• Everyone can read this forum. To post on this forum, you must be a Community or VIP member. You can register here. If you are a member, to login use your email address for the username and the same password you use for the main site. If you have problems logging in to the forum, please email support@holisticactions.com.

Male Feline age 4 to 8 years, Coughing and Resting Respiratory rate 48 breaths. Came in from the wild 2 months ago starving and with worms and coughing.

SharonC

All-Access Member
Registered
Joined
Dec 28, 2020
Messages
23
Frederick, we have seen him in the wild for almost a year. He ran in my daughters back door 2 months ago.
He could hardly walk, he was in pretty bad shape.
A big orange, very very sweet cat. Weighed 5 1/2 lbs, as of Xmas day weighs 9 lbs.
He is recovering, and alert jumps up on the dressers and looking at the birds, and sleeps with me, and his vitality is good.
My concern is possible heart and lung organ damage. His symptons of resting resportiary rate 48. heart, coughing episodes kinda gagging,
(today only one coughing episode.

  • Home Care: HomeeoPet Worm administered for his first two weeks. Threw up and pooped ring, tape and heart worms.
  • Coughing from day one,
  • Vet. Visit 15 days ago. Rabie and distemper shot. worm shot and antibiotic shot.
  • Home Care: Started HomeoPet Cough last night. 1 coughing episode 34 cough this morning.
    Seems to be helping
  • . Grooming 15 minutes a day, Riki every day, Reflexology now the third day. maybe grooming helping with coughing.

  • DIET.Canned food with water added and Hawthorn Berry powder, water added to powder, as Frederick is not a water drinker.
  • Include alfalfa and brocilla sprouts. Taste of the Wild nuggets with Frontiers Hawtheron Berry powder diluted with water.
  • Frederick started eating the pot of winter wheat berries blades yesterday. Loves them.
  • Beam
  • not covering stool
  • purring a lot, and does the massage with his paws on the chair and in bed
    Movement
    vitatility improving, jumps on the furniture and very alert, listens to every noise...

    Respitory Rate;
    Yesterday, for a while 32 breaths per minute, then back to 40 and then to 48 while sleeping
 

Dr. Sara

All-Access Member
Veterinarian
HA! Faculty
Joined
Dec 30, 2018
Messages
331
Dear Sharon,
Congratulations on all you have already done to help Frederick with diet, Reiki, and Reflexology!
The most important thing is that his vitality is good.

Bear in mind that Frederick did receive his vaccinations about two weeks ago. There can be an increase in signs due to the immune stimulation from the vaccine components.

It would be ideal to find a single homeopathic medicine for his cough. I know the chaps who developed the HomeoPet products, and they would agree! As Frederick has improved with the HomeoPet Cough, take a close look at the materia medica of each of the medicines in it, and see if any single one covers his symptoms.
The elevated respiratory rate while sleeping is odd. Respiratory rate at rest should be 15 - 30 breaths per minute. You note a normal respiratory rate at times when he is awake. Is it possible that you are mistaking trembling / purring when he is sleeping for respiration?
Various respiratory diseases like asthma, lungworms, heartworm disease and so forth can cause an elevated respiratory rate, but it is unusual for a sleeping respiratory rate to be faster than when a kitty is awake.

Other things that can cause cough, aside from the problems notes above, are dry / irritated airways, post-nasal drip, allergies, and drainage into the throat from dental or nasal disease.
If you are in any doubt about indoor air quality, consider an air purifiers; the Ion Pacific IonBox is a good option, and there is more information about it on HA!, as well as the IonPacific site.

Please make sure that the humidity in the house is between 50-60 %,
We may not notice, or realize, how much low humidity can bother animals. The optimal humidity level for respiratory and skin comfort for both animals and people is 50-60% humidity. (Higher humidity can lead to indoor condensation and mold growth.)
When the humidity gets lower than this, people may notice it, and need body moisturizers, or have dry itchy eyes or a scratchy throat.
Our animals may be similarly affected, and they don’t have the option of applying moisturizers, or making a steaming cup of tea. Instead, animals will scratch at their dry skin, and their eyes and throat will produce a thicker mucus as a means of protection, and they may cough or gag.
We can help our animals by using ultrasonic cool mist vaporizers in the parts of their house where they spend most of their time. Inexpensive indoor humidity monitors, placed at least ten feet from the vaporizer, will help us know when we are reaching our goal. Some homes will never be able to attain the 50-60% optimum, but even mid to high 40s will improve the situation.
Some homes have humidifiers attached to the heating system. Some of these may actually cause problems, as the humidity in the ducts will be high, potentially leading to mold growth.
I am not an indoor environmental engineer, but it seems more logical to put the moisture in the rooms where it is needed, near the individuals that need it!
I hope this helps,
Sara
S.F. Chapman DVM, VetMFHom, CertIAVH
 
