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Thread: 10 days of diarrhea

  1. #21
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    Default Re: 10 days of diarrhea

    Thatís a very interesting insight into the ingredients of food products. That is exactly what was suspected during the last Esbilac nightmare.

    I think we will see a lot more of this as supply lines are interrupted during these crazy times. Pricing will be an important part of this as manufactures seek out cheaper alternatives. Unfortunately it is usually about the bottom lineÖ. money.

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  3. #22
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    Default Re: 10 days of diarrhea

    Update:

    We're beginning day 12 since pudding poo; day 7 of watery diarrhea.

    I started goat's milk formula yesterday and she's had 3 feedings since. I'm still mixing it 5/2. I don't think she likes it much because she turns it away by 18cc. I'll increase GMF % this afternoon but I was hoping to see some improvement by now.

    I give her a dose of bismuth every 4-5 hours and make sure one coincides with each syringe feeding. I know the smart thing to do would be to wean her (she'll be 11 weeks on Sunday) but she *literally* goes hangry-ballistic if she doesn't get formula 3x daily. I don't believe in "tough love" when it comes to food, if I can avoid it (I mean, other than withholding snacks that aren't good for her-- she hasn't even had any fruit, yet, until I started the banana for the diarrhea).

    Removed the maple log. Now all she has (new) is the gravel paper and one of those inexpensive stacked-wood hanging rat chew toys from the pet store. Those go next.

    Other than formula 3x, I give her a Henry's block 2x day but she mostly just shreds them. I offer her Mazuri but she just buries them. She gets about 6cc of baby rice cereal w/banana slice 2x daily. If she's still hangry I'll give her a slice of mushroom.

    She passes a good amount of clear urine 2-3x daily. Poo is still a little soft, even with Pepto, and it turns into diarrhea each time she eats (anything).

    I weighed her today. Before this started she was (presumably) around 400 grams. On (Tuesday?) she was 360. I'm fairly sure that was an accurate weighing. Today she's 388 so I suspect the weight loss may have been dehydration? She may weigh more than 388: she is getting better enough with the bismuth that she preferred to flip the bowl over and play in it so it was difficult to get an actuate weight (it fluctuated between 381-394 every time she wiggled but landed on 388 most often). This is a good sign that she is gaining some weight back, but we still haven't knocked the poo juice because it comes back between doses of bismuth

    I'm out of ideas. If the goat milk doesn't improve her by tomorrow, is this a sign that she might have an infection? The cyst-wound where she bit it open was still scabby when the watery diarrhea started. The loose bowels started not long (a week?) after she opened it up. I don't feel the scab anymore but there is something hanging from that thigh, tangled up in fur. I don't know if it's feces or from the wound. It's hard, so I soak it three times a day and try to work it without pulling. She only allows me about a minute, so I can't get it soft enough and she won't hold still long enough for "Grandma" to focus her reading glasses to see what it is.

    How would I know if she has an infection? How do you take a squirrel temp? I guarantee she won't hold still for me to stick anything up her butt lol.

  4. #23
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    Default Re: 10 days of diarrhea

    Yeah, this is a problem. I have seen a few cases on TSB in the past where the only resolution to diarrhea was weaning them and getting them onto solid food. At that age we can certainly start thinking about that but itís very difficult when they want the formula so bad. I do think I would start introducing healthy veggies to start the transition. I would give her either kale or sugar snap peas and see what happens. These are healthy greens so letís start there.

    We might need to consider treating her for a GI parasite as well. I find it so strange that she was completely fine for so long and then BAM Ö GI train wreck. I would be happy to send you metronidazole if you want to consider it in the future. You could at least have it on hand if this persists.

    I donít think the wound that she had has anything to do with the diarrhea but we need to make sure the abscess is gone. Based on her activity level and willingness to eat, I donít think she has any systemic issues from that.

    Give it a little longer on the GMF and see if there is any improvement. I would start giving veggies though to start the transition to solid food. We usually start that after they are eating the blocks well around 7 weeks anyway. She is quite the mystery though. I wish I knew for sure if the can of Esbilac started this.

