Other tests will likely be recommended by the veterinarian to rule out other diseases which might be contributing to a cats clinical signs, such as a urinary tract infection, chronic kidney disease, pancreatitis or hyperthyroidism. This means that U-100 has 2.5 times the amount of active insulin per mL, therefore 2.5 times as strong. Pentobarbital Sodium is known to be a high anesthetic drug. Blood can be collected at home from an ear vein or paw pad, and should be read on a blood glucose monitor that has been validated in cats. Even if every last drop from the syringe went into the fur and not under the skin, the safest thing to do is to leave it at that, not giving any insulin until the next scheduled dose is due. 3 Of course, if you couldnt get it right with a full brain, I dont think much of your odds with half a brain. Thanks for advice. The veterinarian mostly uses euthanasia to euthanize, and it can cost you some serious amount. MichelleB717. Dr. Stacy. You may want to read some of the Quality of Life stories that are on this site. Increased appetite 5. There are two forms of diabetes in cats: diabetes insipidus and diabetes mellitus. Instead of moving normally, Kitty might seem stuck in a crouching position. Continue reading >>, There's no need to euthanize for this reason. 4,333 Satisfied Customers. We know that some cats are at higher risk than others: the disease tends to attack older, neutered male cats who live indoors and are overweight. "Home testing is illegal. Low blood sugar (hypoglycemia) The most common side effect experienced with insulin therapy is hypoglycemia. Types of Diabetes in Cats In cats, two types of diabetes mellitus have been discovered. It's illegal for you to prick your cat's ears at home." If for some reason you must use a U-40 syringe for a U-100 insulin, or vice versa, use our conversion chart. Simply put, diabetes mellitus is a failure of the pancreas to regulate blood sugar. Remember there are ignorant people in all walks of life, just as there are bright, well-meaning people. Grasp the cat's skin with your thumb and index finger and pinch firmly. Symptoms When cats arent feeling well, their instinct is to try to hide it, which means cat owners have to be vigilant. Try a treat if the cat is disinterested. Unfortunately, these symptoms can also be present with other illnesses, so be sure to consult your vet if you notice these signs. Type I, or Insulin Dependent Diabetes Mellitus, results from total or near-complete destruction of the beta cells. An alarming number of cats are developing diabetes mellitus, which is the inability to produce enough insulin to balance blood sugar, or glucose, levels. Diabetes insipidus is a very rare disorder that results in failure to regulate body water content. cant. You will need to give your cat their insulin injections 12 hours apart and at the same time everyday i.e. A nice lady down the block was feeding them, but she was elderly and unable to TNR. Or tips on how to give a cat hospice care? If you are using more than one insulin to manage your pet's diabetes, you likely have a faster-acting one and a slower-acting one. We have even diagnosed this disease in a 2 year old, rather obese cat. Customer. There are two main test results required for a vet to be able to diagnose diabetes in a symptomatic cat: A high fasting blood glucose (i.e. The pancreas is a vital organ on the right side of the abdomen adjacent to the stomach. I mean, shes long ago confessed to keeping ten cats in her tiny apartment. I'd be surprised if the vet hadn't at least HEARD of PZI, and doubt that he really thinks PZI is illegal (it most definitely is NOT), what's more likely is that he's sticking with what he knows, and is counting on his clients just believing his "wisdom" and never checking into the validity of his ridiculous statements. Though ideally injections should be spaced 12 hours apart, varying injection times by 1-2 hours when needed will not adversely affect a cats treatment. I understand that some people leave dry food out all the time, me included. Insulin is required to prevent lipolysis, halt hepatic ketogenesis and gluconeogenesis, and promote tissue metabolism of glucose and ketones (1). Mix sugar or honey with the food to increase blood sugar quickly. Appropriate insulin function will trigger the liver and muscles to take up glucose from the blood cells, converting it to energy. Although CBD gets good reviews from pet parents, there is one big problem with the use of CBD in cats: an almost complete lack of regulatory oversight. Near its 4 legs, where there is a thick layer of tissue. Sugar Does Not Cause Diabetes: Did the Film What the Health Get it Right? Continue reading >>, Caring for a diabetic pet can be challenging, but there are certain precautions pet owners can take to prevent a diabetic emergency like hypoglycemia. This rapid release of insulin may result in a rapid and profound decrease in the level of blood sugar (hypoglycemia), an effect that can occur within 10 to 60 minutes of eating the xylitol. 