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Paw Mama | 5 years ago
I Have A Mystery Condition That Causes Cat To Violently Scratch At His Face Constantly…

I have a mystery condition that causes cat to violently scratch at his face constantly. He lives in a cone because once removed he scratches violently. He only scratches at two spots. has been treated for fleas/ticks/mites. Skin was UV light tested. X-rays done when a mass popped up behind his ear. Not ear mites. No infections. Eyes were tested. Awaiting biopsy of a mass (removed)behind his ear & lesion under his tongue. Constant head shaking in that Cone has caused an aural hematoma. Vet is mystified!

A few questions. Can I give my cat metacam and trazodone together ? They were prescribed separate times to treat his destructive scratching at his head and face. We’ve since removed a mass behind his ear and taken biopsy of 3 other lesions. One under his tongue. He has been treated for mites and fleas etc. X-rays and UV testing. He has lived in the cone of shame for about 5 months now. He scratches like mad within seconds of removing it. A bloody mess everytime it heals. It is very localized which makes it hard to be (food)allergies?
He just had surgery to fix the aural hematoma caused by his violent head shaking and cone scratching. (No ear mites either)

So he is in an extreme amount of discomfort. He was given a 2 week injection of antibiotic and sent home with metacam. However. The ear now seems very inflamed. It is stitched down to a piece of surgical ‘plastic’ to keep from refilling I think? He is trying to scratch at it so much. He had caused a severe infection in his back toe from scratching at that cone so intensely. It will need amputation.

It is like taking apart an engine. We are awaiting the biopsy results but until then his poor surgery site seems so uncomfortable.
I’m not sure if I should clean it? His head shaking still causes the ears to tap at the cone edges causing such tenderness the poor guy needs to be so sedated to get rest.
Any advice is great advice! Thanking you in advance.

Symptoms started after he started going outside for the first time, one small wound turned into his face being scratched off. so I got him his first set of shots and an antibiotic injection. Medications tried include: numerous antibiotic injections, metacam, trazodone/tramadol for sedating effects to stop scratching. Cyproheptedine. Advantix/flea tick and mite treatment. His X-rays revealed nothing other than an elongated heart. I had his brother who died suddenly at 15 weeks (heart attack?)

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*** update ~vet visit for biopsy results **^

Hello and Thanks so much for your advice! I saw my vet today for the results. Also because My cat has continued to shake his post surgery ear which split the tip open. Healing post-hematoma has been botched. So they will be removing the ear flap and cauterizing the edges.
As for the biopsies I’ll summarize point form the microscopic interpretations.

Skin: ulcerative dermatitis, pleocellular with eosinophils, low grade to moderate with granulation tissue proliferation with superficial bacteria.

Tongue : ulcerative glossitis, eosinophilic rich with collagenolysis.

Mass from behind bottom of ear: hyperplastic/reactive, draining lymph node.

So basically what he said was its food allergy or an external (who knows what) allergy.
However in the report it noted that these types of allergies usually respond to corticosteroids. He was given about 3 cortisone injections which did nothing.
So at this point we try the vet diet like you recommended.
He will be sent home with prednisone for the recovery of his ear once again.
So basically what we face is should we try the blood test 300$ to narrow allergens down?? Or do we try vet diet first. (I’ve gone into debt with these bills )
The most pressing issue is how to calm the scratching at his cone, head and ear shaking. It is constant. To the point where he doesn’t stop unless we snugly bandage his ear/head. And heavily medicated him. (Trazadone) The pressure helps.
I just want him to be able to get some rest. And not have us constantly bombarding him to clean his wounds. Wrap his head. Clean his cone. Ouff. My poor boy. He’s starting to get real annoyed with all of the fussing over him. However he is actually gaining weight!
I also asked about feline herpetic just in case and he said there are no upper respiratory signs present. And X-rays for the chest and head were all clear.
I pray we find something that works for the itch.

