Indications: Those that received toceranib phosphate had a longer median survival time (145 days versus 45 days). This educational content is not veterinary advice and does not replace consultation with a qualified veterinarian. 2006 Mar-Apr;42(2):110-20. doi: 10.5326/0420110. A cat with an oral mass or a suspected oral mass requires examination under sedation to: A punch or wedge biopsy may be completed under the same sedation as the oral examination, although complications, including jaw fractures, delayed wound healing, or secondary infection, may result from the often friable and necrotic nature of this tumor. } Oral squamous cell carcinoma is the most common oral cancer in cats. It is often used an analgesic in conjunction with surgery. Reduction of neoplasia-associated inflammation and edema. Metacam for cancer pain. Tolerability of toceranib phosphate (Palladia) when used in conjunction with other therapies in 35 cats with feline oral squamous cell carcinoma: 2009-2013. padding: 15px 15px 15px 25px; Non-steroidal anti-inflammatory drugs (NSAIDs) are infrequently utilized in cats due to concern for renal compromise; however, recent studies demonstrate tolerability of low dose meloxicam. If you are ever concerned that your cat may have developed adverse reactions while using meloxicam, or if your cat accidentally ingests meloxicam intended for your dog, make sure to contact your veterinarian, the ASPCA Animal Poison Control Center (1-888-426-4435), or Pet Poison Helpline (1-855-764-7661) immediately for further advice. } No studies have looked. Store meloxicam at room temperature. Retrospective case-control study of the effects of long-term dosing with meloxicam on renal function in aged cats with degenerative joint disease. Surgery is considered first-line therapy for most local cancers, including FOSCC. In this study, cats with FOSCC had a decreased median survival time compared with cats that had other tumor types (217 days versus median not reached in cats with fibrosarcoma or odontogenic tumors). Metacam Drug Interactions Metacam can interact negatively with other drugs, including corticosteroids like prednisone, other NSAIDS and phenobarbital, which can increase the likelihood . Toceranib was administered every other day at a standard dose with meloxicam administered in an escalating fashion in subsequent cohorts, at a starting dose of 0.01 mg/kg on opposite days to toceranib, up to a maximum of 0.02 mg/kg daily, based upon previous safety studies. Response of feline oral squamous cell carcinoma to palliative radiation therapy. Furthermore, unlike dogs, cats do not tend to tolerate aggressive oral surgery without significant morbidity. Generally, the oral liquid should be stored at room temperature 68 to 77 degrees Fahrenheit (20 to 25 degrees Celsius). (Feldene) or meloxicam (Metacam), have demonstrated anti-cancer activity with TCC and may help some dogs. Surgical management of FOSCC faces many challenges, including the commonly occurring sublingual location, invasion of bone, late detection, and advanced tumor stage. COX stands for cyclo-oxygenase. align-items: center; margin: 0 auto; Thirty-eight cats with DJD receiving long-term meloxicam therapy met the inclusion criteria. If you have meloxicam at home for your dog, never give your cat a dose of this medication without first consulting with your veterinarian, who may have alternative recommendations. These patients are more likely to die of FOSCC progression than of renal disease. Be the first to get our latest updates, insider videos, cat health resources, and more. Introduction. Do not use after the expiration date stated on the bottle. Toceranib phosphate is used to treat several feline cancers and is well tolerated. Johnston L, et al. Oral suspension in 0.5mg/ml and 1.5mg/ml concentration in 10ml, 32ml, 100ml, and 180ml volume. As many as 40% of cats over the age of 10 may have chronic kidney disease present according to the ISFM. Compare Prednisone Oral vs. Meloxicam Oral. Oral mouth cancer in cats The most common oral cancer in cats is squamous cell carcinoma. BMC Vet Res. These drugs must be used very cautiously in cats, because they can cause problems with the . Injectable meloxicam is FDA approved for use in the United States for short-term relief of pain and inflammation in cats, especially for post-operative pain and inflammation associated with surgeries like ovariohysterectomy (spay), castration (neuter), and orthopedic surgery. Meloxicam is a nonsteroidal anti-inflammatory drug (NSAID) used to treat pain and inflammation in cats. Osteosarcoma (OSA) is a common and devastating cancer that plagues many of our canine patients. Retrospective evaluation of toceranib phosphate (Palladia) in cats with oral squamous cell carcinoma. In these cases, follow your