Last edited:

SharonC

All-Access Member
Registered
Joined
Dec 28, 2020
Messages
23
My concerns on his breathing, just counted, as he is yawning next to me. 50 breaths per minute.
Again, the worms we tape, ring, and heart-worm, soooooo
Anything that might work here.
 

Dr. Sara

All-Access Member
Veterinarian
HA! Faculty
Joined
Dec 30, 2018
Messages
331
I think you have a bit of confusion about internal parasites.
You would not have seen heartworms in vomit or stool. They are only in the chambers of the heart.
Ringworm is not a worm, it is a fungal infection of the skin.
I assume you saw long thin worms, which were probably roundworms. Roundworms migrate through the lung as part of their life cycle, so you can see some coughing. This is self limiting and resolves over time in well cared for cats. Roundworms are generally only a problem of young cats, as adult cats develop resistance.
Tapeworms look like segments of rice or cucumber seeds. Tapeworms are transmitted by fleas or eating prey. When the cat eats the flea or prey, they get the adult tapeworm. Tapeworms do not affect the lungs, they live in the intestines and eat the food the cat is eating. Well fed cats can carry tapeworms with no problem.

We will need more information to determine what might help Frederick. It does not sound like he feels unwell, and the only symptom you describe is on again - off again rapid breathing.
What did your vet find on exam? How did the lungs sound?
Stay well,
Sara
S.F. Chapman DVM, VetMFHom
 
Last edited:

SharonC

All-Access Member
Registered
Joined
Dec 28, 2020
Messages
23
  • Dr. Sara,
    Thank you for straightening us out on parasites and how they live and effect animals.
    His vitality is good, appetite good, mood good,
  • COUGH: 12 to 25 coughs, 3 to 5 times day.
    His body is pretty consumed with the cough during a episode. Sounds like he is swallowing at the end of the episode.is less then when he came here Xmas.
  • Working to get a video of his coughing episode.
    I was concerned his lungs were full of liquid, or could get full of liquid from something that had to do with his heart.
    So what else do we need to look for something else to improve Frederick's rapid breathing.?

    VETERINARIAN VISIT TOMORROW.
  • First visit almost 3 weeks ago
  • purevax rabies shot.
  • drontal, deworming ( Susan had done 2 weeks HomeoPet Worm
  • convenia, antibiotic.
  • the Vet did not comment on what he heart sounded like, or his breathing rate.
    SHOULD HE HAVE ANY MORE VACCINATION SHOTS TOMORROW?????? and if so what ones???
    Susan thought the vet was planning on more vaccinations.
today starting to work on raising the humidity level in our home.
ordered chicken hearts, to include in his diet.
please ask the vet what oils i should order I should order from her......I have used and blended essential oils for decades.
Thank you
Sharon 570.504.8734
 

SharonC

All-Access Member
Registered
Joined
Dec 28, 2020
Messages
23
Rapid breathing is a constant condition, only saw that one insisdent of 30 something breathing..
 

Dr. Sara

All-Access Member
Veterinarian
HA! Faculty
Joined
Dec 30, 2018
Messages
331
I'm afraid that I can't comment specifically on the rapid breathing. I would need to listen to his heart and lungs and assess the breathing in light of that, along with Frederick's overall condition.
Do specifically ask the vet how Frederick's heart and lungs sound, and what breathing rate they record.
It would be good to see what his cough looks like, if you can get a video.

If Frederick is going to be an inside cat, he doesn't need any more vaccinations. Rabies vaccination is the only one required by law, and he will not encounter cat distemper, upper respiratory viruses or leukemia (the usual cat diseases for which we vaccinate) if he is an indoor cat. I would wait to give any further vaccinations in any case, as there is something else going on with the cough and rapid breathing, and an unwell cat should not be vaccinated.

