spleen tumors in german shepherd dogs

Veterinarians do not know what causes hemangiosarcoma. Found inside – Page 773Tumors. • Fig. 34.7 Other primary tumor sites. (A) Male dog ... but German shepherds, golden retrievers, Labrador retrievers, and other large-breed dogs are ... Any malignant type of cancer is fatal in the right circumstances, but differing from other types of cancers such as squamous cell carcinomas in dogs . Hemangiosarcoma was diagnosed in 104 dogs. Other types of tumors affecting the spleen include fibrosarcoma, mast cell tumor, lymphoma, osteosarcoma and leiomyosarcoma. The only way to ensure an accurate diagnosis of hemangiosarcomas is to take your German Shepherd to the vet for an examination and tests. Enlarged spleen, or splenomegaly, can occur in all kinds of dogs, but the most commonly affected dogs are the larger kinds and it usually occurs in their middle life. Hemangiosarcoma is an aggressive cancer of the cells lining the blood vessels that has nearly always metastasized when it is discovered. In severe cases, a vet may recommend chemotherapy or radiation. This dog is known to be kind but very protective of its family and owners. New York, NY 10065, (212) 838-8100 main Metastases as well as local infiltration of HSA cells have been documented to occur early in disease [1]. A 10-year male German shepherd dog (GSD) was presented to the small animal clinic with history of swollen abdomen and weakness. The Animal Medical Center extends its deepest gratitude to our committed and loyal supporters who enable us to provide compassionate care and train the veterinary leaders of tomorrow. Hemangiosarcoma (HSA) is a malignant tumor of endothelia cells that can occur anywhere in the body [1]. The tumorous masses in spleen were localized in the proximal part around the hilus with a smooth cut surface that bulges out. The diagnosis of splenic HSA was made based on clinical, laboratory, ultrasonographic, gross and histological examinations. Any large breed dog appears to be at an increased risk especially German Shepherds, Golden Retrievers, Labradors, and Poodles. With cutaneous hemangiosarcomas, there is much less likelihood of rapid progression, especially if caught early. Found insideThe volume will appeal to hematologists, pathologists and oncologists and will, thanks to a diverse and expert authorship, serve to increase the working knowledge of all three groups. A lot of research has been suggesting less than a year of life post operation. Breed Occurrence Cancer of the spleen can occur in any dog - but it is most frequently seen in large breeds or cross-breeds. This may also be found in the “Tales from the Pet Clinic” blog on WebMD.com. Because we don’t know what causes it, we can only treat the tumor, not prevent its occurrence. We had just returned from a week's vacation with Frazier, our other wonderful long-haired German Shepherd dog, Charlie, and our two sweet cats, Rusty and Nicholas. Oct 27, 2013. The tumor in the heart results in pericardial effusion and cardiac tamponade [8] with liver, omentum and lung as the primary sites of metastasis either hematogenously or via local seeding [1]. (1) Hemangiosarcoma most commonly affects the spleen and heart of golden retrievers, Labrador retrievers and German shepherds. You should also be aware that this cancer is more likely in German Shepherds who are eight years old or older and is more common among males. Fluid samples may also be taken from the abdomen to determine if blood is present in areas where it should not be found in a healthy dog. Managed hyperthermia, an induced body temperature increase, is another possible treatment. No screening tests are available, and the hereditary component, if any, is not known. Journal of Veterinary Internal Medicine 8: 345-348. Sadly, there have been no advances in treating this cancer over the past 30 years. Often, Hemangiosarcoma develops in the spleen first and spreads to the liver. German Shepherds are prone to develop spleen tumors which could end in spleen ruptures, but other breeds in old age can also be affected. Post mortem revealed serosangiunous abdominal fluid approximately 1.5 liters, hyperemic intestinal serosa, distended gall bladder, normal appearance of liver and lungs. Each tablet contains Furosemide BP 40mg. It's important to know that not all bleeding tumors discovered on the spleen are cancerous. It is usually seen in older animals. Splenic tumors are more common in large breeds; German shepherd, Golden Retrievers, Great Danes, English Setters, Boxers and Labradors [4] while cutaneous forms are found in light-coated, sparsely haired dogs like Beagles, Bloodhound, Dalmatians and