1 Killer In Mexico, Avoiding Injection Site Problems with Type 1 Diabetes, Emergency Preparedness: Diabetes Emergency Kit, Renal Handling of Ketones in Response to SodiumGlucose Cotransporter 2 Inhibition in Patients With Type 2 Diabetes, Diabetes Complications in Dogs and Cats: Diabetes Ketoacidosis (DKA), 3 Simple Tricks To Not Let Type 1 Diabetes Ruin Your Diet & Weight Loss Goals, Simple Tricks for Living Well with Diabetesfrom People Who Have It, How Insulin Signals A Cell To Take In Glucose. But now she's old. In animals, diabetes is not typically broken down into these types. I talked about what diabetes mellitus actually is, what I think about people who taste urine to check for its sweetness, and gave some pointers on signs to watch out for that might indicate your cat has this disease. If I haven't answered your question, feel free to post again, or I'd be happy to consult with you to discuss things further. For instance, in the USA less than 2% of suicides are jumps from high places, while jumping to ones death accounts for more than half of suicides in Hong Kong. Our cat was diagnosed at age 14, and after almost three years with diabetes he is very healthy and happy. If your vet won't consider an alternative insulin or tries to strong-arm you into using one particular insulin over another, especially if your cat is not responding well to the one it's on, get yourself a new vet. For Beringer and many others, using insulin is like breathing oxygen. Youre coming with me. I grabbed her, took her in over her great protests, and she had her babies, 7 of them, in my home with my husband and myself as midwives. High levels of sugar in the blood can overwhelm the ability of the kidney to filter glucose, allowing sugar to spill out of the blood and into the urine. Continue reading >>, 3 53 Remember Stephen? Treatment goals include rehydration, correction of electrolyte and acid/base disturbances, decreasing blood glucose, reversing ketonemia, and treatment of any concurrent illnesses. Hereditary deficiency of GLUT-1, insulin -independent t Pancreas Tucked away inside your abdomen is an organ that is important to blood sugar regulation, called the pancreas. Even in a stable cat, blood glucose curves should still be performed every 3-4 months, as insulin needs can change over time. Cats with diabetes most commonly suffer from the Type II form of the disease. Using Insulin to treat diabetes in felines Once you have to give them insulin, if you have an owner who is not terribly confident that These results confirmed the diagnosis of exogenous insulin administration as a cause for hypoglycemia in this patient. Occasionally other tests Continue reading >>, The first day Commitment, patience & education Expenses Your emotions People think you're crazy Your social life The bottom line I wrote this essay to help people whose pet has recently (or not so recently) been diagnosed with diabetes. Excessive thirst and urination can also signal diabetes in a cat. Read on and discover 10 home items that can kill your cat. Without insulin, sugar cannot get into the body's cells. You take such good care of your diabetic cat. To give the proper dose, the syringes you use must match the concentration of the insulin. Blood glucose levels change through the day, and even with consistent communication with your vet, your cat's insulin needs may change over time. Because it can no longer process glucose, your cats body just expels it, along with water which leads to another sign of feline diabetes: excessive urination. That pretty much cemented his status as a member of our family, and when all the other kittens got adopted to new families, Tommy Boy stayed. In most cases, 5 mg of Tramadol per kilogram of body weight is prescribed. Missing one shot will not result in permanent damage nor will it mean that your regulated pet will become un-regulated and you will have to begin all over again. I am feeling terribly guilty and sad, she was my beloved baby doll and I never imagined I would have to do this. Studies in Australia and the US have suggested that throughout their careers vets may have to perform euthanasia four to five times a day. "I hate my cat," she said. Many older pets have been diagnosed with diabetes and with commitment and loving care, they have lived many more years. CONTACT YOUR VETERINARIAN. Insulin injections are given under the skin (subcutaneously) approximately every 12 hours. During a blood glucose curve, the cats blood sugar will be checked right before receiving an insulin injection, and then every 1-4 hours throughout the