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  1. Paw Mama Post author

    Thanks so much for your advice! I saw my vet today for the results. Also because My cat has continued to shake his post surgery ear which split the tip open. Healing post-hematoma has been botched. So they will be removing the ear flap and cauterizing the edges.
    As for the biopsies I’ll summarize point form the microscopic interpretations.

    Skin: ulcerative dermatitis, pleocellular with eosinophils, low grade to moderate with granulation tissue proliferation with superficial bacteria.

    Tongue : ulcerative glossitis, eosinophilic rich with collagenolysis.

    Mass from behind bottom of ear: hyperplastic/reactive, draining lymph node.

    So basically what he said was its food allergy or an external (who knows what) allergy.
    However in the report it noted that these types of allergies usually respond to corticosteroids. He was given about 3 cortisone injections which did nothing.
    So at this point we try the vet diet like you recommended.
    He will be sent home with prednisone for the recovery of his ear once again.
    So basically what we face is should we try the blood test 300$ to narrow allergens down. Or do we try vet diet first.
    The most pressing issue is how to calm the scratching at his cone, head and ear shaking. It is constant. To the point where he doesn’t stop unless we snugly bandage his ear/head. And heavily medicated him. (Trazadone) The pressure helps.
    I just want him to be able to get some rest. And not have us constantly bombarding him to clean his wounds. Wrap his head. Clean his cone. Ouff. My poor boy. He’s starting to get real annoyed with all of the fussing over him. However he is actually gaining weight!
    I also asked about feline herpetic just in case and he said there are no upper respiratory signs present. And X-rays for the chest and head were all clear.

  2. Krista Magnifico

    hello,
    thank you for the follow up. I would probably talk to the vet about trying to manage the current infections and itching while minimizing environmental allergens (fleas, household products) and attempting a food trial. I dont usually do the derm allergen trials until everything else fails. Just my opinion. Get your cat comfortable and see if this was just a one time occurrence.. (fingers crossed).

  3. Krista Magnifico

    Hello
    I am sorry to hear about your cat. I think it sounds like you and you vet have done a very good job with the basic diagnostics. I also think that the most likely place for the answer at this point is the biopsy.
    Your vet should be the only person to advise you on the medications for your pet. Please call them and ask for assistance today with keeping your cat comfortable and further self-traumatization.
    Here are a few hints based on the description and photos that I would talk to your vet about;
    1. Herpetic dermatitis and a famcyclovir treatment trial
    2. referral to a dermatologist
    3. If all else fails discuss a steroid treatment trial as a last ditch treatment option.
    please let me know how things go.
    krista

  4. Krista Magnifico

    hello again,
    I should also add a note about dietary allergy.. it might help to try a prescription diet like z/d.. please also ask your vet about this.

  5. Paw Mama Post author

    Hello again,
    Here is another update!
    Surgery has been performed to remove the piece of the ear flap that was split in two from hitting against the cone plastic so often (head shaking)
    It was then cauterized, and the stitches from the previous aural hematoma surgery were removed along with the piece of surgical flap that was stitched to his ear (to prevent blood reabsorption?)
    *Sent home with 4 medications
    -Gabapentin (via dropper) 2x a day for 7 days
    -Prednisone tab 1x a day 7 days, half a tab 7 days then every other day
    -Surolan in the affected ear 2x a day for 14 days
    -A derm cream to scabbed/wound areas on face 2-3x a day for 14 days
    -Strict diet of Hills Vet Diet Duck and Pea dry formula D/D food and skin allergies.

    We have surpassed all medication cycles besides the prednisone which is half a tablet every other day.
    Its about 2 weeks into the food diet
    Symptoms: first week scratching at his head (cone) and head shaking was reduced significantly. He was very playful and destructive (back to his old self)
    The 2nd week he started with a couple expected uncomfortable scratches at his head a day. But still eating and playing
    He has escaped outside a couple times (we have 3 dogs that need potty breaks) But he’s back in shortly as its gotten much colder since the last time he was out.
    Now passing the second week, going off most meds he is starting to scratch at the cone again…a lot, usually as the prednisone tablet starts to wear off? 🙁
    I’m not sure if its just his ear being really uncomfortable from all of the surgeries.
    however it is healing well! So long as he cannot get his back claws to it.
    We do clean and switch cones daily. we’ve found a ‘comfy cone’ which saves his ear tips in case he decides to head shake again.
    Anyways, Not sure what the next step is… Very tough.

