Monday, October 26, 2009

Fatty Liver Disease (aka Feline Hepatic Lipidosis)

It was about 6 months ago that Joplin got Fatty Live Disease (FLD). When I noticed such a huge change in her mannerisms I took her to the vet. Now, I am a biology student and I believe in science and modern medicine. I assumed that taking an animal to the vet meant that you were taking them to someone who was in it for the love of animals, NOT to guilt financially strapped university students into paying hug sums of money for unnecessary care. This was not the case at the Glebe Pet Hospital. I am unsure whether or not I can give names so I'm not going to mention any but I will say that it was a women and that she was awful.

I thought going in that all Joplin had was a hairball that she couldn't pass. The vet was gentle with her examination, did a thorough job, then turned to me and said that
she was really sure that she had FLD. I asked what could be done and she told me the following:
1. That she needed multiple tests that needed to be done
2. That she needed to be checked into their "hospital"
3. That it was going to cost upwards of $1500

4. That she only had a 50% chance of living even with the treatment
5. That if it was her cat SHE would do everything she could to help it get better.
6. That she would most likely die if I tried to take care of her at home

As I'm sure you can guess I ended up in tears assuming that m
y cat was going to die because there was no way I could afford such a large sum of money. I had the tests done to make sure ( it was all I could afford and it cost $170) and I took Joplin home.

I was inconsolable and told Steph what the vet had said. I took her word as absolute truth. Steph, being the wonderful man that he is, flew into action searching for hours on the web to check stats, home remedies and symptoms. As it turns out FLD is pretty common among cats and that THERE IS HOME TREATMENT THAT CAN BE VERY SUCCESSFUL IF CAUGHT EARLY ENOUGH, 90% successful in fact.

Using all of this information we created our own at home remedy. I've put all the info below to help anyone who is going through the same thing. One thing I will say is that this remedy requires quite a bit of time and persistence, but obviously it is worth it in the end.

FATTY LIVER TREATMENT AT HOME


Joplin's Symptoms in Order of Appearance
  1. Didn't finish normal amount of food in the morning
  2. Increasing lethargy
  3. Wouldn't come greet us
  4. Completely avoided us
  5. Noticed yellowing of ears, eye membrane, and skin just in from of ear. (This can also be seen in gums)
Now I would suggest seeing a vet if you are not 100% sure, you can go for a simple check-up and move forward from there. I'm not "anti-vet" I was just really upset about how I was treated, and how she tried to take advantage of me. I should also mention that she did call once to check up on Joplin once I had told her that we were doing the home-remedy thing. She had never had a person try this before, but it really doesn't excuse her poor (for lack of a better word) bed-side manner.

Causes?

I believe that Joplin getting into the garbage was the main cause of this. Also I was starting to pack for a move, which couldn't have helped.

Its possible that by eating some rotten meat out of the garbage can she developed pancreatitis or even simple some sort of stomach issue that caused her to stop eating.

By way of evolution the domestication of cats causes them to be unable to convert fats back into energy. So when a cat stops eating their liver works overtime trying to convert fats to keep them alive and begins to fail in a sense. (This is a very general idea of what is happening)

Food Preparation
*

  1. 1 can of Wellness Brand cat food- this one is great because it is a pate which is very fine and so it will not get stuck in the syringe, also is very high quality
  2. 2.5 cat vitamins
  3. 1/4 cup warm water
Crush vitamins and mix together with cat food and warm water.

I used a wide mouth syringe that the dentist will usually give to someone when they have their wisdom teeth removed.

I separated the mix into 6 servings and served them in 2h intervals throughout the day: 8am, 10am, 12pm, 2pm, 4pm, 6pm.

Make sure to warm up the food to body temperature at each feeding. Cold or hot food with cause them to throw up.

Force Feeding

I found that putting Joplin into a pillow case from the neck down was the best way to do this since she is not declawed and I needed to keep her still. Also I put her on the kitchen counter. The diagram above helps to show how to hold the cat. Wrap your arm around them holding their body still and their legs down. Now, slide that same arm upwards once you're ready to feed. Now your arm should be fully wrapped around and your hand free, use that hand to hold their head and chin up and in place.

The best place to insert the syringe is right behind the canine , if you push very slightly there with the tip then they well open their mouth. With the mouth open squeeze a very small amount onto the back of their tongue, DO NOT PUT IN TOO MUCH AS THEY WILL CHOKE AND THROW IT UP. Let them swallow this and then repeat until full syringe is done, or until you have completed the portion.