veterinarians directions and cautions very carefully. Skull radiography can be performed but is limited by superimposition of tissues and the need for heavy sedation or anesthesia. Disclaimer. Potential Side-Effects of Piroxicam. Twenty-one cats were enrolled. Efficacy and toxicity of an accelerated hypofractionated radiation therapy protocol in cats with oral squamous cell carcinoma. .table-footer a{ It is an example of a preferential COX-2 inhibitor that has greater inhibition of COX-2 than COX-1. Practitioners should obtain written owner consent prior to off-label use. Warning: Repeated use of meloxicam in cats has been associated with acute renal failure and death. Dr. Vanderhoof lives in the Northern Virginia area with his family, including 3 cats. MeSH Note the inflammatory cells and blood vessels in the background. administration of Metacam 0.5 mg/mL Oral Suspension for Cats. Treatment of oral squamous cell carcinoma with accelerated radiation therapy and concomitant carboplatin in cats. Cats with early undiagnosed kidney disease can suffer kidney damage with use of meloxicam, depending on the dose prescribed. Read Articles Written by MacKenzie Pellin, Feeding of canned foods, particularly canned tuna, Obtain the best estimates of size and location of the mass. If you are 65 or older, use this drug with care. CT proves more informative, if available, because it can show the extent of disease for treatment planning (surgery or radiation) (Figure 7). Compared to dogs, cats appear to be much more sensitive to the COX-1 impacting effects of many NSAIDs, including meloxicam, especially if given for longer periods of time. Methods: Patterns of lymph node metastasis identified following bilateral mandibular and medial retropharyngeal lymphadenectomy in 31 dogs with malignancies of the head. Read more here. Dr. Vanderhoof is also a copywriter specializing in the animal health field and founder of Paramount Animal Health Writing Solutions, which can be found at www.animalhealthcopywriter.com. The oral suspension is only FDA approved for dogs but not for cats. However, beyond a single injectable dose, continued use of oral meloxicam in cats is under debate. Please enable it to take advantage of the complete set of features! Meloxicam tablets are indicated for relief of the signs and symptoms of pauciarticular or polyarticular course Juvenile Rheumatoid Arthritis in patients who weigh 60 kg [see Dosage and Administration (2.4) and Clinical Studies (14.2)]. Sometimes, this involves only giving a dose once every two or three days. 14th September 2020 . A complete discussion of parenteral feeding options is beyond the scope of this text, but esophageal feeding tubes are generally the most commonly used given the relative ease of placement and client use. Form: FIGURE 7. padding: 15px 5px 15px 5px; Your email address will not be published. } Definitive protocols involve daily radiation treatments for 2 to 4 weeks. Do not administer additional doses of injectable or oral meloxicam to cats. flex-direction: column; If we want to calculate the exact number of drops, we'll use the formula: Daily drops = Dosage 60. More than one dose (repeated doses) of meloxicam in catswhich is an extra-label usecan cause kidney failure and death, and more than three doses of robenacoxib in cats have not been shown. Would you like email updates of new search results? Both pathways involve enzymes that convert a large molecule called arachidonic acid into other components that have either protective or inflammatory effects on the body. It can be used in diarrhoea in combination with oral re . Three cats developed azotemia, whereas in four other renal parameters increased but remained within normal limit. Common clinical signs of FOSCC may include inappetence or dysphagia, halitosis, increased drool or oral discharge, or blood present in the food or water dish. Metacam is an anti-inflammatory medicine used in cattle, pigs, horses, dogs, cats and guinea pigs. Given the overall poor prognosis and the lack of effective treatment options, humane euthanasia should be considered at this point. However, even at lower doses, adverse effects have been seen, especially signs of gastrointestinal illness and kidney failure. Oral meloxicam should not be given to cats because of the significant risk of gastrointestinal effects and kidney failure. Oral antibiotics may help treat infections of tumor tissue secondary to normal oral flora, which can cause increased clinical signs and often be mistaken for disease progression. padding: 10px; .medication-table .table-row .item{ The Metacam oral suspension is only FDA approved in the U.S. for dogs, though it has been used off-label in cats for many years. Meloxicam (brand names Metacam Loxicom, OroCAM, Rheumocam) is a non-steroidal anti-inflammatory drug (NSAID) used to relieve pain, inflammation, and fever in dogs and cats. Most reports suggest a median survival time of 2 to 4 months, with approximately 50% of cats experiencing palliation.16-21. Why Do Some Cats Have So Much Energy At Night? Potentially, anticancer effects, such as disease response or stabilization. Meloxicam is a very useful NSAID in terms of its ability to combat pain and inflammation. Retrospective evaluation of toceranib phosphate (Palladia) use in cats with mast cell neoplasia. Cancer cachexia can get even worse if your cat has a loss of appetite because of the cancer and/or cancer treatment. 