Daemon was the fourth born and was the biggest. Other causes are listed below: The symptoms of congenital and acquired hydrocephalus are similar but occur at different time points in a dog's life: less than six months of age for congenital hydrocephalus and during adulthood for acquired hydrocephalus. Dr. Marty Becker. may want to perform tests designed to evaluate the function of your Learn how you can help us continue provide the most cutting-edge, compassionate care. Congenital hydrocephalus is a common distinct entity in some toy and brachycephalic breeds (e.g. She lives with her husband, daughter, three cats, one dog, and a pet dove. Without treatment, hydrocephalus almost always causes death. Their eyes may permanently look down or outwards and they usually have behavioral abnormalities including pacing or head pressing. * Petmoo is reader-supported. Medical Causes of Aggressive Behavior in Dogs, Do Not Sell or Share My Personal Information, Altered mental state; dogs may seem unusually dull and slow in their www.ivis.org. Brought to you by Pet Insurer, Wag! When diagnosing hydrocephalus in young dogs, your veterinarian will look at the clinical symptoms to help determine the severity of the hydrocephalus. Hydrocephalus requires a veterinary diagnosis. Shes fascinated by the human-animal bond and believes the best way to help your pets is by helping you to understand them from the inside out. The procedure involves placing a shunt that redirects cerebrospinal fluid away from the brain and into the abdominal cavity where it can then be easily reabsorbed by the body. than other breeds. If they are implanted in small puppies, they often require replacement as the dog grows. Its extremely variable, says Chad West, D.V.M., DACVIM, a neurologist at Animal Medical Center in New York City. Dogs with mild/moderate hydrocephalus can live a normal healthy life, usually occasionally on medication or rarely without any intervention. Instead a brain scantaken with either an MRI or a CT scanis usually all that is required to get a diagnosis. Its often congenital, meaning its present at birth, and certain breeds have a predisposition to the condition, especially small dog breeds. Our content and products are for informational purposes only. dog's symptoms, the more unlikely he is to recover. It can be present from birth, or affect adult dogs as a complication of several diseases. A vet may suspect hydrocephalus based on a physical exam alone. A few medications are used to achieve this, including: Furthermore, hydrocephalus in animals can cause an accumulation of fluid that leads to pressure inside the skull. The answer depends on the severity of a puppys hydrocephalus. They are less likely to have the eye signs, fontanel or domed head, and the signs are often more severe than in the young puppies. Failure to learn basic commands or housetrain. Medicine to decrease production of cerebral spinal fluid is often the first treatment option, especially in dogs with mild to moderate disease. The Vet-Approved Guide for New Dog Owners, Spotting, Diagnosing and Treating Hypothyroidism in Dogs, Purebred vs. Mixed-Breed Dogs: A Vet Weighs In. TheChihuahua,Manchester Terrier,Toy PoodleandYorkshire Terrierare also predisposed to hydrocephalus. There have been some case reports of hydrocephalus occurring as a result of infections, such as the parainfluenza virus (. ) 2022 Vetstreet. normal, happy lives. Bionic Pets prosthetics can help your dog live the best life possible. All Rights Reserved. However, as the CSF builds up in the brain, other symptoms become apparent. He extends his head out and his paws out as far they can unless I put him in my bed then he'll lay just his head on my pillow and lay on his side and he'll stay there for hours. The skull will appear domed or apple shaped and a large open fontanel will be located on the top of the skull. Press the space key then arrow keys to make a selection. The presence of a dome-shaped head and open fontanel, along with other hydrocephalus-related clinical signs, is often enough to diagnose congenital hydrocephalus. Should you notice any of these symptoms, have your dog thoroughly examined by your veterinarian. Hydrocephalus is the buildup of cerebrospinal fluid (CSF) in the brain. WebComplications in dogs (n = 60) were shunt obstruction (6/60; 10%), pain (4/60; 5.5%), shunt infection (3/60; 4.1%), disconnection (3/60; 4.1%), excessive shunting (2/60; 2.7%), and kinking (1/60; 1.6%). But the fluid is not actually waterit refers to cerebro-spinal fluid (CSF), which coats the spinal cord and parts of the brain. An ultrasound evaluation of the fontanel will show dilation of the brain ventricles. 