? Vet perscribing higher and higer doses. Starting to get concerned.

Marc & Jen

Marc & Jen

Member Since 2018
We are about a half a year in to our diagnosis and I am starting to get really concerned with the doses are vet is telling us to give. We go to the vet monthly to get a test of his blood sugar, which I know can be high due to stress, but then the vet also does a fructosamine test that is supposed to give an indication of his levels over time. We just heard back from out vet and she said his fructosamine was still over 500. Know she wants us to go up to 10 units a day. It seemed crazy to me when we passed 6 units a day and know this is really starting to scare me. Every time we do increase the dose we do monitor him and he doesn't appear to be sleepy or unresponsive.

A little info on our cat.

Name: Fat Albert
Age: Roughly 8 years old
Weight: 15lbs
Diet: Low Carb Wet food twice daily. Open dry food during the day.

We have tried testing him at home, but it is almost impossible. We will keep trying but in the interim I am not certain how regularly we can check his levels. What should we do? Starting to feel very overwhelmed.
 
You probably know the answer I will give already, but home blood testing is what keeps your kitty safe and how to get him regulated. Fructosamine gives an average, which could be highs and lows. Dry food is probably part of the problem. Which wet and dry food are you feeding? Note, do NOT switch out the dry food until you are home testing. And finally, some kitties have secondary endocrine conditions that cause diabetes, and may lead to the need for higher dose. My girl Neko had two of those conditions, acromegaly and IAA or insulin auto antibodies. One in four diabetic has acromegaly, no symptoms all of them need high doses. It is caused by a benign tumour on the pituitary that sends out excess growth hormone.

Can you tell me a little bit about how you discovered Fat Albert was diabetic? What were the symptoms?

What problems are you having with testing? Maybe we have some tips for you.
 
Thanks for the reply! We discovered he was diabetic mainly due to weight loss. He lost around 5 or 6 lbs in a little under 4 months. Additionally he was drinking a lot of water and was really "cranky".

We feed him a quarter can of Fancy Feast Classic(half in the morning half at night). For dry food we use Wellness Core Dry Food.

I think a lot of our problems is with our inexperience. I have a read a couple posts and watched a few videos, but it still never seems to go smoothly.
 
Marc Henning said:
Thanks for the reply! We discovered he was diabetic mainly due to weight loss. He lost around 5 or 6 lbs in a little under 4 months. Additionally he was drinking a lot of water and was really "cranky".

We feed him a quarter can of Fancy Feast Classic(half in the morning half at night). For dry food we use Wellness Core Dry Food.

I think a lot of our problems is with our inexperience. I have a read a couple posts and watched a few videos, but it still never seems to go smoothly.
Click to expand...
Sounds like the majority of food is dry. A non diabetic cat that weight can eat 5 cans of FF classic pates, in one day just to maintain weight. Diabetic cats cannot process the food nutrients properly and that is why they lose weight and need more food to maintain weight than non diabetic cats. Once blood sugar is better controlled, and he is using the nutrients properly, he will need less food and get to a healthy weight. You can get your cat transferred to a wet, low carb diet, that will help. This needs to be done carefully as Wendy mentioned, especially on higher doses because the diet change can have a substantial and quick reduction on BG numbers and you don’t want a hypo episode due to the combo of more insulin and reduction of BG due to diet change. People here can help you with the transition.

Testing is a process that takes time and patience, there are methods to make it so the cat does not get stressed and after a time hardly minds. I know that sounds crazy, but I for one will attest to it, my cat now come over to be tested. It will not happen immediately, but if you put in the time and make it as enjoyable and relaxing for the cat as possible, 99% of cats will come to accept it as just part of their day.:)
 
What type of insulin are you giving him? I can't see anywhere saying it is Lantus or something else.

Here is a link to home testing below for you to have a look at. It does take a few days for both you and the cat to get used to it. Try playing with his ears without doing anything else for a couple of daysand give him a small treat (low carb) each time you play with ears. Pick a spot to test and always do it there.
What is the troubleyou are having with testing? Not being able to get blood? Kitty not being cooperative?
Try giving him a small low carb treat as you test to distract him. Try not to restrain him as he will resist.
I used to get down on my knees and then sit back on my heels with Sheba between my knees and her back facing into my body and her head facing out. That way she was restricted but not restrained. I put a bit of food in front of her and while she was eating I tested. It takes time but is the very best thing you can do for your cat to see what is happening and getting a good dose and keeping him safe.
I would NOT increase the dose until You are testing regularly. 10 units is FAR TOO MUCH to be giving without testing the BSLs on a daily basis........in my opinion so is 6 units too much without testing on a daily basis to see what is happening during the cycle..

