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By H. Denpok. United Theological Seminar.

Although a variety of beliefs regarding the frequency of stone there are clear differences in some rates by age and disease purchase cialis black cheap erectile dysfunction diagnosis code. In the 19881994 period generic cialis black 800 mg visa erectile dysfunction jack3d, considerable light on the relative importance of these the age-adjusted prevalence was highest in the South factors purchase cialis black with visa erectile dysfunction treatment pakistan. Percent prevalence of history of kidney stones for 1976 to 1980 and 1988 to 1994 in each age group for each gender (A) and each race group (B). The rates in women appear to be According to the Healthcare Cost and Utilization relatively constant across age groups. The steady decline in the rate of hospitalization the true prevalence of stone disease. In addition, for patients with upper tract stones between 1994 these new data cannot be used to determine incidence and 2000 likely refects the greater effciency and or recurrence rates. The include temporizing procedures prior to defnitive high rate of inpatient hospitalization for the older stone treatment such as placement of a ureteral stent age groups likely refects the lower threshold for or percutaneous nephrostomy to relieve obstruction, admission for an acute stone event or after surgical especially in an infected kidney. National rates of inpatient and ambulatory surgery visits for urolithiasis by age group, 2000. Admission group than in the <65 age group, peaking in the 75- to rates for Hispanics were one-half to two-thirds those 84-year group in each year of study. Age-adjustment did not affect regional age-unadjusted and the age-adjusted data, the male- differences in admission rates, but it did slightly to-female ratios also fell slightly over time. Although the total number of procedures increased from 1994 to 1998, the rate decreased (from 14 15 Urologic Diseases in America Urolithiasis Table 9. In all years of study, the rates highest in the 85+ age group, although they increased of procedures increased with age to a maximum in the substantially after age 64by 2. Beyond that age, procedure refecting the higher prevalence of bladder stones counts in this database were too small to be reliable. Inpatient procedures for individuals having commercial health insurance with urolithiasis listed as primary diagnosis, counta, rateb 1994 1996 1998 2000 Count Rate Count Rate Count Rate Count Rate Total 272 25 375 24 539 22 682 25 Age < 3 1 * 1 * 3 * 4 * 310 2 * 0 0. Geographic steadily over time, decreasing by 15% from a mean variation was also evident, with rates highest in the of 3. National trends in mean length of stay (days) for Outpatient Care individuals hospitalized with lower tract urolithiasis listed An individual may be seen in the outpatient as primary diagnosis setting as part of the diagnosis of urolithiasis, during Length of Stay urologic treatment (pre- and/or post-procedure), 1994 1996 1998 2000 or for medical evaluation and prevention. Overall, the absolute Asian/Pacifc Islander * * * * number of hospital outpatient visits during this Hispanic 3. Other * * * * Information on hospital outpatient visits is also Region available from Medicare data for 1992, 1995, and 1998 Midwest 3. There were also regional differences, with the from National Ambulatory Medical Care Survey highest rates occurring in the South. The visit visit rate for a primary diagnosis of bladder stones rate was 43% higher in 2000 than it was in 1992. The rates peaked in the 65-to 74-year nearly 2 million visits in 2000 by patients with age group and then declined. In 1995 and 1998, the rates were higher for translates into a rate of 731 per 100,000 population. Thus, the vast majority offce visit rates slightly widened in all three years of of visits for urolithiasis (74%) are for urolithiasis as study, but the relative differences in geographic and the primary diagnosis (Tables 15 and 17). However, the data do not represent all decreased between 1999 and 2001 (Table 19). This outpatient procedures performed in a population, 24 25 Urologic Diseases in America Urolithiasis 24 25 Urologic Diseases in America Urolithiasis Table 19. The available data regarding ambulatory surgery During the years studied, the male-to-female for urolithiasis in children are too scant to provide ratio varied from 1. Regional differences were apparent: the highest rates were consistently seen in the Southeast; 28 29 Urologic Diseases in America Urolithiasis Table 22. Ureteroscopy of the Holmium laser in 1995 rendered virtually all remained stable over time and comprised 40% to stones amenable to fragmentation if they could be 42% of the procedures. Open stone surgery made up accessed endoscopically (14); however, this new only 2% of the total procedures in 1994 and dropped technology may have not yet reached widespread use to less than 1% in 2000. In database of commercially insured patients (Table both 1995 and 1998, the rates were highest among 24). Each inpatient or outpatient encounter determine whether this represented a sharp increase involves a variety of cost sources, including