Peeka 9/11 Mixed Feelings/Insulin Change/Neuropathy Video : (

Discussion in 'Feline Health - (Welcome & Main Forum)' started by Peter (Peeka&Boo), Sep 11, 2020.

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  1. Peter (Peeka&Boo)

    Peter (Peeka&Boo) Member

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    Good morning,

    my wife sent a video last night of Peeka’s walk shortly after insulin was administered, her hind end is dragging quite a bit. I’m sure this is just part of it, we’ve also noted that she hasn’t been able to jump on the ottoman anymore. Every time I get upset about these developments I just try and keep reminding myself that we have got her started on the right track.

    Her AMPS was 297 today, while I know it’s still high, it’s also the lowest PS reading we have gotten thus far. I’ll be able to get a +2 before work and hopefully some later tests when I get home tonight. I’ll try and collect as much data as I can this weekend to determine if a higher dosage is needed.

    My wife and I also discussed the possibility of switching to Prozinc. I know it’s a longer lasting insulin, and many people here seem to use it. If it’s something that will help out, I’m willing to switch to it for Peeka, I just want to try and get this ordeal sorted as quickly and safely possible. We are expecting our newborn in December, and I’d like to not have to stress about this by that time if at all possible. Even if she’s just able to make it to her litter tray, that would be a huge plus.

    I really don’t have much else to add, I get optimistic about seeing these “lower” numbers, but then I visually see her still struggling to move around and feel down again. She’s mostly just been laying around on her side if she’s not moving to the water bowl. She’s had accidents pretty much every day for the last week if someone isn’t home to physically take her to her litter tray. Idk, I just want to make sure we are doing the right things here and that the results will come in time.
     
  2. KyraCat

    KyraCat Member

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    Peter! :bighug:

    You are doing so so well! All of this is so tough and I think with every step forward it is easy to take 3 steps back, but Peeka will get there I'm sure of it!

    Looking at your spreadsheet she hasn't been diagnosed for that long and as I like to say it's all about the journey!
     
  3. Critter Mom

    Critter Mom Well-Known Member

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    If you have the option, also consider insulin glargine (Lantus or Basaglar). Prozinc gives a wee bit more flexibility on dose times. Glargine typically has greater dose duration than Prozinc but you need to keep dose times as consistent as possible.

    WRT testing over the next few days, the times you're likeliest to catch nadir will be between +3 and +6. You need to get a picture of nadirs for both AM and PM, since some cats may tend to run lower one one of the cycles (usually PM) and you need to identify the lowest level that Peeka gets to when making a decision about dosing.


    Mogs
    .
     
  4. Peter (Peeka&Boo)

    Peter (Peeka&Boo) Member

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    Im trying to work out with my wife what time would be best to give her insulin today since I’ll be at work. Outside of getting Peeka better, our other need is some flexibility, especially as I work my 2nd job on the weekends ,my wife’s work schedule can vary depending on the day at school, and as we are about to have our baby in a few months. We are typically pretty good about timing of shot.

    As I’ve mentioned earlier, I’ll be up a little but later tonight, so I can get some +3-+6 over the next few days.
     
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  5. Peter (Peeka&Boo)

    Peter (Peeka&Boo) Member

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    That is by far the most frustrating aspect. Maybe I’m a linear thinker in that regard, If I do this, then that should happen, and unfortunately, that isn’t the case with diabetes I’m learning.
     
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  6. Critter Mom

    Critter Mom Well-Known Member

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    Never a truer word was said. :rolleyes:

    :bighug:


    Mogs
    .
     
  7. KyraCat

    KyraCat Member

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    I think I am the same Peter! I stare at our SS and think but whyyy?!?! what happened to cause that!!! Nothing changed in the routine!!

    My dad is diabetic and my mom can helicopter over him they way some of us do over our furbabies and they both forever tell me "Well that's diabetes for you" when I get something seemingly random happen with Kyra!

    Just remember to really take notice of the positives, no matter how small!
     
  8. Peter (Peeka&Boo)

    Peter (Peeka&Boo) Member

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    Update: it took a little bit longer than normal, our reader kept giving some error messages, probably my fault. But Peeka +2 is around 193 right now.
     
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  9. Peter (Peeka&Boo)

    Peter (Peeka&Boo) Member

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    That’s what I’ve been trying to take note of. Playing with Peeka while she’s lounging about. Listening to her purr while I pet her, etc.
     
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  10. Peter (Peeka&Boo)

    Peter (Peeka&Boo) Member

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    Trying to upload a video I took this AM of Peekas neuropathy. Anyone have a good suggestion on how to do so? Wont let me upload the video directly from my phone.
     
  11. KyraCat

    KyraCat Member

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    I'm not sure if you would have to share the link of the video as saved on YouTube or Facebook...not sure though I have never tried before...
     
