If you care for an elderly, injured or special needs pet, you've come to the right place!
Sunday night, Maggie, our 5 year old cocker spaniel started experiencing symptoms of what I know now is IVDD. She had been acting funny all day, but around midnight let out a huge yelp and was unable to stand on her hind legs. We took her to the ER who told us she probably had a herniated disc and advised that they keep her overnight for observation. The next day, Monday morning, the neurologist examined her and said she seemed better and was able to stand on her own and walk a little. Of course they discussed the option of surgery with us, but said if we wanted to, we could also just take her home to try medication therapy. We figured we would go that route first initially because of the cost of the MRI and surgery. Monday night we picked her up and started her on her pain meds. She never really seemed to feel much relief, but was able to get some sleep that night. She wasn't able to really stand on her own but could drag her legs. This concerned us, but we thought maybe once we started her on steroids, she'd start to feel better. Tuesday morning I started to worry again because she had been drinking water, but wouldn't go pee. We had tried several times to take her to the grass, but she just couldn't hold herself up enough to go. I decided to take her to the vet to see if they could teach me how to express her manually. They examined her again and did the flip-back test on her paws. Her reaction was significantly different than the days prior. When they flipped her right paw under, she left it that way. We talked to the neurology team and they told us she had gotten worse and were worried that if we took her home and she had gotten that bad overnight, she could very possibly become paralyzed before the steroids had any effect. At that time we decided to get the surgery. They told us that 95% of dogs that still have DPS (which she did) recovered well and were able to walk within a few weeks. So, later that day she went in for MRI and surgery. The neurologist called us and said the MRI revealed a herniated disc, but also showed that her spinal cord was inflamed above the herniation site. She said that could be a secondary effect of the spine injury, or possibly an infection. They were going to do a spinal tap, but after surgery the doctor called us again and said that they decided it wasn't necessary because blood flow seemed to return to normal after she removed the disc fragments and the color of the cord looked good. At this point we were feeling much better. So the next day, Wednesday, we went to visit. The neurologist told us she still had weak legs and wasn't really moving them, but she could still feel them and it would probably take a day or two before we noticed a difference. Thursday is when everything turned upside down. The doctor called me in the morning after her exam and said that Maggie had lost all feeling in her hind legs. The word myelomalacia was mentioned. She said that Maggie's spine still could be inflamed, causing her to get worse. It was during this conversation that the E word was mentioned. My heart dropped. She said that yes, 95% of patients get better after surgery, but then there's that 5%. She said we could give her a couple more days on the anti-inflammatory medicine to see how it worked, but if not, we would need to think about putting Maggie down. I can't believe this is happening. I still am having such a hard time wrapping my head around it. How is this possible?? The thought of losing my baby is just unreal. I am trying to keep positive thoughts, but I am haunted by that E word. I can't find anything online about dogs becoming paralyzed after surgery that were not already paralyzed before surgery. Does anyone have any advice? I am trying to stay hopeful...she has to get better....
I am sorry your dog is having a back problem, but glad you are here. Myelomalacia is a condition that occurs in a small percentage of dogs after spinal cord injury. It is more common in dogs that have a grade 5 disk injury, which is complete loss of deep pain sensation, which your dog did not experience. Ascending myelomalacia is where the spinal cord itself begins to deteriorate, and it progressively deteriorates from the location of injury forward, so that eventually it affects the nerves controlling breathing and the front legs. Fortunately it is rare, but when it happens there is nothing they can do about it with all the miracles of modern medicine, and most people believe euthanasia is the humane choice for these few dogs, rather than let the dog suffer what would essentially be suffocation and heart block. Your vet reported that when she did the surgery, the spinal cord appeared healthy, so that is encouraging. You have 2 reasons to be encouraged, 1) the injury was not grade 5 and 2) the spinal cord looked healthy. Still, I would worry, too, I don't blame you.