physician or simply year-to-year variability. In general, the professional fees, radiographic studies, room and rate for males was twice that for females. It is noted board, laboratory, pharmacy, and operating room that the confdence intervals for these estimates are costs. Among Medicare benefciaries, the rate always be easily arrived at or consistently applied. There were clear regional variations, for those without a claim relating to urolithiasis (Table with rates highest in the South. Hence, a $4,472 difference per covered individual 32 33 Urologic Diseases in America Urolithiasis 32 33 Urologic Diseases in America Urolithiasis Table 27. Expenditures for urolithiasis and share of costs, by type of service (in millions of $) Year 1994 1996 1998 2000 Totala 1,373. Average drug spending for urolithiasis-related conditions is estimated at $4 million to $14 million annually for the period 1996 to 1998. Evaluation 100% of regional differences in medical expenditures 90% suggests that overall higher expenditures for the 80% group without urolithiasis-related claims were found 70% in the South and West, whereas in the urolithiasis 60% group, expenditures were highest in the Midwest 50% and South. As prescription drug costs showed 40% little regional variation, the geographic differences 30% 20% in expenditures are likely related to direct medical 10% expenditures or possibly due to differences in the age 0% distributions of the regions. Percent share of costs for urolithiasis by type was spent on treating urolithiasis in 2000, based solely of service, 19942000. That these fgures are somewhat should be accounted for by expenditures either lower than the $1. Total expenditures (excluding as primary hyperparathyroidism, chronic diarrheal outpatient prescription drug costs) increased by syndrome due to bowel disease, etc. During that time period, non-inpatient differences (such as comorbidities) between those services (including physician offce visits, emergency with and without stone disease. When stratifed by of total expenditures for emergency room services age, the expenditures of those without a urolithiasis- also increased, from 15% in 1992 to 24% in 2000. In contrast, the peak total Medicare population also increased signifcantly over medical expenditure for the group with a urolithiasis- time. However, given the higher incidence of stone on outpatient prescription drugs for the treatment disease in men (a factor of 2 to 3), one might expect of urolithiasis in 19961998 ranged from $4 million a greater impact of gender in the group with stones. Expenditures for Medicare benefciaries age 65 and over for treatment of urolithiasis (in millions of $) Year 1992 1995 1998 Total 613. Expenditures In addition to the direct medical costs of in 2001 were nearly twice as high among infants (0 treatment, the economic effects of urolithiasis include to 2 years of age) as they were among children ages labor market outcomes such as absenteeism and work 3 to 10 or 11 to 17 and twice as high among African limitations. The setting for urolithiasis are diffcult to estimate, largely because of both the acute care and the surgical management of the paucity of data. However, some data are available patients with stones has changed over time: inpatient in the medical and fnancial records of the National admissions and length of stay have decreased as Table 30.

Coronary bypass surgery is currently considered the treatment of choice in patients with left main disease and those with triple vessel disease and diabetes mellitus buy cheap cialis black line erectile dysfunction morning wood. Adequate control of blood pressure reduces the incidence of stroke and may also relieve angina buy 800mg cialis black beta blocker causes erectile dysfunction. Angiotensin converting enzyme inhibitors and beta-blockers such as bisoprolol cheap cialis black 800mg with amex erectile dysfunction at 21, carvedilol and metoprolol succinate should be used in patients with angina who have reduced left ventricular function to reduce hospitalizations for heart failure and to prolong life. Surgical revascularization for patients with significant left main disease and those with severe three vessel disease with diabetes is currently recommended and has been shown to improve survival compared to medical treatment in small studies. Beta-blockers are indicated in patients with angina who have sustained a myocardial infarction to reduce the incidence of sudden cardiac death. Role of stenting to open chronic total occlusions looks promising and like angiogenic gene and cell therapy remains investigational at present. Conclusions Majority of patients with stable angina can be initially managed with optimal drug therapy and or coronary revascularization procedures. A report of the American College of Cardiology/American Heart Association Task Force on Practice Guidelines working group to develop the focused update of the 2002 Guidelines for the management of patients with chronic stable angina. Percutaneous coronary intervention versus conservative therapy in non acute coronary artery disease: A meta analysis. A blinded, randomized, placebo- controlled trial of percutaneous laser myocardial revascularization