I would also get rid of the dry food as it is definitely contributing to the high numbers BUT DO NOT DO THIS WITHOUT CLOSELY TESTING THE BSL DURING THE CHANGE OVER. Once dry food is removed many cats can drop dramatically in numbers and you need to be monitoring the BSL very closely to ensure you don't get a hypo. Most people who come here have used dry food and have to go through the process of monitoring BSL and changing over to low carb food. We will help you.
Keep asking questions,it is the way to learn. And we are happy to help you and kitty find the best dose.:)
Link to home testing
http://www.felinediabetes.com/FDMB/threads/hometesting-links-and-tips.287/
Link to FAQs
http://www.felinediabetes.com/FDMB/forums/health-links-faqs-about-feline-diabetes.14/
 
Last edited:
Thank you all for your replies!! It is reassuring to hear that we are not alone and we now know that we have great resources here to help :)

The insulin we are using is Lantus and as mentioned before we are giving him 5 units twice per day (total of 10 units per day) and have been for the last 3 weeks.

We were able to finally get a couple BSL readings at home last night. FA is a very chill cat who generally sits still or will allow us to hold him for quite a few minutes until he randomly decides he has had enough of us. Our main issue was that we were having trouble getting enough blood using the lancet. After much poking and prodding, we ended up resorting to just pricking him with the pin (without the lancet) and we were able to get a BSL reading of 280 about half an hour after his dinner of wet food last night (he was of course eating dry food all day so that probably had some sort of effect as well). As we are still so inexperienced it is a 2 person job but we're hoping that with time we can each do it on our own. Do you think there are any issues in checking his blood sugar this way? Do we need to be doing anything in particular to clean his ear before and/or after pricking it?

As of this morning, I gave him half a can of fancy feast (double what he usually gets) and still left out plenty of dry food for the day. Our plan is to slowly increase the wet food while decreasing the dry food and see if this has a significant effect on his blood sugar before increasing his insulin dose. We will continue with 2 meals per day until we have increased the wet food to enough that it can be more than that (we are looking into an automatic wet food feeder for when we are at work). Our vet has agreed that this is a good course of action - we are just a little frustrated that this wasn't discussed before recommending to increase the insulin dose. As recommended we will begin checking his BSL regularly and hopefully become pros :) How often is it recommended to check, right before each feeding/insulin dose? What BSL values should we be looking for?
 
Sounds like you're doing great and making the changes your boy needs to get better!

The way you're pricking his ear is perfectly okay - the lancet is actually just the tiny pin part; the holder that you put the lancet in is entirely optional. Some find it easier to use with the holder, others prefer just poking directly. Either way is fine, as long as you get the results you need. Some people even poke with the needle from a syringe. As long as you get blood to test! No need to use anything special to clean his ear, though a dab of antibiotic ointment can be helpful for two reasons: one, it can help the blood to bead up, making it easier to test, and two, it can help ease any slight pain there may be (get the triple-antibiotic which contains an analgesic).

At minimum, you should be testing before every shot, to make sure he's at a safe BG level to shoot, and at least once more, typically about 3 hours after a shot (which we refer to as +3). Some caregivers test more often than that, especially if they're following the Tight Regulation protocol. I don't know if you've checked them out, but there's lots & lots of great information in the stickied posts at the top of this forum. They take a bit of digesting, but it's good to read through them.
 
Welcome to the best forum on the web for helping your cat. And congratulations for learning to test at home. I'll admit it's not without it's trials and tribulations. We too started out with the two-person testing experience...Luci wasn't tolerating any of it well...and refused to be still, much less be poked by someone who had no idea what she was doing! But we got there...as for your vet giving you advice, etc. If you start reading some of our threads here you'll see we have come to depend less on the vets and more on the collective experience and wisdom of the members of this group.