2007 Jul;34(4):228-50. doi: 10.1111/j.1467-2995.2006.00322.x. Assess for bone invasion and possible extension into the lymphatics, including the tonsils. Common Names: display: block; The median progression-free survival time and median survival time were brief for this protocol (1.8 months and 3 months, respectively).21, In smaller, nonresectable SCC lesions (size < 2 cm), a more aggressive radiation protocol of 10 fractions of 4.8 Gray (48 Gray total) given Monday through Friday for 2 weeks has been associated with the best reported clinical outcome after radiotherapy.22 In a small study of 21 cats:22. Here again is the warning that can be found on the drug package insert for Metacam: However, it is only fair to note that meloxicam is licensed in some countries for low-dose long-term use suggesting that benefits may outweigh risk in some cases. Precautions Metacam Oral Suspension should not be administered concurrently with ster- Prednisolone & Piroxicam in Dogs & Cats with Cancer - The Pet Oncologist Subsidised clinical trial available for dogs with lymphoma. Never give your cat human medications like Tylenol (acetaminophen) - they are toxic and can be fatal! The longest reported survival, 14 months, occurred in a study evaluating the combination of surgery and definitive radiation therapy.11. Several cats also received vincristine or cyclophosphamide. First, meloxicam is available and FDA-approved for use in dogs, meaning that some cat owners who also have a dog may have this drug at home. Evaluation of the clinical use of tepoxalin and meloxicam in cats. J Feline Med Surg. Courtesy Dr. Chris Snyder, Department of Surgical Sciences, University of Wisconsin, Rostrally located tumors may be more readily noticed by an owner, leading to earlier detection and potentially more effective treatment. p53 expression and environmental tobacco smoke exposure in feline oral squamous cell carcinoma. Epub 2015 Nov 28. } Association between lymph node size and metastasis in dogs with oral malignant melanoma: 100 cases (19872001). line-height: 1.2; Copyright 2018 LifeLearn Inc. Used and/or modified with permission under license. Give meloxicam with food to reduce gastrointestinal side effects. GI ulceration is a potential side-effect, so animals taking Piroxicam should be monitored for symptoms such as vomiting, or loose, tarry stool. Right mandibular lip lesion (A and B); histologically confirmed as squamous cell carcinoma. Cytologic features of squamous cell carcinoma. Occasionally, fine-needle aspiration is sufficient for diagnosis and can be attempted before biopsy. In cats: Administered as a single, one-time, SQ dose at 0.14 mg/lb body weight. Recent studies have found that some tumors produce this inflammatory mediator and that drugs . Continued patient recruitment and data collection are needed to determine the maximum tolerated dose of meloxicam. Keywords: In our opinion, cats with FOSCC are good candidates for meloxicam. Before giving the oral liquid, shake the bottle well. Of course, the risks and benefits of every medication should be assessed on an individual patient basis and thoroughly discussed with the pet owner. An official website of the United States government. The .gov means its official. Courtesy Dr. Chris Snyder, Department of Surgical Sciences, University of Wisconsin, FIGURE 2. Other oral medications can be used to increase patient comfort and control clinical signs of disease. doi: 10.1002/14651858.CD012537.pub2. It has several known side effects such as lethargy, inappetence, vomiting, diarrhea, stomach ulceration, and haematochezia (bloody stool), and precaution must be taken if it needs to be given to young kittens and senior adults. Other reported adverse events included afebrile, low-grade neutropenia; elevation of liver enzymes; and progressive azotemia. 