    Thank you again for your advice, it has gotten to the next steps 🙂

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Bonnie Goldstein | 5 years ago
My Cat Had An Aural Hematoma 14 Days Ago. He Went Right To Vet Where…

My cat had an aural hematoma 14 days ago. He went right to vet where it was lanced & given a shot of depo medrol & prednisolone 15mg to take 2x’s/day for 5 days then once/day for 5 days & once every other day for 7 days. No antibiotics we’re given. Throughout the past 13 days liquid drained from the Lance site. Watery but milky in color. Today it is a pillow ear again. I am frantic that my vet is gonna say the only other alternative is surgery. Is there another alternative​? Why wouldn’t I have also gotten antibiotic to give these past 14 days? Was just left w/a gaping hole, no drain.

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  1. Krista Magnifico

    Hello,
    The missing piece to this puzzle is “what caused the hematoma to begin with?” If it was an ear infection then antibiotics are indicated. If it wasn’t they probably aren’t going to help. To be completely honest I don’t ever start with medical therapy I start with surgery for exactly this reason. I’d rather treat it once and have it done then put my clients and patients through trying when I am pretty sure the steorid route won’t work anyway.

  2. Bonnie Goldstein Post author

    Thank you for your response. My vet says my cats ears r quite clean (no mites & no infection) & no excessive head shaking. Seems the hemotoma may have been caused by a conflict w/his little kitty sister. Today a small amt. of liquid was drained which was mostly clear. I was asked to wait a week & see if the ear fills again. Thanks again Krista Magnifico?

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Lindsay Miller | 5 years ago
My 15 Year Old Dog Developed An Ear Hematoma Several Weeks Ago. I Did Some…

My 15 year old dog developed an ear hematoma several weeks ago. I did some research and was scared off from seeking vet help when multiple vets reported that treatment would include putting the animal under anesthesia. I tries keeping the ear upright with the use of a bandage around my dog’s head and that proved to be helpful when she would keep it on. Since research assured that the hematoma would naturally reabsorb I didn’t fight with the bandage but now the ear seems to have a solid mass in it rather than a fluid filled pocket. Is that cause for concern? What can I do to help my old girl. She does not seem to be in any pain, I can touch and squeeze the ear with no protest.

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  1. Krista Magnifico

    Hello,
    The blood inside the flaps of the ear has become a solid hard fibrotic mass. It is now not treatable and the misshapen ear flap is permanent. You should have not been scared away from treating it earlier. Placing a drain does not require anesthesia and my concern is that theisshapen ear flap will predispose the ear into more infection. It is not painful any longer but they are cosmetically unpleasing and may predispose to more ear problems.

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Leisha Lockwood | 5 years ago
Recurrent Aural Hematoma. Recurrent After 3 Surgical Procedures. Now She Has One Again. Same Ear…

Recurrent Aural Hematoma. Recurrent after 3 surgical procedures. Now she has one again. Same ear, same problem.

My 11 year old staffy has a known problem of small ear canals. This is because she has had recurrent ear infections since I have had her from 2 years of age. Ear infections are a common problem for the staffy breed. She is always treated and has for the past year been on regular antibiotic ear wash daily and antibiotics and anti-inflammatory ear drops every second day to try to keep on top of it. She has regular vet checks for her ears. She is up to date on immunisations, flea treatments etc, she is on a grain free diet and is well looked after. For the past three years on at least an annual basis she gets a hematoma on her ears. We have had three surgeries on this to fix it and it’s cost us an absolute fortune. It’s around $3k each time. My issue is this. This will be the 4th she will need surgery to fix this problem. She is 11 years old. Will it fix itself naturally over time if I keep up the treatments I am already doing or am I going to have to spend another $3k on yet another surgery. I just don’t have the money at this time to keep doing this with her. I am and always have been a responsible pet owner. I do everything in my power to ensure my pets are cared for and well looked after. They are on top quality foods, they are regularly vet checked, they get everything they need but I just cannot afford to keep spending this money on surgeries which only has an 8 to 12 month benefit when I already pay out hundreds each month on her antibiotics and anti-inflammatory medications. What is the answer here? Her ear canals will never open properly again at her age, ear infections are a part of life for us with her. Management is the best that can be done. Do I have to do yet another surgical procedure?