Now this is simply what worked for me, it all depends on your cat and their temperament. If you absolutely cannot calm them down then you might have to work directly with a vet, however the first time is the hardest so give it a few tries.

After the feeding is done, clean them up a little bit and sit and pet them for a while to calm them down.

For each day as of Day 2 I'd try and coax them to eat their first portion by themselves. If they eat the full portion then try with the 2nd portion etc etc...

Joplin was eating on her own by Day 7!

I will warn people that this is a VERY messing job and you will smell like cat food for that whole time, but it gets easier each feeding.

Now I am no expert, vet or anything like that but this system worked well for me twice. If you have any questions please email me :)

* This was the correct amount for my cat who is quite small, these proportions may need to be changed depending on how much your cat eats a day.

Picture 1 taken from:
http://2.bp.blogspot.com/_maBfo7TdlMA/SX0a0Rt1WMI/AAAAAAAABCw/0OKdoxXSmuc/s400/cat_teeth.jpg

Picture 2 taken from:
yikes can't find the pic, but I got it from google!




30 comments:

  1. This is great advice - I wish I had it last week because I am currently feeding my oldest cat via syringe. We aren't sure why he stopped eating (we know he has lymphoma, hepatitis (inflamed liver - partly caused by fatty liver disease) and pancreatitis but he was eating fine before on his meds). I totally understand the vet issue - we have a great vet but they are pretty basic so we had to find a vet with more advanced diagnostic tools and the one we went to was very worst case scenario. Luckily it is my boyfriends mom's vet so we knew going in that was the case. But I also found them to be very expensive for a regular vet (they were more advanced then mine but not what I would call a specialist at all). Now, if they were a specialist I would understand (we have one we see now on occasion) but for a regular vet they wanted a lot of extra tests and extra cost for chemo - the specialist gave that as an option but also had another that was less expensive, less time consuming, less stress on the cat and as effective as the chemo would be. It drove me nuts at that second vet - yes, they are good but they give you little hope and lots of cost. We also later found out that they totally missed an obvious problem with my aunts dog that should have been easy to diagnose, but that is another story. You were right to look online and see what info you could find before committing to pricy treatments - a lot of vets are not very well aquainted with pet nutrition, and that is also an issue.

    I wanted to stop by and thank you for visiting my blog too - I am glad you liked the costume pics. Like I said before, I wish I this post was last week - I have had some bad luck with cat food not watering down well to use in the syringe - some of it is just too chunky and you can't really tell. I have been trying kitten food that is in pate form - higher calories are good for us. And I have been lucky - my cat, though he gets very messy (which is partly my fault) is very good about eating from the syringe.

    Good luck - your blog is great!

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  2. Hi there thanks for all the comments! I still haven't found a great vet but for the next check-up I'm going to try one here in Ottawa that was suggested by the woman who runs our local pet food store. Apparently he's more of a back to basics guy and is big on home remedies.

    I wish I had been able to put this information up sooner as well. Its hard enough having to be upset about a sick cat, but having to figure out how to do all of this as well can be really difficult! I'm so sorry to hear that your cat is sick, how many days have you been feeding him by syringe? It's good that he doesn't mind the feeding, I know my cat was very temperamental at first. She would just bite the syringe over and over again until I pulled it out, she got better with time but no less messy (I wore a garbage bag with holes for my head and arms).

    A suggestion for the food getting stuck in the syringe would be to use one of those mini-food processors (even if its a fine pate). This was great for getting that perfectly smoothness. Also I found that the more watery the better! Yes it will be more work to give the cat the full portion but 1. It won't get stuck and 2. The cat will get even more water!

    Hope this helps a little, I look forward to following your blog!

    Thank you again for the great comments!

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  3. I had a vet I didn't like so when my cat got sick I took him to a new place. The vet looked at the cat, did his thing and gave me some meds for him. When I went to pay I noticed a sign that said No Checks (this was a long time ago). I groaned and told the nurse thats all I have is checks. She didn't even bad an eye, no problem she said. She told me they were discouraging checks because the Dr had a lot of people bringing in there pets, writing checks for the visits then going home and canceling the checks. I asked her why he doesn't just turn those people away (she said a bunch were repeat offenders)she told me the Dr. would never make the animal suffer just cause the owners were idiots. I took my animals there for the next 10 years till he retired.

