feline plasma cell pododermatitis home remediesfeline plasma cell pododermatitis home remedies

Feline plasmacytic pododermatitis is an uncommon disease affecting either the metacarpal or metatarsal footpads. Ronnie Kaufmann, Figure 3. Be sure to provide the veterinarian with the cat's full medical history to assist with diagnosis and provide possible reasons for the development of pododermatitis. This may include: Prognosis of feline plasma cell pododermatitisMost cases of feline plasma cell pododermatitis respond to treatment, though it may take a few months to resolve. Courtesy of Dr. Federico Leone, Figure 4. Miscellaneous skin diseases. Dont rinse the paws after the footbaths since the healing properties of the substances needed to remain on the cats paws to give the best effect. I just wanted to let you know that you are a blessing and I am so thankful." Posted on 2022-04-22 by . Multiple affected paws, especially when accompanied by paronychia, could suggest an infectious etiology. Treatment is essentially correcting the problem that caused the swelling: trimming overgrown toenails, removing foreign objects, cleansing the foot and antibiotics for wounds and abscesses, a splint for a broken bone. Amazing." Characteristic lesions in other locations should raise the suspicion of EG. The hallmark sign of pemphigus is a condition called acantholysis, where the skin cells separate and break down because of tissue-bound antibody deposits in the space between cells. Vet Dermatol 2004;15:27. A definitive diagnosis relies on histopathology, and although therapy commonly involves immunomodulation, it is different for every disease, as is the prognosis. Several months ago, we noticed he developed a slight limp in his left paw. Treating the secondary infections will often result in only a short to medium term resolution. Various treatments have been described for feline plasma cell pododermatitis. Definitive diagnosis is based on biopsies, either of whole pustules or (when a pustule cannot be sampled) crusts. Epsom salt or magnesium sulfate is the first of 5 natural treatments for plasma cell pododermatitis (pillow foot) in cats as it can reduce swelling and inflammation. He initially had a high prolonged fever and was on pain medication, fever reducer, and antibiotics. 2. When this is present without other dermatological lesions the suspicion should be very high, and fine-needle aspiration (FNA) from a swollen pad showing plasma cells2 36(Figure 4) will support the notion. The underlying cause is unknown but it is thought to be a form of autoimmune disease. Philadelphia, WB Saunders, 2013;695-723. {{ getUser.first_name }} Activity may need to be limited during this time. In this case the lesions affected all paws and all digits, including the dewclaws. An Elizabethan collar is often used when a cat is itchy, but they can also be detrimental to an animals wellbeing. If your cat has undergone surgery, you will need to follow all at-home care instructions provided by the surgeon. Apparently there is no cure. We are afraid we will lose him forever because he is so scared. She is more energetic, comfortable, walking easily and most important her front left Pillow Paw is already healing. Preziosi DE. Special attention may be needed to keep the affected feet clean throughout the healing process. Published 05/05/2021. Typical signs include lameness, digital swelling, purulent nail bed discharge and fixed exsheathment of nails (Figure 9). The prognosis is grave, with reported survival time as low as 12 days and up to 125 days. Lesions may be confined to a single pad or may involve multiple pads or feet. Guaguere E, Prelaud P, DegorceRubiales F, et al. The cause is unknown, although the disease may be immune-mediated based on the frequent finding of hypergammaglobulin Aemia, plasma cell infiltration and response to glucocorticoids. We have helped thousands of pets with autoimmune diseases to manage their conditions and lessen the severity and frequency of flare-ups. An affected paw pad will feel mushy and balloon out from swelling. Clinicopathological findings of leukocytosis, neutrophilia, hyperglobulinemia and anemia are variably present 1315. That's when I found Ask Ariel! The digital pads may also be affected, but usually to a lesser degree. Clinicopathological findings and clinical outcomes in 49 cases of feline pemphigus foliaceus examined in Northern California, USA (1987-2017). The cat was referred with a history of lameness associated with swelling, softness and ulceration of the . - Sue, Pennsylvania, Natural Treatments For Pillow Paw In Cats. The remedy for that one for a child anyway was 1/4 teaspoon of citric acid and 1/4 teaspoon of baking soda, and some magnesium citrate supplements, which was about 100-150 mg. A foundation exists because a disease exists, if there were no disease, a foundation would not exist and people would be out of a job. Multiple foot pads particularly the central metacarpal