*+10 BG reading "HI" + 598* what do I do? Agatha isn't eating AGAIN!

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PM +5 381, +8 533, +9 566. I don't understand what's happening! Her BG keeps getting higher. I managed to get 3 PM tests. She seems to be drinking more water in the last day. I'm going to try to feed her.

I know getting that urine sample is very important but I just can't catch it! What do I need to be doing to help her?

Do I give more insulin even if it hasn't been a full 12 hours? I feel panicky bc these things are so urgent + I don't know how to act.

Edit: she ate a very small amount of Friskies + some treats. I put her in the bedroom with food, water + rigged a different setup in hopes of catching a urine sample.

Do I need to get to the vet today? I cancelled work so I could depending on what she needs. Is there anything he can do for her?

Edit 2: 11:20am got a tiny sample of urine, tested twice, both negative!
 
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Sorry, I'm not over-familiar with Agatha and don't have the time to read through all the posts, but as long as there are no ketones, you should be okay. For today, you'll just have to wait out the numbers. Do not give extra insulin. The numbers will start to come down, I promise. The Greenies are high carb but I do understand that it is more important for her to eat right now.
 
Yay! on the negative ketone tests! I would still try to get another one later today, and twice a day when you can, for a while.
I actually moved my cat's litter box to the center of my living room where I hang out, when I really needed a ketone test. I would wait quietly until he started peeing and then get up and put a little cup under him once he started the process of peeing.
I eventually got the blood ketone meter (NovaMax Plus) by calling all the pharmacies around. They had the meter, but didn't have the strips, but said they could have them in 24 hours, so I ordered them and got them the next day. The blood ketone tests are so much easier to check, at any time.
I'm glad you raised the dose. I would just keep on doing what you are doing with the fluids, anti-nausea and appetite stimulant meds, and the syringe feeding to when needed to get his needed calories into him.
How is he feeling and acting?
 
Do not give extra insulin. The numbers will start to come down, I promise.
I won't give extra dose! I was waiting to hear from anyone, wringing my hands. I syringe fed 60ml a/d + gave 1.75u of insulin. Going to let her rest and in a couple hours will test. Thinking along the lines of getting her to eat anything, I gave her maybe 2 tsp ice cream last night. That couldn't have caused such a spike in BG numbers, could it?

How is he feeling and acting?
She doesn't look well, you know the tired, ragged look? That's what she looks like today. Trying to drink water, but getting her beard/chest fur all wet.

I would wait quietly until he started peeing and then get up and put a little cup under him once he started the process of peeing.
Those are massive skills! I set up the baggies again to get another sample.
 
Hi Sam
Well done getting the urine test. Great no ketones.
Yes ice cream will raise the BG as it’s high carb ...all that sugar in it! Also aren’t the treats high carb.?
Make sure you test often now you have raised the dose again.
Keep feeding frequently. You are doing a great job with Agatha.
When you write in the remarks column or the thread you have given food at 2 pm for example, could you write +6 or+10 instead please. We all live in different time zones and when you say a time it means nothing to me. Thanks!
 
@Bron and Sheba (GA) will writing the time this way work?

11:20am urine test negative for ketones (tested twice), 12pm /AMPS 60ml a/d + 1.75u, +3/3:12pm BG 290, +5/6pm BG 339, ate a little bit of Friskies + treats + gave Veraflox + Cerenia- put on balcony for sunshine, +9/9:48pm BG 460 + gave 100ml fluids, +11/11pm urine test negative for ketones, PMPS / 12:30am BG 456, ate a little bit kibble, boiled egg + drank water. *will test in a couple hours/+3+4*

She's eating some on her own but not enough. I shouldn't have given that little bit of ice cream.

How often + how much is to be syringe fed when they aren't eating anything on their own?
 
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In my experience it is hard to get too much food in when syringe feeding unless they are very eager for food in which case they would probably eat on their own. I can't advise on dose. I have tagged deb incase she can help as you could really do with it. @Deb & Wink
 
She's very much not eager to be syringe fed. Poor girl let's me do it although after I've gotten to about 40ml she starts not tolerating well.
 
@Bron and Sheba (GA) will writing the time this way work?