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  4. I can only hope that I'll be able to find a vet like yours one day. I always just assumed that vets were in it for the health and safety of animals, a naive thought apparently. At the moment I'm almost finished an undgrad in biology and hopefully moving on to veterinary school on the east coast. I hope that in the future I can get the chance be a vet like yours.

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  5. What an interesting post! I'm so glad you found a way to get Joplin well after she had such a scary illness. Vets are sometimes just useless with the people skills, but terribly good with money making skills. Pancreatitis can be as hard to recover from as FLD but I think you did brilliantly. I've found as a rule of thumb, 1ml of liquid = 1 adult cat swallow, that seems to avoid them gagging. Maybe your pro-active approach to treating Joplin at home opened up your vet's mind a bit about options for FLD. I hope so!

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  6. ahhh, I hope this helps me, I dont have funds to take cake to Vet, but he has all the same syptoms, he a very fat cat, was fine then all of sudden I notice he stop eating, then flesh around mouth turned yellow, and his ears also vomiting, and he has eating since, he just keeps drinking water, and staying in one area. I gave him alittle warm milk which he did drink on his own, but he want eat anything else, I feel in my gut its fatty liver , since he is Obese cat. Any other info you can help Im so scared.

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  7. Hi Nixkix,

    I was just looking back over my emails and for some reason my attachment never got sent to you! I'm so sorry!! I hope your cat is doing well, its been quite some time but my best advice was all there.

    Please keep in touch, best wishes

    DIY Catcare

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  8. Thanks for Sharing Home Remedies to treat Fatty liver Disease at Home.
    Herbal Treatment for Fatty Liver Disease

    ReplyDelete
  9. What cat vitamins did you use? I'm already up to 2,000 in vet bills and my cat is not getting better because he won't eat. I think he's scared to be in a cage all day. How long did it take for your cat to start to look better and feel better? I'm very nervous to try on my own because I don't want to lose him.

    Thank you.

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    Replies
    1. Hi Ashlee, this was so long ago that I can't remember what kind of vitamins they were, nothing too fancy. Just picked them up at the local pet store.

      Now just to re-iterate I am not a vet or trained in any kind of pet care, but my exact instructions above worked for my cat. She is still alive and well, and she got FLD a second time (again getting into the garbage) and it worked then too. I had no choice because I couldn't afford the obscene vet bill.

      Like I said above it took 7 days to get her to eat on her own, but from my vague memory she got noticeably better after about day 4?

      I was able to do all these feedings because I was still in university and back and forth from class, it was very time consuming between preparing, feeding, and cleaning. Working a full time job and trying to do this would be very difficult and you don't want to try to over feed them at the end of the day because feedings were missed. They will just throw up or possibly choke on it..

      I really hope this helps, and I hope your cat gets better very soon! Please keep me updated and I'm happy help in anyway with any other questions!

      Delete
  10. Heyou there... I'm so glad I saw your post.. my name is Annie and today my vet called me to tell me that. My cat has liver disease, high blood cells, and his levrl of beliruben is very high.. Max is not eating, and Im trying to get some food one way or the other.. I tried your technic and so far he did took it well.. max is 12 years old, and I'm so broken to see him so sick.. thank you for your advice...my vet wants me to try him on antibiotics to help him lower his white blood cell..she also suggested to have a sonogram wicheck cost $600 :( I know I won't be able to afford that, but I'm going to try what I can.. take care I'm sorry for just venting.. God bless you l annie.. you can email me at annie.Rubio@gmail.com

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  11. I had the same vet experience. Took cat home with antibiotics and "he'll be dead in 2 weeks" comment. My mom researched on line . In addition to what you did, instead of cat vitamins she added cat calorie supplement recommended at pet store, a capsule of vitamin E, fish oil, milk thistle into the small can of pate and mixed well. Feeding and giving water every 2 hrs for 2 weeks or until could eat and drink on own. . Cat survived and thrives. Vet refused to refill antibios without another visit and surprised cat was alive. Big shock.we didn't go back for meds, screw it, cat was recovering.