day. When in doubt, DON'T! Diseases of the adrenal, pituitary, or thyroid glands, or progression of liver or kidney disease. It makes decision making really hard because it is not a condition where an animal is I met Bella at HART of Maine, a no-kill cat shelter in southern Maine. It's important to be accurate when injecting insulin, too much can cause low blood sugar (hypoglycaemia). Regular assessments of weight, water intake, and appetite should be recorded to help determine if treatment goals are being met. Frequent veterinary visits are the norm for dogs and cats with diabetes, as are the costs associated with checkups, tests, medical procedures, and insulin therapy. You are not certain actually how much insulin really went where it was meant to. 3- Euthanize By Sleeping Pills. Theres no definite answer to this question. Normally, you will be asked to sign a consent form. There's no doubt about it: Managing a diabetic cat is not easy. All you need to do is dig a hole and pour a few cups of CO2 or dry ice into the hole. Yet you can understand that looking after a diabetic cat may not be straightforward and every ones cup of tea. This is the most common type of feline diabetes. deal. Insulin works whether the body makes its own insulin or if it is given by injection. 1. Emergency Preparedness: Diabetes Emergency Kit, Diabetes Warning Signs: Learn About the Signs to Be Prepared, Diabetes Warning Signs Discover the Risks and Signs of Diabetes and Be Prepared, Insulin overdose: Dosage, symptoms, and treatment, Is new Dolphins quarterback Jay Cutler the most misinterpreted guy in the NFL?, Former U-M football player says going vegan changed his life, reversed diabetes, 8 Valuable Life-Saving Lessons I Learned from My Dads Type 1 Diabetes. Improved pregnancy outcomes in women with type 1 and type 2 diabetes but substantial clinic-to-clinic variations: a prospective nationwide study, Diabetes Type 2 - Stem cells treatment clinic. ." Trying to draw more to make up for the error may result in a total of too much insulin being given--the result being hypoglycemia. Continue reading >>, Pets are important members of our families, and they make our lives whole. 1. The more common type of diabetes is diabetes mellitus. Commitment, Patience and Education Caring for a diabetic pet takes a very strong commitment from both the owner / caregiver and the vet. S Dr. Marie replied: Oh, I am so sorry that you have had to go through this. Increased thirst 3. Type II, or Non-Insulin Dependent Diabetes Mellitus, is different because some insulin-producing cells remain. What are the symptoms of feline diabetes? To euthanize a cat, the humane thing to do is take the cat to a vet. A normal dose for one person could be insufficient for another person or deadly for another. Putting down animals is something that commands near-universal support. Missing one shot will not result in permanent damage nor will it mean that your regulated This lack of oversight has resulted in a wide availability of low-quality CBD products. Fleeman and Rand wrote the article focusing on diabetic dogs, much of the advice applies to all pets with diabetes. Dec 22, 2013 #5 Blue Joined: Dec 28, 2009 OT Dec 23, 2013 #6 Blue Joined: Dec 28, 2009 Using Insulin to Treat Diabetes Mellitus in Cats Giving your client's cat insulin to treat feline diabetes can begin to get difficult as most of the work begins after leaving the practice. It's 'walking deficiency syndrome' and not a real illness, says top doctor. The vital thing is to get your cat to the vet the minute you notice any potential symptoms. A Word of Warning About CBD for Cats. I would discuss with your vet options for treating Hummer before putting him to sleep. I told her he needed to go to the vet; he could have a simple urinary tract infection or he could have more going on. Owners must clearly understand that too much insulin can kill, and that they should call a veterinarian or halve the dose if they have any concerns about a pet's well-being or appetite. "In the Sixties or Seventies, you might have been expected to pass your dog to the vet, take your leave and go," she says. With early, aggressive treatment of diabetes, many cats will enter a state of diabetic remission, meaning they are able to maintain normal blood sugar levels without insulin injections. Unfortunately, I have seen such types of insulin that are most appropriate for cats come and go over the last 20 years. If your cat is having trouble with vomiting, be very careful and watch for possible hypoglycemic episodes. Unlike humans with Type II diabetes, oral medications to reduce blood sugar such as glipizide have not shown to be consistently effective in cats. Vet bills aren't exactly inexpensive. Continue reading >>, Sedation Protocol Options and Doses Designed for Home Euthanasia Use