have been worth a shot. Hope yours gets well soon.

I don't have any golden syrup but I do have some maple syrup so I'll give that a go. I've tried ham, tuna etc. but he turns away from all of it.

morgana · 23-01-2014 11:44am

He really should go on a drip - he is severely dehydrated (having just gone through a similar episode with our cat). It is absolutely essential he gets some liquid into him. Our fella had similar symptoms but only very little vomitting and he kept most what we managed to get into him with a syringe in him. Also try some cat milk - both liquid and some nutrients.

heathercat · 23-01-2014 11:59am

WTF ??? I so can NOT believe your vet didn't put the wee furry on a drip!!! When my Morty was having serious trouble and wouldn't drink or eat, the vet told me to come in every single day and Morty would get the Ringer's solution (or equivalent) subcutaneously in very large amounts (it made big bulges under his skin). For 4 days we went, and finally my little man got better. Additionally he also got antibiotics.

With cats, dehydration is VERY VERY dangerous and life threatening.

I'm shocked your vet didn't care enough to give your wee man fluids!

Nody · 23-01-2014 12:03pm

heathercat wrote: »

With cats, dehydration is VERY VERY dangerous and life threatening.

I'm shocked your vet didn't care enough to give your wee man fluids!

I can only agree with this one and the previous posters; if no food or water in 24h -> Vet and drip because they are at serious risk basically.

I've had a cat brought in on behalf of someone and with in 5 min the vet set up a drip for them when they were told it was not eating/drinking with orders to come back at least every 24h if they did not start eating/drinking for further drips.

Pumpkinseeds · 23-01-2014 5:51pm

How is your cat doing OP?

VonVix · 23-01-2014 6:33pm

Wondering the same thing. Hope there have been improvements.

Merry Prankster · 23-01-2014 11:10pm

Hey everyone, sorry for the delay in posting an update. I brought him to another vet this morning who decided to place him on a drip and keep him overnight. She was surprised at how docile he was while she was examining him and said that he was obviously very depleted. If it is gastritis, she expects that we'll see an improvement by the morning; if there is none then she's going to run blood tests etc. I'll post an update tomorrow when I get him back. Cheers for all the help everyone!

Merry Prankster · 23-01-2014 11:24pm

heathercat wrote: »

I'm shocked your vet didn't care enough to give your wee man fluids!

In fairness, the original vet stated that he was planning to place him on a drip tomorrow if no improvement were evident (after he was told we had sought out a second opinion). It's partially my own fault in that I never explicitly asked the vet about putting him on a drip - I just stated that he wasn't drinking and I wasn't sure how much water I was getting him to swallow with the syringe. Maybe the cat wasn't as dehydrated as I suspected he was and the original vet could tell this (although one glow-in-the-dark urination in three days can't be good). I guess I'll know more tomorrow.

Merry Prankster · 24-01-2014 5:49pm

Hey everyone,

I got a phone call from the vet today saying that his condition had deteriorated and that they were going to do an X-ray, take blood tests and keep him in another night. They suspect he may have pneumonia and confirmed that he was severely dehydrated. I've just got back from visiting him and I was shocked at his condition. I'm not sure if it's the stress of sharing a room with very vocal dogs, the effect of the medication or simply the impact of his illness, but his breathing has gone to hell. I wouldn't even call it breathing - it's very fast, open-mouthed panting that rocks his whole body with each breath.

When you look into his eyes it's like looking at a different cat, a stranger who bears an uncanny resemblance to Sam. I can't even tell if he recognises me or not. What made his appearance even more distressing was the drip secured to his arm with a pink bandage and the food smeared onto his face into a weird Joker smile (the vet is having to syringe feed him).

I spent as long as I could with him, mindful that it may be the last time I see him alive. The vet is hopeful that he'll make a recovery and stated that I could bring him home tomorrow if his breathing has improved. I'd be stunned if it did. If he's dying, I'd prefer to end his suffering now or bring him home to die here. I really don't want him dying in a room full of whimpering dogs and strangers.

morgana · 24-01-2014 6:57pm

I am so very sorry to hear that

. I do hope he recovers overnight and that you don't have to make the hardest decision. My thoughts are with you.