11:20am urine test negative for ketones (tested twice), 12pm /AMPS 60ml a/d + 1.75u, +3/3:12pm BG 290, +5/6pm BG 339, ate a little bit of Friskies + treats + gave Veraflox + Cerenia- put on balcony for sunshine, +9/9:48pm BG 460 + gave 100ml fluids, +11/11pm urine test negative for ketones, PMPS / 12:30am BG 456, ate a little bit kibble, boiled egg + drank water. *will test in a couple hours/+3+4*

She's eating some on her own but not enough. I shouldn't have given that little bit of ice cream.

How often + how much is to be syringe fed when they aren't eating anything on their own?
Hi Sam
To tell us the times things happened or BGs you just write +3 BG 290 or +11 negative ketones, then we know exactly where in the cycle it happened. Everything is relative to when the insulin was given.
That is OK that she ate the ice cream. When you are trying to get her to eat, anything is OK.

What you are giving her at the moment....ice cream, treats and the a/d is higher carb but that is OK. We just need to get food into her. And it will raise her BGs a bit but that is OK in the short term as long as the ketones are negative.
Did she eat some boiled egg? ....that is great. Egg...scrambled, boiled or poached is perfect meal for cats.
How much of the a/d are you giving each time? You write in the SS you gave 60 mls on one occasion. Do you give that much each time?
And how many times a day?
How much food is she eating on her own at the moment?
 
I used to count how many syringes it took to feed one can of food, and then divide the number of syringes by the calories in the can. That gave me how many calories were in each syringe. I took my cat to a feline nutritionist and was told to try to give him about 230 calories per day, but every cat is different and to fight off ketones you need as much food as you can get into him, thus the ice cream was okay.

She's very much not eager to be syringe fed. Poor girl let's me do it although after I've gotten to about 40ml she starts not tolerating well.
Sometimes you can only do 40ml. Then let him rest, and try for another 40ml in an hour or so. Go slowly, and try to slowly build up how much he will tolerate at a time.
 
+7/7:42am BG 530, drinking lots of water, ate some egg w/ mayo, negative ketones, +9/9am 60ml a/d.

How are her teeth? Will she eat plain chicken on her own? Will she drink on her own?
Her teeth are fine as far as I know. However, she acts like she can't grab things with her teeth much. I do not think she's in pain but just an "eating style"? She really does well with pate and I even mix some water with that to get her to eat it but that's if she's eating good. As for water, I know she's drinking on her own although I cannot be sure how much because much of her face and chest hair get sosking wet in the water bowl and she creates a trail everywhere she goes.

how much you are managing to give her?
I add only a little water with the a/d to syringe so it'll stream easily. I have been doing 60ml twice daily in addition to offering treats + pate (the pate she won't eat much of, I'll have to buy more of the expensive soft treats).

used to count how many syringes it took to feed one can of food, and then divide the number of syringes by the calories in the can.
What a great idea. I'll do this with the next can.

Did she eat some boiled egg?
After her PM insulin she ate a little bit of previous higher carb kibble I've saved, a couple treats and a tiny amount of the egg. I meant to test her earlier than now but didn't wake up.

How much of the a/d are you giving each time? You write in the SS you gave 60 mls on one occasion. Do you give that much each time?
And how many times a day?
How much food is she eating on her own at the moment?
60ml twice a day in addition to other food offerings. She sniffs + licks a little bit but not much on her own.

I hope I answered everyone's questions. -Sam + Aggy
 
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+7/7:42am BG 530, drinking lots of water, ate some egg w/ mayo, negative ketones, +9/9am 60ml a/d.


Her teeth are fine as far as I know. However, she acts like she can't grab things with her teeth much. I do not think she's in pain but just an "eating style"? She really does well with pate and I even mix some water with that to get her to eat it but that's if she's eating good. As for water, I know she's drinking on her own although I cannot be sure how much because much of her face and chest hair get sosking wet in the water bowl and she creates a trail everywhere she goes.


I add only a little water with the a/d to syringe so it'll stream easily. I have been doing 60ml twice daily in addition to offering treats + pate (the pate she won't eat much of, I'll have to buy more of the expensive soft treats).


What a great idea. I'll do this with the next can.


After her PM insulin she ate a little bit of previous higher carb kibble I've saved, a couple treats and a tiny amount of the egg. I meant to test her earlier than now but didn't wake up.