to improve angina symptoms in patients with severe coronary disease. Testosterone replacement in hypogonadal men with angina improves ischaemic threshold and quality of life. The loading and therapeutic W doses in Gr1 pts were calculated in accordance to genotyping by Gage algorithm. Introduction Warfarin remains the most commonly prescribed anticoagulant in primary and secondary prevention of thromboembolic disorders associated with atrial fibrillation, mechanical prosthetic valves replacement, venous thromboembolism, etc. Nevertheless, application of warfarin is complicated because of relatively narrow therapeutic window for the drug, high variability in its dose requirements, as well as often occurring bleeding complications especially at the beginning of the treatment. Warfarin maintenance dose depends on multiple factors such as age, body mass, diet, concurrently taken medications and genetic variability of the patient. Materials and Methods Our study was open, prospective, multicenter and randomized. In Group 1 (Pharmacogenetics dosing regimen) the loading and therapeutic doses of warfarin were calculated by use of Gage et al. In Group 2 patients (Typical dosing regimen) warfarin was prescribed at initial dose of 5 mg/day. Therapeutic warfarin dose was titrated until the therapeutic range has been achieved and maintained, at least, for a two consecutive days. Blood samples for warfarin genotyping were collected during first visit from all patients. Major bleedings included those 1) were fatal, 2) required blood transfusion and/or hospitalization, 3) were induced by hypotension (with blood pressure <90 mm Hg, decrease of Ht 20%) or irreversible loss of organ. In case when a genotyped sample revealed a single variant of the genes nucleotide sequence i. In case when a genotyped sample was heterozygous (two variants of nucleotide sequence revealed), both probe variants formed complete duplex, hence their fusion temperatures were practically equal. Group differences were analyzed using Mann-Whitney U test and two-sided Fishers exact test. Total of 17 patients were withdrawn from the study because of discrepancy with inclusion criteria (n=5), renunciation of study participation in the study (n=11) and allergy to warfarin (n=1). Participants in each group were drawn from NorthWest, Central, Ural and Siberian regions of Russia. These numbers were similar to the numbers characteristic to European and North American populations. The frequency of bleedings during the first month of warfarin treatment was similar in both groups (Table 3). The frequency of bleedings during 6 months of follow up was similar in both groups. Importantly, no major bleedings were observed in patients of pharmacogenetics group. Whereas, 6 major bleedings (5,1%) were registered in Group 2 patients and 5 of those occurred during the first month of warfarin therapy. It was crucial to observe that in pharmacogenetics dosing regimen group there was no major bleedings during 6 months of follow up. Use of Pharmacogenetic and Clinical Factors to Predict the Therapeutic Dose of Warfarin. The frequency of cytochrome p4502C9 genetic variants in Russian population and their associations with individual sensitivity to warfarin therapy. All pts underwent fool examination twice, at baseline visit and after a month, the third and last visit. A total of 6 points for improvement or [-6] for worsening of these parameters were possible. Two weeks after baseline visit, pts were assessed by the questionnaires alone, while checking adverse events related to the treatment. There were significant release in foot pain, tingling and night pain, as well as sleep disorders (p<0. As an additional and alternative possible treatment there is a lack of information about it in the medical literature. Foot pain relief together with hemodynamic effect might be explained by improving peripheral circulation and cardiac function by vasodilatory effect. The assumption is that the mode of action is mental on one hand and physiological on the other hand as well. Material and Methods 30 out of 34 recruited pts have finished this prospective study and were eligible for analysis. Two weeks after baseline visit, at the second visit, pts were assessed by the questionnaires alone, while checking adverse events related to the treatment. Maximal blood velocity, left ventricular ejection time and the amount of body fluid were measured directly and were applied to Medimond. Other hemodynamic parameters like total peripheral resistance and left cardiac work were calculated based on accepted physiological equations. Recently, we have observed that cardiac dysfunction and subcellular remodeling were partially reversed upon treatment of 12 weeks infarcted animals for 8 weeks with losartan, metoprolol or prazosin (11-13). Experimental Observations As reported earlier (11-13), 12 weeks infarcted rats were treated with or without prazosin (10 mg/kg/day), metoprolol (50 mg/kg/day) or losartan (20 mg/kg/day) for 8 weeks. Cardiac remodeling concepts and clinical implications: a consensus paper from an international forum on cardiac remodeling. Subcellular remodeling as a viable target for the treatment of congestive heart failure.