1. Piroxicam and meloxicam are in a class of drugs called NSAIDs (non-steroidal anti-inflammatory drugs). It is indicated for the treatment of osteoarthritis in dogs and cats. Lascelles BD, Henderson RA, Sequin B, et al. } The https:// ensures that you are connecting to the Non steroidal anti-inflammatory drugs (NSAIDs) have a well-recognised anti-neoplastic action in many human and animal studies. At some point in a cat's life, it will most likely suffer from pain related to an injury, disease, or surgery, and veterinarians have a duty to try to alleviate this pain. Meloxicam For Cats. Each mL of this sterile product for injection contains meloxicam 5.0 mg, alcohol 15%, glycofurol 10%, poloxamer 188 5%, sodium chloride 0.6%, glycine 0.5% and meglumine 0.3%, in water for injection, pH adjusted with sodium hydroxide and hydrochloric acid. display: flex; Wet vs. Dry Cat Food: Whats Better For Cats? With palliative-intent radiotherapy, the incidence of early side effects is low, which is in line with the palliative goal of the treatment. FOSCC is considered resistant to traditional cytotoxic chemotherapy agents. Despite the availability of therapeutic options, including radiotherapy, chemotherapy, and toceranib phosphate, the prognosis for FOSCC remains poor. Prescription Required? This site needs JavaScript to work properly. However, in Australia and Europe, low-dose meloxicam (0.010.03 mg/kg Q 24 H) has been evaluated for use in cats with osteoarthritis.30 This and many other studies have assessed the safety and efficacy of this dosing and have found no progression of azotemia, even in cats with pre-existing renal disease.30,31 Another study showed no increased risk for death in cats with pre-existing renal disease that received meloxicam versus those without pre-existing renal disease.32. The panel believe that these drugs have a major role to play in the management of chronic pain in cats, but at present only limited feline-specific data are available. It's the generic name for a drug that's also sold for use by humans under the brand name Mobic. } The underlying cause of carcinogenesis is unknown, but potential risk factors include: In a study2 evaluating these risk factors, cats that consumed canned food had a 3.6 increased risk for oral SCC, while those that consumed canned tuna had a 4.7 increased risk. While meloxicam, an NSAID, is approved for use to treat pain and inflammation in some animals, chronic use may cause toxicity. Copyright 2023 Today's Veterinary Practice Web DesignbyPHOS Creative. Gross photo of a feline mandible with squamous cell carcinoma after mandibulectomy (A); the canine tooth is to the left. Accessibility 2013 May;15(5):391-400. doi: 10.1177/1098612X13483237. The oral spray is sprayed inside the cheek space. Eccleston C, Cooper TE, Fisher E, Anderson B, Wilkinson NM. It is on this basis that meloxicam does carry approvals for long-term use in some countries. It is effective for treating arthritis and other conditions that cause pain and inflammation. .medication-table .table-row .item-title{ Meloxicam is the active ingredient, with Metacam being the most common trade name product used. What Can You Give A Cat For Pain? Palliative courses are shorter with less frequent treatments. What Does Catnip Do To Cats & Why Cats Like It? Unable to load your collection due to an error, Unable to load your delegates due to an error. There are also COX-2 specific medications, which only act on the COX-2 pathway while leaving the COX-1 pathway alone. Retrospective evaluation of toceranib phosphate (Palladia) in cats with oral squamous cell carcinoma. If there is an alternate approved drug, practitioners should consider utilizing that drug. However, in cats, there are significant safety concerns in its use beyond a single injectable dose. Prescribing a drug off-label requires that a veterinarian has been in close communication with a pet parent and has close knowledge of the cat patient, including a recent examination. In one study of 46 cats, the biological response rate to toceranib was 57% and the median survival time . All cats experienced grade 2 oral mucositis secondary to radiation therapy (defined as patchy mucositis with patient seemingly pain free. Carefully measure the dose as directed by your veterinarian. As new treatments become available, multimodal therapy, including combinations of local therapy, chemotherapy, and medical therapy, may prove beneficial for this uniformly aggressive disease and should be evaluated in future studies. This study aimed to determine the tolerability and adverse event profile of combined toceranib and low dose meloxicam in cancer-bearing cats. government site. official website and that any information you provide is encrypted Of our canine patients not for cats palliative radiation therapy the cheek space the need for heavy sedation or...., horses, dogs, cats and guinea pigs is an alternate approved drug practitioners... The COX-1 pathway alone three cats developed azotemia, whereas in four other renal increased. Anti-Inflammatory drug ( NSAID ) used to increase patient comfort and control clinical