60ml twice a day in addition to other food offerings. She sniffs + licks a little bit but not much on her own.

I hope I answered everyone's questions. -Sam + Aggy
You are doing a wonderful job. I've only had to assist feed a few times, and I understand how much work and stress it is. She's very lucky to have you. Have you ever tried forti flora on the food?
 
Thank you for your kind words. I have the Fortiflora and when eating normally she's eaten it several times. Right now it's not tempting her, she won't eat it or on top of Friskies.
 
It's probably been mentioned before, but have you thought about trying Ondansetron (Zofran) in place of or in addition to the Cerenia?
 
It's probably been mentioned before, but have you thought about trying Ondansetron (Zofran) in place of or in addition to the Cerenia?
Hi Dyana, I have 14- 8mg pills of ondansetron a friend gave me back in January.

Agatha weighed 10.8lbs on Monday. Do you know the dosage would be for her, mg per pound? Is it a much stronger, effective medicine than Cerenia?

Edit: I saw a website that said .11mg per pound which would be 1.18 for her weight. I don't think breaking it into eighths would work well?
 
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Can you call your vet to call in a prescription for you, or tell them you have some and want to try them but want to know what dose to give? I am not a vet, so I can not tell you what dose to give.
FWIW: My cat J.D. was prescribed 1mg BID when he was 10 pounds. My cat Ginger is 11 pounds and was prescribed 2mg SID. One of the side effects is sleepiness, so when Ginger didn't seem as active, I switched her to 1mg. as needed. My pills are 4mg per tablet, so either a half (2mg) or a quarter (1mg). I know they are tiny, at least the 4mg are.
 
My sister has 4 mg tablets of ondansetron but they are the dissolvable kind with a sweetener, I think aspartame. Can I give this to her?

AMPS/2:27pm BG 433, tried eating Friskies but not much, syringe fed 60ml a/d (almost ½ can) (2 hours late in getting insulin to her), +3 BG/5:02pm 415, left in room with food, treats + water.
 
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Have you tried Fancy Feast instead?
Thank you for your kind words. I have the Fortiflora and when eating normally she's eaten it several times. Right now it's not tempting her, she won't eat it or on top of Friskies.
 
My sister has 4 mg tablets of ondansetron but they are the dissolvable kind with a sweetener, I think aspartame. Can I give this to her?
.
The zofran (ondansetron) I gave Sheba in Australia has aspartame in it. I just looked it up.
I had the 4 mg wafers and gave her 1/2 wafer. You just need to be sure that your hands are dry because the wafer will stick to your fingers if not.
You just need to put it on the tongue and it will stay there.
 
The zofran (ondansetron) I gave Sheba in Australia has aspartame in it. I just looked it up.
I had the 4 mg wafers and gave her 1/2 wafer. You just need to be sure that your hands are dry because the wafer will stick to your fingers if not.
You just need to put it on the tongue and it will stay there.
Thank you, I'm so glad I could get what she needed. I got a 24 variety pack of FF pate and will offer again tonight but if she doesn't eat it I will syringe feed another 60ml a/d and then give insulin.

. +10/11:44pm BG 532, gave 2mg ondansetron dissolvable + Veraflox, didn't want FF pate, negative ketones, gave 100ml fluids. *Update: PMPS/2:25am BG 397, only ate tiny amount of FF pate, had to syringe feed 60ml a/d (approx=½ can), in bedroom overnight w/me w/ water, kibble + FF pate.*
 
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Really hope you see some improvement overnight. You are doing such a great job for aggy. I guess you have tried squeezing the gravy out of food and giving that. Will be thinking of both of you and sending good vibes during our day.
 
Really hope you see some improvement overnight. You are doing such a great job for aggy. I guess you have tried squeezing the gravy out of food and giving that. Will be thinking of both of you and sending good vibes during our day.
Thank you so much for your encouragement! I have tried so many things with the wet foods to get her to eat, including that with the gravy. Blending to puree, adding water, adding broth, adding Fortiflora, adding bonito flakes, adding fresh chunks of meat.
 
Have you tried canned sardines in water...no added salt?
What about plain cooked chicken ?
bbQ chicken ....the inside bits with no salt or the stuff they put on the skin?
 