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    Default Re: 10 days of diarrhea

    I started her on broccoli and Brussels sprouts (about a teaspoon of each) at 8 weeks. Since she did well, I added mushroom, lettuce, sugar snap peas and wild foods in small amounts (dogwood berry and rose hips). It was when I introduced dogwood and at the same time increased the broccoli/Brussels sprouts that the watery diarrhea started and I was advised to withhold veggies and give her only BRF & Henry's until it resolved. Since it's not resolving, I (and probably she) will be happy to reintroduce veggies. I will not give her gassy veggies until it's resolved.

    Although I was preparing her to wean, I am mostly holding off until she starts drinking water. I know they don't drink that much, but I'm currently unemployed and hang out with her all day so I notice if she even dips her nose in it and she doesn't lol.

    Her appetite isn't great. She is hangry and demands to be fed but then doesn't eat much. Her energy level is much better since hydrating and starting the bismuth and she is eating more, but miss a dose and her appetite goes down again along with BM solidity.

    I'm not sure about the likelihood of a parasite but it's possible. I did put the fresh dogwood branch in, but I rinsed it under a hose for at least five minutes. I don't think the maple log could have because I baked it for many, many hours. Let me look and see if I have metronidazole. If I do, it's many years expired, though.

    It may be time to call the vet but it's so difficult to catch her if she escapes and the trip terrifies me that she'll get hurt. I was trying to find a harness for that possibility but have returned two that were too large or too bulky for her and may end up just trying to make one. Hey! Maybe I can collect a stool sample!

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    Default Re: 10 days of diarrhea

    Yes!!! Vet agreed to test her stool without seeing her. Sample successfully collected. Unfortunately, they send it out AND they're closed on Saturday so I'm not sure how long it will be before I know.

    So, I still think there is the possibility of a bacterial infection. The "hard thing" matted in her fur is definitely from the wound. She decided to rip out a bunch of fur to try to get rid of it. I caught her when she ripped the scab loose... And ate it The hard stuff was bloody but might be old blood that just turned red again when I soaked it and she started gnawing on it. I dunno. I didn't give her an antibiotic when she opened the abscess because I never saw any swelling and she didn't lose any fur. I flushed with diluted betadine once and then with saline for three days. It was scabbed last week but it's possible she broke the scab and caused infection?

    If the test shows no parasites and she continues with the diarrhea despite all the restrictions on her diet and environment, I really can't think of anything else it could be, besides a bacterial infection.

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    Default Re: 10 days of diarrhea

    I would consider coccidia with the pattern of poo she has. The fecal test might not necessarily show for coccidia cos it might not be shedding the oocytes at the time the test was taken. It is a quick treatment. If she does have coccidia the damage to the large intestine is pretty intense. Hopefully the fecal will show something. Baycox or panazuril is what is used to treat coccidia.

    There are a lot of GI bugs that could be causing diarrhea and two weeks of diarrhea is too long. Thank you for taking a fecal in.
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    Default Re: 10 days of diarrhea

    Quote Originally Posted by redwuff View Post
    I would consider coccidia with the pattern of poo she has. The fecal test might not necessarily show for coccidia cos it might not be shedding the oocytes at the time the test was taken. It is a quick treatment. If she does have coccidia the damage to the large intestine is pretty intense. Hopefully the fecal will show something. Baycox or panazuril is what is used to treat coccidia.

    There are a lot of GI bugs that could be causing diarrhea and two weeks of diarrhea is too long. Thank you for taking a fecal in.
    I wish I had taken the sample on Monday. I don't know why I didn't think to ask vet if I could just bring the sample in instead of her. I guess I was still thinking food reaction because I cleaned the wild things I gave her and thought it was unlikely.

    Will the fecal study look for those other bugs, too?

    Yes, I read a couple of medical articles, studies on squirrels in the wild from Virginia, and saw that coccidia was the more common parasite, at 91% infection in wild squirrels! Nematodes were common at about 60% I think but I don't see anything in the poo. The study said they just live with it or recover, except in the young or immune impaired. I don't want her to have to live with it.

    I will let the vet know what you said if she isn't sure what to prescribe (she doesn't specialize in wildlife). Thanks!

    You are ABSOLUTELY right that two weeks is too long. Three days of watery diarrhea is too long and that's been going on a week. I would be at my wit's end, even if it was just still the pudding-poo she began with but I started freaking out and seeking wider range of advice on the second day of the watery stuff.

    She's "okay" (has energy to play and is eating better) as long as she gets her Pepto. I really hope we get some news from the vet. It's been a long, hard road for her and I'm praying it's near its end and she'll come out the other side triumphant.