SillyMangoX · 24-01-2014 7:37pm

ah so sorry to hear that. If there is any chance of recovery he is in the best place for it. Fingers crossed for him, hopefully the medications will sort him out over night!

Merry Prankster · 24-01-2014 8:36pm

morgana wrote: »

I am so very sorry to hear that . I do hope he recovers overnight and that you don't have to make the hardest decision. My thoughts are with you.

SillyMangoX wrote: »

ah so sorry to hear that. If there is any chance of recovery he is in the best place for it. Fingers crossed for him, hopefully the medications will sort him out over night!

Thanks. We just got a call from the vet to say that they're going to have to remove fluid from his lungs. It's infuriating that it's taken so long to get a proper diagnosis, and all the while he's not been eating or drinking and thus getting weaker and weaker. He's only five and a half and ordinarily a very healthy, strong cat, but right now he's in terrible shape to fight pneumonia. I just hope this vet's skill level is as high as his prices!

aonb · 24-01-2014 9:11pm

thats so hard. if they vet thinks he will make a recovery though, there is hope. Keeping everything crossed for you here, and hoping to hear better news tomorrow.

Merry Prankster · 27-01-2014 9:33am

Hey everyone,

Just a quick update to let you know that Sam died on Friday night. I'm disgusted with myself knowing that he died alone, terrified, surrounded by barking dogs and strangers. The last time I saw him his breathing was terrible and his face was all smeared with food because the second vet that I brought him to had been trying to force feed him with a syringe.

I'm disgusted with myself because I knew that he was severely dehydrated and depleted and I should have insisted that he be placed on a drip from the Monday. But I deferred to the vet's advice and brought him home each day and tried to syringe water down his neck, adding to his distress. He must have thought I was punishing him for being sick.

It was a completely unnecessary death and his last week was absolutely horrible. I can't believe that he died under the noses of two vets (who cost €400 between the two of them) and I'm certain that had he been placed on a drip early on, he would not have got pneumonia and died.

I really want to phone the first vet today to tell him the outcome and ask why he decided against putting him on a drip for the whole week. In hindsight, I realise that taking him to the second vet was a grave mistake because it was a very stressful experience and I have no doubt that the stress contributed to his death. I'm devastated because Sam went to his death thinking I abandoned him and, in truth, I completely let him down by deferring to the 'expertise' of the professionals. Sorry to everyone for such a depressing post on a Monday morning.

Puzzle35 · 27-01-2014 9:51am

Merry Prankster wrote: »

Hey everyone,

Just a quick update to let you know that Sam died on Friday night. I'm disgusted with myself knowing that he died alone, terrified, surrounded by barking dogs and strangers. The last time I saw him his breathing was terrible and his face was all smeared with food because the second vet that I brought him to had been trying to force feed him with a syringe.

I'm disgusted with myself because I knew that he was severely dehydrated and depleted and I should have insisted that he be placed on a drip from the Monday. But I deferred to the vet's advice and brought him home each day and tried to syringe water down his neck, adding to his distress. He must have thought I was punishing him for being sick.

It was a completely unnecessary death and his last week was absolutely horrible. I can't believe that he died under the noses of two vets (who cost €400 between the two of them) and I'm certain that had he been placed on a drip early on, he would not have got pneumonia and died.

I really want to phone the first vet today to tell him the outcome and ask why he decided against putting him on a drip for the whole week. In hindsight, I realise that taking him to the second vet was a grave mistake because it was a very stressful experience and I have no doubt that the stress contributed to his death. I'm devastated because Sam went to his death thinking I abandoned him and, in truth, I completely let him down by deferring to the 'expertise' of the professionals. Sorry to everyone for such a depressing post on a Monday morning.

Very sorry to hear this update, had to euthanise several times with pets myself. Take it easy on yourself you did the best you could. Neither vets sound great mind you but what's the point in hiring a vet and having to tell them how to do their jobs. Rip to your furry friend.