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The captive population consisted of 16 animals (seven males order 800mg cialis black amex xylometazoline erectile dysfunction, nine females) in 2006 and of 52 (28 males cheap cialis black express impotence etymology, 24 females) in 2008 (Vargas et al discount 800 mg cialis black amex erectile dysfunction shakes menu. The frst birth in captivity was in 2005, since then 24 cubs have been raised in the Breeding Programme. Animals were kept in separate enclosures (550 m ), and during mating season (January to February) all females were allowed 2 to mate by introducing a male into the females enclosure. Depending upon the females behavior, the couples were maintained together for several weeks or just for the copulatory period. Mating was documented in all females, and the cycle was considered to involve a pseudo-pregnancy if no parturition or abortion was observed (Gritz et al. Prior to the test, Iberian lynx females were encouraged to use cork plates as resting spots. After 30 min of uninterrupted resting (generally sleeping) on the plates, females were removed from the enclosure and bugs were taken out of the cork holes. If samples were drawn carefully, bugs could be reutilized for other purposes, although never to draw blood again from another potentially pregnant Iberian lynx female. Blood was centrifuged to obtain plasma, a few drops of which were used for pregnancy diagnosis via Witness Relaxin, while the remaining sample was sent for additional hormone and antibody analyses. Co r k p l at e s, w h i C h ly n x e s u s e as r e s t i n g s p o t s, are equipped w i t h h o l e s Fo r speCial C o n ta i n e r s C o n ta i n i n g b l o o d -s u C k l i n g b u g s (arrow). Co m o pa r t e de la r u t i n a diaria, l o s Cuidadore s manejan l o s C o r C h o s pa r a q u e l o s l i n C e s n o sospeChen en el m o m e n t o en el q u e F i n a l m e n t e se i n t r o d u C e n l o s i n s eC to s. The collectors consisted of vertical stainless steel plates (60 x 60 cm) ending in gutters at the bottom and a slight v-shape inclination that allowed the urine to run into a collector cup. During the breeding season (January to April), samples were obtained 2-3 times per week, for the rest of the year at least one sample per month per animal was used. For steroid analysis, urine aliquots of 100 L were hydrolysed, extracted and subjected to hormone assays Fi g u r e 4. Co l l e C t i o n o F u r i n e s a m p l e s F r o m F e m a l e ly n x a t t h e el aCebuChe ib e r i a n ly n x Ca p t i v e br e e d i n g Center d u r i n g b r e e d i n g (ja n ua ry -ap r i l ) a n d n o n -b r e e d i n g (ma y -deCember) s e a s o n s 2006 to 2008 (jewgenow et a l. Urinary hormone concentrations are expressed as ng per mg creatinine in order to control for differences in urine concentration. The cross-reactivitys of both antibodies and their inter- and intra-assays coeffcients were as described before (Braun et al. The cross-reactivities of antibodies and inter- and intra-assay coeffcients were as described before (Jewgenow et al. Finally, urine samples were concentrated up to ninety times of the original urine volume. In brief, two drops of plasma were transferred to the sample well followed by two drops of the provided buffer. The appearance of a specifc relaxin and a control band was judged as an indication of relaxin in blood serum. A missing relaxin band after a prolonged time (1 hour) was an indication of a negative test result. Thus, urine was mixed with equal amounts of lynx blood serum (serum from a non-pregnant Iberian lynx female obtained during chemical immobilisation in november 2006) before it was subjected to the Witness Relaxin test. In case of concentrated urine samples, they were diluted with of blood serum from a non-pregnant Eurasian lynx and 64 L of the urine- serum mixture (estimated volume of two normal blood drops) was added to the sample well followed by two drops of the provided buffer. Positive relaxin signals were seen in the reading window within at least 20 minutes after application; control bands were visible in every test. Re s u l t s a n d d I s c u s s I o n Urinary P4 levels did not reveal a distinct increase during pregnancy compared to non-breeding season levels (Table 2). Also, no difference was found in progestin concentrations when non-pregnant (no mating), pregnant 383 Immune reactive steroid outSi de br e edi ng S e a Son Pr eg nancy un Pai r e d t teSt w i t h welch ng per mg creatinine (day 1 to 64) co rr ect ion (number of samples) MeanS ( SeM) MeanS ( SeM) Progesterone (n) 1. Co m o ejemplo s e m u e s t r a n l o s p a t r o n e s estaCionales d e d o s h e m b r a s a d u lta s sa l i e g a (p a n e l s u p e r i o r ) y au r a (p a n e l inFerior). The mean progesterone concentrations were slightly lower, when no mating occurred (Table 3, Artemisa), but progesterone levels of pseudo-pregnant and pregnant cycles did not differ signifcantly. Thus, urinary progesterone may indicate the existence of corpora lutea after induced ovulation, but a reliable pregnancy diagnosis based on