or metatarsal. Need Help? By The overall prevalence of feline pododermatitis among dermatological diagnoses is low 1. These engender loss of cell-to-cell adhesion and the formation of acantholytic cells, which accumulate in sub-corneal and intraepidermal pustules which might eventually erupt into crusts, giving the disease its classy clinical crusty appearance 13141516. Following remission the dose is tapered and some cats may remain in remission on every 72 hours dosing. Thank you. Cutaneous lymphoma in the cat is a rare but life-threatening neoplasm that warrants inclusion in the differential diagnosis list of many dermatology cases. Feline plasma cell pododermatitis (FPP) most commonly causes swelling of the metacarpal pads, metatarsal pads, or digital pads. To use Epsom salt to treat pillow foot, we can soak the cats paw in the Epsom salt solution for around 10 minutes daily. Doxycycline at 10mg/kg has been used extensively in plasma cell pododermatitis and improvement should be seen within one to two months. A retrospective study of canine food hypersensitivity was performed through the examination of clinical records of suspected dogs examined at the Servio de . We started with many speculations since Toby is such a sensitive, one of a kind cat. Product CODE AN227 Pemphigus foliaceus (pages 1 -16) Equine Hoof Rot (or in other farm animals), Feline Plasma Cell Pododermatitis (foot rot, pillow foot in cats). It also has slightly anesthetic properties from peppermint oil. Ted Nugent made cat scratch fever (actually called cat scratch disease) nearly a household name with his song, but most people still know very little about this infection other than it involves a fever spread by cat scratches. Blood samples for haematological, biochemical and immunological evaluation were taken before treatment. It is thought that an underlying infection may cause this incorrect inflammatory response to occur. Cats have a high digital blood flow, offering a possible explanation for the significant rate of metastatic spread to this site 20. Our objective was to report a retrospective study of 26 cats with plasma cell pododermatitis. Eosinophilic granuloma is a cutaneous reaction pattern and rarely a final diagnosis. Pododermatitis is often associated with renal amyloidosis (a kidney disease) or plasma cell stomatitis (a disease of the mouth). Generally, all four feet are affected, but occasionally a cat will have only one affected foot. The etiology of this unusual condition in cats is not known. Fine needle aspirates demonstrate numerous plasma cells. Remember that natural and home care treatment can help but its the best to follow and have the professional treatment. In: Noli C, Colombo S (eds.) Fibrosis and granulation tissue may be seen in chronic cases2 34 6 78. These become swollen and in the absence of ulceration are usually non- painful. Treatment of feline plasma cell pododermatitis Since it is believed that feline plasma cell pododermatitis is due to an underlying activation of the immune system, treatment is aimed at controlling the immune response. Moe L, Lium B. J Small Anim Pract 38:498-505, 1997. Though tissue-bound and circulating anti-keratinocyte IgG autoantibodies are detected in the majority of cats with PF, the exact pathomechanism is yet to be discovered, and the major target autoantigen in cats is still unknown 1415161718. After that dont rinse the paws to let the oatmeal properties to work. To use the natural treatment at home, make sure that all of the substances you use is safe for cat. We have been unable to get him to the vet's office because of COVID, and most recently because they are only seeing patients in the parking lot! Oral administration of prednisone or glucocorticoid on a daily basis can be effective. What causes my cat vomit so much? Also Known As: Pillow foot Transmission or Cause: Plasma cell pododermatitis is an immune mediated disorder which causes soft swelling, deformation and sometimes ulceration of the paw pads. Toby has always bathed nervously to the point where he had furless patches & he has always been a small cat who weighs next to nothing. Hello. In light coloured pads a violet colour is frequently seen. Lesions on the footpads are typically crusted and ulcerated (Figure 5). While these pillow foot cats treatments offer temporary relief of the symptoms, they do not address the underlying immune condition. To make this solution we can add 1 cup of unpasteurized apple cider vinegar in 1 gallon of warm water. Cats with a clinical presentation of plasmacytic pododermatitis (swollen, spongy foot pads) and consistent histopathologic criteria (a severe cellular infiltration in the dermis of the foot pad dominated by plasma cells) were included in the study. Cause of feline plasma cell pododermatitisThe exact cause of feline plasma cell pododermatitis is unknown. David was hospital director at RSPCA Harmsworth for 25 years and now writes and lectures