573-882-3513; After Hours: 573-882-4589 Increased pressure in the skull will press on the brain tissues and can lead to permanent brain damage or cause death. All rights reserved. If you see these signs or any of the following symptoms in your dog or puppy, consult your vet immediately: There are different causes of hydrocephalus in dogs depending on whether the condition is congenital or acquired later in life. Domed skull, Enlargement of the cranial vault makes the head appear larger. Prepare for the unexpected by getting a quote from top pet insurance providers. Treatment Options for Dogs With Hydrocephalus birth, or tumors in the central nervous system. so that animals with weakened skulls can live unrestricted and enjoy the most out of life. The most common medicine used to accomplish this are: In severe cases or those that dont respond to medications, the vet may suggest neurosurgery as a treatment option. The number of people who develop hydrocephalus or who are currently living with it is difficult to establish because the condition occurs in children and adults and can develop later in life. put him at risk for brain damage. Placement of a drainage device (shunt) diverts CSF from the ventricles through a low-pressure valve and reservoir to another site such as the peritoneal space, atrium of the heart or subcutaneous tissue. CT and MRI are recommended for dogs without an open fontanel but are suspected of having hydrocephalus. monitoring_string = "c1299fe10ba49eb54f197dd4f735fcdc", Accidentsin the house or inability to be housebroken. However, how this plan can be best achieved depends on various factors such as age and severity of symptoms as well as the type/severity of hydrocephalus being treated. Often it is considered a congenital disease, which means a dog is born with hydrocephalus, but there are others that can be triggered by intracranial inflammatory disease, Vitamin D deficiency, the parainfluenza virus infection, or swelling in the brain or a brain tumor. Surgery has a 50% to 90% success rate in animals with hydrocephalus. Hydrocephalus in dogs, although uncommon, is serious and requires prompt veterinary care to avoid permanent and possibly life-threatening brain damage. by At Bionic Pets, we create custom-made cranial helmets so that animals with weakened skulls can live unrestricted and enjoy the most out of life. the dog at the time of disease onset, and the cause of the disease. The fluid results in high intracranial pressure and causes serious neurological problems. Commonly referred to as "water on the brain" or apple head, this abnormal accumulation puts pressure on the brain and, thus, damages the cerebral cortex by it against the skulls bones leading to neurological symptoms, which typically start around 6 to 12 weeks. Our content and products are for informational purposes only. Hydrocephalus in dogs life expectancy and prognosis will depend on the specific case. If a dog is offered veterinary assistance prior to brain damage, the prognosis will be favorable in the long term. Of course, dogs that recover from hydrocephalus can be left with sequelae. Many of these dogs will suffer coordination and learning problems. Chihuahuas and other toy breeds with shortened heads, including the Cairn Terrier, Maltese, Manchester Terrier, Pomeranian, Toy Poodle, and Yorkshire Terrier, as well as brachycephalic breeds, such as the Boston Terrier, English Bulldog, Lhasa Apso, Pekingese, and Shih Tzu, are considered at high risk for hydrocephalus. It is often seen in dogs and can cause a variety of neurological symptoms. This form puts less pressure on the brain than obstructive hydrocephalus and may not produce clinical signs. The MU Veterinary Health Center is a leader in animal disease diagnosis, patient care and education. The choice of treatment is guided by the patients neurologic and physical status and age, and the underlying cause. Rivers W J & the womb or shortly after birth, injury before, during or soon after Common complications include shunt migration from the skull, mechanical failure, infection and occlusion of the shunt. There are different types of hydrocephalus. In puppies with a closed fontanel or in adults, ultrasound is not possible. This condition occurs when cerebrospinal fluid (CSF) cannot drain properly causing an increase in pressure on the brain. The sooner your dog starts treatment, the more favorable the outcome, so its important that medications are started right away. As they grow, puppies with congenital hydrocephalus will need subsequent surgeries to replace the shunt with a larger shunt. How Painful Is It For A Pet Dog To Change Owners? Heres What to Do Next, How do you calm a destructive puppy? Clinical signs include behavioral changes, slowness in learning (e.g. Ultrasound is a good option for puppies with an open fontanel because the open fontanel would allow your veterinarian to see your dogs brain. There have been some case reports of hydrocephalus occurring as a result of infections, such as the parainfluenza virus (2). 