As far as 95% of dogs walking again after spinal surgery, well, I don't know what to say. Given that your dog still had deep pain sensation going into surgery, you have reason to be optimistic. However, overall I think the figure of 95% is somewhat high. I have heard a vet give the example of a dog he did surgery on that was walking the next day, but to me, that partly just makes us feel bad when our dog is not walking the next day. So many dogs are down for 6 weeks or longer following surgery, but there have been dogs on this message board who have begun walking *long* after surgery, 6 months, 9 months, 18 months. I hope it does not take that long for your dog, but one way to look at it is, you hope for the best and plan for the worst. Right now your dog has just had surgery, there is a lot of swelling in the area of the surgical site, it will take time to go down, I think it is too soon to really know what you have yet in terms of function. However, slow return of function is not a reason for putting a dog down. I would not even consider it unless the dog show signs of myelomalacia, such as respiratory problems and neurological deficits in the front legs.
If you end up in a situation where the dog is not walking within what you consider a reasonable time, such as 8 weeks, then you may want to think about getting a wheelchair. They do not recommend getting one too soon because very often it looks like the dog was going to need one but then turns out he does not. But I can definitely tell you, a dog can have a great life even though paralyzed. I have 2 paralyzed dogs and they are happy, healthy family pets. Like you, I could not imagine or even say the e word when thinking of them. So I guess what I am saying is, I do not think you have to worry about that sad decision at all, unless the very rare case occurs where the dog begins to deteriorate. You are bound to worry, that is natural...
How is she doing now?
P.S. Here is a post from one of our moderators, BethT, who took her dog for surgery and they told her it looked like he had myelomalacia after surgery, but it turned out he didn't.
Our little girl (8 pound shihtzu) had 5 ruptured discs. I felt horrible not knowing something was wrong but other than occasional dragging of her one leg, she did not give us any indication she was in pain. We had taken her to our vet several times over a two year period .. each time she was given Rimadyl and occasionally a course of Prednisone. Once she was done with the Pred she was like a new furkid, bouncing around and playing, running, etc. Well, early this year she had another bout of the dragging leg so I took her in. The vet put her on Pred and by week four he decided to do another round of it. But after the first week of the 2nd round of Pred I knew it wasn't helping and I called the vet again and demanded a referral to the specialists. I got in that week and we had a myleogram performed with showed the 5 ruptured discs. Our surgeon - and this is where it will answer your inquiries - said on any back surgery there is always the chance the surgery will push them over the edge, where they can't walk. We knew our chances. And looking back, the times where our sweet Darcee would snip at someone who came into the house, she was in pain, but we just didn't realize that was her way of telling us ! We took the chance and immediately had the surgery done. That was February 16th. Before going in Darcee had deep pain sensation. She now has none and has no use of her back legs. It's been right at 8 weeks. We are working with her 3-4 times a day doing leg exercises as well as trying to get her to stand on her own. So far she can balance for almost a minute without toppling. We are not giving up. We started water therapy .. hoping she'll remember her back legs and start using them. She has started to wag her tail again, which, if nothing else, makes up smile. I have a Pet Pouch that I had from a teeny shihtzu I had many years ago and carried her around (she was very spoiled) .. Darcee was sitting in that and at one point she pulled her legs in and pushed them out. I don't know if these are reflexes or not but I am going to keep faith that one day I'll get to see my little girl walk across the room again. If nothing else, that wagging tail is the absolute best.
Now, on another one of our furkids, I came home and found little Rocky sitting on the floor and he would not move. When I tried to pick him up he started yelling. I immediately rushed him to our vet who kept him overnight but called first thing the next AM and had already called the specialist. Rocky had surgery that day and began walking about a month later and today, 9 months later, you'd never know he had a ruptured disc.
You'll adjust. The furkids don't know the difference .. after surgery they only realize the pain is gone. And in the end, that's the best! Don't underestimate the surgery .. in the end it'll be worth it regardless of the outcome. Prayers to your Maggie.
Thank you both for your replies. It really helps to talk about this with people who have gone through it before. Prior to the surgery, the neurologist did say that most dogs are able to at least stand a couple of days after surgery. So of course since my dogs has now lost feeling, I suppose she is only trying to prepare me for the worse. Do you know what would cause them to lose deep pain sensation after having the disc material removed? She has me worried because she is saying that the swelling should be going down since they removed the compression. How long after would signs of myelomalacia start to show? Is that not something they'd be able to see on the MRI that they do before surgery? I saw Maggie today and it's sad because she'll lay on her hind legs funny since she can't feel them...and obviously her bladder is being expressed manually. But, she is eating and drinking and giving kisses, which makes me so happy. I will continue to be hopeful and think positive thoughts.