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    Default Re: 10 days of diarrhea

    So, here is something I have used with great success, and the last three people I recommended it to on here also managed to stop the diarrhea with it.

    First, diarrhea often is the cause of prolonged diarrhea. That is, it is very caustic, and it inflames the heck out of the digestive tract. And the inflammation causes more diarrhea, which further inflames the digestive tract which causes more diarrhea and on and on and on. What is needed is something very mild that SLOWS the passage of the feces and also pulls the water out of the digestive tract. And tastes good.

    Rice Chex. It is crunchy and tasty and every squirrel I have ever given it to or recommended it to has loved it. My now late Mister P loved Rice Chex more than any other food including nuts. It is dry and thus absorbs water, mild so it doesn't cause further issues, and is made of RICE which is very commonly used for this very reason. I would strongly recommend you buy the real General Mills Rice Chex and not the store brands. I use a site called nutritiondata.self.com which has full nutritional info on tons of foods and if you look up Rice Chex you will see that it is calcium supplemented to bring it up to the 2:1 calcium to phosphorus ratio, so it isn't going to start causing MBD. The store brands MAY be as well, but since I just can't verify it, I always spring for a little more money and buy the brand name.

    Now it is possible that you have something going on giardia or coccidia wise but it is also possible that something minor triggered the diarrhea initially and you are on the inflammation/diarrhea downward spiral. If that is what is happening, the Rice Chex will fix it and you can join my Magical Anti-Diarrhea Rice Chex club.

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  12. #29
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    Default Re: 10 days of diarrhea

    Are you giving full strength GMF? Did you ever order any Fox Valley Dia-stat from Henrys?

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    Default Re: 10 days of diarrhea

    Quote Originally Posted by CritterMom View Post
    So, here is something I have used with great success, and the last three people I recommended it to on here also managed to stop the diarrhea with it.

    First, diarrhea often is the cause of prolonged diarrhea. That is, it is very caustic, and it inflames the heck out of the digestive tract. And the inflammation causes more diarrhea, which further inflames the digestive tract which causes more diarrhea and on and on and on. What is needed is something very mild that SLOWS the passage of the feces and also pulls the water out of the digestive tract. And tastes good.

    Rice Chex. It is crunchy and tasty and every squirrel I have ever given it to or recommended it to has loved it. My now late Mister P loved Rice Chex more than any other food including nuts. It is dry and thus absorbs water, mild so it doesn't cause further issues, and is made of RICE which is very commonly used for this very reason. I would strongly recommend you buy the real General Mills Rice Chex and not the store brands. I use a site called nutritiondata.self.com which has full nutritional info on tons of foods and if you look up Rice Chex you will see that it is calcium supplemented to bring it up to the 2:1 calcium to phosphorus ratio, so it isn't going to start causing MBD. The store brands MAY be as well, but since I just can't verify it, I always spring for a little more money and buy the brand name.

    Now it is possible that you have something going on giardia or coccidia wise but it is also possible that something minor triggered the diarrhea initially and you are on the inflammation/diarrhea downward spiral. If that is what is happening, the Rice Chex will fix it and you can join my Magical Anti-Diarrhea Rice Chex club.
    I've been mixing baby rice cereal with formula but good point! And Chex is one of the few things in this world that I will never buy generic. I'm off to the grocer tomorrow so I will add it to my list!

    Quote Originally Posted by Mel1959 View Post
    Are you giving full strength GMF? Did you ever order any Fox Valley Dia-stat from Henrys?
    At this point, I have her on 6/4 Esbilac/GMF mixture. Tomorrow I will phase out Esbilac entirely if she continues to prefer it this way. I want her off the Esbilac but I don't want it to be too quick transition with all the tummy troubles. I'm watching her very closely.

    She should probably be weaning but 1) I don't like how much weight she's lost and she stopped growing at 9 weeks when this started so added nutrition is probably smart right now and 2) she is extremely insistant that she is NOT ready to wean, probably because liquid is easier to digest and she is always hungry with the tummy trouble even if she doesn't eat much.

    I made the decision today to order FV even if she might turn around next week and wean before it arrives. I figure it's worth the investment because there will probably be other rescues who will need it in future if she doesn't want it. I usually keep it in freezer just in case but my last bag expired months before she was old enough for it. I should have transitioned when she was 4 weeks but she was doing so well on the Esbilac... Until this last can, new lot.