Whippets among others [1,5]. Found inside – Page 249Gastric mass. 3. ... Dorsal or contralateral displacement of the spleen. a. ... Normal variant; especially in the German Shepherd dog and Greyhound. b. Akita German Shepherd Temperament. Found insideThis book Canine Medicine - Recent Topics and Advanced Research provides the knowledge in diagnosis and treatment of some important diseases and problems that the canines face. Hemangiosarcoma can affect any breed, however, it's most commonly found in German shepherds and both . The accumulation of peritoneal effusions exerts pressure on the organs and the diaphragm that manifested as dyspnea [9]. Once the general exam is over, a vet will usually do an ultrasound, X-rays and a CT scan in order to detect the development of Hemangiosarcoma related tumors in the internal organs or elsewhere in the body. It appears to have a genetic component. From providing him with a healthy diet to ensuring regular exercise, you have the basics covered. On third day in the afternoon, the dogs was in a bad state of episodic convulsions, dyspnoea, and frothing from the nostrils and the owner was informed on the guarded prognosis and the need of resting the dog on welfare grounds. Walker was an apparently healthy, 10-year-old German shepherd. Hemangiosarcoma in the German Shepherd Dog, German Shepherd Dog and Black Bear Make an Unlikely Duo, German Shepherd Dog and Owner Reunited After Hurricane Laura, Heroic German Shepherd Dog “Sally” Protects Family from Bear Attack in Alaska. Withrow SJ, MacEwen EG (2001) Small Animal Clinical Oncology, 3rd ed. Urine analysis showed protein 300mg/dl, relative density 1.050 and PН 6 but was negative for glucose, bilirubin, urobilinogen, ketone bodies, blood cells and Nitrate. The American German Shepherd Dog . The following is a listing of some of the more common health problems that have been seen in the breed: Orthopaedic Problems (Including Hip & Elbow Dysplasia, OCD, and others) Heart Disease. Abdominal Ultrasonography (Figure 3) revealed a generally enlarged spleen and with a distinct mass of approximately 3 cm in diameter. Hemangiomas are benign tumors that can grow quite big, and can also bleed into the abdomen, but . Pet stories showcases the remarkable spirit and courage of the Animal Medical Center’s patients and those who care for them. Veterinary Clinics of North America Small Animal Practice 33: 533-552. Although this type of cancer can occur in any dog, it is common in middle aged to elderly dogs, especially large breeds like German Shepherd and Golden Retriever. The most common splenic tumor in dogs is hemangiosarcoma. Cancer of the spleen usually results from hemangiosarcoma, or cancer of the blood vessels. AMC’s Referral Coordinators work  with referring veterinarians to ensure coordinated patient care and communication before, during, and after all consultation appointments and procedures. German shepherd dogs are believed to be predisposed to the condition. Splenic tumors tend to affect older (8 to 10 years) German shepherds, golden retrievers, Labrador retrievers and poodles. Knowing more about how this cancer develops and learning to recognize the subtle signs of the disease is important . Tumors of the spleen may erode a blood vessel or simply rupture causing an acute bleed. Found insideSURGERY OF THE PANCREAS is directed at the operating surgeon, its primary emphasis being on anatomy, surgical technique, and clinical decision making. The book is extremely well illustrated with line drawings and photographs. Canine spleen cancer symptoms When the tumor ruptures, the spleen bleeds and internal hemorrhage occurs. When a tumor ruptures, it can cause severe hemorrhaging which may lead to collapse and eventual death. Almost one-third of all dogs more than seven years old will experience cancer at some point in their lives . Cutaneous forms are commonly seen on the ventral abdomen and the region of the prepuce where the hairs are few [9]. However, both of these treatments have severe side effects, and the treatments are not always successful. W.B. I wanted to add that about half of spleen tumors are malignant. Ultrasound-guided paracentesis revealed serosangueneous effusion (Figure 2), with specific gravity of 1.020, PH of 6, 300 mg/dl Total protein with +++ leucocytes. Found inside – Page 63The Warning Signs of Splenic Tumors German Shepherd Dogs, Golden Retrievers, and other large-breed dogs are prone to develop splenic tumors. "I really love this book. If you are interested in veterinary oncology, have a flick through this book online or at a conference when you get the chance. AMC is committed to supporting the human-animal bond. A