progesterone was unattainable. In this respect, urinary progesterone follows the pattern described for fecal progestagen excretion in Iberian lynx females (Pelican et al. We suggest that this might be the consequence of the prolonged presence (and function) of corpora lutea throughout most of the year (Kvam, 1990; Gritz et al. Thus, a permanent progestin production may ensure the strong seasonality in lynx (but masks any changes associated with the luteal phase of pregnancy). In most felids, increased estradiol excretion is associated with estrus behaviour or exogenous gonadotropin treatment (Brown et al. Unfortunately, the collection of urine samples from individual females during the period of mating was impossible, since the husbandry scheme allows breeding pairs to share enclosures until two weeks before parturition. Urine samples collected from females with males were characterized by several-fold higher (t=35. The elevated estrogen concentrations in mixed male and female urine were found not only during co-housed pairs immediately before and during the mating period (and thus possibly related to estrus of the female), but was also seen when the couples were left together during pregnancy (three females in 2007, Table 1; Artemisa, Table 3). Within the Iberian Lynx captive Breeding Programme the collection of samples to monitor the onset of estrus in the absence of males was not possible, since all females were sharing enclosures with males prior to entering estrus. Yet, such information would be valuable for further characterization and for better understanding the onset of the Iberian lynx breeding season. The results from the female Artemisa (Table 3) showed a signifcant difference (P<0. Unfortunately, during her pregnancy in 2007, this female was kept together with a male and data on urinary estrogens (46. Although samples from only one female that failed to copulate were available, the low estrogen levels in Artemisa during the 2008 breeding season are an indication of the missing ovulation and corpora lutea (cL) formation. We conclude that Iberian lynx are induced ovulators as described for many other felid species (Brown and Wildt, 1997). Thus, if mating occurs, corpus luteum (cl) formation is evident by elevated estrogens and ultrasound examination (Gritz et al. The positively tested animals were all between day 32 and 56 of pregnancy, of a 63-66 day gestation period (Vargas et al. The animal whose plasma yielded negative WitnessRelaxin test results, was at day 32 after her frst mating, although later she was proven to be pregnant. Only when urine samples were concentrated by ultrafltration at least 50x, a weak relaxin positive reaction was observed between day 29 and 46 of the pregnancy (n=17). These failed pregnancy diagnosis might be explained by the ongoing degradation of relaxin within the urine samples (late collection) and/or insuffcient level of the ultrafltration procedure. Thus, the urinary relaxin was still under the detection level of WitnessRelaxin test. In contrast to urinary progestagens, estrogens refect cl formation after ovulation.

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Weaning should start around the ffth week of life and be completed around the age of 100 days buy 800 mg cialis black with amex erectile dysfunction exercises dvd. To ensure the behavior of hand-reared individuals matches the goals of the Ex situ Conservation Programme order cialis black 800mg with amex erectile dysfunction performance anxiety, an appropriate socialization programme should begin on the cubs second week of life discount cialis black 800mg mastercard doctor for erectile dysfunction in dubai, in parallel to the feeding and care of the cubs. Hand-rearing should only be considered when all factors and circumstances point to a high risk of disease and/or death of the cub, the mother or the cubs siblings. The few remaining populations of Iberian lynx are in such an extreme situation that each individual is valuable for the conservation programme. Thus, all efforts aimed at avoiding the loss of a cub, even if premature, 111 are justified. These figures substantiate the effort involved in trying to substitute for maternal care and the importance of knowledge and experience in successful hand-rearing. This chapter is a compilation of the most important sections of the Guidelines for Hand Rearing Iberian Lynx cubs (Rivas et al. In addition, neonates depend on their mothers stimulation of the perianal area in order to defecate and urinate. At 3-4 weeks of age the distance is 16 mm in females and >16 mm in males (Palomares, pers. In felids, as in other carnivores, immunity of cubs is essentially passive at frst. It is vital to maintain strict hygiene for all cubs, but especially for the colostrum-deprived ones. Following are specific features of each of these landmarks: Eyes: The eyes start to open in the second week of life (8-14 days) and are fully open in the 3rd week (around 14-18 days of age). In contrast, in Iberian lynx cubs the frst teeth to erupt are the upper canines, between 15 and 20 days of life. The order of eruption of permanent teeth