    OH! The diastat. No. I didn't order. With the Pepto she started taking more formula and I offer water in between so she isn't currently dehydrated.

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    Default Re: 10 days of diarrhea

    Quote Originally Posted by ConfusedMuse View Post
    OH! The diastat. No. I didn't order. With the Pepto she started taking more formula and I offer water in between so she isn't currently dehydrated.

    Electro-Stat is the FV rehydration solution


    Dia-Stat is for diarrhea as well as re-hydration from diarrhea... and just for anyone reading this thread now or in the future because this baby is not emaciated and weak... Dia-Stat is my go to not only for difficult cases of diarrhea but a life saver IMO for severely dehydrated, emaciated, starving babies. One of the ingredients for treating diarrhea is Guar Gum which I don't see in other products. In addition it contains easily digestible dextrose to give some extra energy and calories.... I have been preaching Dia Stat for a long while now and it has saved babies (IMO) that I believe I would have lost without it.

    https://henryspets.com/dia-stat-for-diarrhea/

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  17. #32
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    Default Re: 10 days of diarrhea

    Good news!!!

    So, last night, her BMs cleared up to "partly formed". Although it does this after every Pepto dose, the poo juice always returns within 4 hours. Because it was firming up, I didn't give her a bedtime dose.

    I awoke to this, so didn't dose her this morning:

    Name:  IMG_20210926_091246_496.jpg
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    It's still a little mushy (you can see her footprint in the long one) and way too big to be called "normal" (her normal is about 1/4", like the one in the background, and these are 1/2" and 1-1/2 inch in the foreground).

    Fed her Henry's block, then her morning formula (about 2/6 mix Esbilac/GMF), then a bowl of fresh veggies (I added those back in on Friday because withholding wasn't helping). Then she gave me this:

    Name:  IMG_20210926_094946_306.jpg
Views: 16
Size:  28.0 KB

    WOOT! And her appetite is back (although that improved with bismuth and again when I introduced GMF).

    I went ahead and treated with toltrazuril 5% last night although the poo never had an unusual odor. I spent the day reading about the horrors of late treatment for coccidia in young animals and decided the benefits outweighed the risk. In addition, she's transitioning off Esbilac, so I don't know which finally helped. Maybe I'll know when her stool results come back from the vet. I will never use Esbilac again (but I'm not sure what to do if faced with a pinkie again-- 32/40 is still not good, as I understand it, which is why I used Esbilac when she was rescued and continued when she was old enough for 20/50 on the assumption "if it ain't broke, don't fix it." But it's broke, now, so...).

    This is what I used for coccidia (older version of baycox). If anyone needs it, the website is on the label. I'm told not to do second dose after 24 hrs as listed on label for rabbits but can repeat in 7 days.

    Name:  IMG_20210925_151140.jpg
Views: 16
Size:  68.8 KB

    I've been replacing the paper in her cage 2x daily. I guess today I will do my best to clean it thoroughly (I have chlorhexidine soap) just in case it was coccidia. If all remains well, I'll start adding things back into her cage because she's going cray without her chew toys lol. Every other day, though, because I need to watch to make sure they don't cause a relapse. Obviously, I have to throw out the wood stuff since I can't wash it. Sigh. Unless... Does anyone know how long coccidia can survive in dried poo? I can surface-clean but I worry it might have permeated into the wood...

    I'll give another update this evening. It looks like she's on the mend!

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    Default Re: 10 days of diarrhea

    Quote Originally Posted by Spanky View Post

    Electro-Stat is the FV rehydration solution


    Dia-Stat is for diarrhea as well as re-hydration from diarrhea... and just for anyone reading this thread now or in the future because this baby is not emaciated and weak... Dia-Stat is my go to not only for difficult cases of diarrhea but a life saver IMO for severely dehydrated, emaciated, starving babies. One of the ingredients for treating diarrhea is Guar Gum which I don't see in other products. In addition it contains easily digestible dextrose to give some extra energy and calories.... I have been preaching Dia Stat for a long while now and it has saved babies (IMO) that I believe I would have lost without it.

    https://henryspets.com/dia-stat-for-diarrhea/
    I'm going to order it even though she's improving because I could have used it when she was way down. It wouldn't be a bad thing to have on hand so if (g*d forbid!) it happens again it will be on hand and won't have to wait for it. So it can be used for dehydration even if no diarrhea? Thanks!