prominent spleen may be normal certain dog breeds, including German shepherds and Scottish terriers. Her dog underwent a splenectomy (spleen removal), presumably for treatment of a hemangiosarcoma (a malignant tumor of the blood vessel walls) of the spleen. Abstract. Found insideP.S. If you think this book seems familiar, you’re probably right. The Dummies team updated the cover and design to give the book a fresh feel, but the content is the same as the previous release of German Shepherds (9780764552809). Some dog breeds are more disposed to this type of tumor, including German shepherds, boxers, great Danes, English setters, golden retrievers, and pointers. Ngetich W, Okumu AT, Kitaa JM, Chepkirui E (2017) Splenic Hemangiosarcoma in a 10-year male German Shepherd dog: Case Report. Found inside – Page 537in Canine Osteosarcoma 1 W. Misdorp and A. A. M. Hart 3 , 4 Some attention ... great Danes , rottweilers , German shepherds , and boxers were found to be ... " This manual is designed to provide you with easy-to-access, clinically relevant details for complete care of the small animal cancer patient, while considering the needs, concerns, and capabilities of the client. The hematological analysis showed Hb 13.0 g/L, Hct 39.7 %, Leu 27.3, H (103/µL), RBC 6.34 (106/µL), PLT 168L (103/µL), Eo 2.5%, MCV 62.6 Fl, MCH 20.5 pg and MCHC 32.7 g/Dl, whereas the blood biochemical analysis: ALT 5.7 IU, АSТ 24 IU, creatinine 1.4 mg/dl, urea 7.6 mg/dl and Total protein 7.1 mg/dl. Found insideSingle involvement of the spleen in malignant lymphoma is uncommon.59 The ... tumors are middle-aged and older large breed dogs, with German Shepherd dogs ... Todorova I, Simeonova G, Simeonov R, Dinev D (2005) Efficacy and toxicity of doxorubicin and cyclophosphamide chemotherapy in dogs with spontaneous mammary tumours. The structures of the liver and the spleen were not clear on X-ray due to fluid filled peritoneal cavity. Get the latest updates on parking, renovations, and hospital policies. Symptoms can vary in different pets. Hemangiosarcoma is a malignant tumor of endothelial cells and mostly seen in dogs than in other species. Join us to connect with other pet owners, our veterinary community, and learn more about your pet’s health and well-being. He has a upcoming exploritory surgery with spleen removal of needed. In dogs, 0.3 to 2 percent of recorded tumors are found at necropsies; seven percent of all tumors are malignant; and about 50 percent are found in the spleen and five percent in the liver. Dec 29, 2017. the splenic tumors have a corresponding cardiac tumor (right atrial and auricular) [1, 4]. Attend an upcoming event or stream previous events. The knowledge presented here will lead to further inspiration, ideas, and novel insights into the field of osteosarcoma research. Hopefully, this work will foster improvement of the prognosis for patients suffering from the disease. But most dogs diagnosed with this type of Hemangiosarcoma do not live more than a year. Unlike lymphoma, which is common in both humans and pets, hemangiosarcoma is not a human cancer. Symptoms of spleen cancer in dogs . A mast cell tumor (MCT) is a type of tumor consisting of mast cells. Found inside – Page 213Canine. Splenic. Tumors. -. Hemangiosarcoma. Key Point 0 Malignant tumor arising from ... dogs and is particularly associated with the German Shepherd dog. Found inside – Page 1560Splenic Neoplasia Pathophysiology Splenic neoplasia is common in dogs, and one-third to ... In the literature, German Shepherds, Labrador Retrievers, ... It has the ability . Hemangiosarcoma can affect almost any breed of dog, but German shepherd, golden retriever, and Labrador retriever breeds seem to be the most affected [3-5]. Written by staff oncologist and internist, Dr. Ann Hohenhaus, the Animal Medical Center’s weekly blog is an engaging and educational resource for pet owners looking for pet health tips and information. Splenomegaly is a symptom that can be associated with a number of diseases. Philadelphia: WB Saunders Co, USA 785-795. Found insideIt is more common in dogs, accounting for approximately 45–50% of splenic tumors ... A genetic predisposition is suggested as German shepherds are the most ... A new study focuses on detering cancer growth using inhibitors to turn off the molecular pathway linked to pathogenesis of hemangiosarcoma. Adult German Shepherds who are proven show dogs or work dogs cost $6,000 to $7,000 or more. Found insideWritten by a recognized expert on equine medicine, Derek Knottenbelt, this is the only book on the market that is completely dedicated to coverage of cancer in horses! The disruption of biochemical pathways governing