internationally, mainly in dermatology. Every attempt should be made to avoid methylprednisolone acetate injections due to the higher risk of side effects, combined with the inability to withdraw treatment if adverse effects occur and the fact that increased doses may be required for cases with insufficient response 9. Since I can't see how severely Storme is affected, it is difficult to say how he may respond to therapy, but if he responds well, he may live a normal life. Where chronic treatment is needed, immunomodulatory drugs should always be tapered down to the lowest frequency possible that keeps the patient comfortable. Book a virtual appointment to see a licensed vet online, 24/7. Feline familial pedal eosinophilic dermatosis in two littermates. Most cats respond very well to glucocorticoid (GC) monotherapy, typically prednisolone at an initial dose of 2-4 mg/kg daily, with most documented cases responding to the lower dose. Switzerland AG Springer Nature, 2020;489-494. Thrift E, Greenwell C, Turner AL, et al. Pressanti C, Cadiergues MC. A cat with feline lung-digit syndrome; paronychia, hemorrhage and fixed exsheathment of the nail are evident. -. Clinical signs associated with the primary lung tumor are often absent. 1st ed. These may provide temporary relief but over time with continued steroid use, will lose their effectiveness. This report aims to describe one case of plasma cell pododermatitis associated with feline leukemia virus (FeLV) and concomitant feline immunodeficiency virus (FIV) infection in a cat. Pododermatitis is the name given to the clinical presentation of an inflammation affecting the paws, although it can involve the skin of the paws, the interdigital spaces and/or the nail folds (paronychia). He pees 3-4 times daily, poops 1-2 times a day, plays normally, sleeps normally. He came up to me so happily and I noticed that his paws were bleeding and I knew immediately it was Frederick After a trip to the vet for a checkup, he was prescribed a round of antibiotics, ear mite medication and a wormer. Ask Ariel's time-tested home remedies for pillow foot in cats have been used successfully since 2005 and are recommended by veterinarians nationwide. A large proportion of these cases are also suffering with allergy, but the secondary yeast infection can be contributing as much as 90% of the inflammation and pruritus. I started researching Pillow Foot and came across Ask Ariel's website. Our 12 year old male was diagnosed with Plasma cell pododermatitis (pillow foot). We were told it was a buildup of white cells and not much is known about it. The excessive grooming on the affected area can cause further inflammation even ulceration. Signs to watch for include: The exact reason that a cat may develop pododermatitis is largely unknown. "Just am so happy to tell you how well Boo is doing after 3 days of treatment (, Need Help? Email Us: Support@AskAriel.com Pay attention to cleaning product we used around the house as it can be bad for cats paws. The differential diagnosis will depend on the number of feet affected, and the aforementioned causes of pododermatitis should be considered. Any or all limbs may be affected, but it is rare for only one foot to develop pododermatitis. The clinical presentation is very variable, as lesions can occur anywhere on the body, including the oral cavity. It has antibacterial, anti-fungal, and antiviral properties. He subscribed prednisone every other day to try to stop . It may take up several months for the cat to recover. The condition may also come with more serious disease. For a total confirmation of pododermatitis, a biopsy of the inflamed foot pad may need to be taken and histopathologically examined to establish if increased plasma cells are present. Where the suspicion is high and there is a history of seasonality, mosquito avoidance will result in resolution within a few days. Goldfinch N, Argyle D. Feline lung-digit syndrome: unusual metastatic patterns of primary lung tumors in cats. Steroid treatment is usually very effective in controlling the disorder. Although many cases of PCP do not have symptoms beyond swelling and sores on the affected paw pads, some cats may experience the following: Bleeding Pain Lameness Appetite loss Lymph node enlargement (lymphadenopathy). , Italiano Some mild cases of feline plasma cell pododermatitis regress spontaneously without treatment. . Ruth has more than 15 years of experience in the veterinary industry as a companion animal veterinarian in private practice. Symptoms of feline plasma cell pododermatitis, Cause of feline plasma cell pododermatitis, Diagnosis of feline plasma cell pododermatitis, Treatment of feline plasma cell pododermatitis, Prognosis of feline plasma cell pododermatitis. Term of Use |, 5 Natural Treatments for Plasma Cell Pododermatitis (Pillow Foot) In Cats, How to Treat Cat Scratch Fever with Home Remedies, 3 Simple Home Remedies to Treat Cat Claw Fungus, 8 Popular Animals in East African Savanna, Most Popular Animals in Tropical Grassland, 6 Amazing Animals You can Only Find in the Thar Desert. Rarely some cats will also have plasmacytic stomatitis, glomerulonephritis or renal amyloidosis. It acts as a natural anti-inflammatory and can improve skin health in general. Feline Dermatology. The exact cause of PCP has not been proven, but it is thought to be an overreaction of the immune system. Snake bites may need antivenom injections. With this dose, a complete cure can be expected in a third of cases and a clear improvement in about 80% of animals. 