It's expensive and exhausting trying to get our treasures to eat. The only other suggestion I have is Atlantic cod or Atlantic pollock. Pabay will eat these boiled in water. He will not eat haddock salmon or any fish from the Pacific (including Pacific pollock). I don't want to send you on a wild goose chase - you are already diing well above and beyond any other cat carer.
 
I wasn't able to check Aggy's BG during the night, I was so exhausted. Now at +10/11:57am BG 598. The reading before that said "HI" + I have never seen that before. She's going from water bowl to water bowl. She only had access to water, FF pate + a bit of not LC kibble.

I'm so scared for her. Should insulin be raised at her next cycle 2 hours from now? I know I'll to have to syringe feed. Should I be offering treats? The only ones I have are HC + she won't eat them.

Edit: +11/12:54pm BG HI, 2mg ondansetron. Syringe fed 60ml a/d. Leaving in bedroom with 3 foods + water. Have to run errands, will be back to test BG soon.
 
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I wasn't able to check Aggy's BG during the night, I was so exhausted. Now at +10/11:57am BG 598. The reading before that said "HI" + I have never seen that before. She's going from water bowl to water bowl. She only had access to water, FF pate + a bit of not LC kibble.

I'm so scared for her. Should insulin be raised at her next cycle 2 hours from now? I know I'll to have to syringe feed. Should I be offering treats? The only ones I have are HC + she won't eat them.

Edit: +11/12:54pm BG HI, 2mg ondansetron. Mixing up a/d to syringe feed.
@Wendy&Neko @Marje and Gracie

Sam,

I am so sorry to hear Aggy is so poorly still. I have tagged two moderators to see if they can help. Urgent dosing advice needed please Wendy and or Marje. Sam's situation with Aggy is pretty desperate. Please can you assist with urgent dosing advice.

Also sam you could post under the prozinc forum asking for dosing advice.

Sam I am not confident giving you dosing advice. I do hope the moderators can help. The time difference with Bron in Australia means she might not pick this up. I hope someone gets back to you soon.
 
Sorry, I'm not much help on Prozinc dosing. It be good to update the spreadsheet so people know you shot already. If she's on an antibiotic, Veraflox, you might want to consider adding a probiotic to her food, a couple hours apart from when you give the Veraflox. Antibiotics can mess with tummy flora, and that can make her feel unwell and not want to eat.

Have you figured out how many calories she's getting a day yet? She should be getting close to if not a complete can of a/d. It's 180 calories per tin.
 
I'm so sorry, in my panic I got the info to The forum first and forgot about SS. It is updated. I'm syringe feeding 60ml twice a day plus offering other treats and pate. Each 60ml syringe is half a can of a/d.
 
Good to know you are getting at least one can in per day. I used to find it easier to split my feedings into several smaller amounts, so syringing six times per day but less at once. Otherwise either me or the cat ended up wearing a lot of it. :p

You can give the ondansetron, 2 mg dose, at least 3 times per day. It doesn't last a long time in a cat.
 
Fortiflora isn't a great probiotic, it's a single strain. There are lots of human ones that can be used too. Just make sure you give it two hours apart from the antibiotic.
 
I'd increase the dose, to try and get those high BG levels down.

I think that a 0.5U increase may even be needed, since the nadirs are only down in the high yellow BG range right now.

Part of the high BG's can be attributed to the higher carb food. BUT don't worry about that, as it's more important to get Aggy eating ANYTHING, than it is to ge``t her eating a lower carb food. Please keep syringe feeding her as you are doing, as much as you need to.

Perhaps think about splitting those syringe feedings into smaller meals. So she doesn't get too full at one sitting.

I had to assist feed Wink, and was feeding him at least 6-8 times a day, small amounts each time, and going really slowly. It could take 15-20 minutes or more to get a meal into him. Probably 1 ounce of food each time.

Feeding tubes save lives. I could not do that with Wink, because of his heart problems, because the feeding tube insertion required sedation, and he would not have tolerated or survived that.

Dehydration can make a cat (or human) not want to eat. So keep up the hydration too.
 
Sam, it’s been over a week since you have been to the vet with Agatha and she is not really making much progress with her eating. Are you able to take her back to the vet to get her checked again to see if the infection she had is resolving or has resolved and maybe you need to look at a feeding tube so she can get all the nutrients she needs. There may be something else the vet could do or prescribe to help things along.
You are doing a great job but it’s hard when they won’t eat. The feeding tube would only be short term and is much less stressful for you and Aggie than syringe feeding.
 