Oh, what a sweet, sweet picture, and I can hardly believe that was taken the day after surgery.
This is some information on myelomalacia.
In addition, these statistics look similar to the ones your vet was quoting, and it mentions 3 months as a time frame for some of the dogs.
http://veterinarysurgerycenter.com/news ... rtebr.html
In general, deep pain perception can be hard to verify. The Long Beach Animal Hospital calls the test for deep pain subjective because some dogs don't consciously respond to pain so the test is easy to misinterpret.
Where along the back was your dog's surgery? Is it near her tail or mid-back or what location?
Thank you for the links! I have to say though, the one about myelomalacia makes me nervous. We are at day 5 since her disc rupture (Sunday) and today is the day she supposedly lost feeling in her hind legs. I guess all we can do is pray and wait.
In regards to the study on the other link, 7 dogs out of 87 being euthanized for myelomalacia is a lot isn't it?
I read this story off Dodger's list which sounds very similar to Maggie's situation, so that gives me hope. Although it makes me wonder if maybe Maggie still could have disc material in her cord? Maybe that's a stretch.
http://www.dodgerslist.com/monthstory/a ... ghbour.htm
Her surgery was on her lower back by her tail. I think the rupture was right before her hips. L-6 L-7 I think? That doesn't mean a whole lot to me, but that's what the MRI read.
True, but as I read it, they are talking about a group of 87 dogs with stage 5 disk injury. It is probably easier to interpret if you read it in context on the website instead of the part I quoted. If your dog had deep pain going in, then it was not stage 5. Dogs with stage 5 do have a higher incidence of myelomalacia. Going from memory (on lunch hour, no time to check links) dogs that have a sudden, catastrophic, high velocity rupture are the ones that are more likely to have the complication of myelomalacia. With your dog, the neurological symptoms were coming on gradually.
Well, that's actually kind of a good thing. If you have to express her bladder for a while, it should be easy to do with a lower back injury, and the link above suggests dogs with a lower back injury recover sooner and better. My dog had a mid-back injury, and it took her 9 months.
I received a call from the doctor this morning. She said Maggie was the same as yesterday. Still no feeling in her hind legs, but seems very happy and is not in any pain. She is eating and drinking and is very alert. This may seem like bad news, but as long as she's not getting worse, I'm happy! I went to visit her and she was shaky. They told me they were going to give her some Valium, thinking she was probably just feeling anxious. They set me up in one of the exam rooms so I could spend a lot of time with her. She was fighting the sedative like crazy! She wanted to bark at all the activity going on outside the exam room and actually seemed kind of restless. She kept sitting up and didn't want to lay down. At one point I had to call the vet tech over to help me because I wasn't sure how to handle her without hurting her. I don't know why but I feel so afraid to pick her up. Anyway, the tech helped me move her onto the floor and wow, it looked like she was ready to go! She wanted to walk all over the place! Obviously she couldn't feel her legs, but that didn't stop her from trying to get around! I know she needs to stay quiet so I was trying to discourage her as much as I could, but at the same time it was giving me hope that she'd be okay. After a bit, she relaxed and was able to get some good rest. I'm hoping the next couple of days go well and we make it into the clear...
As far as the incontinence, what would be the best way to keep her dry? She has such long fur, which I'll try trimming, but I definitely don't want the urine to irritate her skin. Do they usually leak between expressing? Thank you so much for all of the info you are giving me. It's definitely helpful!
It might be best to ask the vet to shave her wherever she is getting wet, before you bring her home. They can do it easier, they have excellent grooming tools because they are used to shaving for surgery. That would be her rear, lower abdomen, inside of the legs, underside of the tail, and any breeches or feathers down the back of her legs. It's a sanitary clip and they will probably be glad to do it, and it won't be that noticeable, those areas don't show much. When the dog has a lower back injury, the urinary sphincter tends to be loose, so there may be dribbling between expressing. You still want to express to be sure the bladder is getting completely empty at least 3 times a day, but she may dribble between expresses, anyway. You could put her in disposable diapers (cut a hole for the tail and tape it so the gel filling doesn't come out), or get her some reusable cloth seasonal pants and put a Poise pad in them. You'll want at least 2 or 3 pairs, one to wash and one to wear. That is what I do with my dog, I like the fact that the cloth pants adjust with velcro and I can get them nice and snug so she doesn't bounce out of her diaper. If her skin needs protection while wearing the diaper, you can use a barrier ointment. It is OK to use Desitin with zinc oxide if you are sure she will not lick it. If she is going to lick it, then it's better to use something like petroleum jelly or A&D ointment that does not have zinc oxide, as zinc is not good for dogs if they swallow it.