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  21. #34
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    Default Re: 10 days of diarrhea

    Yay to good poo!!!
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    Default Re: 10 days of diarrhea

    Quote Originally Posted by ConfusedMuse View Post
    Good news!!!

    So, last night, her BMs cleared up to "partly formed". Although it does this after every Pepto dose, the poo juice always returns within 4 hours. Because it was firming up, I didn't give her a bedtime dose.

    I awoke to this, so didn't dose her this morning:

    Name:  IMG_20210926_091246_496.jpg
Views: 17
Size:  37.0 KB

    It's still a little mushy (you can see her footprint in the long one) and way too big to be called "normal" (her normal is about 1/4", like the one in the background, and these are 1/2" and 1-1/2 inch in the foreground).

    Fed her Henry's block, then her morning formula (about 2/6 mix Esbilac/GMF), then a bowl of fresh veggies (I added those back in on Friday because withholding wasn't helping). Then she gave me this:

    Name:  IMG_20210926_094946_306.jpg
Views: 16
Size:  28.0 KB

    WOOT! And her appetite is back (although that improved with bismuth and again when I introduced GMF).



    This is what I used for coccidia (older version of baycox). If anyone needs it, the website is on the label. I'm told not to do second dose after 24 hrs as listed on label for rabbits but can repeat in 7 days.

    Name:  IMG_20210925_151140.jpg
Views: 16
Size:  68.8 KB

    I'll give another update this evening. It looks like she's on the mend!
    Thank you so much for the site on ďall things bunniesĒ that carries toltrazuril for coccidia. Great find.
    redwuff
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    Default Re: 10 days of diarrhea

    Aaaand, we're back. Now I'm confused because this looks more like vomit than poo. I'm at a loss.

    Name:  IMG_20210926_111133_139.jpg
Views: 16
Size:  37.5 KB

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    Default Re: 10 days of diarrhea

    Quote Originally Posted by redwuff View Post
    Thank you so much for the site on ďall things bunniesĒ that carries toltrazuril for coccidia. Great find.
    It was actually a combined effort. When you gave me the brand names of treatment, I googled to find active ingredient, then asked my local rehabber friend if she had any of those. She came up with the rabbit med which she had on hand, and the website, where she says they have all kinds of good stuff.

    www.allthingsbunnies.com

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    Default Re: 10 days of diarrhea

    Quote Originally Posted by ConfusedMuse View Post
    I'm going to order it even though she's improving because I could have used it when she was way down. It wouldn't be a bad thing to have on hand so if (g*d forbid!) it happens again it will be on hand and won't have to wait for it. So it can be used for dehydration even if no diarrhea? Thanks!
    Yes, but here is my protocol: I use homemade hydration for run of the mill dehydrated intakes. Kids that come in from the wild or finders that did things very wrong and the babies are close to deaths door, skin and bones. I start with homemade hydration for 8 - 24 hours then transition to DiaStat depending on their condition: For the kids who are just not perking up like they should from hydration I use DiaStat as the first two "meals" instead of formula.

    It would be worthwhile to read more detail on the FV site (link below). I'll point out it says Dia Stat can be used in conjunction with additional water (or electrolyte solution), it is not recommended to be used if the squirrel (mammal?) is being treated with antibiotics,

    https://store.foxvalleynutrition.com/dia-stat



    Quote Originally Posted by ConfusedMuse View Post
    I will never use Esbilac again (but I'm not sure what to do if faced with a pinkie again-- 32/40 is still not good, as I understand it, which is why I used Esbilac when she was rescued and continued when she was old enough for 20/50 on the assumption "if it ain't broke, don't fix it." But it's broke, now, so...).
    FWIW: Zoologic 33/40 with FV 32/40 and cream, birth to wean. If you use the formula calculator at eWildAgain you'll see this is much closer to mom's milk that just Esbilac or FV 20/50.