  12. Critter Mom

    Critter Mom Well-Known Member

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    Uploading the vid to YouTube first and then using the 'Media' Icon above to add the YouTube link to your post definitely works.


    Mogs
    .
     
  13. Peter (Peeka&Boo)

    Peter (Peeka&Boo) Member

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    Here is the link. Please don’t think any less of me or my abilities as a cat dad.
     
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  14. KyraCat

    KyraCat Member

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    Oh the poor baby <3

    I'm sure no one would ever think less of you! It is so clear how much you are trying to get Peeka back to good health
     
  15. Critter Mom

    Critter Mom Well-Known Member

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    Peter, you are doing all the right things to help Peeka. It shines out of every word you post here how much you love Peeka and how hard you're working to help her get better. Who could ask for a better cat dad than that! :)

    :bighug::bighug::bighug:

    I understand how hard the 'marathon' part of feline diabetes can be at times. I think it's important to remind yourself of all you're doing right:

    - Starting insulin treatment (many people sadly don't...).

    - Home testing to keep Peeka safe (and to improve her regulation going forward).

    - Changing Peeka to a low-carb diet - giving her a better chance of achieving remission. :)

    - Giving Peeka her methylcobalamin supplement to help her nervous system.

    - Giving Peeka a safe and loving home, where she is warm, fed, protected and loved. (Boo, too!)

    Now that you've got the diet change under your belt and you are testing more you can move forward with optimising Peeka's insulin dose. Pity it's not possible to fast forward. ;)


    Mogs
    .
     
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  16. Critter Mom

    Critter Mom Well-Known Member

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    @KyraCat - Like the new avatar, Jemma. :cool:


    Mogs
    .
     
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  17. Peter (Peeka&Boo)

    Peter (Peeka&Boo) Member

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    I know, my wife keeps asking if we should increase dosage. I have to remind her (and myself) that even if we increase dosage, it won't necessarily mean she will get better overnight. It's the slides backwards that bother me the most. Thank you all for reminding me (sometimes constantly) that we are in this for the long haul. Just seeing her nueropathy like in the video above feels defeating.
     
  18. jt and trouble (GA)

    jt and trouble (GA) Well-Known Member

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    ((((Peter & Mrs))))

    Its hard I know. One day you will be telling someone else your "memories" of Peekas neuropathy. This truly IS a marathon...the longest marathon of all but once you cross that finish line it will ALL be in the past.
    You come and vent. We can take it.;):bighug::cool:
     
  19. JL and Chip

    JL and Chip Well-Known Member

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    Is Peeka on Zobaline? It’s a methylcobalamin supplement specially made for diabetic cats (no sugar or artificial sweeteners) that helps with diabetic neuropathy.

    Here’s a video that shows how bad neuropathy can get and how much hope there is for improvement. I like to watch it periodically as a reminder.
     
  20. Ale & Bobo & Minnie (GA)

    Ale & Bobo & Minnie (GA) Well-Known Member

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    Dec 21, 2019
    Peter that’s true, but remember that the dosing protocol is you increase .25 every 7-10 days if the numbers are not where they should be. Peeka will be due for another increase soon
     
    Last edited: Sep 11, 2020
  21. Peter (Peeka&Boo)

    Peter (Peeka&Boo) Member

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    Peeka is currently on methyl B12 from Vitacost, which was also recommended to me by this forum. We give her, 5000mcg/day, typically in the morning with breakfast. I've watched that video a number of times as well to try and help remind me of what's possible, my biggest fear is that the damage is too severe and it may never be reversed. We have no evidence saying that, it is just a fear of mine.
     
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  22. Peter (Peeka&Boo)

    Peter (Peeka&Boo) Member

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    Which is why I am going to get some more testing in this weekend. Could we ever get to a point where we have found her correct dosage, and we just need to allow more time to pass for the neuropathy to resolve, or what would next steps at that point look like?
     
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  23. Critter Mom

    Critter Mom Well-Known Member

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    That's the plan.


    Mogs
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  24. Peter (Peeka&Boo)

    Peter (Peeka&Boo) Member

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    That way if my wife ever asks, I can point to the data and show her that the numbers are where they should be and that we just need to allow everything to work the way it is supposed to.
     
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  25. Critter Mom

    Critter Mom Well-Known Member

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    The general principles for the next stage are:

    - Run curve.
    - Assess curve results and daily tests to determine safety and efficacy of current dose.
    - If necessary, adjust dose.
    - Hold (adjusted) dose for 7 days (unless a dose reduction is needed, in which smaller dose is given at next cycle and clock gets reset back to day 1).
    - Rinse and repeat until dose is optimised for the insulin in use and the cat's current insulin requirements (can fluctuate).