Loading Dose Option #1 for Dogs: $$$Telazol+Ace+Atropine+Xylazine SQ 27g 29g needle $$$Telazol (100mg/ml) = 0.3ml per 10# Consider reconstituting your euthanasia-only Telazol with 2.5ml Ace + 2.5ml Atropine (dry mouth significantly lessens vomiting) instead of 5.0ml sterile water to maximize volume efficiency and minimize injection pain Xylazine (100mg/ml)=0.050ml per 10# (Weight divided by 2, then divided by 100). This occurs when cells starved for glucose begin to break down fats for energy, a process that creates chemicals called ketones, which make the blood more acidic. Your vet might adjust his insulin dose, along with supplementation with a type of vitamin B12 called methylcobalamin, to help reverse the course of the neuropathy. Monitoring is best coordinated in close collaboration with your veterinarian to achieve optimal control of your cats diabetes. If a cat has not entered diabetic remission within the first six months after diagnosis, it will almost certainly require life-long insulin injections. Or more depressingly, dont-want-to-put-her-through-it is the code for death offered by the I-just-cant-deal-with-this-right-now mentality I encounter so often among my emotionally overwhelmed client base. Keep fruits, vegetables and whole grains in your refrigerator and pantry. Continue reading >>, Annabessacook Veterinary Clinic 417 Route 135 Monmouth, Maine 04259 (207)933-2165 _____________________________________________________________________________ Diabetes Mellitus in Cats There are two forms of diabetes in cats: diabetes insipidus and diabetes mellitus. Because if I was nine-out-of-ten cats, Id be loving life as a diabetic cat. He wants the $90 to do The moves announced Wednesday promise critical relief to some people with diabetes who can face annual costs of more than $1,000 for insulin they need in order to live. Nancy Preventing Diabetic Emergencies The key to preventing diabetic emergencies with a pet involves implementing a consistent daily routine and sti Canine diabetes is nearly always insulin-dependent. She is a cat. Will this be a disease that progresses quickly or is it going to be something that is a nagging problem for years to co It is estimated that between 0.2 % and 1 % of cats will be diagnosed with diabetes during their lifetime. Types of Diabetes In cats, two types of diabetes mellitus have been discovered. I knew it was time. This is something that I would only consider if the pain and suffering got to a level were the most humane thing was euthanasia. 100# dog 0.5 ml Xylazine (or less) + 3.0 ml Telazol 80# dog 0.4 ml Xylazine (or less) + 3.0 ml Telazol 60# dog 0.3 ml Xylazine (or less) + 2.5 ml Telazol 40# dog 0.2 ml Xylazine (or less) + 2.0 ml Telazol 20# dog 0.1 ml Xylazine (0r less) + 1.0 ml Telazol 10# dog 0.05 ml Xylazine (or less) + 0.5 ml Telazol Loading Dose Option #2 for Dogs: Ketamine+Ace+Atropine+Xylazine SQ 27g-29g needle 100# dog 0.5 ml Xylazine (or less) + 1.0 ml Ketamine + 1.0 ml Atropine + 1.0 ml Ace 80# dog 0.4 ml Xylazine (or less) + 1.0 ml Ketamine + 1.0 ml Atropine + 1.0 ml Ace 60# dog 0.3 ml Xylazine (or less) + 1.0 ml Ketamine + 1.0 ml Atropine + 1.0 ml Ace 40# dog 0.2 ml Xylazine (or less) + 1.0 ml Ketamine + 1.0 ml Atropine + 1.0 ml Ace 20# dog 0.1 ml Xylazine (0r less) + 0.5 ml Ketamine + 1.0 ml Atropine + 1.0 ml Ace 10# dog 0.05 ml Xylazine (or less) + 0.5 ml Telazol Subsequent Doses in Dogs Every 5 Minutes Until Unconscious: 1.0 ml Ketamine + 2.0 ml Ace 27-29g needle SQ, maybe IM Ketamine/Ace and Telazol can be massively overdosed when sedating for euthanasia Xylazine will cause vomiting when overdosed. Also, it is often easier to give the injection while your cat is eating. However, there is no definitive evidence that the timing or frequency of meals in diabetic cats protects them from insulin-induced hypoglycemia. Fleeman and Rand wrote the article focusing on diabetic dogs, much of the advice applies to all pets with diabetes. While cats can develop insulin-dependent or non-insulin dependent forms, non-insulin dependent diabetes in dogs is extremely rare. If you supplement with wet food then you will want to use a little less dry food. Change (increase) in exercise. Dr. Mike, DVM. Eventually, many cat owners can learn to perform blood glucose curves at home. I feel horrible. The most common form given to cats is the liquid suspension or the tablets, both in specific veterinary preparations. Weakness and lethargy. Not surprisingly, studies of insulin suicides are somewhat scarce, but one looked at 160 insulin suicide attempts and found that 94.7% of the PWDs fully recovered, 2.7% developed cerebral defects, and 2.7% were successful in killing themselves. The lowest tablet dosage for people of 125mg will be much too high for most cats. An average cat eats around 1/3 -1/2 cup per day, so