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  1. Leisha Lockwood Post author

    Thank you for your response. We have already been down the dermatologist route. They cannot find any underlying allergen causing her dermatitis and recurrent ear infections. We spent thousands there trying to get on top of the dermatogical issues. Her diet is grain free to eliminate any issues with yeasts, she is fed several times a week with raw as well to give her variety and to clean out her system. She has been on cortisone injections until she started having an issue with an overproduction of cortisol in her system. She couldn’t regulate as well as she has gotten older. She has been on special bland diets, she has had skin scrapes done, she has been on antibiotics. Nothing has eliminated her recurrent ear infections. Her skin problems are worse in summer and spring with pollens and grass seeds and water being trapped in the ear or on the skin. She has an ingested worming and flea treatment to avoid any skin contact with medications. I did mention that she is very well taken care of. Anything she needs we do as a priority. We have spent many thousands over the years to try and combat these issues. The ear infections are always the same. It’s always a yeast infection due to her narrow ear canals. This will never change and at 11 years old we don’t have that many years left with her. Her ears are already misshapen due to the three surgeries she has had which also adds to the problem.

    If surgery is our only route we will do it and just find the $3k from somewhere. But it will be the 4th time and my issue is that it is never a permanent solution. The amount of money spent on this recurrent problem is becoming an issue.

  2. Krista Magnifico

    Hello.
    I’m sorry to hear about your dog. I am also sorry that your vet has not referred you to a dermatologist. Clearly your dog has a very significant underlying allergy and sensitivity and it needs to be addressed instead of just treating the ears. As far as your question goes I cannot ethically tell you to ignore them. If you do they will continue to be painful, and eventually the blood inside the ear pinna will coagulate and be reabsorbed. As it does it will shrink and misshape the ear flap and become both unsightly and perpetuate more ear problems. Ask your vet about a referral and whether it might be helpful to try apoquel.

  3. Krista Magnifico

    Hello. I’m sorry to hear. I would try talking to the vet about apoquel and/or long term low dose steroid use. Especially if the financial burden isn’t becoming too great. Also as crazy as it sounds it might prove beneficial to see if someone you know who lives in a very different environment than you do (like the desert) would be willing to try her there. In some cases they are just not built for the climate and area they are found in. I only offer this as a last ditch effort to help her and resolve your issues. I wish you the best. Let me know what happens. Don’t give up, but do be honest with the vet. Any compassionate vet will listen and offer anything they can to help

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Melissa Heppell | 5 years ago
My 7 Year Old Cat Recently Developed An Aural Hematoma. Hehad Clean, Healthy Ears When…

My 7 year old cat recently developed an aural hematoma. Hehad clean, healthy ears when the vet examined him and she put it down to rough housing with my other cat (his brother) the drained it and gave him steroid tablets and it seemed to be ok. It swelled a little bit but nothing too drastic. Today i woke up to him screaming in discomfort/pain so took him to the vets and they said to give him relief it was best to drain it again. Tonight it looks like its filling up again. Its not as big as it was this morning. Hes been given more steriod tablets too. Any advice would be greatly appreciated. Im getting upset about it all and I am heavily pregnant which is probably not helping me. Id appreciate any info or advice 🙂 x

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  1. Krista Magnifico

    Hello,
    I have to admit that I don’t drain aural hematomas. I place a drain for dogs and use an elliptical incision on the inside of the ear with a few through and through sutures to hold the inner and outer ear skin together. This is a one time fix but it does require anesthesia. I would also be very curious as to why it continues to be swelling. It doesn’t sound like trauma is the cause if it keeps recurring. I would call the vet back and tell them that you are worried about your cat and that based on your impending baby you really could use some help getting the cat fixed ASAP. We vets totally understand that life and your cats needs often coincide at rather inopportune times. I wish you both the best of luck.