replacing deciduous ones is incisors, molars, canines and fnally premolars (Garca-Perea, 1996). Deciduous canines begin to emerge during the ffth post-natal month, and are completely replaced by permanent ones by the sixth month of life. It gradually starts to disappear from the forehead and distal part of the limbs at around 11 post-natal days, follows a cranial-caudal pattern of thinning until it eventually disappears completely at around 70 days of age. The ears start to unfold around the tenth day of life and remain half-folded until the ffth week (31-36 days), when they become fully erect. Claws: cubs are born with their claws fully extended and covered from the base with a sheath of connective tissue. The claws only become completely retractable another trait of felid species between the third and fouth post-natal week. Motor skills: Although cubs are able to move from the very beginning, their movements are clumsy and shaky. They begin to crawl and are strong enough to stand on their four limbs between the second and third week of life. They only acquire enough motor skills to start to walk and explore their surroundings at four weeks of age. This is a sign that the cub might have an infectious disease or a developmental disorder. One or several Iberian lynx cubs can be hand-reared with those of other Lynx species (e. Four weeks is a good age to introduce a domestic kitten or a cub of another species of small felid (Mellen, 1998). A high standard of hygiene must be followed when handling the animal, preparing its food, and cleaning feeding bottles and other utensils. This is particularly important for those cubs that have not had mothers colostrum. Hand-raised neonates should be taken care of by no more than 2-3 people in order to ensure consistency in the handling and feeding of the animals as well as maintaining a good record-keeping. At around 15-20 post-natal days, cubs are fairly mobile and need more space, it is advisable to provide them at his stage with an area of approximately 1x1 m to move around. At around fve weeks, mother-raised cubs begin moving all over their enclosures, at this age, it is important to provide hand-raised cubs with a larger area where to exercise and explore. The incubator or denning box, can also be provided with additional hot water bottles or electric heating pads. The sources of heat should be placed so that there is always a temperature gradient and some areas are warmer than others, enabling neonates to fnd the most comfortable spot for them. The sources of heat should not come into direct contact with the animal, as they may cause burns. It is vital that the inside of the incubator and the room where it is placed have a similar temperature, so that the neonate does not suffer a sudden change in temperature when being fed and cared for outside of the incubator. The room and incubator temperature should be regulated depending on the age of the cub. The recommended temperature gradient is as follows (Prats, 2004; Gunn-Moore, 2006b; Murtaugh, 1994): 1st week: 30-32 c0 2nd week: 27-29 c0 3rd and 4th week: 27 c0 5th week: 24 c0 After the 6th week: 21 c0 Observation of the cub between two feeds will tell whether the animal is too cold or too warm. If the cub is agitated, restless and/or making whining sounds it may be a sign that the temperature is not well regulated. For humidity control, one can use humidifers or maintain containers full of water near heat sources. Levels that are too high (85-90%) or too low might compromise the health of the cub. For Iberian lynx neonates, the ideal ones are PetAg small nipples for 60 cc feeding bottles. Once a nipple works with a cub it should always be used exclusively for the same cub, until it needs to be replaced by another one because it is too small or too worn. Disinfectants and wet heat sterilization gradually damage the nipples, which eventually have to be replaced. The size and volume of the bottle will increase as the cub grows and needs more food. Several nipples, bottles and bottle brushes should be available while hand-rearing the young. After each feeding, they must be washed with soap, very well rinsed and sterilized with steam or a bottle sterilizer. It also provides an appropriate amount of taurine, an essential amino acid for cats. Esbilac and Lactadiet have also being used with Iberian lynx and they are considered appropriate for this species. However, cats cannot synthesize a suffcient amount and, therefore, must acquire the rest through diet. Taurine defciency can lead to impaired vision (feline central retinal degeneration), heart disease (dilated cardiomyopathy) or a decreased reproductive performance and growth. They are used as a source of energy and hydration in the frst few feedings of cubs that are going to be bottle-fed (see Feeding), as a gut stabilizer during episodes of diarrhea (see Diarrhea) and to treat cubs with hypothermia (see Treating hypothermisc cubs). In general, electrolytes such as Pedialyte and Glucolyte provide a good energy supplement to neonates, particularly those that are cold and/or weak.

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