With that being said, please continue to decrease the dry food - the sooner he's off it the more likely you are to see improving numbers - and potentially a need for LESS insulin. Since we don't know how many carbs are in the dry food (unless you mentioned it??) you may be feeding him a high-carb diet which has required a steady increase in insulin. You'll want to be very careful as you reduce the dry food with his current insulin dosage - please be sure to continue to test. ALWAYS before a shot and highly advised to get a test two hours after the shot to see what effect the insulin has had...

Please read the stickies and we'll be looking forward to seeing your spreadsheet - please look at the SS's of others to see what we're doing - I found it to be most helpful!

See you on the forum tomorrow. Please post as follows: date / kitty name / AMPS (first blood test of the day - before shot) - then you can also copy/paste your thread from today on that - so everyone will know what's already been said. :)
 
Also - not wanting to overwhelm with too much crammed into one post - it would be very helpful for you to both set up a signature, and to set up a spreadsheet to track Fat Albert's progress. The signature is easy - hover over your username in the top right, and click on Signature. Then you can create a signature that tells us about you & your cat. The signature is the text in gray that you see at the bottom of users' posts - you can look at some of them to get an idea of what to include.

The spreadsheet is a Google doc that each of us set up, then set to share with the group. Once you create it and choose Share, you will get a link that you can include in your signature, so that when you have questions, we can see at a glance how FA has been doing. The instructions for setting up the spreadsheet can be found here:

http://www.felinediabetes.com/FDMB/threads/fdmb-spreadsheet-instructions.130337/

ETA: LOL - looks like Sue and Luci posted while I was typing. :D
 
Have you read the Yellow sticky note on the Feline Health:(Main Forum) by DR. Lisa Pierson "Dry FOOD" You need to slowly get him off all dry food as people here have advised. I've seen some cats go into remission just by stopping all dry food.

The people here have been donating their time to help new people. Some have been doing this for many years & really do know more than most Vets. Trust in their advice they can get you through this.

I hope these photos help with where to test on Kitty's' ear.
89de2d3ee90e37de809d904f7d41fe2c.jpg
earpokey_zpsc6584fc3.jpg
EASY NOPE.jpg
Hang in there we were all new like you. You can do it. Just be patient.
Read as much as you can about the insulin .The more you know the easier it will be to help your cat.
And ask a lot of questions. Everyone here wants to help :):bighug:
 
Marc Henning said:
We were able to finally get a couple BSL readings at home last night.
Click to expand...
That is awesome news! It only gets easier from here. Make sure he gets a treat for every poke, and it won't take long before he comes running when you get the test kit out. Make sure you are using a larger gauge lancet to start. It'll poke a bigger hole and make it easier for you to get enough blood per poke. Over time their ears develop the ability to bleed easier and you'll be able to go to the smaller pokes. After the poke, use a cotton gauze or other thing to hold some pressure on the poke spot for 30 seconds. That'll help prevent bruises from developing. Bron gave you a link to a couple of really good posts. Make sure you look at the one by Marje and Gracie on Home Testing Tips.
Marc Henning said:
How often is it recommended to check, right before each feeding/insulin dose? What BSL values should we be looking for?
Click to expand...
Always test before each shot, you want to make sure it's safe to give insulin. Lantus has a sort of bell shaped downwards curve in action, so it'a a good idea to try and get some tests in between the shots when you can. We determine how to change doses with our dosing methods here, based on how low the dose is taking the cat. It does take a while for a kitty's numbers to settle down. Take a look at some of the spreadsheets of other people around here. It'll give you an idea how variable it'll be. Neko's 2012 spreadsheet was way different from her 2016 SS. It'll be your job to figure out how FA responds to the Lantus. We have a saying here ECID - each cat is different. The amount of insulin needed and how they respond to the insulin are two examples. Similarly ECID in the beginning, kitties can do a lot of what we call bouncing (definition in the New to the Group Sticky Note), so numbers can vary a lot to start. Numbers below 50 on a human meter are low, and mean you need to respond with high carb food to bring him up.
 