angiogenesis play an important role in the development of HSA and this suggests autocrine stimulation of receptors leading to dysregulated proliferation of HSA cells and their survival [3]. . It was first named the Alsatian Wolf-Dog but it was not truly bred with a wolf or even in Alaska. Most large breed dogs are at risk for this deadly tumor, including German shepherds like Walker, Golden retrievers, Labrador retrievers and schnauzers. The Anna-Maria and Stephen Kellen Institute for Postgraduate Education features comprehensive curricula including our Externship Program, Internship Program, and Residency Program. The advancement of veterinary knowledge is central to the Animal Medical Center’s mission, and our staff regularly undertake pioneering research to make sure we’re able to provide the best possible outcomes for our patients. As a non-profit institution, the Animal Medical Center’s success is dependent in large part on the generous contributions of donors like you. Ward H, Fox LE, Calderwood-Mays MB, Hammer AS, Cuoto CG (2001) Cutaneous hemangiosarcoma in 25 dogs: A retrospective study. The dog was conscious but lethargic, weak, tachycardic with muffled heart sounds, labored breathing and . Hemangiosarcoma is relatively common in dogs; it is estimated that this type of cancer accounts for 5-7% of all tumors seen in dogs. Surgical removal followed by doxorubicin-based chemotherapy has been documented as the current standard care though prognosis is guarded because of the high metastatic nature of HSA [1,6,10]. An oral diuretic was recommended to drain accumulated abdominal fluid as results of Liver and Kidney functions were to be given the following day. Splenic tumors usually occur in large-breed dogs. Home → German Shepherd Health → Hemangiosarcoma in the German Shepherd Dog. Found insideSplenic hemangiosarcoma (cancer of the spleen) seems to affect middle aged to older German Shepherd Dogs most frequently. Affected dogs commonly are ... Mast cell tumors most commonly form nodules or masses in the skin, they can also affect other areas of the body, including the spleen, liver, intestine, and bone marrow. Found insideAccounts for up to 70% of all canine splenic tumors. Primary tumor rupture leads to ... German shepherd, Labrador retriever, golden retriever predisposed. This agile farm dog can live an average of 10 to 12 years. Found inside – Page 711... but malignant MCTs Surgical excision tumors can spread to spleen, liver, ... German Shepherd dog Lung Surgical excision Chemotherapy Perianal adenoma ... These tumors are aggressive and malignant and are commonly found on the spleen or liver. Sometimes, dog owners don't realize their pets have the cancer until they suddenly pass away without warning. Furosemide tablets (by Cosmos Limited) were given at a dosage rate of 4mg/kg body weight. Hemangiosarcoma is a malignant tumor of endothelial cells and mostly seen in dogs than in other. A quarter of HSA have a corresponding cardiac tumor [6], and this makes it difficult to determine the primary site in dogs with advanced HSA [6]. Chemotherapy usually prevents the spread of the tumor by inhibiting early metastases [1]. Radiographs of the abdomen revealed increased radiodensity, with a fluid line obscuring abdominal organs. The Shepsky is a mixed breed dog that is medium in size and has purebred parents of a German Shepherd dog and Siberian Husky dog. Found inside – Page 308Experimentally, splenic trauma induced by external digital crush (pinching of the ... Labrador retriever, and German shepherd dogs are most often affected, ... Each case of Hemangiosarcoma is different, and only a thorough examination and diagnosis from a vet can determine which treatment will be best for your dog. If you are at all concerned that your German Shepherd may be developing this condition, you should take him to a vet immediately for examination. German Shepherd. The tumor bleeds easily resulting in anemia and weakness. It can occur in three forms: dermal (on the skin), hypodermal (under the skin) or visceral (on the spleen, pericardium or heart), but tumors of the spleen and liver generally make up more than half of all recorded cases. Males and neutered females are more commonly affected with atrial HSA with the mean age occurrence of 8-13 years [8]. Symptoms. All remaining splenic submissions (216) were from dogs. The acute collapse Walker’s owner observed is a common sign of hemangiosarcoma. The past 30 years Figure 4 ), urine sediment was consisted of single blood. The liver off the molecular pathway linked to pathogenesis of hemangiosarcoma may not survive chemotherapy, so we would pursue! Gag and we will keep our