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  12. I had the same vet experience. Took cat home with antibiotics and "he'll be dead in 2 weeks" comment. My mom researched on line . In addition to what you did, instead of cat vitamins she added cat calorie supplement recommended at pet store, a capsule of vitamin E, fish oil, milk thistle into the small can of pate and mixed well. Feeding and giving water every 2 hrs for 2 weeks or until could eat and drink on own. . Cat survived and thrives. Vet refused to refill antibios without another visit and surprised cat was alive. Big shock.we didn't go back for meds, screw it, cat was recovering.

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  13. My question is I how do you keep your cat from throwing up the food? I can see myself making this doing what I need to do but in order for me to give my cat the nutrition he needs I need him to keep it down?

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    Replies
    1. Prilosec! My vet told us to use the 20mg pill and cut it into quarters. It really helped

      Delete
  14. I have a 4 1/2 year old cat going through this exact thing. A month ago, he weighed 21 pounds. We noticed the changes in him, used to play and hang all over us like a puppy to avoiding us all together. Not eating, not drinking, not playing with his brother, major weight loss. Took him to the vet yesterday. $1500 estimate for tests, hospitalization, etc. When the vet weighed him, he weighs 12 pounds!! That scares the doo doo out of me! I told them there was absolutely no way we could afford that and asked for anything we could do at home to help until we came up with a solution. She said to push as many calories into him as possible. So we are trying but he really has no interest. We really want to try your method, but with such extreme weight loss, are we too late? Heading to the pet store tomorrow with a list from this blog. Any other info or advice is greatly appreciated!

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    Replies
    1. Hi Dawn,
      I know this is very long over-due but I hardly ever check this blog anymore. I left this up for this exact reason, with the hope that it can provide help for people who were in my situation. It's been 7 years since this happened to Joplin and I am happy to report she is still a happy and healthy 15 year old girl. I truly hope your cat made it though.
      All the best,

      Laura

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  15. I am so grateful that I found this blog. Our cat had been acting very lethargic and weak the last few days so I took him to a nearby walk-in clinic. The doctor looked him over checked his ears and eyes and pointed out the jaundice. It wasn't bad enough yet to show on visible skin like inner ears but I wouldn't have thought to pull back his eyelids or attempt to pry open his mouth, so I'm glad I took him. Everything after that really makes me angry at how you're not safe from swindlers anywhere. So, that's the extent of the exam he got and the Dr. briefly mentioned fatty liver disease being common in "cats like this," whatever that means. He's just a nondescript, regular, tabby housecat; until now, I've never had this issue or known anyone who has. Anyway, they come back with this outrageous diagnostic-treatment plan, in tandem, which I still can't make sense of to the tune of about $800 total. Of course, you have to pay it all up front or just go dig a hole so I settled for the antibiotics, dose of REVOLUTION, tube feeding (which I'm kind of wishing I hadn't put him through), and I think a couple other minor things I'm forgetting at the moment, for about $120. They did all that and sent him home, never did see the actual doc again, and the desk jockeys were talking to each other and snickering in my direction while I waited for my poor Goku's torture session to be over. They brought him out and I came home thinking for sure he was a gonner, knowing I couldn't afford all kinds of crazy long-term treatments...I mean, if I had to pay up front I couldn't even do it for myself or one of my kids either, let's be real. So, I began my search online for a second opinion, which led me to this blog. They got about a quarter of a can of food in him with the tube, so they said, and gave me the rest. I did what you suggested and by the end of the night he was eating some dry food on his own, actually he seemed to have developed an appetite but not enough strength to support it. This was last night and he's eating on his own and gaining considerable strength, he couldn't jump up to the bathroom sink and was just staying in one spot on the floor, now he can jump up on his own, it's walking around a little, and even looks less yellow.....already! We probably got to it soon, or it could just be the antibiotics but you gave me hope and I think you nailed it. Thank you! Thank you!

    ReplyDelete
    Replies
    1. Dear friend,
      Please excuse this late reply. I am elated that this blog helped you!I truly hope your little Goku is still doing well.

      All the best,

      Laura

      Delete
  16. My cat has FLD. Been to vets. Your advice is GREAT for using syringe!!! They told me 5-10 mls 2-3 Times a day. How much did u use?