As far as bowel incontinence, I would expect some of that, too. It's best to have the diaper with a big enough tail hole that any solids will fall out, not be trapped in the diaper. That is especially true with a female, you do not want fecal germs getting into the urinary tract and causing an infection. The main secret with bowel incontinence is to have the dog on a diet that produces firm, non-sticky, low odor stools. If she drops one, it will not stain the carpet, you pick it up and dispose of it and never need to run for the Resolve or spot cleaner. Bowel incontinence with an indoor dog is really only a problem if the stools are messy or smelly, and they do not have to be either of those if she is on a diet that produces firm, low odor stools. Science Diet w/d dry kibble has worked well in this house, but other people have found other foods that work well, too, you find what works with your own pet's particular system. I'm assuming she will be resting for the next few weeks, so you have time to work all this out before she has the run of the house. I don't let my pets into the living room or dining room, I probably could but I just feel better that way. I close doors or use babygates as needed.
If possible, you might look for a way to let her skin air with no diaper part-time. My dog that dribbles wears a diaper all day but sleeps in a playpen without any diaper at night. I do a lot of that way. You'll probably find yourself doing a load a day, or 2 loads every 3 days. I've handled the doggy laundry several ways. I used to shake out her blankets and bring them down to the laundry room every morning, then do a load when I had about 6-8 pieces. However, I finally got smart and started carrying it down and putting it straight into the empty washer. Every 36 hours it is full and I run it. This causes no problem getting the human laundry done, either.
I am glad her spirits are so good. I'll bet they love her there and are spoiling her, she looks like she would be a favorite.
Maggie is beautiful !! And I agree .. doing doggie laundry is now just part of our routine. We have a smaller kennel we keep in the bedroom so she can "sleep" with us. During the day I'll put her in her living room kennel, which is slightly bigger. I keep kennel pads in them but I put a peepee pad over it and then put several towels and blankets over that. Laundry is just second nature now but it's okay. It'll become second nature for you. Hoping for positive recovery for her !
Thank you Carol for the information on the diapers! I think that is definitely something we'll have to look into. We got to bring Maggie home today (yay!), but I realize the journey is just beginning. When it came time to express her bladder for the first time, I had some trouble. She was napping and started to leak, so I knew her bladder must be getting full. She woke up enough for me to try expressing her, but I couldn't quite feel the "balloon" that the vet tech told us about. She was just dripping until I put more pressure on her abdomen. A stream started to come out and then it turned into a drip. I thought she might be done and I tried feeling for her bladder again, but I wasn't sure where to find it. I put down a new pad and thought maybe I just couldn't feel it because it was empty. However, once I started to lift her to put her on the new pad, a stream of urine came out again. Do you have any tips for how to do this? I tried to YouTube it, but a lot of the videos were without good explanations.
Do you ever have a problem with your dog sitting in her urine for too long if she pees in her playpen at night without the diaper?
What is your opinion on crate rest? I have read all over that "strict" rest is crucial, but I am not exactly sure how that's defined. Maggie likes to get up and adjust herself, which sometimes includes dragging herself to a new position. The vet said that's okay as long as she's not dragging herself from room to room. I worry though as I don't want anything to affect her healing process. Did your dogs do this also?
Good tip about the laundry. My husband went out and bought a special doggie hamper for Maggie's blankets.
Thank you both so much for the information and support. It's so easy to feel lost in the beginning...I'm hoping we find our routine soon!
Congratulations on having her home. I personally would go with the crate recommendations from Dodgerslist, you may have seen them already. It should be fine if she wants to turn herself or move herself to a different part of her crate.