    It is hard to recommend this generally on the board because I have not found anywhere to buy the Zoologic in less than 5lbs quantities.. so for someone caring for the "one off" baby or litter it would be a big ask to buy 5lbs. Also, since Zoologic is also a PetAg product some folks will refuse to use it as well Esbilac (but there are some very good rehabbers that continue to use both Esbilac and FV32/40). Some folks will refuse to use the FV 32/40 as well... I was not rehabbing during the 32/40 disaster, but did used it early in my squirrel experience without issue, then stopped using it after learning about the debacle. I was lucky during the more recent Esbilac debacle not to have used the bad lots (maybe the luck of buying in 5lb bags?), but I was using half Esbilac and half FV 20/50 starting at 3 weeks back then... I always like to think the half and half provides some reassurance against an issue with one formula or the other. I did intake quite a few kids suffering from MBD (75% from other rehabbers often from very far away!) during the Esbilac debacle and am happy to say MBD was reversed in all of them and they were all successfully released. I was very lucky. Quite a number of them had fractures in their X-Rays but they were young enough to grow healthy bones and had no deficiencies at release age.


    (Sorry that I am "ranting" in a few posts in your thread, but this seems like a thread that includes and productive and healthy exchange of ideas! It is not intended to be a thread hi-jack!)

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    Default Re: 10 days of diarrhea

    I'm sometimes stubborn about clinging to things I've used that work, but I am a "permanent student" always interested in learning more and new things. I think I accidentally dismissed the dia-stat because 1) I thought shipping was too slow and wanted something for immediate care and 2) I thought it was just another electrolyte (maybe I accidentally got electro-stat when I googled?) So THANKS very much for bringing it up again! This is, indeed, a thread that welcomes discussion!

    I've looked around TSB but see no mention of how to feed FV 20/50. Does it require extra cream? She is basically weaning age but I really hesitate to wean (more of that stubborn streak) until we have this figured out and she starts drinking water on her own, so I'd like to start her on FV. She takes formula 3x daily (about 6 hours between).

    Should I add cream or yogurt?



    Quote Originally Posted by Spanky View Post
    Yes, but here is my protocol: I use homemade hydration for run of the mill dehydrated intakes. Kids that come in from the wild or finders that did things very wrong and the babies are close to deaths door, skin and bones. I start with homemade hydration for 8 - 24 hours then transition to DiaStat depending on their condition: For the kids who are just not perking up like they should from hydration I use DiaStat as the first two "meals" instead of formula.

    It would be worthwhile to read more detail on the FV site (link below). I'll point out it says Dia Stat can be used in conjunction with additional water (or electrolyte solution), it is not recommended to be used if the squirrel (mammal?) is being treated with antibiotics,

    https://store.foxvalleynutrition.com/dia-stat





    FWIW: Zoologic 33/40 with FV 32/40 and cream, birth to wean. If you use the formula calculator at eWildAgain you'll see this is much closer to mom's milk that just Esbilac or FV 20/50.

    It is hard to recommend this generally on the board because I have not found anywhere to buy the Zoologic in less than 5lbs quantities.. so for someone caring for the "one off" baby or litter it would be a big ask to buy 5lbs. Also, since Zoologic is also a PetAg product some folks will refuse to use it as well Esbilac (but there are some very good rehabbers that continue to use both Esbilac and FV32/40). Some folks will refuse to use the FV 32/40 as well... I was not rehabbing during the 32/40 disaster, but did used it early in my squirrel experience without issue, then stopped using it after learning about the debacle. I was lucky during the more recent Esbilac debacle not to have used the bad lots (maybe the luck of buying in 5lb bags?), but I was using half Esbilac and half FV 20/50 starting at 3 weeks back then... I always like to think the half and half provides some reassurance against an issue with one formula or the other. I did intake quite a few kids suffering from MBD (75% from other rehabbers often from very far away!) during the Esbilac debacle and am happy to say MBD was reversed in all of them and they were all successfully released. I was very lucky. Quite a number of them had fractures in their X-Rays but they were young enough to grow healthy bones and had no deficiencies at release age.


    (Sorry that I am "ranting" in a few posts in your thread, but this seems like a thread that includes and productive and healthy exchange of ideas! It is not intended to be a thread hi-jack!)

  27. #40
    Join Date
    Sep 2011
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    Default Re: 10 days of diarrhea

    I do not add anything to FV 20/50. Other people do.
    redwuff
    State Licensed
    Master Wildlife Rehabilitator

  28. Serious fuzzy thank you's to redwuff from:

    ConfusedMuse (09-26-2021)

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