Bellasmom said:
One thing I found that helped with testing is I test and give a treat purebites chicken, so now when I open strip container he just on couch, @Sue and Luci has trained her cat so well, heck shes waiting for the test lol
Click to expand...
Yes indeed...speaking of Luci - here she is at 4 pm today - it's not time for a test! That's her kit behind her...she's ready and waiting! If someone had told me she'd have come this far I would NEVER have believed them! Photo proof:
LuciWaiting.jpg
 
Hi All! Thanks again for all your very detailed replies! I realize we have some work to do to get our account fully set up, so I will work on that over the next couple of days :)

We were able to test again tonight before his dinner of wet food/insulin shot and he was at 179 which is actually quite low for him! It did take us a while to get enough blood again but it did go better than it did yesterday so I think we're learning. We did give him some chicken purebites but we took too long and he was starting to get a little angry with us so the treats weren't enough of a distraction this time. We want to make sure that he doesn't associate the testing with a negative experience so we will have to be careful/patient with him. Of course, after some moderate success with the testing, I missed his insulin shot for the first time in months and injected it on the outside of his skin by accident...

How do you manage the monitoring when you are not home? I do work from home a couple days a week but the other 3 days we are out of the house between at least 7am-4pm. I worry that as we change him over to the wet food that we will not always be home during the day to see how he's doing.
 
If you have any difficulty shooting insulin in the scruff remember you can also use his side or Flank
SHOOTING INSULIN.jpg


Move the fur so you see his skin & the needle should be at an angle,not straight in.

You need to be consistent & give the insulin 12 hours apart at the same time each day.When you get the SS (spreadsheet) going it will make it a lot easier for people to look at it & advise you. A lot of the people here work. I'll let them give you advice on how to handle
the feeding & monitoring. I'll tag @Bellasmom She can advise you better than I can.

Sounds like your doing better already! Good job. Little by little it will get easier :):bighug:PUT YOUR MIND TO IT.jpg
 
JoyBee&Ravan said:
If you have any difficulty shooting insulin in the scruff remember you can also use his side or Flank

Move the fur so you see his skin & the needle should be at an angle,not straight in.

You need to be consistent & give the insulin 12 hours apart at the same time each day.
Click to expand...

We have been injecting in his flank. I have found that I am much more successful doing it one direction however I am trying to rotate the injection site and just need to take a bit more time to get it right when I am trying in a new area. He has extremely long and thick hair so we probably need to shave a little patch again and that will make it easier. Because I missed the injection this evening, I expect his BSL will be quite high in the morning before his next injection however again, I am concerned about being at work for the day and not being able to monitor him as we slowly make small changes to his diet.
 
Marc & Jen said:
How do you manage the monitoring when you are not home? I do work from home a couple days a week but the other 3 days we are out of the house between at least 7am-4pm. I worry that as we change him over to the wet food that we will not always be home during the day to see how he's doing.
Click to expand...
Step 1 is setting up the spreadsheet. We will help you learn the data you need to gather to learn FB's patterns on Lantus. With many cats, the +2 test is a "heads up" to give you an idea how the cycle will play out. If it's lower than the preshot number, it's a sign of an active cycle that will need either more monitoring, or for you to leave out some higher carb food to keep him safe. Many people rearrange shot times so they can get a +2 test as they head out the door. An automatic feeder will also help you dole out food during the day, if your cat is not a grazer. If the +2 is worrying, you leave out high carb food.

Whether or not you end up using the Tight Regulation protocol, this post has some idea on how to handle working a full time job with a diabetic kitty.
 
Hi All! FA's spreadsheet is now set up but with minimal data but hoping to fill it up better this week since we may have finally figured out how to successfully check his BG without taking a half hour of poking and prodding him. Fingers crossed that our success continues. While I am so happy to have figured out how to monitor him, I have so much more anxiety about leaving him now than I did before when we were just shooting blind. Unfortunately it's not realistic for us to get a second reading on week day mornings as we are up at 5:45am and out of the house by 6:40ish. However once I am able to figure out the monitoring on my own, I will be able to gather more data on the days that I am working from home.

In the last week we have reduced the dry food to no more than 1/3 cup per day between our two cats and they usually don't eat the full amount. We plan on maintaining this level of wet/dry food this week as we will be away this upcoming weekend and won't be able to monitor him for a couple days. We will then try to fully transition over to wet food next week - currently looking at automatic wet feeders on amazon. Does anybody have experience/recommendations with regards to automatic wet food feeders?
 
You are doing a really good job ! We also have 2 cats, one was acro. To be sure that the right cat got the right food (and medication) we bought feeders from Amazon that read the cats chip, and only open for the right cat.
https://www.amazon.co.uk/SureFeed-M...eder/dp/B00O0UIPTY/?tag=felinediabetesfdmb-20
Doesn't help with the timing.