In answer to your question, I've never had a problem with Dolly lying in a wet spot, but I'm thinking that is one of those "each dog is different" kinds of things. I guess you'll have to observe her and see if she is good about moving out of a wet spot. I suspect she will be OK because she can turn herself, unless she is sedated due to medication. With Katie, the biggest problem I had was that she would lie on her tail funny and not feel it, so I was forever pulling her tail out from under her. She did not leak, she had a tight sphincter. With Dolly, she is a dribbler but she is good about moving out of a wet spot in her playpen at night. As far as those disposable pads (like puppytraining pads), in my experience, they are fine for keeping the bedding dry, but they do nothing to keep the dog dry, there is not enough absorbency in them to draw the urine away from the skin. If the dog wets the pad, you have a wet dog. Also, the disposable pads wrinkle up when the dog moves. There is a product called Palace bedding that is specially designed to keep down dogs dry, if you can afford it. I've never tried it but I've heard it's good.
http://scoutshouse.com/store/index.php? ... cts_id=330
Attached is an example of a dog bed in a playpen. In the picture you can see a white waterproof pad in the bottom. It is a waterproof material in the middle, sandwiched between some kind of thick synthetic felt covering on both sides, so it is soft and the felt helps somewhat to keep the dog up off the actual wetness. The pads are sold at places like Wal-Mart in the baby section, but the one in the picture is a larger size suitable for a crib, and the only place I can find the large ones like that is Target. They are easy to wash and easy to dry, or they drip dry quickly if you want to save electricity. All I have to do is lay the white pad in the bottom and tuck a few inches under each end of the playpen mattress, and it stays in place all night. She has an assortment of cotton blankets that are quilted and contain fiberfill, that I have picked up in the baby section of the thrift shop. When I put her to bed, the quilt is folded on the side like in this picture, but during the night she sleeps under it and in it and on top of it, and in the morning it has wet spots and needs to be washed, but she is a clean dog. The thicker the quilt, the better the results, this is a thin one I chose to photograph because it's pretty, but you can imagine the quilts and mattress pads pile up pretty quickly. That's great about the hamper! There is no trick to washing them to get them clean. The mattress pads would get clean with only detergent and warm water, they are designed that way. The quilts are usually fine that way as well, if you have any doubt you can put in 1/4 cup of bleach. I wash the quilts and pads together on the long cycle and dry on knit setting (medium low). They're lovely when they come out.
With your dog, I'm not sure you could use a playpen because you have to bend over to put her in and take her out and a cocker is bigger (my dogs are 5 lbs, 7 lbs, and 11 lbs). You might be able to use a baby crib. It would be a good size for her and the height of the crib would save your back. They are easy to clean. Quite a few people have used a baby crib. There was one case of a beagle that managed to climb out of a crib following back surgery, you don't want that to happen, but if you're sure she won't climb it would be a great option. I just think you'd be better off if you could have something for her to do crate rest in where you are not doing a lot of bending to pick her up or put her down, and especially where you are not leaning forward to maneuver her into a crate, that is awkward for your back.
I've got to say, if you were able to express her the first try, that is great! Yay!!! What happens is, if you find the bladder and express it, then lose it or let go, in my experience it will relocate itself, most likely to a location higher toward the spine and closer back by the tail, than it was when you first found it. You might make a note of what position you were holding her to move her when you unintentionally expressed her the second time. It may be a "hold" you can use to help empty her. There is no certain way you have to do it, it is truly whatever works for your dog. I should have mentioned in my earlier message, there are dogs that don't urinate at all unless expressed, and dogs that dribble all the time, but there are also dogs in between, where if you express them they will stay dry for several hours. You will have to see how your dog does as you get in a routine of expressing, hopefully she will be like that. Also, having the colon empty makes expressing easier, and at the same time when you are squeezing her abdomen to express her bladder, don't be surprised if you discover she needs to go Potty Number Two. Squeezing the abdomen will kind of start things moving sometimes, but then she is easier to express afterward.
Thank you for the suggestion on the dry padding. That looks like it would work great. I think we've gotten to the point where she only leaks during the night. It's either because we aren't expressing her completely before bed or because maybe at this point she can't hold it for 6 hours yet. She is peeing a lot from the Prednisone I think so I'm finding we need to express her about every 3-4 hours to avoid leaking. I still worry that it could be because we aren't doing it fully each time. I've been reading about expressing the bowel on the board also but haven't really found anything that works for her yet. Luckily her poop is solid, it's just that it seems to come out really slowly in small amounts throughout the whole day. I think we may try to introduce some fiber and hopefully that will help.