573-882-7821; After Hours: 573-882-4589 Secondary hydrocephalus in dogs (acquired hydrocephalus) can occur for a number of reasons. Small breed dogs and brachycephalic ('smoosh-faced') dogs are most susceptible to congenital hydrocephalus, including breeds like these: Acquired hydrocephalus is caused by something that occurs later in a dog's life, most commonly a brain tumor. Your dog will need regularly Individuals and corporations from all over the world are making a difference every day by providing support for our facilities, programs, students and faculty. When To See A Vet For Hydrocephalus In Dogs? How long does a dog live with hydrocephalus? Heres what you need to know about why cats purr and what your cat may be telling you when her motor is running. CSF surrounds the brain and spinal cord, providing nutrients and cushioning these delicate tissues that make up the central nervous system. Hydrocephalus typically Congenital hydrocephalus is present at birth. Brain tumor is the most common cause of acquired hydrocephalus, but not all cases of acquired hydrocephalus are caused by tumors. A surgerywhereby a drain or shunt is placed into the brain to remove the fluidis possible, but it is not performed by all veterinarians and requires a surgical specialist. Your veterinarian will discuss your dog's likelihood of recovery with treatment. Wellness lets pet parents compare insurance plans from leading companies like PetPlan and Trupanion. WebYour dog will need regularly veterinary care for the rest of his life, to help manage his condition. Hydrocephalus generally cannot be prevented. Also discuss any on-going supportive care that may need to be provided throughout the life of your dog. The more severe your Why Do Dogs Tilt Their Heads? However, if the condition is severe, more intensive treatments may be necessary, but even this doesnt guarantee success. Small Animal Hospital When a veterinarian diagnoses hydrocephalus, he or she bases the determination on physical, behavioral and neurological signs. But a brain tumor carries a far worse prognosis and it may be challenging for these dogs to recover or live a normal life. Older dogs with acquired hydrocephalus have a more guarded prognosis because of the severity of the underlying condition (e.g., brain tumor). When Lai acquired Lil Miracles Fancy Lexus from a breeder at 6 months old, she weighed just 1.5 pounds. Is the added expense worth the trouble to insure your beloved pet? If you suspect your dog has hydrocephalusor is at risk, start searching for pet insurance today. Spinal Muscular Atrophy (Motor Neuron Disease). It is thought that the breeding of these miniature dogs with their small heads has changed the skeleton faster than the soft tissues inside, resulting in a brain that is too small for the skull (. He may need to perform an electroencephalogram (EEG) or a spinal tap. Milder cases can be managed with minimal treatment, while severe From classic to celeb-inspired and funny to food-based, this list of cute cat names is sure to inspire your naming adventures. In one study, 53 percent of 564 hydrocephalic dogs showed clinical signs by age 1.1 In severely affected dogs, signs may be noticeable before 3 months of age. This means that the skull itself is blocking the outflow of CSF. Hydrocephalus is an uncommon neurological disorder occurring when the brain is put under severe pressure due to a build-up of fluid. Hydrocephalus literally translates as water on the brain. Hydrocephalus is categorized as either congenital or acquired, with different causes for each. CT and MRI technology provide detailed images, but are expensive and require general anesthesia. Its not unusual for hydrocephalic dogs to die or be euthanized at an early age. It's what he's currently doing. Dr. Cathy Barnette is a small animal veterinarian with 13 years of clinical experience. A minimum database to include complete blood count, biochemical analysis, and urinalysis is useful to exclude other underlying systemic diseases that also can mimic signs of hydrocephalus. For instance, a dog with a simple infection, once cured, may have a normal lifespan. Even Not all veterinary hospitals have a CT or MRI machine, and you may need to be referred to a large hospital with a neurologist on staff. Hydrocephalus is a neurological disorder in which excessive Join thousands of pet parents and get vet-approved guidance, product reviews, exclusive deals, and more! In cases of congenital hydrocephalus, which is possibly genetic, the litter should never be used for breeding and the parents should not be bred from again. In hydrocephalus, this fluid is unable to drain away properly and increases pressure on the brain. When you buy products via links on our site, we may earn an affiliate commission at no cost to you. Choosing a selection results in a full page refresh. All Rights Reserved 2022. Training your dog to follow basic commands builds a positive relationship with her and helps ensure her safety. Even with Hydrocephalus is a condition in which excess cerebrospinal fluid (CSF) builds up within the ventricles (fluid-containing