Merry Prankster · 27-01-2014 10:02am

Puzzle35 wrote: »

Very sorry to hear this update, had to euthanise several times with pets myself. Take it easy on yourself you did the best you could. Neither vets sound great mind you but what's the point in hiring a vet and having to tell them how to do their jobs. Rip to your furry friend.

Cheers. I wish I'd had him put down on the Friday when I saw him - he was in a dreadful state and very distressed. But the vet said they were hopeful and were even saying that I could bring him home the following day if his breathing had improved. He suffered needlessly for the rest of that day and some of that night. It's not the fact that he died that is so upsetting, it's the length of his suffering and the fact that it was so needless.

Nody · 27-01-2014 10:33am

Merry Prankster wrote: »

Cheers. I wish I'd had him put down on the Friday when I saw him - he was in a dreadful state and very distressed. But the vet said they were hopeful and were even saying that I could bring him home the following day if his breathing had improved. He suffered needlessly for the rest of that day and some of that night. It's not the fact that he died that is so upsetting, it's the length of his suffering and the fact that it was so needless.

Take the lesson from it and never use your first vet again would be my advice; if your first vet had done their job (i.e. drop from first visit) we'd likely have a more positive outcome and never, ever, take vet's word as an absolute truth unless you trust them 110%.

aonb · 27-01-2014 10:48am

so very sad to read about Sam and your horrible experience. Really, what can you do in your ignorance but defer to the professionals - its the same with humans and doctors sometimes - you thought you were doing the best you could for your pet. Im very sorry that you are feeling so guilty - but again, you thought you were doing your best for your pet.

morgana · 27-01-2014 11:54am

I am really very sad to hear that, I had been thinking about you and your poor little furry friend, but had already suspected a bad outcome when there were no updates to your thread.
It is very understandable that you are raging about the vet's treatment of your cat, I would be the very same. You brought him to the vet as soon as you could and you were let down. You did what you could, and nothing will take away the guilt you are feeling, the feeling of having let down a trusting animal. Please do not be too hard on yourself, in hindsight we all know better. Try to concentrate on the good times you have had.
MY thoughts are with you.

username123 · 27-01-2014 1:10pm

Im really sorry to hear about Sam, its so hard when a pet leaves us.

Listen, you did your absolute best for Sam. You are not a vet, all you did was what you were advised to do. Try and remember the good times with Sam and that you gave an animal a great home and love for the time you were his custodian.

Please dont feel guilty, you did your best.

SillyMangoX · 27-01-2014 1:57pm

So sorry to hear this

sparkle_23 · 27-01-2014 2:10pm

So sorry to hear about poor little Sam

RIP

WattyWoo · 27-01-2014 4:38pm

So sorry to hear this.We were thinking of u all weekend but kinda knew.
You have nothing to berate yourself for you did everything for Sam.
He was lucky to have such a caring owner

Pumpkinseeds · 27-01-2014 4:50pm

I'm so sorry to hear about Sam, losing them is the hardest thing in the world. Please don't be so hard on yourself. You did what you thought was best for Sam.

thalia_13 · 27-01-2014 10:29pm

So so sorry to hear this, Sam knew you loved him, don't beat yourself up over this. Try remember all the great memories with him for now, thinking of you. Take care

Merry Prankster · 28-01-2014 11:12am

Thank you to everyone for the kind words. I was wondering if anyone knows anywhere I can go to ask whether the vet dropped the ball on this one? I'm deeply upset and angry that my cat had such a horrible last week and a horrible death whilst under the care of a vet. It seems incomprehensible that a cat was allowed to suffer so badly for so long without food, water, blood tests or an X-ray. Cheers.

username123 · 28-01-2014 12:47pm

I came across this link on another thread, maybe contact them and see what they say?

http://www.vci.ie/Disciplinary/

Merry Prankster · 28-01-2014 1:03pm

username123 wrote: »

I came across this link on another thread, maybe contact them and see what they say?

http://www.vci.ie/Disciplinary/

Cheers for the link. I'm going to see another vet this afternoon to see if they'll offer an opinion about the level of care Sam received - I don't want to start bandying about accusations of negligence if they are unwarranted. Nothing will bring my cat back or erase the suffering he endured, but if negligence was involved I'd like to see that it doesn't happen to any other cat.

username123 · 28-01-2014 1:53pm

Merry Prankster wrote: »

Cheers for the link. I'm going to see another vet this afternoon to see if they'll offer an opinion about the level of care Sam received - I don't want to start bandying about accusations of negligence if they are unwarranted. Nothing will bring my cat back or erase the suffering he endured, but if negligence was involved I'd like to see that it doesn't happen to any other cat.