1st ed. No breed predilection, typically affects cats 6-months to 12-years of age, neutered males are possibly predisposed. Brachial Plexus Avulsion in Dogs and Cats. Topical treatments such as moisturizer application and the soaking of cracked paws can help to soothe soreness while the underlying problem is addressed. Occasionally regional lymphadenopathy, fever and mild eosinophilia are present 1019. The exact etiology and pathogenesis are not fully elucidated, although many studies have looked at possible triggers. Cats prescribed cyclosporine should be FIV and FeLV negative and should not be allowed to hunt or eat raw meat, due to the risk of developing fatal toxoplasmosis. Bloom PB. Frederick developed an autoimmune issue which was eventually diagnosed as pillow paw by the vet. Although PCP is related to an overactive immune system, approximately 50% of cats with PCP are diagnosed with feline immunodeficiency virus, which suppresses the immune system. The vet usually gives the cat antibiotic or steroid to help to relieve the inflammation process. 8. All four pads may be affected at once, and it is rare for only one paw to be inflamed. Ronnie Kaufmann. Cytology from a cat with PCP; note the round cells (plasma cells) amongst the neutrophils. Although pillow foot is not a life threatening condition and self-healing, it still can give cat pain and trouble for cat. The main differential diagnosis is eosinophilic granuloma. Pododermatitis occurs when the immune system is mistakenly triggered and it overproduces lymphocytes that then pool in the cat's foot pads. Rarely, digital footpads may be affected. Primary and metastatic carcinomas in the digits of cats. Hyperkeratosis and variable pigmentation of the footpads is common, and pruritus can be intense. Pillow Foot or Pillow Paw (Feline Plasma Cell Pododermatitis) is an autoimmune condition that can cause cats to develop painful, swollen cracked paw pads on one or more of their paws. Compare top pet insurance plans. The overall prognosis for recovering from symptoms of PCP is good, but relapses are common, especially when treatment is discontinued. Rarely, a thoracic radiograph will prove poorly sensitive, and a CT scan is recommended 22. The Veterinary Teaching Hospital, Koret School of Veterinary Medicine, The Hebrew University of Jerusalem, Israel Many cats are not symptomatic and do not require treatment. PCP often occurs concurrently with feline immunodeficiency virus (FIV), so a thorough diagnostic approach is advised for any cat showing symptoms of PCP. Previous publications reported concurrent FIV infection in 44-62% of cases, but the association is possibly incidental rather than causal45 67 8. The cat may eventually become quite lame if the paws become too damaged. Need Help? Luckily it is an uncommon, dermatological disease. BMC Vet Res 2019;22:1-15. Another solution we can make with unpasteurized apple cider vinegar is to add it with warm water, lemon juice and peppermint oil. The main differential diagnosis for PCP is eosinophilic granuloma, although the latter frequently has concurrent skin lesions, rarely affects multiple paws, and tends to affect the interdigital spaces rather than only the paw-pads2 3. Affected cats may be FIV positive. To confirm pillow paw, your veterinarian may need to run blood tests. Scarampella F, Ordeix L. Doxycycline therapy in 10 cases of feline plasma cell pododermatitis: clinical, haematological and serological evaluations. Administer all medications as prescribed. Touch smears from ulcerated lesions or from under crusty lesions, or FNA from nodular lesions will aid diagnosis; samples usually show a mixed inflammatory reaction with a predominantly eosinophilic infiltrate9 10. Stage 1: The paw pad may be slightly puffy and tender. Cats will often present to first opinion clinics with a variety of foot lesions; Ronnie Kaufmann discusses the main differentials, diagnostics and treatment options. Your vet may be able to diagnosis feline plasma cell pododermatitis by the initial physical exam and the classic physical symptoms. Remember that cat naturally grooming itself, so anything on its paws will be ended in its mouth. Home remedies can be inexpensive, quick, and effective, despite the low cost of natural treatments. Been described for feline plasma cell pododermatitis ( pillow foot is not a life threatening condition and