Animal EO Open Air would be a good choice for overall respiratory support. You can find further guidance from the AnimalEO website. I only use the AnimalEO oils with cats, as I have had bad experiences with clients getting old, impure, or overly strong essential oils and cats having bad reactions. I have had only good results from Dr. Shelton's essential oil blends. Her webinar last night also addressed respiratory problems.
Stay well,
Sara
S.F. Chapman DVM, VetMFHom, CertIAVH
 

Dr. Jeff

Administrator
Moderator
Veterinarian
Joined
Feb 23, 2017
Messages
5,242
Hi Sharon-

Frederick is one "lucky" boy to have wandered into your daughter's home. You are doing an amazing job!!

I concur with everything that @Dr. Sara said. I especially want to emphasize the no more vaccines part, except rabies in 3 years.

I would focus on promoting play, purring and petting, which along with the better breathing will raise his cellular energy.

The biggest energy building method I would add is your feeding as much fresh food as possible. Things like chicken, beef, fish, and especially eggs (yes, eggs) etc.

If you have any bloodwork or x-rays, please post them in this thread.

Thanks!
 

SharonC

All-Access Member
Registered
Joined
Dec 28, 2020
Messages
23
Frederick is going to the vet at 2, probably the new vet will want to do blood work and a xray.
will post .
Our vet has been advised Frederick is a member of holistication.com, and have forwarded your foreum recommondations.
thank you
lso see you tonight on the webinar.
 

Dr. Jeff

Administrator
Moderator
Veterinarian
Joined
Feb 23, 2017
Messages
5,242
You're welcome, Sharon and I look forward to hearing what your new vet says.

I also look forward to seeing you tonight.
 

SharonC

All-Access Member
Registered
Joined
Dec 28, 2020
Messages
23
update; ;Frederick's new vet Amy, is well respected by pet owners locally, and after 15 years of practice in three different vet clinics opened her own clinic this fall, Yea yea, yea.
Amy is happy you guys are part of Frederick's new life.
  • Curb service is in place at Am practice, We spoke on the phone all together about 20 minutes, ( and while the Xrays were being processed Amy read the print out copy of your forum comments.)
  • I am waiting a call from Amy, with the results of SA715 blood work. Amy kinda narrowed Frederick' age down to 6 years old, didn't think he was 4. Last vet said between 4 and 8.
  • Amy read the 3 Xrays, said Fredericks heart is good.read, " the lung Xray's are shocking, little white dot all over".
  • Suggested the SA715 panel....... Amy take, since Frederick was in the wild and came into the house starving, Frederick ate anything he could find, worms snails, etc. and after Amy reads the blood work,
  • Amy had a short video clip of Frederick coughing. (not sure if I posted it on the forum yet).
  • Frederick's cough eposide still usually occur when he gets up from sleeping or resting, maybe 1 or 2 during the day when he is resting..
    Thank you for being part of Frederick's health, and it looks like between you guys and Amy we should have diagnostic information to continue Frederick's Care Plan.
    of course any comments before I speak with Amy. I shall post the blood work and x rays when they are forwarded to me by email.
    Thank you

 

SharonC

All-Access Member
Registered
Joined
Dec 28, 2020
Messages
23
On 1/14/2021 9:32 AM, fflvetcare@gmail.com wrote:

Hi all, I have copied Frederick's vet treatment plan is
The 3 Xray's and Fredick' SA715 Blood Work Panel.
Thank you
Coughing episodes: It will be three weeks tomorrow 6 year old Frederick has lived with me.
I can see where the coughing episodes is body is experiences put a strain on him, he does recover.
Day 75 since he ran into my daughter house, hardly could walk and in bad shape. Frederick is in need to treatment for the Lung Worms.
Friends 4 Life treatment is at the bottom. Please comment, and what else do you recommond.
thank you

Chems all normal

BUN=22 (14-26)

Cr=1.1 (0.6-2.4)

CBC all normal except eosinophilia (1800 (N=0-1000))

U/A

low specific gravity (1.010) but inactive sediment (o adding water water to canned food)