I understand, I'd feel the same.

I was thinking about you last night, I hope you are ok.

SpaceTime · 28-01-2014 2:09pm

Really sorry that your cat died. They become a big part of the family.

I think it's important to find a really cat-aware vet for any future cats you might have.

Cats (unlike dogs) mask and hide symptoms especially if they're under stress or in a scary environment. They're very hard to diagnose without really knowing cat behaviour.

We take our cat to the Cat Hospital in Cork and I would genuinely say the level of care and specific knowledge of cats and feline behaviour is just leagues above any vet we've gone to before. There's simply no comparison.

The lack of dogs and cat-friendly environment makes a huge difference too.

When you call in. It's a calm, relaxed environment with special cat pheromones being released by plug in defusers. Everything is designed to be cat friendly.

They ask you to take the cat out and let him or her wander around the room and chill out for a few minutes before they even attempt to examine and they observe the cats behaviour as it helps to spot problems.

All in all couldn't recommend them highly enough.

Alun · 28-01-2014 2:13pm

Wow, that's amazing .. a specialized cat's hospital!! Sounds like a great idea.

Merry Prankster · 28-01-2014 2:31pm

SpaceTime wrote: »

Cats (unlike dogs) mask and hide symptoms especially if they're under stress or in a scary environment. They're very hard to diagnose without really knowing cat behaviour.

The lack of dogs and cat-friendly environment makes a huge difference too.

I so wish that I'd had a similar facility nearby. I was shocked when I went to visit him after he'd spent his first night at the veterinary clinic (the second place I brought him too). He was terrified because the dogs in the cages beside him were going bananas and were very loud. I'm certain that the stress of not only being away from home, but being in such a scary environment and being force fed with a syringe (which I was shocked at - I thought they could give food through IV), precipitated his decline.

He was very lethargic when he went in - the following day (the last time I saw him), his breathing had gone crazy and his heart was beating at an unbelievable rate. He was struggling to get his breath and was breathing through his mouth. I feel so stupid for not taking him out of there then rather than leaving (abandoning) him there for another night, during which he passed away. But the vet seemed hopeful and even discussed taking him home the following day if his breathing had improved.

Ironically, the first vet I took him to would have been able to accommodate him in a much quieter environment because he isn't running an actual clinic, but by then I had lost confidence in him. Plus, I didn't realise that Sam would be housed in such a scary environment. I assumed he'd be in a quiet, peaceful location, especially seeing as he was so obviously very sick. I essentially threw him out of the frying pan and into the fire. To be honest I'm disgusted at service that both vets provided.

username123 · 28-01-2014 3:06pm

Merry Prankster wrote: »

He was terrified because the dogs in the cages beside him were going bananas and were very loud. I'm certain that the stress of not only being away from home, but being in such a scary environment and being force fed with a syringe (which I was shocked at - I thought they could give food through IV), precipitated his decline.

Tbh with you, when I read this I thought it was very distressing. However - I dont know if this is the norm in a vet clinic?

Merry Prankster · 28-01-2014 3:48pm

username123 wrote: »

Tbh with you, when I read this I thought it was very distressing. However - I dont know if this is the norm in a vet clinic?

I guess it is. It just doesn't seem very conducive to aiding an animal's convalescence; that cat hospital mentioned earlier seems like an ideal alternative. In fairness, it probably wouldn't even have registered with me had he lived.