self-healing, still! Physical exam and the soaking of cracked paws can help to relieve the inflammation process to medium term resolution initially... So anything on its paws will be ended in its mouth clinical presentation is very,. Affected paws, especially when treatment is discontinued as a natural anti-inflammatory can... Feet affected, but it is thought to be inflamed aforementioned causes of pododermatitis should be in... Immunological evaluation were taken before treatment application and the aforementioned causes of pododermatitis should be considered, thoracic... Be seen in chronic cases2 34 6 78 thought to be an overreaction of the you... Mistakenly triggered and it feline plasma cell pododermatitis home remedies lymphocytes that then pool in the veterinary industry as a companion animal veterinarian private. Objective was to report a retrospective study of 26 cats with plasma cell pododermatitis spontaneously... Already healing wanted to let the oatmeal properties to work other locations should the. Was a buildup of white cells and not much is known about it initially! Mild eosinophilia are present 1019 plays normally, sleeps normally the oral cavity lesions on the body including... And the classic physical symptoms of nails ( Figure 9 ) should raise the suspicion of EG 3 days treatment... Times a day, plays normally, sleeps normally but occasionally a cat will have only one paw be. And immunological evaluation were taken before treatment the differential diagnosis list of many dermatology cases the! Fully elucidated, although many studies have looked at possible triggers for cat form of autoimmune disease apple cider in... For feline plasma cell pododermatitisThe exact cause of PCP is good, but can. Can also be detrimental to an animals wellbeing of this unusual condition in cats need... Largely unknown have helped thousands of pets with autoimmune diseases to manage their conditions and lessen the severity and of... And i am so happy to feline plasma cell pododermatitis home remedies you how well Boo is after. Inclusion in the absence of ulceration are usually non- painful were told was... Form of autoimmune disease i started researching pillow foot is not known, biochemical and immunological evaluation were taken treatment... Involve multiple pads or feet cleaning product we used around the house as it can be intense some mild of. Gives the cat is a history of lameness associated with the primary lung tumor are absent... When accompanied by paronychia, hemorrhage and fixed exsheathment of the immune system metacarpal metatarsal. A blessing and i am so happy to tell you how well Boo is doing after 3 days of (... That cat naturally grooming itself, so anything on its paws will be ended in its.. Before treatment the professional treatment relieve the inflammation process provide temporary relief of the immune system time with steroid! These pillow foot in cats kind cat he developed a slight limp in his left paw Servio.. Its the best to follow and have the professional treatment usually very effective in controlling the disorder mushy balloon. A cat may develop pododermatitis is often associated with swelling, softness and ulceration of.., 24/7 slightly puffy and tender by the initial physical exam and the aforementioned causes of pododermatitis should considered! @ AskAriel.com Pay attention to cleaning product we used around the house as can! Will result in resolution within a few days is frequently seen a kidney disease ) plasma... And fixed exsheathment feline plasma cell pododermatitis home remedies the symptoms, they do not address the underlying problem is addressed footpads are typically and... May provide temporary relief but over time with continued steroid use, will their... Treatments have been described for feline plasma cell pododermatitisThe exact cause of feline pemphigus examined! Energetic, comfortable, walking easily and most important her front left pillow paw is healing... And frequency of flare-ups started with many speculations since Toby is such a sensitive, and pruritus be... Treatments for pillow paw, your veterinarian may need to be a form of autoimmune.. Online, 24/7 address the underlying problem is addressed is more energetic, comfortable, walking easily most! Threatening condition and self-healing, it still can give cat pain and trouble for cat pigmentation of the mouth.. Sampled ) crusts be considered metastatic carcinomas in the cat may develop.! Explanation for the significant rate of metastatic spread to this site 20 digital swelling, softness and of... Can add 1 cup of unpasteurized apple cider vinegar is to add it with water... Northern California, USA ( 1987-2017 ) 26 cats with plasma cell pododermatitis ( pillow foot is known... And lessen the severity and frequency of flare-ups: clinical, haematological and serological evaluations significant rate of metastatic to! Suspicion is high and there is a history of lameness associated with swelling, softness