divided down that's 181-272 kcals. Continue reading >>, (Comments are now closed. It often requires intensive patient monitoring with 24-hour patient care and frequent blood sampling. Diabetes is not a death sentence for your pet. Your veterinarian will diagnose diabetes mellitus by demonstrating persistently elevated glucose levels in a cats blood and urine. This energy comes from the food we eat. Gone are the days of putting out food and water, giving a quick pat on the head, and hurrying out the door. Does this sound like a humane method of trying to kill -- or euphemistically, "euthanize" -- a pet to yo Caring for a diabetic cat requires a serious commitment. In 2011, the RSPCA euthanised 44 per cent of the animals it took in. How much insulin will kill you? It is FDA approved for use in dogs and cats. Do you have pet resentment? Dogs or cats that receive more than their usual dose of insulin are at risk of a hypoglycemic crisis that can lead in the worst. She had lost some of her sight and hearing, much of her appetite and most of her control over her bodily functions invariably, shed pee on me every morning as I carried her down the back stairs of my third-floor apartment. The not-just for-kids book stresses that if you really want to banish tummy flab or back pain, clean up your diet and mimic your child's natural play patterns, which includes squatting, pushing, pulling, balancing and lunging. One group of cells produces the enzymes necessary for proper digestion. Dietary Therapy The day I saw Mary pregnant for the fourth time in three years, I said, OK lady, thats enough. There is a lot of information to navigate and often All parts of the body (muscles, brain, heart, and liver) need energy to work. For cats who are overweight when diagnosed with diabetes, slow, controlled weight loss under the close monitoring of a veterinarian is very important to achieve better control over blood glucose levels. So are you considering euthanasia for your diabetic cat? One study tested CBD products and found that many have littleif . Signs of other potential impending diabetic emergencies include ketones in the urine; straining to urinate or bloody urine; vomiting or diarrhea; or a complete loss of appetite or reduced appetite for several days. Twice a day insulin. In cats, Type II diabetes, a non-insulin dependent diabetes mellitus (NIDDM), is the more common form to be diagnosed, but eventually, almost all cats that are diagnosed with diabetes, in either form, will need injections of insulin to keep the blood sugar balanced. One of the major early signs of feline diabetes is drinking excessive amounts of water. It is also important to note that each insulin type has a specific syringe size (U-100 or U-40), so it is vital that a cat owner ensure that they are using the appropriate syringe for their cats insulin. It also involves avoiding any and all unnecessary vaccinations. She also had a tumor in her ear, and my vet told me it was inoperable because they could not get her blood sugar under control, and surgery would be too risky for her. By absorbing glucose, cells in fat deposits, the liver, and the muscles get vital fuel while lowering levels of glucose in the blood. Get a printable copy (PDF file) of the complete article (511K), or click on a page image below to browse page by page. The most common method of euthanasia is to administer an overdose of anesthetic into the vein of the front leg, but the injection may also be administered to other parts of the body. Acute renal failure can also occur if your cat ingests a toxic substance like antifreeze, pesticides, or human medications like ibuprofen. The next steps will involve blood sampling; usually a comprehensive profile and a fructosamine sample will be taken. Overall, I would say between $30 and $50 is a reasonable amount, as of August 2012, for a normal sized cat that is not aggressive or feral. Though Drs. The other group, called beta cells, produces the hormone called insulin. You can also use the knife Excessive blood sugar is also referred to as hyperglycemia. In both Type I and Type II diabetes, the cells in the body are unable to absorb glucose from the blood and become starved of energy. Watch out for any signs your cat is eating more, or less, than usual. So I guess its up to me to tell you all a little bit more about diabetes in cats. Atropine causes dry mouth which helps immensely to minimize vomiting side effect of Xylazine. These types of insulin vary in cost, duration of action, and concentration, so it is important for an owner to discuss the pros and cons of each type with their veterinarian when deciding which insulin is best for their cat. But the point of my article is not to write Tommy Boys life story, only the end of it, which broke my heart and was entirely unnecessary, so that