    The initial target is to find a dose that will keep Peeka below the renal threshold (FDMB sets this as approximately 200mg/dL as measured on a human meter) and that doesn't cause hypo episodes. It may be possible to improve on the upper bound thereafter but the requirement to keep the kitty in safe numbers at nadir always holds true (obviously!).


    Mogs
    .
     
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  26. Peter (Peeka&Boo)

    Peter (Peeka&Boo) Member

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    So what happens in the event that the NADIR gets too low, but the pre shot numbers are still above 200? For example, the PS numbers I've been getting have been around 300, but we would ideally like to consistently stay around 200, or are PS in the 200-300 range good enough to get Peeka regulated? Sorry for asking, I'm just trying to understand the "target" here.
     
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  27. Critter Mom

    Critter Mom Well-Known Member

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    If the nadir gets too low the dose needs to be reduced.

    The longer a cat spends in higher numbers each day the more time there is for high blood glucose levels to damage organs and the nervous system. Numbers over the renal threshold also put greater strain on the kidneys and, because of the sugar in the urine, increase the risk of developing urinary tract infections.

    The closer you can safely keep a cat to the normal BG range, the better it is for its body and overall health.

    It's not a case of 'if I do X then Y will happen'. As treatment progresses, the pancreatic beta cells may regain more function. The process described in my previous post above is the method used to manage the regulation process. All of this is covered in the FDMB Caninsulin/Vetsulin guide. It might be worth re-reading it.

    As I already explained above, a cat is not considered to be regulated if it spends a lot of time each day above the renal threshold. Longer-acting, gentler insulins help in this respect.


    Mogs
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    Last edited: Sep 11, 2020
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  28. Peter (Peeka&Boo)

    Peter (Peeka&Boo) Member

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    So from what I'm understanding now having re-read that sticky, is that right now, what I am hoping for is her PS levels to be below 300, and for her NADIR to be somewhere in the 90-150 range. If that's the case, then we would consider that her "correct" dosage for the time being. And if we can maintain those levels, we are hopeful that nerve systems will start working like normal over time? I know with diabetes it's not a straight line to that, but that is the line of thinking as it pertains to diabetes? It's staying within a certain "sweet spot" if you will.
     
  29. Critter Mom

    Critter Mom Well-Known Member

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    Yes, that's the minimum degree of regulation to aim for, and may be all that's possible with Vetsulin/Caninsulin (depends on the response of the individual cat).

    Please see my earlier reply in post #27 above.


    Mogs
    .
     
  30. Peter (Peeka&Boo)

    Peter (Peeka&Boo) Member

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    Sorry for asking these questions, I feel like I'm starting the understand how we are going to get there, I just want to know from a technical standpoint what we are trying to achieve. Thank you for making that clear to me, I will look into the Prozinc next week. I'm not sure how crazy I am about the harsh in and out nature of the Vetsulin, if we can more or less keep the levels the same throughout the day, that would seem to be the best bet, correct?
     
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  31. Critter Mom

    Critter Mom Well-Known Member

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    Yes, but the tighter you wish to regulate the more frequent and consistent the testing needs to be to keep the cat safe. I posted a link to Saoirse's spreadsheet. Have a look at it again to see the difference between her time on Vetsulin (Caninsulin - first part of sheet) and Lantus.

    The better the cat is regulated, the better its chance of remission (diet-controlled diabetic, no need for insulin).


    Mogs
    .
     
  32. Peter (Peeka&Boo)

    Peter (Peeka&Boo) Member

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    Well the wife just got home, no accidents for Peeka, but her walk seems to be getting worse as the insulin goes on. She commented that it looks like she is just scooting her hind end along almost on the floor. I know some may have seen the video I posted earlier, I just want to know this isn’t all done to just keep her alive and have no quality of life. I want her to be able to walk again somewhat normally.
     
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  33. Gill & Mac (UK)

    Gill & Mac (UK) Member

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    Poor kitty! she is so lucky to have you & Mrs Peter as parents as you are doing so much to help her. You will get there - thankfully Mac did not have neuropathy but but was getting scrawny, permanently hungry, thirsty and miserable. We started noticing a little improvements after only 7 days of insulin - as it says above look out for the little things - like the first time in ages that Mac chased his sister. There will be ups and downs on this journey but you will get there and every little step counts - the video from JL shows just what a miraculous improvement can happen.. Peeka knows you are there for her.
    PS congrats on your future arrival !
    Gill
     
  34. Gill & Mac (UK)

    Gill & Mac (UK) Member

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    Wow thanks for sharing that @JL and Chip it is truly inspirational to see the difference devoted parents made. Have to confess it has left me with a little (happy) tear or two in my eyes.
    Gill
     
  35. Peter (Peeka&Boo)

    Peter (Peeka&Boo) Member

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    Sorry to sound like a downer, I just went back and read through others success stories with their cats. I have to keep reminding myself that we are only a few weeks into this thing. Some people didn't see results for months. Thank you all once again for your continued help and support!
     