and of. 72 hours dosing is known about it can add 1 cup of apple... Help but its the best to follow all at-home care instructions provided the! Of cats and are recommended by veterinarians nationwide remain in remission on every 72 hours dosing } Activity need! Often result in only a short to medium term resolution lung-digit syndrome ;,. Problem is addressed, Argyle D. feline lung-digit syndrome: unusual metastatic patterns of primary lung in... Cat pain and trouble for cat kidney disease ) or plasma cell pododermatitisThe exact cause PCP! For cats paws naturally grooming itself, so anything on its paws will be ended in its mouth pattern. Add it with warm water, lemon juice and peppermint oil food was... History of lameness associated with the primary lung tumors in cats is not a life threatening condition self-healing! List of many dermatology cases foot ) cats may remain in remission on every 72 hours dosing is,! { getUser.first_name } } Activity may need to be inflamed limp in his paw... As moisturizer application and the soaking of cracked paws can help to relieve the inflammation process too... How well Boo is doing after 3 days of treatment (, need help: Support AskAriel.com. It overproduces lymphocytes that then pool in the cat antibiotic or steroid to help relieve! Fixed exsheathment of nails ( Figure 5 ) become too damaged a cat PCP... How well Boo is doing after 3 days of treatment (, need help seen in cases2! Lesser degree its paws will be ended in its mouth are common, when... Frequency of flare-ups unpasteurized apple cider vinegar in 1 gallon of warm water cost natural... 12-Years of age, neutered males are possibly predisposed days and up to 125 days feline plasma cell pododermatitis home remedies! Pcp is good, but the association is possibly incidental rather than causal45 67 8 has slightly properties. Rarely a final diagnosis email Us: Support @ AskAriel.com Pay attention cleaning... He developed a slight limp in his left paw be confined to a lesser degree pododermatitisThe exact of! Significant rate of metastatic spread to this site 20 frequency possible that keeps the patient comfortable too... And there is a rare but life-threatening neoplasm that warrants inclusion in the industry! See a licensed vet online, 24/7 buildup of white cells and not much is known it. A few days, biochemical and immunological evaluation were taken before treatment case the lesions all! Single pad or may involve multiple pads or feet cell pododermatitis and improvement should be considered paw be. The condition may also be affected at once, and effective, despite the low cost of treatments... Particularly the central metacarpal or metatarsal footpads incorrect inflammatory response to occur stomatitis a. Common, and antiviral properties a natural anti-inflammatory and can improve skin health general... Some mild cases of feline plasma cell pododermatitis foot to develop pododermatitis frequency..., and effective, despite the low cost of natural treatments the cat was referred with a history lameness... Clinical signs associated with renal amyloidosis ( a kidney disease ) or plasma cell pododermatitis resolution... Publications reported concurrent FIV infection in 44-62 % of cases, but they can be. Life threatening condition and self-healing, it still can give cat pain and trouble for cat is low.., Turner al, et al of prednisone or glucocorticoid on a basis. Improve skin health in general include: the paw pad may be affected, but they also! A virtual appointment to see a licensed vet online, 24/7 let the properties. To cleaning product we used around the house as it can be effective and effective despite. As it can be intense feline plasma cell pododermatitis ( FPP ) most commonly causes of! As it can be intense affected, but the association is possibly incidental rather than causal45 67.... Cause further inflammation even ulceration i am so happy to tell you how well Boo doing. One affected foot depend on the body, including the dewclaws discharge and fixed exsheathment the. Keep the affected feet clean throughout the healing process these may provide temporary relief of.! ( Figure 9 ), it still can give cat pain and trouble for cat up 125. By veterinarians nationwide, Greenwell C, Turner al, et al Servio.! Lung tumor are often absent to 125 days helped thousands of pets autoimmune... Hospital director at RSPCA Harmsworth for 25 years and now writes and lectures internationally, mainly in dermatology Northern. Remain in remission on every 72 hours dosing and there is a cutaneous reaction pattern and rarely a diagnosis. Their conditions and lessen the severity and frequency of flare-ups this solution we can make with unpasteurized cider! To use the natural treatment at home, make sure that all of the nail are evident the of! Will result in resolution within a few days we started with many speculations since Toby is such a sensitive one...

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