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    Replies
    1. Hi Jenny,

      My sincere apologies for the delay in my response. I really hope that your cat is doing better. Unfortunately since it was so long ago I cannot remember my methods beyond what I have written in the blog post. Please let me know how your little fur baby is doing.
      All the best,
      Laura

      Delete
  17. I'm going through the same thing with my cat if anyone out there could help me find remedies to make him better right now I want to figure out how to keep him from throwing up
    Jasmineford2922@gmail.com
    Conqueror2922@gmail.com

    ReplyDelete
    Replies
    1. Hi Jasmine,

      So sorry to hear you're going through this. My only suggestion (and again I have no vet or medical training) is what my blog post details. I vaguely remember my at throwing up a few times when I gave her the first few feedings but I believe she eventually was able to keep one feeding down and it got better from there.

      I hope things improve soon,

      Laura

      Delete
  18. Laura


    A few weeks back, my dad changed out our two cats' tuna dry food with a bag of turkey dry food (of the same brand and type) on sale. He didn't think much of it, because we've changed out their flavor before and they've been ok.
    However, our five year old cat wasn't eating much of it and we didn't notice how skinny she was until a few weeks later. Our other cat seemed to like it though, and ate a lot of it, so we didn't notice an apparent change in the amount of food they ate. As soon as it occurred to us to change it back to tuna, we did, and we saw my five year old cat start eating again. Soon after that though, she began eating less, and becoming lethargic and weak.
    We took her to the vet and he took some blood tests, resulting in elevated liver tests. He wasn't sure exactly what our cat was suffering from, but he gave us some antibiotics to give to her twice a day for two weeks in case she had some kind of liver infection, and suggested we come back afterwards to see if it made a difference. It hasn't seemed to do anything but make her stressed out, and she doesn't handle stress well.
    Since she wasn't eating any dry food, we gave her tuna because she LOVES that. She still isn't eating much, barely a tablespoon a day, and is still very weak, but I'm almost certain she has fatty liver. We can't afford feeding tubes and hospitals and all that for my five year old kitty, but I love her very much and couldn't stand to see her go.
    I think these syringes are a good idea, and although it is time-consuming, I believe it would be worth it. I just wish we noticed her condition sooner... Anyways, I'm not sure what kind of syringe to use or how to get her to eat on her own after a few days of the syringe. I'm not sure how much to give her based on her weight...I'm pretty much clueless on this whole syringe thing. This blog does give me hope though. She's a strong, young cat, and I believe that if I can get this syringe method done, she has a chance!

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  19. Wish I had stumbled upon your blog earlier. I am currently in day two of syringe feeding my sweet Lucy. I unfortunately spent around 3,000 until I found a good vet that helped me come to the same conclusion that you had. Thank you for sharing your story. Hope Joplin is well.

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  20. Just found this blog and I'm dealing with FLD in my 16 year old Priss. She was pretty sick about a month ago and I took her to the vet. They kept her for 4 days and did various tests, but couldn't find anything specific except she was fecally impacted. They sent her home with some antibiotics, a laxative and prescription food to syringe feed. )LAURA - get a 30 ml big syringe and really blend the food well, might have to add water to get a consistency you can use with the syringe.) The vet was $1800.00, but she seemed to be on the mend, even ate some treats. About 2 weeks ago there was a downturn. I've been syringe feeding her and this weekend went to a nearby pet food place that carries holistic supplies, etc. and the owner recommended colostrum (a powder I mix with water) and kitten food. Further research also recommended a high calorie supplement that I'll pick up tonight. I'm also using milkthistle (no alcohol!) twice daily to detox the liver. Don't know if I'll be able to pull her out of it, but I'm going to give it my best. Glad to see the Prilosec suggestion above because she doesn't always keep things down. And the woman at the pet store recommended mixing the colostrum, supplement (theirs is a powder too, but I've seen gels)and food all together. Unfortunately I work full time and have no one who can feed her during the day, but I'll do the best I can and hope I can pull her through. Was trying to get through to the vet today and first time I was the 9th caller in line, second time I was the 13th caller in line, so it doesn't look promising that I can reach them today.
    (LAURA - my cat is about 8 lbs. and I was able to determine she should be eating about 240 calories per day - google how many calories your cat needs daily based on his/her weight and you should be able to get info - then check the calorie counts on the food you're feeding - you should be able to figure out how much you need to feed.)

    ReplyDelete
  21. Bagaimana mengobati kencing nanah tanpa obat?