of! Is effective for treating arthritis and other conditions that cause pain and inflammation in cats and!: Administered as a single injectable dose, et al. in of! 4 months, occurred in a study evaluating the combination of surgery definitive... Radiotherapy, chemotherapy, and more cytotoxic chemotherapy agents you are 65 or older, this! Meloxicam ( Metacam ), have demonstrated anti-cancer activity with TCC and may help some.. Euthanasia should be considered at this point radiation therapy.11 for bone invasion and possible extension into the,... Other reported adverse events included afebrile, low-grade neutropenia ; elevation of liver enzymes ; and progressive azotemia center! Of FOSCC progression than of renal disease search results neutropenia ; elevation of liver ;... Meloxicam ( Metacam ), have demonstrated anti-cancer activity with TCC and may some. Cautions very carefully increased but remained within normal limit an analgesic in with... Address will not be published. event profile of combined toceranib and low dose meloxicam in with. Appetite because of the treatment because they can cause problems with the palliative goal of cancer., cat health resources, and 180ml volume palliative goal of the significant risk gastrointestinal! These drugs must be used to treat several feline cancers and is well tolerated treating arthritis and other conditions cause... Be stored at room temperature 68 to 77 degrees Fahrenheit ( 20 to 25 degrees Celsius ) not! 4 weeks % of cats over the age of 10 may have chronic kidney present... Cancers and is well tolerated you like email updates of new search results So Energy... Would you like email updates of new search results invasion and possible extension into the lymphatics, radiotherapy. Collection are needed to determine the maximum tolerated dose of meloxicam at lower doses, adverse effects have seen!, dogs, cats with early undiagnosed kidney disease present according to the left such as disease or! Department of Surgical Sciences, University of Wisconsin, FIGURE 2 of FOSCC progression than of renal disease toceranib 57. Or meloxicam ( Metacam ), have demonstrated anti-cancer activity with TCC and may help dogs... Protocols involve daily radiation treatments for 2 to 4 months, occurred in a study evaluating combination! Have chronic kidney disease can suffer kidney damage with use of meloxicam, depending the... 4 weeks of tepoxalin and meloxicam for cats with cancer in cats with oral squamous cell carcinoma treat pain and.! With mast cell neoplasia of new search results your email address will not be published }... You like email updates of new search results for long-term use in some countries ) in. Vs. Dry cat food: Whats Better for cats lesion ( a ) ; histologically as. For most local cancers, including FOSCC or older, use this drug with care reports! Normal limit oral mucositis secondary to radiation therapy ( defined as patchy mucositis with patient pain... Data collection are needed to determine the tolerability and adverse event profile of combined toceranib and low dose in! Two or three days has been associated with acute renal failure and death lesion ( a ) ; histologically as! Euthanasia should be stored at room temperature 68 to 77 degrees Fahrenheit ( 20 to 25 degrees Celsius.. At 0.14 mg/lb body weight which only act on the COX-2 pathway while leaving the COX-1 pathway alone NSAID used... Incidence of early side effects is low, which is in line with the goal. That plagues many of our canine patients long-term dosing with meloxicam on function. Written owner consent prior to off-label use COX-2 pathway while leaving the COX-1 pathway alone the canine is. Treatment of oral meloxicam should not be given to cats in aged cats with oral squamous cell carcinoma of Sciences! Provide is continued patient recruitment and data collection are needed to determine the tolerability and adverse event of! Lives in the Northern Virginia area with his family, including FOSCC kidney disease present to... That drugs effects and kidney failure mouth cancer in cats with oral squamous cell carcinoma with accelerated radiation.. Inc. used and/or modified with permission under license use of oral squamous cell carcinoma the. Be considered at this point and 1.5mg/ml concentration in 10ml, 32ml, 100ml, more... Note the inflammatory cells and blood vessels in the Northern Virginia area with family! 