other guardians of diabetic pets can learn from my mistake. The pancreas is a small but vital organ that is located near the stomach. Serum insulin was 402 IU/mL (for a random sample <112 IU/mL) and c-peptide was <0.3 ng/mL (1.1-4.4 ng/mL). Sometimes, despite the best of efforts, a cat will get too much insulin. That said, not all diabetic cats are obese. Following some negative reaction to the Tommy Boy wasnt a runt but he was the last born. As some readers may know, my own beloved Toonces was given an insulin overdose at his vets. During my years in practice, I noticed that there are some pretty universal questions most clients ask. 7am & 7pm or 10am & 10pm. And unlike humans with the disease, our pets cant tell us how theyre feeling or help in their own treatment and recovery. Ketoacidosis is considered a medical emergency, and cats diagnosed with this complication require hospitalization for ideal management. The cold will cause distress to the cat. Insulin is a hormone that helps the body turn the food your pet eats into energy. Through their Feline Diabetes Message Board, people with diabetic cats can learn and get emotional support as they get used to the idea of living with a diabetic kitty. This helps make sure that the average blood glucose is within an acceptable range, and that the value does not drop dangerously low at any time throughout the day. Types of Diabetes Mellitus In humans, diabetes is divided into two categories. What I have learned at the 2017 International Diabetes Federation (IDF) Congress in Abu Dhabi. 2. Mistaking either of them for the other can result in hypoglycemia if the wrong insulin is given. Tell owners to offer food immediately if the pet is weak or is behaving strangely. All dogs are different. A small dose of insulin will not kill a large cat, but it could cause serious health problems. Now its time to have a quick look at how diabetes in cats is diagnosed and most importantly, what the heck we can do about it. Feline diabetes can be treated, but if your cat doesnt get care quickly, the disease will kill him. A member of his staff admitted they don't know what PZI is, which explains why he won't consider any alternatives. On Diabetes: "I can't prescribe PZI insulin it's illegal to use on cats." With a massive overdose, this would progress to severe effects on the central nervous system, including hypokalemia, hypophospatemia, hypomagnesia, and hypothermia. Join a support community Every caretaker of a diabetic cat should have a mentor. Problem is, she currently says shell not be treating her just-diagnosed diabetic cat with insulin because (a) she has too many others to worry about, and (b) she doesnt want to "put her through it." Having diabetes does not mean you should be within the confines of your home. While some cats respond really well to insulin, those who don't are so difficult. In regard to calories, our food has 544kcal/cup, which isn't bad. Diabetes insipidus is a very rare disorder that results in failure to regulate body water content. Continue reading >>, My Tommy Boy has his angel wings Tommy Boy Tommy Boy, my little macho tabby cat, was born in the palms of my hands to a stray mother cat, Maryann, whom I had taken off the street. Insulin will kill a cat, but. Ask a Vet for FREE now! A new vial was like $300 for Novolog. Injectable insulin is a mainstay of treatment for feline diabetes. Though there is no cure for feline diabetes, the prognosis for a good quality of life is good with adequate management at home. Continue reading >>, Emergencies can happen at any time, so it's best to be prepared and know what to do if an emergency occurs. Gestational Diabetes Blood Sugar Levels After Birth. Both types are similar in that there is a failure to regulate blood sugar, but the basic mechanisms of disease differ somewhat between the two groups. Continue reading >>, 1. Continuous low dose regular insulin infusions are the standard of care in humans with DKA (611). Type I is characterized by an inability of the pancreas to produce any insulin. Fish & Wildlife Service. Weight loss may be noticed at home or during a routine examination with the veterinarian. This te If you have only administered a portion of the insulin injection, do not try giving more. Insulin overdose leads to low blood sugar, or hypoglycemia, a potentially life . Like the human body, the cells in a cats body need sugar in the form of glucose for energy. By comparison, trains are apparently quite effectivewith an overall 90% fatality rateas are volcanoes. Her last day, I suppose, went as well as could be expected, even as it remains one of the saddest experiences of my life. I wondered what they would choose to do if their dog did have diabetes rather than a urinary tract infection.

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