    Mengobati kencing nanah tanpa obat mungkin sangat kecil kemungkinan yang bisa dilakukan dengan cara ini. Karena jika anda menderita penyakit maka anda harus melakukan pemeriksaan dan pengobatan dengan dokter yang tentunya akan diberikan obat yang sesuai dengan penyebabnya.
    Apa yang anda rasakan jika anda terkena atau terinfeksi penyakit menular seksual ini?

    1. Stress, Malu, Takut di Kucilkan
    2. Putus asa
    3. Malu untuk melakukan pemeriksaan dengan dokter

    "Jika anda merasakan gejala atau tanda2 kencing nanah, jangan merasa malu untuk melakukan pemeriksaan. segera lakukan pengobatan secepat mungkin untuk membantu anda agar terhindar dari infeksi penyakit lain yang dapat di timbulkan dari penyakit kencing nanah."
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  24. My cat was diagnosed with fatty liver or hepatic lipidosis after she had stopped eating/drinking altogether after catching a cold and went from 14lbs to 10lbs. The vet said her eyes and skin looked yellow (jaundice) and ran blood work that revealed that her GGT and bilirubin enzymes were elevated, so they wanted her to stay overnight to get an IV, antibiotics, and to do an ultrasound. They said she had hepatic lipidosis and may not survive the week, but they still wanted her to stay another night to monitor her to see if she ate. If she didn't eat, they wanted to do a liver biopsy.

    We were already at over $800 so we talked it over and said we would rather take her home rather than her dying at the hospital. Since she is a very finicky cat, I felt she would eat at home vs the hospital. At home she immediately ate a bit and was more vocal and active. After we gave her the antibiotics, she vomited everything up. My husband and I did research to see if there were natural remedies because the vet still had no answers after almost $1000 in care and then we found this article.

    It saved her life. After day 4, she was eating on her own and is still eating on her own now and back to being active with her 2 sisters chasing lasers, drinking lots of water, jumping on and off her posts, hunting, kneading, etc.

    What I used:
    (10) 3oz cans of Healthy Gourmet pate
    (1) MILK THISTLE by Pet Wellbeing
    (1) 10mL plastic syringe from Walgreens
    (1) Blender
    (1) GNC Ultra mega high calorie booster premium formula gel for cats (chicken flavor)
    Water
    Paper towels
    Hand towel/bib

    Day 1: I blended a 3oz can of Healthy Gourmet turkey/chicken pate + 1/4 cup of warm water + 1 tsp of GNC Ultra mega high calorie booster premium formula gel for cats (chicken flavor) + 10 drops of milk thistle. I put mixture into a ramekin and syringe-fed her 30mL of that mixture at 8:30am, 10:30, and 12:30. I made another batch of 3oz ocean fish/tuna pate mixed + 1/4 cup water + 2 tsp of the GNC gel for the feedings at 2:30, 4:30, 6:30, and the rest of the last batch (about 20mL) at 8:30pm.
    ***The key to feeding her through the syringe was blending everything very well so the syringe doesn’t clog and making it as pleasant as possible for her. I wet a paper towel with hot water and set it next to me, put her next to me with a hand towel around her neck-not too tight so it didn’t get all over her, and placed the syringe behind her canine while giving her small squirts towards her cheek and not the back of her throat so she could swallow. I also gave a few seconds after each squirt so she could catch her breath and not feel forced or start choking. It does get messy and you will smell like fish but it doesn't matter when you hear that your cat will die within a week. After she finished the 30mL, I would praise her and use the wet paper towel and wipe off all the cat food around her mouth and then just wiped her face in general then opened the door and let her run out on her own. This made the process more of a bonding experience and she never freaked out when I took her in the bathroom.

    Days 2-4: Same concept. 3 oz can of Healthy Gourmet pate + 1/2 cup of water (since she wasn't drinking water) + 2 tsp of the GNC calorie gel + 10 drops of MILK THISTLE = blended together very well. Fed 30mL at 8:30am, 10:30, 12:30. Blended a second batch of mixture and gave 30mL at 2:30, 4:30, 6:30, 8:30pm. I started placing her in the litter box and scraping the litter with her paw to stimulate her to use it and it often worked. By day 5, she was eating and drinking and using the bathroom by herself. Over the course of each day, she became more active and energetic and gained 2lbs back within 4 days.

    Please feel free to reach out to me, as I have saved my plan of treatment to my excel docs and would love if this can help any other mom's or dad's out there in this situation since it worked for us.

    ReplyDelete

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