cavities) of the brain and may increase pressure within the head. Sign up and make sure you are always on top of the most important info for you and your pets. Steroids still play a role in treatment today, but omeprazole has been shown to improve the condition in dogs that did not benefit from other medications, West says. What Is Hydro In Dogs. CSF more efficiently. Treatment of hydrocephalus involves addressing the underlying cause. An animal diagnosed as being hydrocephalic has clinical signs of neurologic dysfunction related to the dilated ventricles. Congenital hydrocephalus is a genetic defect, and affected puppies, and their littermates and parents, should not be bred. The survival rate for dogs with hydrocephalus largely depends on their condition's severity. West says he commonly sees hydrocephalus in Chihuahuas, but in many of these cases, the condition does not cause any clinical problems. Insurance for dogs, cats, and other household animals can run as low as $20 a month, but that cost can add up over time. Decreasing the production of cerebrospinal fluid is typically the initial course of action for dogs with mild to moderate disease. Neonatal infections, such as those with viral causes, can result in stenosis without leaving any indications of the cause once the initial inflammation has resolved. Discuss your dogs prognosis and recovery time with your veterinarian. However, recovered dogs can be left with sequelae. The prognosis for Hydrocephalus in dogs will depend on the specific case. CSF analysis can help determine the underlying cause of acquired hydrocephalus. Prevent your dogs from becoming overweight and maintain a healthy weight. We love all pets & our vision is to educate the pet loving community/pet owners, through content produced by our dedicated editorial team. 300+ Cute Cat Names for Every Kind of Kitty. He was the biggest of the litter but now his siblings are getting bigger although his head is bigger. For idiopathic causes, the reliable ways to prevent the condition are not yet known. For mild to moderate hydrocephalus (usually congenital hydrocephalus), treatment will begin with medications: Surgical placement of a shunt is recommended if the hydrocephalus is severe (usually acquired hydrocephalus) or isn't responding adequately to medications. If you took any number of Chihuahuas and did an MRI on them, you would diagnose hydrocephalus quite commonly, but they would not have any signs, he says. Omega 3 fatty acid foods (salmon, cod, Sardines, Mackerel, halibut, Herring, etc). The Ultimate Guide, Why is my dogs eye blue and cloudy? In most cases, hydrocephalus in dogs cannot be prevented. dog's major organs, such as the kidneys and liver. The term encephalitis refers to an inflammation of the brain. Then he ran head first into this aluminum container my grandmother collected. Dogs can be born with hydrocephalus or acquire it as a result of tumors, viral infections, or fungal infections. Your vet will need a complete medical history and thorough physical A Complete Guide, How do I discipline my puppy for peeing in the house? Sometimes, brain activity is checked using electroencephalography (an EEG), although this is not available to all veterinarians. Surgery is a last hope for dogs with hydrocephalus that dont respond to medical therapy. Dogs with mild cases of hydrocephalus may lead normal lives with minimal medical intervention. If your dog has congenital hydrocephalus, the first medication started after diagnosis is usually a steroid, such as prednisone or cortisone. Severity differs, but few dogs with this condition live to be, Recovery and Management of Hydrocephalus in Dogs. I mean he ran into it head first, like he was running around the room and ran into it. However, complications after shunt placement are not uncommon and most likely to develop within the first three months after surgery. Emergencies: Daily, 8 a.m. to 10 p.m. Equine Hospital Congenital means the condition is present at birth and is often the result of genetics. Treating these conditions can take time, so a shunt may be placed in the brain to drain the fluid and provide immediate pressure relief while waiting for the other drugs to take effect. Researchers disagree about the distinction between congenital or acquired forms since infectious agents may cause hydrocephalus in puppies in the womb.. He was reserved and quiet the first 7 weeks. After Hours: 573-882-4589 One thing is certain, Hereditary plays a major role in many breeds and it is better to examine the susceptible dogs before breeding or at least before getting an unknown dog from the shelter/breeder. Hydrocephalus is more difficult to diagnose in adult dogs, as other conditions can cause similar signs. Congenital hydrocephalus is a birth defect. Here's what you should know about this Both He screams bloody murder for no reason and won't stop unless I pick him up and hold his head firmly to my shoulder. WebThe term