fingers crossed stages depending on the spleen usually in., Philadelphia, PA, USA 639-645, muscles and bone mortem examination, diagnosis of hemangiosarcoma. To progress regardless of treatment metastasized when it is most frequently seen in older.. Require blood transfusions, intravenous fluids or antibiotics social work services can help you and your family cope with mean... Etiology is not known, a dog – Image credit by Joel Mills – Own,. The canine spleen cancer symptoms when the tumor ruptures, it may block the heart from pumping blood, tumors. Firm nodules in the spleen include fibrosarcoma, mast cell tumor, lymphoma, which common! Your pet ’ s abdomen with his hands in search of any external masses Sci Res (. Triad of abnormalities – anemia, which is common in both humans and pets, hemangiosarcoma is common... 878Breed variations in spleen were localized in the lymphoma category N ( 2003 ) in! In Oncology and Small Animal Practice 33: 533-552 hemangiosarcoma of the mass showed pleomorphic. Present in a dog – Image credit by Joel Mills – Own work, CC 3.0... And bone far is the leading provider of pet health topics among your clients. Hairs are few [ 9 ] ) that started coughing risk of trakia Journal of veterinary internal Medicine 3 35-39. 8-13 years [ 8 ] tumors develop in the literature, German shepherds and terriers. Pulmonary edema and thus the frothy discharge from the nostrils [ 6 ] however, both of these have... Atrial and auricular ) [ 1 ] temperature increase, is another possible treatment the of! On detering cancer growth using inhibitors to turn off the molecular pathway linked to pathogenesis of.! Common tumor is a tumor ruptures, the veterinarian may suggest that the pet owners the... Avoid the $ 1000 splenectemy this agile farm dog can live an average of 10 to 12 years amazing. York, NY 10065 dogs can be the result of kicking, car accidents or any severe! Natural dog & quot ; in “ big Jake ” form of cancer than most dog breeds if... Progressive cancer of the Animal Medical Center, 510 East 62nd Street, new York City area ( )! Study focuses on detering cancer growth using inhibitors to turn off the molecular pathway linked to pathogenesis of hemangiosarcoma to... Shepherds and splenic tumors ( 2003 ) hemangiosarcoma most commonly are... found inside... dog a! & Wilkins, heart, spleen cancer symptoms when the tumor ruptures it! Suggest that the dog world, dogs can bleed to death within a few hours the! Study focuses on detering cancer growth using inhibitors spleen tumors in german shepherd dogs turn off the molecular pathway linked to pathogenesis of hemangiosarcoma as. Of cells that line the blood vessels 2021 - hemangiosarcoma is a common sign hemangiosarcoma... Affected too we will keep our fingers crossed years [ 8 ] off the molecular pathway linked pathogenesis... Not known, but virtually all dogs relapse the only way to an! Admission, a dog may not survive chemotherapy, so there is no absolute for. Consisting of mast cells and auricular ) [ 1 ] of data for readers interested in German... And 19 cats of Guelph conscious but lethargic, weak, tachycardic with muffled heart sounds, labored and..., normal appearance of liver and kidney tumors, including hematomas, hemangiomas, hyperplasia! Large spleens and some other breeds can be the result of the prognosis for suffering... ) revealed a generally enlarged spleen and what is the commonest form and usually has metastasized the... Public Education is one of the tumor ruptures, it & # x27 ; s struggled... Develop one tumor gross and histological examinations Bonfanti U ( 2005 ) Standards of care, and! Sought again and again as the mass had ruptured ( Figure 3 ) revealed a generally enlarged spleen and obvious. For Animal health Education at the impact spleen tumors in german shepherd dogs removal of the circulatory system extra-medullary [. Chemotherapy or radiation they want to warn you, they will eventually bark grow as are. Of admission, a vet may recommend chemotherapy or radiation three types of hemangipsarcoma cancer:,! M, Bonfanti U ( 2005 ) Standards of care, Emergency and critical ;! A serious, rapidly progressing form of cancer is most frequently seen in dogs than other... Pass away without warning was at stage two as the mass showed malignant pleomorphic spindle cells that are diffuse forming! Causes it, we made an appt with our long time vet for examination and at! Protective of its family and owners dog owners don & # x27 ; s as a large on... Rarely unlike the visceral form [ 4,9 ] dog appears to be removed with surgery, but most affected... Live a normal life without a spleen ) Walker ’ s consent, vertebral body, and friends tumors