FeLV/FIV=both neg

T4 normal

HW Ab=neg



eosinophilia=parasitic or allergic

can r/o HWD with neg HW test

recommend treat with Profender--2 doses given 2 weeks apart for lungworms

as worms die, they may set up an intense inflammatory resopnse so should also be on Pred short term (2-4 weeks) to reduce inflammation

notified o--alpw



Rx: Profender 5.6-11 lbs x 2

sig: Apply one tube to the back of the neck now and repeat in 2 weeks

Prednisolone 5 mg #35

sig: 1 BID x 7 days, 1 SID x 14 days, 1 EOD x 7 days



recommend recheck blood renal values and u/a at end of treatment (approx 1 month) to ensure no underlying renal disease
 

SharonC

All-Access Member
Registered
Joined
Dec 28, 2020
Messages
23
The 3xrays and blood work has also been attached, thank you
 

Dr. Jeff

Administrator
Moderator
Veterinarian
Joined
Feb 23, 2017
Messages
5,242
Thanks for posting your update Sharon.

Fantastic news about your new open-minded vet!

I am not personally familiar with the dewormer Profender but perhaps @Dr. Sara or @dr_ judy herman is. I typically use the very benign treatment of oral Panacur for lungworms so can't comment on its use.

It also looks like Dr. Amy recommended a month of steroids (prednisolone)? I would imagine that she thinks his lung inflammation is pretty severe due to the eosinophilia and white spots in his lungs since pred. is a strong anti-inflammatory.
 

SharonC

All-Access Member
Registered
Joined
Dec 28, 2020
Messages
23
thank you Dr. Jeff, Amy knew i had concerns about steroids.... Amy acknowledged that right off the bat.
I plan on being in touch with Amy on the steroid for sure during Frederick treatment..
Amy said Frederick's Xray was shocking and Amy spoke about her concerns of inflammation.. I may not have this exactly....her concerns because of the lungworms, infection as they were dying and moving out of his body. I may not have this right. His breaths are 48 to 52 a minute.
Amy is glad you guys are aboard.
Lets see what Dr. Sara and Dr. Judy have to say and what recommendation you all have for the next months,
Amy noted his urine was diluted, and would look at that after getting rid of lungworms. I mentioned as far as his kidneys, the only thing I was doing was growing wheat grass for him, and is eating maybe 10 stands plus nibbling on his own.
with you guys help, i will do my part to see Frederick's vitality and balance improves.
Thank you
 

Dr. Sara

All-Access Member
Veterinarian
HA! Faculty
Joined
Dec 30, 2018
Messages
331
I have never used Profender.
I can understand using steroids when the lung inflammation is severe. Inflammation snowballs on itself, and when the body is that much out of balance, it may need some help stopping the run away inflammation.
 

SharonC

All-Access Member
Registered
Joined
Dec 28, 2020
Messages
23
Hello valued Doctors.
Update: Frederick the Fifth BEAM is very good, is doing well, please provide:
Support for his lung and breathing issues, that our vets treatments are almost complete.
working on his diet,
Below is the copy of our vet update, and continue readying the information I gave her on his current condition. Included his pdf blood work.
Thank you
also I would like to scedule our telemedicine times.
Thank you
2.21.2021
attaching a file with our vet, Dr. Amy comments,:
  1. Possible Asthma-- Frederick cough returns or resting breaths go back up over 40.
  2. Recheck renal values and urine: potential kidney issue to retest end of March.
    Urinaysis-complete. Specific Gravity --Results 1.010(low) --Adult Reference Range 1.015-1.060
    Prednisolone treatment finish end of Feb. needs to be is out of his system to recheck the renal values and the urine., and 2 topical does of Bayer's Profender for lungworm.
  3. From: <fflvetcare@gmail.com>
    2/18/2021
    Hi Sharon,

    I got your email regarding Frederick the Fifth and his progress. As far as if there is any long term effects due to the steroids--there should not be. My concern is that he may have feline asthma and the prednisolone is keeping the inflammation down. He may flare up after stopping the prednisolone and it may be immediately or it may be some period of time. It all depends on if he is allergic to something in the environment or something seasonal (pollens). I would continue to monitor his breathing rate as you have been diligently doing. If it begins to increase over 40 breaths per minute on a consistent basis or you notice he is beginning to cough again, that may indicate an asthmatic flare up. If he actually has asthma, we may be able to control it better with an inhaler called AeroKat (AeroKat for Cats | Trudell Animal Health). As far as the potential kidney issues, we should wait until 2-3 weeks after he has finished the prednisolone to make sure it is out of his system to recheck the renal values and the