  2. Sandra Mowry

    Very worried.. can’t get into see a vet for another 4 days… is there something I should be doing

  3. Krista Magnifico

    I’m sorry. I cannot offer a treatment plan without knowing what the cause of the swelling is? Or knowing the state of your cats condition. I’m sorry. Other than following your vets directions or trying to do some detective work in understanding how the ears are swelling I cannot offer much. Is there an emergency number your vet leaves for their patients?

  4. Dawn Ferara, DVM

    I’m sorry you are having such problems. I tell my clients that there are 100’s of treatments for aural hematomas because none of them work 100% of the time. Unfortunately, I much like Krista can’t offer a treatment plan without examining your cat. I would give your vet a call explain your concerns and see what they can do for your cat.
    Good Luck

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Vanessa Chen | 6 years ago
My Dog Recently Had Surgery For Ear Hematoma, But I’m Not Sure That His Ear…

My dog recently had surgery for ear hematoma, but I’m not sure that his ear looks right.

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VictoriaandAnth Hewitt | 6 years ago
Hi, I Really Need Some Unbiased Advice Please My Dog Had A Hematoma In His…

Hi, I really need some unbiased advice please my dog had a hematoma in his ear about a year and a half ago it was a really really big one we first started on steroids and draining this never worked so we then paid the £420 to have the operation to take the glands away. He has ended up with a califlower ear but we weren’t bother as long as it work. His war swells up in the little pockets created by the stitches so he was prescribed steroids to take when it swelled up but because he suffers from allergies he’s constantly itching and chewing his feet and tail so the vet put him on steroids one every day to see if this worked, but it doesn’t and his ear is still swelling and is sore because when he knocks it or when the kids stroke him and touch it he cries. Some people have said to go back to vet and get stronger tablets but I feel like all this is cruel for my dog I don’t want him to be on tablets all of his life and feel dreadful off side effects but then at the same time I would be devastated if we had to put him down I honestly don’t know what to do for the best x

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  1. Sonia M

    I agree with that, take your dog to another vet and get a second opinion.

  2. PK Dennis

    Let’s address the allergy…

    So, have you gotten all grains out of your dog’s diet?  Including treats?  Many dog’s allergies are aggravated by grains.  And don’t let the kids share corn chips, bread crusts etc.  

    So find a good pet store (one that does not sell puppies) and start reading labels, you want a grain-free, and by-product free dog food that lists real meat as the first 2 or 3 ingredients.  Read meat is easy to spot, it will say “elk, bison, beef, turkey, lamb, salmon meal, whitefish meal, etc.  Avoid feeding chicken in any form (many dogs are reactive to chicken), and some folks say to avoid beef as well (my dogs tolerate beef very well).  This premium food may cost more than what you feed now, but most likely you will be feeding less of it to maintain your dog’s health so the expense evens out in the long term.

    Try using the drugs for the short term, and see if a grain-free diet improves things for his swelling and itching.  

    Rinse him once a day in vinegar water (1/3 vinegar, 2/3 water) or take him swimming each day – this will wash allergens out of his coat and off his skin.  You can even dunk his paws in the bowl of the vinegar mix when he comes in from outdoors.  By doing this you will decrease the amount of allergens coming into the house.  Wash all his bedding weekly.

    None of this will fix the ear – or maybe it will help!  But it certainly won’t hurt to try to reduce his allergic reactions.

    Fight the good fight!

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John R | 6 years ago
My 8 Yr Old Lab Had Aural Hematoma Surgery (incision To Drain Fluid And Requisite…

My 8 yr old lab had aural hematoma surgery (incision to drain fluid and requisite stitches) on Dec 1. It is now Jan 15th and while having gone through two courses of antibiotics over last month, the ear still will not heal and is impossible to keep clean.