As far as testing the BG and pricking the ears is concerned, it is incredible that at one time we thought it was impossible. Now it's easy. Bribery with freeze dried chicken was the key.
 
Congrats on getting the spreadsheet going. And starting to get more tests in. A request, if you shoot what you think is a fur shot, could you put something like FS in the units column, or “5.0 FS”. It’s amazing how many times some insulin gets in when we think we did a fur shot.

As for the feeder, many of us use the Petsafe 5 for wet food. There is a spot under the tray that can hold a small ice pack or some ice cubes, to keep things cool. I fed both cats the same food, and since Neko was dominant, she owned the feeder anyway.
 
For WIW , I'm don't think Marc is an Acro cat. He still seems to be responding to the insulin. Take a look at Titans Spreadsheet and you will see he stayed in the red and black even though we were increasing the dose faster than the vet wanted.
I could be wrong... I would get IGF1 and IAATests done, if feasible.
 
@John Irene and TITAN size of dose does not rule out whether or not a cat has acromegaly. RVC found some acros on as low a dose as 1 unit. Neko saw greens at about 3.5 units and tested positive for both acromegaly and IAA. However, Fat Albert is being transitioned off of dry food, which should help the dose requirements. The blues he is seeing are really promising.
 
Wendy&Neko said:
Congrats on getting the spreadsheet going. And starting to get more tests in. A request, if you shoot what you think is a fur shot, could you put something like FS in the units column, or “5.0 FS”. It’s amazing how many times some insulin gets in when we think we did a fur shot.
Click to expand...

Updated and I will make sure to note fur shots in the future! I was able to get a +6 this morning (all by myself!) and he was at 127 which is the lowest we've seen him! He came down quite a bit from his AMPS today of 349, which I believe was so high due to the FS last night.
 
Well done on the solo test! :) With his current diet in mind, if you were to see anything under 90, he would earn a dose reduction, meaning giving less insulin. The transition to wet is really helping him. If you take a look at the Sticky Note on Dosing methods, I am assuming for now that you are following the Start Low Go Slow method, which is our dosing method used if there is dry food in the picture.

A question, did he get 5 units the mornings of the 3rd and yesterday? If so, could you put 5 in the AM units columns for those days. Even if there isn't data from certain days, it does help us to know if he's been on the same dose for a while, due to the depot. As well, if you make any significant changes like diet, it's helpful to note it in the Remarks section.
 
Wendy&Neko said:
Well done on the solo test! :) With his current diet in mind, if you were to see anything under 90, he would earn a dose reduction, meaning giving less insulin. The transition to wet is really helping him. If you take a look at the Sticky Note on Dosing methods, I am assuming for now that you are following the Start Low Go Slow method, which is our dosing method used if there is dry food in the picture.

A question, did he get 5 units the mornings of the 3rd and yesterday? If so, could you put 5 in the AM units columns for those days. Even if there isn't data from certain days, it does help us to know if he's been on the same dose for a while, due to the depot. As well, if you make any significant changes like diet, it's helpful to note it in the Remarks section.
Click to expand...

Thank you :) Yes, I have read through the Start Low Go Slow method (even though we're already at 5 units 2x per day) and am following that. I just was able to get his PMPS on my own as well! He actually came over both times today as he heard me taking out the meter and sat very still for me. I am shocked!

I have also updated my spreadsheet again, he has been on 10 units per day for about 4 weeks now with the diet change just in the last week. Now that we're hopefully in the swing of things and can keep the testing somewhat consistent, should I be creating a daily post? Or is that only for when I may be concerned/have questions?
 