    From: <fflvetcare@gmail.com>
    Date: Thu, Jan 14, 2021 at 9:32 AM
    Subject: Lab interpretation and treatment recommendations
    To: <sharoncarroll1@verizon.net>

    Chems all normal

    BUN=22 (14-26)

    Cr=1.1 (0.6-2.4)

    CBC all normal except eosinophilia (1800 (N=0-1000))

    U/A

    low specific gravity (1.010) but inactive sediment (o adding water water to canned food)

    FeLV/FIV=both neg

    T4 normal

    HW Ab=neg



    eosinophilia=parasitic or allergic

    can r/o HWD with neg HW test

    recommend treat with Profender--2 doses given 2 weeks apart for lungworms

    as worms die, they may set up an intense inflammatory resopnse so should also be on Pred short term (2-4 weeks) to reduce inflammation

    notified o--alpw

    Rx: Profender 5.6-11 lbs x 2

    sig: Apply one tube to the back of the neck now and repeat in 2 weeks

    Prednisolone 5 mg #35

    sig: 1 BID x 7 days, 1 SID x 14 days, 1 EOD x 7 days



    recommend recheck blood renal values and u/a at end of treatment (approx 1 month) to ensure no underlying renal disease

    urine. He can visit our technicians to perform the tests. I guess that would be towards the end of March. It sounds like he is doing well and is enjoying life! Keep up the good care!

    Dr. Platko

    ---------------------------------------

    On 2/18/2021 2:25 PM, sharon carroll wrote:

    Hi Amy,
    Frederick has made good progress, thanks to you and your staff are an important part of Frederick's life recovery.
    Thank you
    So.........its only Day 111 since his arrival:
    In my humble opinion from watching this guy. If lung and breathing and kidney are not damaged, at least, course of action may be cellular build up. You said his heart sounded o.k.

    Please give me up best thoughts on whether or when we would see recurring evidence of lung damage, inflammation
    or a return on symptoms indicating underling conditions(you guess, 6 year old)
    Thank you


    Amy, with your update, I shall share it with the vets at Holisticactions.com for their input and suggestions on Day 111 forward.
    With the team Frederick has in place, and of course Friends4life as part, with all of us pulling for Sir Frederick the Fifth,
    he has a good chance of never having to live in the wild or be scared again or hungry, and be loved an important part of a our family.
    Onward.
    at the bottom of this email, is my interactions with Holisticoptions vets, and your treatment plan.
    Thank you

    Lungworm
    Tracking symptoms:

    Coughing episodes:
    Stopped day 2 on Prednisolone.

    Resting breaths: Improved to now, 30 35, Now when Fred laying on his side, his breathing appears normal not labored.visible improvement, not labored.
    Previously 48 -52. labored breaths before mostly in diaphragm area,.

    Kidney: your: recommend recheck blood renal values and u/a at end of treatment (approx 1 month) to ensure no underlying renal disease.



    Update Frederick's Current Conditions:
    Day 111--- s
    ince he ran into my daughter house starving and 5 1/2 lbs. living in the wild.
    Frederick was 9 1/2 lbs. Jan 11, when you treated him.. He looks like he has gained a little weigh.

    Frederick now is a inside cat:
    Hoping it will work out, ....we will see if I can keep him as a inside cat, when weather improves. Has had his rabies shot...

    Vitality is good,

    Appetite good, water added to his food, as he doesn't drink his water.

    Diet Work in Progress: as per Holistic options.com, getting more farm raised, cooked chicken, beef, vegetables.

    Sleeping during the day, runs at full speed on hallway at night

    Movements good, jumps up on counter, dressers etc. Very quick, attentive, we do a lot of eye contact communication.

    Very alert: listen to everything, watches birds out window.

    Mood: Good, attentive.

    Aggressive, and lighting fast to swat and bite, or just put teeth on my finger if he is not happy with being fuses with or at.

    Sweet boy,
    sleeps with me, sleeps on chair next to desk as I'm working. Follows me from room to room, running next and in front of me.