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  36. jt and trouble (GA)

    jt and trouble (GA) Well-Known Member

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    Its going to be ok Peter. Peeka isnt suffering. She may be a bit uncomfortable but shes not in pain. If she was she wouldnt even try to walk and cry out. My Trouble walked worse than this video. He recovered completely but it took months.
     
  37. jt and trouble (GA)

    jt and trouble (GA) Well-Known Member

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    ACK we crossed posted.

    We do downer pretty well (((Peter)))
     
  38. Peter (Peeka&Boo)

    Peter (Peeka&Boo) Member

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    Thank you Jeanne, you have been with us every single step of the way, and I can't thank you enough for your emotional support! Wife and I joke that I spend more time with you all, than I do with our friends at the moment. Thank you again for your encouragement.
     
  39. jt and trouble (GA)

    jt and trouble (GA) Well-Known Member

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    Oh and Peter? We did it on NPH insulin. ;)
     
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  40. jt and trouble (GA)

    jt and trouble (GA) Well-Known Member

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    J
    Just doin ma job :p
     
  41. Ale & Bobo & Minnie (GA)

    Ale & Bobo & Minnie (GA) Well-Known Member

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    Like I’ve said before Peter, it took Minnie about 3 months after being regulated to recover about 85% and the rest came slowly after that. I don’t know how else to say it to you, there are no short cuts. It’s not going to happen overnight and not before she’s regulated. If you keep thinking that way, you’re just going to continue being disappointed.
     
  42. Peter (Peeka&Boo)

    Peter (Peeka&Boo) Member

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    I know, I’m trying to change my mindset about a lot of things. Not just Peeka and her diabetes, you all are helping with more than just that, and I can’t thank you enough.
     
  43. Ale & Bobo & Minnie (GA)

    Ale & Bobo & Minnie (GA) Well-Known Member

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    Just remember I was told by one vet she’d never recover and another that she’d recover at the most 30%. My heart sank sure, but I decided to hold on to hope and have faith on what everyone said about b12 methyl. I had to do that or I’d have gone insane. It hurts to see them this way yes, but cats are resilient. Minnie acts like she doesn’t even remember all that struggle. He’ll, it’s like she doesn’t even remember the feeding tube at all and that was way more recent! She’s back to all her old antics, pawing at the kitchen cabinet door when she wants treats, jumping on my bed and waking me up at 6am and the past 2 nights I had to dig her out of the lavender bushes where she was stalking mice. There is a light at the end of the tunnel. Just look for it and focus on it. Forget the darkness. Only and best advice I can give you.
     
  44. Peter (Peeka&Boo)

    Peter (Peeka&Boo) Member

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    Thank you for sharing this, and honestly, I just need to know that things are going to work out in the end. Despite the stress, despite the anxiety I’m currently feeling. When I spoke to my wife on the way home, she told me Peeka didn’t really care to eat her food, and didn’t show interest in getting up from her spot by the back door. But when I got home and pulled into the garage, I was greeted by Peeka (albeit struggling heavily) to walk down the hallway to greet me and inform me she has been starved (dramatic cat, I know)

    She has been happy nibbling on her food. I was able to get a +6 tonight as well at 267. There were some per accidents tonight, but I’m looking ahead. I know we are on the right track and I believe that in due course, she will get better, ESPECIALLY with her neuropathy. Thank you all for encouraging me, I promise, I’m not done needing encouragement. If I’m down, it’s only because I can’t quite make out the light at the end of the tunnel. You all have shown me that there is one though.
     
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  45. Gill & Mac (UK)

    Gill & Mac (UK) Member

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    [QUOTE="Peter (Peeka&Boo), post: 2632800, member: 30833", I was greeted by Peeka (albeit struggling heavily) to walk down the hallway to greet me and inform me she has been starved (dramatic cat, I know)
    [/QUOTE]

    Aww bless her - it's those little victories to savour Peter. And aren't they all drama queens both the girls and boys !!
    Keep up the good work.
    Gill
     
  46. Polgeria

    Polgeria Member

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    Aug 30, 2020
    Hi Peter!
    I just wanted to chime in to let you know that Peeka is beautiful, and I love the word play with you fur baby's names!!

    I think you're doing a great job with her. :bighug:

    -Allison
     
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  47. Peter (Peeka&Boo)

    Peter (Peeka&Boo) Member

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    Thank you, I must admit that was the cleverness of my wife and sister in law. We adopted them at the same time and of course they wanted a cute name like that.
     
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