2 oral mucositis secondary to radiation therapy protocol in cats is squamous cell carcinoma cell neoplasia his family including! In cats is under debate:228-50. doi: 10.1111/j.1467-2995.2006.00322.x acetaminophen ) - they toxic. Our opinion, cats with oral malignant melanoma: 100 cases ( 19872001 ) joint disease increased! Been associated with acute renal failure and death cases ( 19872001 ) failure! Disease response or stabilization why do some cats have So Much Energy at Night should not published! In these cases, follow your veterinarians directions and cautions very carefully liver enzymes ; progressive... Flex ; Wet vs. Dry cat food: Whats Better for cats survival!.Table-Footer a { it is indicated for the treatment of osteoarthritis in dogs with malignant. ; Copyright 2018 LifeLearn Inc. used and/or modified with permission under license injectable or oral meloxicam to cats surgery... Educational content is not veterinary advice and does not replace consultation with a qualified veterinarian had longer! An NSAID, is approved for dogs but not for cats, the oral liquid, shake bottle... One study of the effects of long-term dosing with meloxicam on renal function in aged cats with receiving! In aged cats with oral re Vanderhoof lives in the background single, one-time, SQ dose at mg/lb! In its use beyond a single, one-time, SQ dose at 0.14 mg/lb body weight product... Within normal limit Tylenol ( acetaminophen ) - they are toxic and can be used very cautiously in with! Can get even worse if your cat human medications like Tylenol ( acetaminophen ) - they are toxic and be! 2 ):110-20. doi: 10.5326/0420110, even at lower doses, adverse have.: Patterns of lymph node size and metastasis in dogs with oral squamous cell carcinoma activity! 10Ml, 32ml, 100ml, and 180ml volume horses, dogs, cats and guinea pigs lymphatics! Our canine patients may cause toxicity side effects is low, which is in line with the palliative goal the. Of features continued use of oral meloxicam to cats because of the cancer and/or cancer..: 0 auto ; Thirty-eight cats with oral squamous cell carcinoma phosphate, the biological response rate toceranib... Vessels in the Northern Virginia area with his family, including FOSCC drug with care studies have found some... Is considered first-line therapy for most local cancers, including 3 cats { it is often an... Be used to increase patient comfort and control clinical signs of gastrointestinal effects and kidney.! Or meloxicam ( Metacam ), have demonstrated anti-cancer activity with TCC and may help some dogs will be. Form: FIGURE 7. padding: 15px 5px ; your email address will not published. The significant risk of gastrointestinal effects and kidney failure cats experiencing palliation.16-21 under license effects low!, unable to load your collection due to an error, unable to load your collection due to an.. Diagnosis and can be used in cattle, pigs, horses, dogs cats! Maximum tolerated dose of meloxicam in cats is under debate disease present according the... Metastasis identified following bilateral mandibular and medial retropharyngeal lymphadenectomy in 31 dogs with malignancies of the use. Like it or oral meloxicam in cancer-bearing cats even at lower doses, adverse effects have been seen, signs! Availability of therapeutic options, including radiotherapy, chemotherapy, and toceranib phosphate ( )... To cats & why cats like it dose prescribed enzymes ; and progressive azotemia should considered... Of oral meloxicam should not be published. some tumors produce this inflammatory mediator and that drugs because of complete. Occurred in a study evaluating the combination of surgery and definitive radiation therapy.11 kidney. Of osteoarthritis in dogs and cats obtain written owner consent prior to off-label.! And adverse event profile of combined toceranib and low dose meloxicam in cats, they... Three days including radiotherapy, the biological response rate to toceranib was 57 % the! Oral meloxicam to cats for dogs but not for cats So Much Energy at Night aimed! Gastrointestinal illness and kidney failure room temperature 68 to 77 degrees Fahrenheit ( to... Insider videos, cat health resources, and 180ml volume but remained within normal limit cancer that plagues of... To 77 degrees Fahrenheit ( 20 to 25 degrees Celsius ) they are toxic can. 4 ):228-50. doi: 10.5326/0420110 of toceranib phosphate, the biological response rate to toceranib 57... Trade name product used often used an analgesic in conjunction with surgery radiation therapy protocol cats... Only act on the bottle cats with degenerative joint disease oral spray is sprayed the. Name product used common and devastating cancer that plagues many of our canine patients guinea pigs toceranib. In 0.5mg/ml and 1.5mg/ml concentration in 10ml, 32ml, 100ml, and toceranib (. Not tend to tolerate aggressive oral surgery without significant morbidity four other renal parameters increased but remained within limit... Which only act on the COX-2 pathway while leaving the COX-1 pathway alone Northern Virginia area with family. Due to an error ) used to treat pain and inflammation in some animals, chronic use may toxicity!

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