    Fast, runs at full speed from one end of the house to the other, smart,

    Elimination daily, still not a drinker,

    Prednisolone 5 mg #35

    sig: 1 BID x 7 days, 1 SID x 14 days, 1 EOD x 7 days

    Prednisolone 5 mg #35

    sig: 1 BID x 7 days, 1 SID x 14 days, 1 EOD x 7 days


    www.Holisticoptions.com.
    Webinar:
    Every Monday at 7:00, each month different topic related to animal care with guest speakers.,
    Chat feature: i update the vets on Frederick each week during webinar, using the Chat feature.,
    Forum: I have can post in and one of the vets answers the post that day. I emailed you the posting in the forum from January.
    TeleMedicine; and a 2 telemedicine calls a month.

    Amy, the vets at Holisticactions.com have your Xrays and blood work, and treatment plan and his symptoms and journey.

    Frederick's current improved conditions or concerns I update in the chat on the Monday night webinars.

    Introduction to a diet towards farm raised and good premium bought foods.

    Green Stuff; Loves his organic wheat grass pot, nibbling on the grass multiple times a day... eat some of the alfalfa broccoli sprouts in the food.

    Ongoing Body Work: Healing Treatments:

    Reiki,

    Acupressure points,

    massage around the head and shoulders

    (Definitely Discontinued two weeks ago. Frederick has decided he will have not have ANY of

    my fingers in his ears

    or brush grooming or

    Reflexology,------------as Frederick has a short fuse, and gave me a good swat with claws out and a bite,)

    Thank you
    Sharon Carroll 570.504.8734

    On 1/14/2021 12:44 PM, Amy Platko wrote:



    This email is sent from an account we use for sending messages only.

    Replies sent to this email may not be received, please use frontdesk@friends4life.vet if you need to contact us.


 

Attachments

  • fredrick labs.pdf
    12.8 KB · Views: 2

Dr. Jeff

Administrator
Moderator
Veterinarian
Joined
Feb 23, 2017
Messages
5,242
Hi Saron-

I'm so glad to hear that fabulous Frederick is doing better!

You asked:

please provide:
Support for his lung and breathing issues,
Increased vitality through promoting purring, play and petting can help activate his healing mechanisms. Supplements like Liquid Immuno and Respiratory Relief can help support his body as he heals from his presumptive lungworms (or allergic bronchitis),
working on his diet,
Wonderful. What's he eating nowadays? Eating fresh food, especially heart, will give the highest vitality/energy.
also I would like to scedule our telemedicine times.
@aruna I'd appreciate if you would reply to Sharon's post.
 

SharonC

All-Access Member
Registered
Joined
Dec 28, 2020
Messages
23
Dr. Jeff,
Do you have any supplier/brand you trust for Liquid Immono or Respiratory Relief? I just did a little clicking to see what materials are in the extracts......

You may remember as a avocation, I make my own extracts for since 2007 with materials from our property or local friends property, my vocation is interior design.
We have a couple of ginko trees, Tulsi Basil, Reishi mushroom and a couple of other mushrooms. and a friend of mine does a bunch of extracts also., The area has much material for extracts.
My daughter Susan is a organic grower, (also graphic designer) on our land, Susan's herbs are awesome.

Dr. Jeff, the reason for this long post is, we value what you guys are doing, and we have some knowledge and experience with extracts and use them and give them away to our friends.
Diet: working on it....Cooked or raw beef hearts, I kinda remember one of you guys said "have the butcher cut up in 1" cubes...The best I can do is farm raised beef hearts with the farmers now, as it is winter in north east PA.

Playing and Purring and Happy: Frederick is starting to play and do yoga, and run around the house. Yea Yea Yea
Thank you
See you tonight on the webinar
Would like to scedule the telemedicne with you.
Thank ou
Sharon
 

Dr. Jeff

Administrator
Moderator
Veterinarian
Joined
Feb 23, 2017
Messages
5,242
Fantastic that Frederick is playing more and even practicing yoga. Now lets also promote his ujjayi pranayam via purring.

The Liquid Immuno is from Rx Vitamins. HomeVet (my private practice) and VetRxDirect are good sources.

The Respiratory Tonic (10% discount code = resp10) comes directly from them. I usually prefer to not buy supplements on Amazon unless I know that they are being fulfilled from a reliable source and are not grey market.

You also may want to connect with Phillip Reich who is the herbalist owner of the Pet Health and Nutrition company:


For 15 minute HMDM calls use:

 

Weekly Digest

Weekly Digest
Subscribe/Unsubscribe
Top Bottom