Are you able to take her back to the vet to get her checked again to see if the infection she had is resolving or has resolved and maybe you need to look at a feeding tube so she can get all the nutrients she needs. There may be something else the vet could do or prescribe to help things along.
I will call him in the morning to see if he thinks I need to bring her in + what could be done.

She has had hepatic lipidosis twice + feeding tubes twice (2014 + 2018). She's 14 now.

I would appreciate more than ever right now to get opinions on what treatment Agatha may need. If this is a one-time thing, her having an infection from an unknown source, and that's what made her stop eating then I want to continue helping her to get through this.

The week's prior to her stopping eating, there were many AMPS numbers I didn't give insulin when I was misinformed about what I thought was my "no shoot number" (I thought it was 200 when another suggested 90 was my new no shoot number). I have no idea if my actions affected her getting some sort of infection which doesn't really make sense or if it messed her up with not eating/nausea.

This is really difficult for me to put into words that I hope are coherent. I have been very upset and distraught over what's best for her.

I have heard so many beautiful stories on this forum of cats doing well and thriving despite diabetes. I want this for my girl. She's been by my side side I was 16. I know it has only been 3 months since her diagnosis but it has felt like an eternity. I don't know if it's normal for diabetic cats to continually have issues not eating and requiring the supportive care to get their appetite back on track?

Everyone's situation is entirely different, but how do you know if or when it is time to say goodbye?

I want to do my very best for Agatha, but to be very honest it feels like I am in a losing battle right now. I'm not financially in a position to take long term care if all these complications continue. I do not have good health and I struggle brutally with my mental health (depression, anxiety, dissociation). I am also in the middle of transitioning antidepressant medications so I don't even know if I'm thinking straight about all of this.

I respect all of you and trust your opinions and appreciate you very much. This is about all I can figure out at the moment tonight and as everyone is in different time zones I thought I should get it sent as soon as possible. -Sam + Aggy
 
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((((Sam))))
It is very hard when our beloved cats are sick. If only they could talk.
When cats stop eating like Aggy, it is usually something doing it, such as pancreatitis or an infection somewhere. Some cats get over it quickly and some cats take longer.
Do you know if the vet did a fPL test for pancreatitis. He didnt mention it. You are doing almost everything needed to help pancreatitis except she may need some pain meds if it happened to be that. The vet said most of the blood work was good including the kidneys so that is really good.
The vet did say to bring her back if she hadn’t started eating, didnt he? Maybe ring him. I do understand the financial side of things and vet are expensive.

It would be good to know if the infection had resolved.
It isn’t a good idea to stop giving insulin as that can bring on its own problems. Sometimes you have to give a reduced dose and that’s OK.
Im sorry if you were given conflicting advice. If you are unsure always post again and tag someone.

What are her favourite foods? Any particular canned foods? Dry foods? Cooked chicken, meat, minced meat?.
Have you seen this link https://www.felinediabetes.com/FDMB/threads/suggestions-on-how-to-stimulate-kittys-appetite.130770/

I wouldn’t give up yet. Sometimes it can take a while for them to get their appetite back. Ask the vet for some more ondansetron and cerenia, ask about the fPL test for some pain meds. We are here to support you for as long as you need us.
Try and make sure you are getting enough sleep if you can as that is just as important.
:bighug::bighug::bighug:
 
When cats stop eating like Aggy, it is usually something doing it, such as pancreatitis or an infection somewhere. Some cats get over it quickly and some cats take longer.
Do you know if the vet did a fPL test for pancreatitis. He didnt mention it. You are doing almost everything needed to help pancreatitis except she may need some pain meds if it happened to be that. The vet said most of the blood work was good including the kidneys so that is really good.
The vet did say to bring her back if she hadn’t started eating, didnt he? Maybe ring him. I do understand the financial side of things and vet are expensive.
He definitely said to bring her back if she wasn't eating good on her own in a couple days and it was be a week tomorrow. He did not mention the fPl test. Is that a blood or urine test? Do you have any approximation of how much that test might be? Either way I want to get it done for her.