I have been using a medical cleaning solution provided by vet 2X per day and also Mupirocin healing agent 2X day.

But still nothing. It is clearly still infected and wound is still wide open.

What can be done? Vet who did surgery is confounded by results and I’m concerned.

attached is photo from yesterday showing current state.

Th yellow build up is the seepage from the open wound. It is really hard to get out of the pinna and other parts of the ear as it is crusting.

Thanks!!!

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  1. John R Post author

    Thank you Krista! I have been in touch with the surgeon and she suggested waiting a week or so since we have already tried Clavamox and Cephalex (sp.). I spoke with a vet online and they recommended a culture and new antibiotic. Will that gap where the incision was eventually narrow and close or will the granulated tissue just rise and and fill in the exposed area? Just trying to understand what to expect in terms of cosmetics. Thanks.

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Rosie Tyler | 7 years ago
The Inflammation Does Not Seem To Be A New Hematoma But It Is Nonetheless Inflamed…

The inflammation does not seem to be a new hematoma but it is nonetheless inflamed. I also can´t really tell if his ear is floppy due to the inflammation or due to a broken cartilage.

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  1. Dawn Ferara, DVM

    The inflammation is likely to stick around for awhile.  Not knowing exactly how the hematoma was treated originally it is hard to say if the cartilage is broken.  In my opinion I would say it will take 6-8 weeks for the inflammation to clear and honestly until it clears it is going to be hard to assess the ear cartilage.

    If you are concerned about the ear I would suggest calling your vet for their opinion.

    Good Luck 

    Dr Dawn

  2. Rosie Tyler Post author

    He has had two hematoma surgeries. After the second his ear was bandaged and taped and it was upright for about 3 days and he seemed to be able to move it fine. After that the badge fell off and it was hard to place again. The vet commented on the ear cartilage being possibly broken and issued a glucosamine supplement for him to take. After that my dog has been giving subtle hints that he wants to move his ear upright but it still is quite floppy. If it is indeed broken can it regenerate back to normal with the use of supplements?

  3. Becky Arnold

    You might ask your veterinarian about getting to the root of the infection or irritation causing the problem that lead to the hematomas, and see if your vet has a therapy laser to reduce inflammation and speed healing

  4. Matthew Kelcourse

    Hello Rosie.

    Underneath the skin of a dog’s ear are two “sheets” of elastic cartilage – like two sheets on a bed. The only way the cartilage can be broken (a term I am unfamiliar with) so the ear now flops down permanently, is if both of the cartilage sheets are severed cross the entirety (or most) of the cartilage sheets.

    The inflammation you mention is likely part of the healing process (no two aural hematomas are exactly the same) but you should have your veterinarian take a look to make sure all is going as expected.

    Re: Glucosamine – this is a supplement that significantly benefits the health of hyaline cartilage (joint cartilage) and would have very little, if any, effect on the health or condition of elastic and fibro cartilage. Though I definitely promote glucosamine supplements in GSDs to help reduce the severity of degenerative joint disease as they age, it offers no beneficial (nor harmful) effects on the elastic cartilage found in the ear pinna.

    I hope this helps,

    Dr K

  5. Rosie Tyler Post author

    Thank you for the detailed response! Now I really understand what is going on with the cartilage. In the meanwhile is there anything I can do to strengthen the fibrocartilage and help with his inflammation? Thank you again! 🙂

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Paul Silva | 7 years ago
I Took My Dog To The Vet On Saturday And He Was Diagnosed With Hematoma…

I took my dog to the vet on Saturday and he was diagnosed with hematoma .. his ear is swollen because we decided we would let it heal on its own. He’s been acting lazy lately and quiet so I assume that’s why. Today he started to limp and I have no idea why?.. he didn’t hurt himself. My dog is on merrick grain free dog food so it’s a farely good brand compared to beneful. He is over 14 years old and I started to see his ribs when he walks. I can see his bone structure a lot more now. We got him weighed he is 56lbs compared to 65lbs last winter..

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