Merry Prankster · 29-01-2014 12:06pm

Hey everyone,

I've been doing a little reading around the subject and I'm now more convinced than ever that serious errors were made in my cat's treatment. I'm planning to visit both vets today - I was wondering what information I am entitled to? Can I ask for the results of the blood tests and X-ray? Can I ask the vet for a description/report of the treatment the cat received whilst under their care?

Also, who can I approach for a professional opinion about the matter? I have contacted the VCI who are sending out a form, but obviously I would like to get the opinion of a veterinary professional first before I instigate any formal procedures.

Cheers for any help.

anniehoo · 29-01-2014 1:08pm

Merry Prankster wrote: »

Can I ask for the results of the blood tests and X-ray? Can I ask the vet for a description/report of the treatment the cat received whilst under their care?

Yes you're entitled to a copy of all records of your pet held by your vet.

wrote:

Also, who can I approach for a professional opinion about the matter? I have contacted the VCI who are sending out a form, but obviously I would like to get the opinion of a veterinary professional first before I instigate any formal procedures..

The VCI is your best option initially. I wouldn't approach a third vet asking for advice. If they were not directly involved in the care of another vets patient they will not give advice, especially if the VCI is investigating it.

Merry Prankster · 29-01-2014 1:25pm

anniehoo wrote: »

Yes you're entitled to a copy of all records of your pet held by your vet.

The VCI is your best option initially. I wouldn't approach a third vet asking for advice. If they were not directly involved in the care of another vets patient they will not give advice, especially if the VCI is investigating it.

Cheers for your help, I really appreciate it.

So I just ask for all of the records they have on him? Will this will include the cause of death, an appraisal of his condition when he first arrived and a summary of the treatment he received, or do I have to ask for this info additionally?

I did contact another local vet but he said he couldn't really offer an opinion as he hadn't personally treated the cat. The VCI are sending out forms, but I'd be reluctant to go down this route without the benefit of a professional's opinion as to whether it's likely that errors have been made and that further investigation is warranted. A bit of a Catch 22 it seems.

oppenheimer1 · 29-01-2014 1:52pm

I can't see a complaint to the VCI disciplinary going anywhere to be honest. Its only used for cases of professional misconduct. As you said in your first post, the vet did advise hydration via syringe. It needs to be a very serious complaint because essentially you're trying to have the vets livelihood taken from them.

anniehoo · 29-01-2014 1:57pm

Merry Prankster wrote: »

So I just ask for all of the records they have on him?

Yes and if they refuse you can apply under the Freedom of Information Act (see section 3.3)

wrote:

Will this will include the cause of death, an appraisal of his condition when he first arrived and a summary of the treatment he received, or do I have to ask for this info additionally?

It should contain all procedures done, medications given, health workup profile, blood results, xrays, comments on hospitalisation,complications, suspected cause of death etc

wrote:

The VCI are sending out forms, but I'd be reluctant to go down this route without the benefit of a professional's opinion as to whether it's likely that errors have been made and that further investigation is warranted. A bit of a Catch 22 it seems.

To be honest if you're going this route I would follow what the VCI ask you to do. They are the "professionals". Many people aren't familiar with the complicated medical terminology used so this is what they analyse for you. They will assess the records and info given to them and decide if a case is warranted. No vet wants to be reported to the VCI but be warned it can be a slow process. Some people feel the VCI are biased towards the veterinary practitioner so if you're not happy and still feel the outcome is not to your satisfaction then escalate it privately to your own solicitor. That's if you want to go that far

Merry Prankster · 29-01-2014 2:00pm

Cheers for all of your advice Anniehoo.

Just one more question, did I mess up by not having an autopsy done? They asked us if we wanted it but we were too upset and declined.

anniehoo · 29-01-2014 2:02pm

oppenheimer1 wrote: »

I can't see a complaint to the VCI disciplinary going anywhere to be honest. Its only used for cases of professional misconduct. As you said in your first post, the vet did advise hydration via syringe. It needs to be a very serious complaint because essentially you're trying to have the vets livelihood taken from them.

To be honest very few VCI complaints go in favour of the client, but if anything it will make the process of what happened more transparent and understandable for the OP.

Cat very sick and dehydrated

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