I like the set up you have for your dog. We're still trying to figure out the best way to keep her confined because you're right about the crate... it is difficult to get her in and out. I thought a playpen could work but I think it would be hard to have to bend over and pick her up at the right angle without hurting her back like you mentioned. Hopefully we'll think of something.
We took her today for a consult appointment with a holistic vet specializing in physical therapy/accupuncture/chinese herbs and the like. I wasn't sure if it'd be too soon, but they had a cancellation and didn't have any other appointments until May so I figured we could go and at least ask some questions we had about what we can do for now to encourage her healing. They ended up actually doing some acupuncture where they could (avoiding her incision area) and it was through this that we found that she had some pain in her legs! The vet first tried checking for deep pain and it seemed like when she was pinching in between Maggie's toes on the right side, she turned her head back to look and responded to it. Although, looking back, maybe I was imagining that because she didn't respond to the needles in that area... But, when she stuck an acupuncture needle on the inside of that same leg around her thigh, she yelped! I don't know if that's a good thing or not, but obviously we're hopeful that her DPS will return. They want to try the laser light therapy also and do what they can for now until her spine heals at which point they told us we could try chiropractic. I don't know much about the results of laser light or chiropractic, so I'll have to learn more about that before we go down that road. Here's a pic of the little porcupine.
Hi Maggie. I just read your post. It sounds like you are going through exactily what I went through this past September. My boxer had spinal surgery and also came out of the operation paralyzed. I got the same line that you did about the 95 % success rate. My Talulla had absolutely no deep pain sensation after her surgery and was unable to control her bowels or her urine. The first few weeks were really really hard, but by week 3, we were able to get into a schedule. We started taking her to outpatient P.T. along with accupuncture. About 7 weeks post surgery, Tallula began standing and attempted to take some steps. We kept up with the therapy (both at home and outpatient) and the improvement continued. Today, Talulla can walk without the aid of a sling, and is even able to run around the back yard. Her rear end is still weak and will probably never completly heal, but that's fine with us. What I'm really trying to say is never give up. I did not believe that Talulla would ever walk again. I was wrong. Talulla actually came around pretty quickly, but healing can take months and months. Shower her with love and affection (which I'm sure you are doing anyway). And most importantly, keep the faith! Ricky
Thank you so much for your comment. I actually just read your story yesterday! My husband has been feeling pretty discouraged, but since I've found this forum, I've definitely had more hope! We're just a day past 2 weeks post-op and we're still trying to find our routine. She's being treated for her first bladder infection already, which really bums me out because it makes me realize that I'm still probably not expressing her completely. And I think one of the biggest things with having a down female dog is trying to keep her poop away from her female area since that also can contribute to the infection. Luckily, I'm home with her during the day for now so I can clean her up fairly quickly, but sometimes she'll sit in it in such a way that I worry no matter how quickly I get to it, it's too late to keep the bacteria out. We just started trying the diaper thing last night, cutting a hole out of the back for her poop to fall out. It was kind of a quick act of desperation so we just bought basic baby diapers at Target that I don't think are going to do the trick. I wanted something to keep her dry between expressing because I'm finding that even though I try to express her every 3 hours, she'll still leak in between and I'm thinking it's either because a) I'm doing a horrible job at expressing her or b) she has a lower motor neuron bladder so no matter what, she'll always leak. Since she's a cocker, she's got thick fur that is so hard to keep dry. We've trimmed the hairs on her back legs and all around her back end, but I think we're going to have to really just shave it down for now. I know there have been great suggestions about diapers here so now that we have something to help temporarily, I'm going to try to find what will work better. I feel the same way about you when you talked about going through peepee pads like there's no tomorrow! But, I guess there's no avoiding that. Does Talulla have full control of her bladder/bowels now? I'm so glad to hear she recovered quickly! At our 2 week post op appt on Monday, we were told that by the neurologist that she still has no DPS, so it's time to get her a cart because how it is now is basically how it's going to be. But, from reading all the inspirational stories on here, I know that 2 weeks is really a short amount of time for the nerves to heal and to never lose hope! We're doing acupuncture and laser light therapy right now. She actually has her third session today. What kinds of at-home therapy we you doing for Talulla? I find that whenever I try to do range of motion exercises on our pup, she seems uncomfortable by it and will readjust the way she is laying so that I can't move her legs. She's already lost so much muscle tone so I worry about her!
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