Im sorry if you were given conflicting advice. If you are unsure always post again and tag someone.
I think I took what I read in the beginners guide to explaining how to give insulin. The first time I saw a lower number I didn't know what to do so the second day when it happened again I looked up about those lower numbers and the original post I saw said if it was below 200 to not shoot. I really wish I had asked.

What are her favourite foods? Any particular canned foods? Dry foods? Cooked chicken, meat, minced meat?.
Have you seen this link https://www.felinediabetes.com/FDMB/threads/suggestions-on-how-to-stimulate-kittys-appetite.130770/
I've studied that link like the Bible! I'm pretty sure I tried all of those things. She was never a picky eater but also I unfortunately never strayed from giving her anything but kibble. She was never really interested in human food before. She wasn't picky but now that she's dealt with so much nausea since the diabetes I would have no clue how to entice her with food. The last time she stopped eating in February the only thing that would work was the baby food BeechNut. Right now she will only readily eat soft cat treats.

I wouldn’t give up yet.
This gives me so much hope. Even if it's just for tonight. It is exactly what I needed to hear, to not give up.

Ask the vet for some more ondansetron and cerenia, ask about the fPL test for some pain meds. We are here to support you for as long as you need us.
I will ask for that test + whether he thinks it's pancreatitis and if pain meds. So ondansetron + Cerenia can be taken together- is it like a double whammy for anti-nausea?

We are here to support you for as long as you need us.
Try and make sure you are getting enough sleep if you can as that is just as important.
:bighug::bighug::bighug:
Y'all have helped me so much so far. I cannot thank you enough. I will keep you updated. <3 -Sam + Aggy <3
 
Do you have any approximation of how much that test might be? Either way I want to get it done for her.
It should not be expensive. There are two tests you can get done. The fPL Snap which is done in the vet office and only takes 10 minutes to get a result and it will tell you yes/no if she has pancreatitis. In Australia this test costs around $50 I think...I haven't had it done for about 5 years
The other test is the fPL Spec and is sent out to laboratories and will tell you a number as to how bad it is. It takes a couple of days and it is more expensive.
I think just finding out yes or no is sufficient so I would go with the fPL Snap

I've studied that link like the Bible! I'm pretty sure I tried all of those things. She was never a picky eater but also I unfortunately never strayed from giving her anything but kibble. She was never really interested in human food before. She wasn't picky but now that she's dealt with so much nausea since the diabetes I would have no clue how to entice her with food. The last time she stopped eating in February the only thing that would work was the baby food BeechNut. Right now she will only readily eat soft cat treats.
Just keep trying different foods. Any she wont eat...freeze the rest of the can in a small container for later so its not wasted. I used to do that when Sheba would not eat. Would she eat the gravy foods do you think? Or the dry?


This gives me so much hope. Even if it's just for tonight. It is exactly what I needed to hear, to not give up.
I had Sheba very sick at one point and I really thought it was the end. The vet gave her a medication for pain and she was a different cat.
She used to get pancreatitis and was usually a great eater but couldn't eat with pancreatitis.
I have seen many cats here on the forum struggling to eat after having an infection, pancreatitis, hepatic lipidosis etc. Some cats bounce back quickly but many don't and need the support for longer. Some a lot longer.

will ask for that test + whether he thinks it's pancreatitis and if pain meds. So ondansetron + Cerenia can be taken together- is it like a double whammy for anti-nausea?
Cerenia and ondansetron work on different pathways in the body and when one doesn't work, the other one often will.
Yes they can be given together because of the different pathways in the body.
Cerenia is given once a day.
Ondansetron can be given 8 hourly if needed.

Y'all have helped me so much so far. I cannot thank you enough. I will keep you updated. <3 -Sam + Aggy <3
We are really happy to help you and just want to see Aggie back to her former self eating well!
You know you can tag any of us at any time. Just put a @ in front of our name like this @Bron and Sheba (GA) and a box will come up for you to choose a name.
Give Aggie a big hug from me and hang in there and make sure you get some rest too:bighug:
 
Sam, oh poor you and Aggy.
1. Pain relief: a good idea as pancreatitis is so painful. Gabapentin works well for Pabay as it gives pain relief and it is an appetite stimulant.
2. Sound advice from deb and wink on dosing.
Everyday must seem like an eternity for you wrestling with these decisions and caring for yourself and Aggy. Sending hugs and positive thoughts from us. :bighug:
 
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