Hi!
I'm not on the board regularly at all but I wanted to quickly chime in. All the advice you have been given is excellent! It's really thanks to this group that I was able to get Aurora into remission. Aurora was a free fed dry kibble eater as well as canned wet. I stopped the dry kibble when I started home testing and that helped to significantly drop her daily numbers pretty quickly. I feed the Weruva cats in the kitchen mine like the funk in the trunk flavor and also the freeze dry raw that you activate with hot water just before you feed, I buy the Stella & Chewy but the freeze dry is ridiculously expensive. I kinda had no choice after rad cat went out of business and mine snubbed most other brands of raw food out there. I test aurora only 1x weekly now since she's been in remission for almost a year. I can tell you I never used the lancet pen either, only just the little lancet in my hand. I also like to use a ankle sport sock and filled that with rice and tied the sock in a knot. I warm that up for about 20 seconds in my microwave first to warm it up. I check to be sure it's not too warm and hold that on the outside of her ear to get the blood. Then I prick with the lancet. Sometimes if you don't get a drop to form I'll hold the warm sock on the outside of her ear again and kinda pulse the area to get the blood drop to form.
I know all of this seems overwhelming, I'm by far no expert here but I managed to limp by and learn, it gets easier as you go along. Stick with the group here, it's a great community of knowledge and support!!!
 
As you have seen, the testing treats are good at getting our kitties to learn the routine. :)

As for posting, it can help,at least in the beginning, to start a new post every day. That way we can see what has happened new on that day and can keep an eye on things. Especially with the transition to wet, you may be moving into the phase of “reducing the dose”. People pay more attention to new posts than stuff added to old ones. The other thing you might want to do is visit some of the posts for other kitties. A lot of the newer members have similar questions, so are good places to learn. I found it very informative to read those where a kitty was experiencing low numbers. Check out other spreadsheets too.
 
Yes I would create a daily post. It is a good way for people to get to know you, and you them. In the subject line put the date, kitty’s name and AMPS. then add a question if needed. You will get more input this way.
 
You're doing amazing and have already made a lot of positive changes this week! You'll start feeling more and more in tune with your kitty during this process. When I started testing at home (just a month ago) it had me in tears. But it really does get worlds easier. Good luck with everything, you're in good hands with the people on this board :)
 
Nicole Z said:
Hi!
I'm not on the board regularly at all but I wanted to quickly chime in. All the advice you have been given is excellent! It's really thanks to this group that I was able to get Aurora into remission. Aurora was a free fed dry kibble eater as well as canned wet. I stopped the dry kibble when I started home testing and that helped to significantly drop her daily numbers pretty quickly. I feed the Weruva cats in the kitchen mine like the funk in the trunk flavor and also the freeze dry raw that you activate with hot water just before you feed, I buy the Stella & Chewy but the freeze dry is ridiculously expensive. I kinda had no choice after rad cat went out of business and mine snubbed most other brands of raw food out there. I test aurora only 1x weekly now since she's been in remission for almost a year. I can tell you I never used the lancet pen either, only just the little lancet in my hand. I also like to use a ankle sport sock and filled that with rice and tied the sock in a knot. I warm that up for about 20 seconds in my microwave first to warm it up. I check to be sure it's not too warm and hold that on the outside of her ear to get the blood. Then I prick with the lancet. Sometimes if you don't get a drop to form I'll hold the warm sock on the outside of her ear again and kinda pulse the area to get the blood drop to form.
I know all of this seems overwhelming, I'm by far no expert here but I managed to limp by and learn, it gets easier as you go along. Stick with the group here, it's a great community of knowledge and support!!!
Click to expand...
I may have to try the freeze dry raw as treats, we have the pure bites but they all are crumbly and I've gone through a small bag already in just a few days between my two cats. Thanks for the suggestion!
 
Wendy&Neko said:
As for the feeder, many of us use the Petsafe 5 for wet food. There is a spot under the tray that can hold a small ice pack or some ice cubes, to keep things cool. I fed both cats the same food, and since Neko was dominant, she owned the feeder anyway.
Click to expand...
I found this one on Amazon and it's much more affordable than some of the other options! I was thinking of buying one for each cat but was wondering does it make any noise when it opens up for the next meal? FA is the dominant one in our house and he would eat all of Molly's portion too if she happened to miss the meal time (and she's the one that could put on a few pounds!). We also feed them the same food so that won't be an issue.
 
There is definitely a noise as the motor turns. First couple times Neko ran away from the noise. Once she figured out it meant food, it became her BFF and would run towards it, if she wasn’t already parked in front of it.
 
Hi there Marc & Jen and welcome to you and Fat Albert!
You've received some excellent advice above! I have nothing further to offer; just wanted to welcome you to the board!
 
Sheba’s autofeeder used to make a click when it was about to open, then my recorded voice would call her. As soon as she heard the click she would race from wherever she was in the house to the feeder.
 
You must log in or register to reply here.
Back
Top