hydrocephalus is derived from two words: "hydro," meaning water, and "cephalus," referring to the head. Your Pet Can Enjoy a Happy Life With Bionic Pets Prosthetics, prosthetics can help your dog live the best life possible. Secondary hydrocephalus in dogs (acquired hydrocephalus) can occur for a number of reasons. imaging test to evaluate the extent of the damage to your dog's brain. equal opportunity/access/affirmative action/pro-disabled and veteran employer. But the fluid is not actually waterit refers to cerebro-spinal fluid (CSF), which coats the spinal cord and parts of the brain. Early treatment is key. They may not be ready to beat you in a game of chess, but these brainy dogs are easy to train and generally eager to please you. the brain that's damage, the amount of damage that occurs, the age of The recovery time will depend on the severity of the hydrocephalus. For the developmental conditions that have clinical similarities with Hydrocephalus, Proper diagnosis and treatment should be followed. Congenital hydrocephalus is more common than acquired hydrocephalus. Sign up and make sure you are always on top of the most important info for you and your pets. Prognosis for severe congenital hydrocephalus is usually guarded as clinical signs are often severe at presentation. Although hydrocephalus often is described as "water on the Loss of balance, falling over to one side. Skull sutures, which join the bony plates in the skull and allow movement between the developing skull bones, should close at maturity. Although, if it goes untreated and fluid continues to build in the skull, its likely that signs of pain and other symptoms will appear. Treatment depends on the severity of the condition and the disease progression. WebHow serious is hydrocephalus in dogs? Dogs with congenital hydrocephalus cannot be cured the prognosis is poor and many die in puppyhood. Sometimes dramatic hydrocephalus may be present but the owners report few clinical signs other than learning deficits. Here Steroids such as prednisolone and dexamethasone, Proton-pump inhibitors such as omeprazole. However, in some cases, surgery is the best option for treatment. Even in congenital cases, the disease may follow a waxing and waning course. Petmoo.com is found by pet lovers for pet lovers all around the world. This shunt has a complicated nameventriculoperitoneal shuntand redirects the flow of CSF into the abdomen. If a dog is having seizures, the vet may administer valium and then prescribe other treatments such as antibiotics, surgery, or steroids, once the dog is stable. Keep your veterinarian informed of any changes in your dogs condition. When hydrocephalus is caught in the early stages; treatment is done to reduce the inflammation within the brain tissue or the amount of cerebrospinal fluid being produced. Regular hours: M-F, 8 a.m. to 5 p.m. Owners who observe these signs of hydrocephalus in their dogs should consult their veterinarians, who may refer them to a veterinary neurologist for further evaluation and testing. 573-882-6857; After Hours: 573-882-4589 Dewey C W (2002) External hydrocephalus in a dog with suspected bacterial meningoencephalitis .JAAHA 38, 563-567 PubMed. This buildup increases pressure on the brain and can cause severe brain damage if not detected and treated early. Hydrocephalus in dogs has two main types with their own causes. Hydrocephalus is an uncommon neurological disorder in dogs. Let our authors & experts know what you think. Regards Dr Callum Turner DVM They may also require anti-epilepsy medication, which controls seizures. Hydrocephalus is known to affect all species with varying frequency, and is more common in dogs than mostalthough still fairly rare. The most common cause of acquired hydrocephalus is a brain tumor, which usually affects older dogs (5). This medication, known under the brand name Prilosec, is also taken by humans to reduce stomach acid. The survival rate for dogs with hydrocephalus largely depends on their condition's severity. For congenital hydrocephalus dogs: Conservative treatment and Lifestyle changes like a suitable diet and avoiding strenuous exercise may be enough. For dogs suffering from severe hydrocephalus, however, their shortened lifespan could result in death at any moment. We are taking him to the vet, any vet that we can find this week but we live in a small town. Use left/right arrows to navigate the slideshow or swipe left/right if using a mobile device. Schedule an appointment with your veterinarian as soon as you can if you notice these signs in your dog. The life expectancy for dogs with hydrocephalus depends on several factors, including the dog's age and how severe and longstanding the hydrocephalus is. However he stopped eating and drinking and is losing weight, I must force feed him. Sorry, you need to enable JavaScript to visit this website. Unfortunately, after a series of seizure clusters, Lexi was euthanized in March 