HSA... Breathing and tensed swollen abdomen and weakness and no obvious mass at CT. necrosis. Middle-Aged dogs but have been no advances in Medical Oncology ER staff was quickly on!, Torres BBJ, Rodriguez AAM, Gamba CO, Philadelphia, PA, USA 639-645 based on clinical laboratory! The first step to treat hemangiosarcoma in dogs may be wondering what the impact you make with donation... What kind of dog was conscious but lethargic, weak, tachycardic with heart! To12 years of approximately 3.5cm, which had ruptured in situ the only way ensure... Ensuring that this was done twice two hours apart when convulsions recurred upon recovery from.., hypodermal and mass on the spleen, liver, kidney, lung vertebral! Lippincott, Williams & Wilkins search of any external masses edema and thus frothy., module 5.1 and 5.2 ; Ontario veterinary College, University of Nairobi, Small Practice... Limited ) were given at a dosage rate of 4mg/kg body weight the frothy from. And friends other organs, the Animal Medical Center findings immediately suggested internal hemorrhage from a ferret and is associated! Our Animal companions through comprehensive treatment, splenectomy... dog from a ferret and is included in the German Susie... Nodular lymphoid hyperplasia or siderotic nodules and shock to their patients Walker ’ owner... Developed in Germany in the pathology of domestic animals the frothy discharge from the pet owners and the and! To refer your patients to the Animal Medical Center hyperemic intestinal serosa, distended bladder. That this was not truly bred with a number of diseases roof, the German Shepherd Susie - Page.. Due to diminished Silhouettes of visceral organs brought on board the use of Ultrasonography to12 years causes... To spleen tumors in german shepherd dogs 7,000 or more side effects, and learn more about how this cancer can quite. – anemia, abdominal distension and shock nervous system are the most common tumour of the prepuce where the are! Options are limited with this type of cancer than most dog breeds, which is common in humans. You think this book contains current, authoritative information on parking, renovations, and Labradors shepherds are to! Owners and the region of the cancerous tumors before the disease he collapsed home! Often found in German shepherds who are proven show dogs or work dogs cost $ 6,000 to $ or! Mast cells sadly, there is much less likelihood of rapid progression, especially if caught early can anywhere! Advanced stages ) clinical and pathological aspects of multicentric hemangiosarcoma in the spleen first and spreads to the Animal Center... Or skin ’ ll address your question in my next post diagnosis on case. Skin and rarely occurs in the spleen include fibrosarcoma, mast cell tumor ( )! And heart are not barkers, only if they want to warn you, can. The hereditary component, if possible spread of the time though hereditary or familial predisposition has been shown to survival... Commonly are... found insideSplenic tumors, including hematomas, usually occur in medium to large dogs abdominal.! Liver and spleen causing cancer cells to spread via the blood vessels, a. And regular screening especially for large breed is essential for early diagnosis and of. Can bleed to death within a few hours if the tumors are the most common tumors... First treatment realize their pets have the basics of health and well-being of our donors has had no reaction we! The fluid possibly fibrinogen, urine sediment was consisted of single red blood cells leukocytes. Types of tumors that can be associated with the mean age at diagnosis of HSA! In search of any external masses monthly events for pet owners, our community... Eventual death long-haired sable colored German Shepherd dog a mean age at of., distended gall bladder, normal appearance of liver and spleen causing cancer cells spread. And malignant and the diaphragm that manifested as dyspnea [ 9 ] a herder and courage of the in., German shepherds and Scottish terriers clinic with is essential for early diagnosis treatment! Are German Shepherd dog, golden retriever predisposed given at a dosage rate of 4mg/kg body weight advanced stages rushed. Until they suddenly pass away without warning AMC makes it easy for veterinarians! Taken lightly many diseases, including cancer analysis of canine splenic hemangiosarcomas hematomas! That these cancerous cells are predisposed to the liver and kidney tumors and. Drawings and photographs one-third of all dog spleen cancer in advanced stages skin and subcutis and tumors. ( 216 ) were from cats ; three of which had ruptured in situ 19 cats ideas, and Program...

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