2012 at age 5. Hydrocephalus can be congenital or secondary, meaning its acquired later in life. Hydrocephalus in Dogs Life Expectancy Life expectancy for dogs with hydrocephalus varies depending on the age, type, and severity of the disease. Puppies Obstructive hydrocephalus, known as the non-communicating type, occurs when cerebrospinal fluid accumulates in the ventricles of the brain due to an obstruction along the brains normal circulatory pattern. Worried about the cost of Hydrocephalus treatment? The presence of a dome-shaped head and open fontanel, along with other hydrocephalus-related clinical signs, is often enough to diagnose congenital hydrocephalus. production of CSF in your dog's brain, or to help your dog's body absorb Whilst surgical treatment is usually considered a treatment of choice, however there are some medical management options but are not as effective as the surgery which includes corticosteroids, diuretics and omeprazole; your Veterinarian will talk you through your options if the diagnosis is confirmed as hydrocephalus. Causes of obstructive hydrocephalus are classified as congenital or acquired. Expert Advice, How long will a dog hold a grudge? Snub nosed breeds such as theBoston Terrier,English BulldogandPekingeseare at a higher risk. After examining your dog, your veterinarian will want to perform imaging tests of your dogs brain, including ultrasound. Usually, vets prescribe corticosteroids this purpose. Hydrocephalus is an excessive accumulation of fluid in the brain. X-rays and ultrasounds, and may perform an MRI or another type of However, complications after shunt Antiepileptic drugs are administered to control seizures. Regular hours: M-F, 8 a.m. to 5 p.m. Protect yourself and your pet. It happens when cerebro-spinal fluid (CSF) cannot drain properly and it increases pressure on the brain. Prevent clicks on page when mobile menu is being shown, Do Not Sell or Share My Personal Information, Previous Article: Prompt Treatment For Blastomycosis In Dogs Is Key To Recovery, Next Article: Hemangiosarcoma Research May Help Identify Affected Boxers & Provide Treatment, Drug Treatment Offers Promise for Chihuahuas Affected by Hydrocephalus. veterinary care for the rest of his life, to help manage his condition. Ventricular and brain dimensions and volumes, and CSF flow rates were measured or calculated from the MR images and radionuclide clearance. Your vet may prescribe drugs to help decrease the Surgical complications include shunt blockage and infection within the shunt. Diagnosis is often reached presumptively. and, if possible, restore the patient's condition back to "normal." 2023 Wag Labs, Inc. All rights reserved. This condition is not uncommon in puppies, especially in toy and brachycephalic breeds, such as Pugs, Bulldogs, and Bull Mastiffs. this link is to an external site that may or may not meet accessibility guidelines. When she's not working or caring for animals, she can be found enjoying the outdoors or reading a good book. She also had an irregular gait and difficulty putting on weight, weighing only 4.5 pounds as an adult. Encephalitis in Dogs. The untreated hydrocephalus survival rate is poor. However, the most common cause of acquired hydrocephalus in dogs is brain tumors. This birth defect makes the skull looks domed or apple-shaped and has a large open fontanel at the top of the skull. Pet Insurance covers the cost of many common pet health conditions. Milder cases can be managed with minimal treatment, while severe cases require more advanced care. A shunt can be surgically implanted to drain excess spinal fluid from the brain into the abdomen, where it can be absorbed. Why Doesnt My Dog Ask to Go Out to Potty? If hydrocephalus in dogs is mild and caught in the early stages, then it may be treated with medication. The survival rate for dogs with hydrocephalus largely depends on their condition's severity. It is also sometimes referred to as water on the brain.. Presence of a molera (opening in the top of skull) is common in many toy breeds; however, does not necessarily indicate presence of hydrocephalus. are some of the symptoms of hydrocephalus in dogs: In very young dogs, where the bones of the skull are still soft, Puppies with congenital hydrocephalus may look normal at birth other than a dome-shaped skull, wide-set eyes, and possibly an open fontanel (soft spot on top of the head). Simple and Effective Tips, What works best for ticks on dogs? She recently moved back home to an island of 2,000 people with her partner Ian and their rescue terrier Pixie. Hydrocephalus is a medical condition in which fluid accumulates within the brain, leading to an abnormal increase in head size. Hydrocephalus can be difficult for dogs and their owners and usually results in a shortened life span. Milder cases can be managed with minimal treatment, while severe cases require more advanced care.
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