YorkieTalk.com Forums - Yorkshire Terrier Community


Welcome to the YorkieTalk.com Forums Community - the community for Yorkshire Terriers.

You are currently viewing our boards as a guest which gives you limited access to view most discussions and access our other features. By joining our free community you will have access to post topics, communicate privately with other members (PM), respond to polls, upload content and access many other special features. You will be able to chat with over 35,000 YorkieTalk members, read over 2,000,000 posted discussions, and view more than 15,000 Yorkie photos in the YorkieTalk Photo Gallery after you register. We would love to have you as a member!

Registration is fast, simple and absolutely free so please, join our community today!

If you have any problems with the registration process or your account login, please click here to contact us.

Go Back   YorkieTalk.com Forums - Yorkshire Terrier Community > YorkieTalk > Sick & Injured / Emergencies Talk
Register Blogs FAQ Calendar JavaChat Mark Forums Read

Reply
 
LinkBack Thread Tools
Old 07-07-2008, 09:33 AM   #1
Senior Yorkie Talker
 
BarbaraM's Avatar
 
Join Date: Dec 2007
Location: chicagoland
Posts: 209
Question Pancreatitis - Other causes than high fat in diet?

Hi everyone,
Just picked up my Ted this am from ER hospital. He spent the night on IV and meds for pancreatitis. I took all three of my "kids" in yesterday due to stomach problems of one sort or another.
I thought Ted was fine. Just wanted to be sure the black tar poo wasn't serious. It is. That was the only symptom he has. He is active, playing, eating, doing fine other than the BLACK TAR poo.
The blood work and xray performed confirmed the pancreatitis dx.
I picked him up this morning and was to take him directly to my vet to continue on fluids and my vet is out of town. During the phone conversation Ted licked his catheter out of his arm - a head's up would have been nice - I didn't realize he still HAD the catheter!! I scooped him up and took him to the nearest vet hospital/clinic where he is now. Stable.
He only eats Spot's Stew for Dogs. ONLY and tomatoes for a treat. Organic grape tomatoe in slices. That is IT. No other food.
Could he be eating bunny rabbit turds?? We have a baby bunny in back yard? I am going crazy. Thanks for all the help !!!
__________________
TeddE SammE Gisele
Member of Little Gentlemen's Club
BarbaraM is offline   Reply With Quote
Welcome Guest!
Not Registered?

Join today and remove this ad!

Old 07-07-2008, 09:41 AM   #2
And Rylee Finnegan
Donating Member
 
Ellie May's Avatar
 
Join Date: Apr 2007
Location: Metro Detroit, MI
Posts: 17,928
Default

Infection, metabolic disorders and hypercalcemia can also cause pancreatitis (but sometimes it just happens).
__________________
Crystal, Ellie May (RIP), Rylee Finnegan, and Gracie Boo🐶
Ellie May is offline   Reply With Quote
Old 07-07-2008, 10:41 AM   #3
Lovin' to the MAX!!
 
nvnvgirl's Avatar
 
Join Date: Oct 2006
Location: Yorkieville
Posts: 2,774
Default

When Max had it, the vet wasn't sure if he might have gotten into something (like out in the yard) or if it was b/c of his diet and being a little overweight. I think that they pick up a lot of things that we don't know about and some things can make the pancreas work overtime, so they just get it.

On a positive note, Max hasn't had a problem with it since the original incident (he was put on prescription food and NO people food, he gets a few low fat, low calorie treats or apples), so hopefully, Teddy will do just as well once he's fully recovered! All the best and big hugs to Ted!
__________________
Seana and Max and Madison too!
Come visit me at: celebritydogwatcher.com
nvnvgirl is offline   Reply With Quote
Old 07-07-2008, 10:52 AM   #4
Donating YT 2000 Club Member
 
Ladymom's Avatar
 
Join Date: Sep 2007
Location: North Carolina
Posts: 8,317
Default

According to this, Yorkies are prone to pancreatitis:

"Multiple factors can contribute to the development of pancreatitis. Certain medications, infections; metabolic disorders including hyperlipidemia (high amounts of lipid in the blood) and hypercalcemia (high amounts of calcium in the blood); and trauma and shock can be associated with the development of pancreatitis. Middle-aged dogs appear to be at increased risk of developing pancreatitis; as a breed, Schnauzers and Yorkshire Terriers appear to be more prone to pancreatitis. Nutrition also plays a role. Dogs with diets high in fat, or dogs who 'steal' or are fed greasy 'people food' seem to have a high incidence of the disease."

Pancreatitis (Inflammation) in Dogs

This is the first time Ted has had pancreatitis, right? If he has another attack, you may want to consider switching him to special diet. Repeated bouts of pancreatitis can cause other problems including diabetes like Lady has.
Ladymom is offline   Reply With Quote
Old 07-07-2008, 12:55 PM   #5
Crazy about Kacee!
Donating Member
 
yorkieusa's Avatar
 
Join Date: May 2005
Location: Kansas
Posts: 21,173
Default

To add to the list, I have read that high sodium can cause pancreatitis as well.
__________________
Karen Kacee
Muffin 1991-2005 Rest in Peace My Little Angel
yorkieusa is offline   Reply With Quote
Old 07-08-2008, 01:21 PM   #6
YT Addict
 
GoofyBritt's Avatar
 
Join Date: Jun 2008
Location: Grove City, OH
Posts: 328
Default

Pork products have a high risk of causing pancreatitis. We found that out because my grandmother's dog was being fed hot dogs and other pork products and she always got really ill with vomiting, diahrea and bad siezures. NEVER feed any pork products to your dog.
__________________
Bentley
Bentley is my angel. I never knew I could love a dog so much, he is truly a miracle.
GoofyBritt is offline   Reply With Quote
Old 07-08-2008, 02:10 PM   #7
Senior Yorkie Talker
 
BarbaraM's Avatar
 
Join Date: Dec 2007
Location: chicagoland
Posts: 209
Default Thank you everyone! Ted says thank you too.

Ted is HOME. woohooo. Lots of meds and Hill's I/D diet for all three. His vet really wondered why all three came up with stomach problems. I need to watch them very closely outside.
The vet mentioned to me that his dog had some problems after eating Bunny turds, that they are sweet to dogs. WHAT??? I have a baby bunny that I have been feeding. Could it be? (Note to self: Do not feed the bunnies )
Ted was not vomiting at all. His white cell count was normal. So, did he have it or not? It's a toss. My vet says no. But he does have an inflamed stomach and irritated intestines, etc. Possibly bunny buttons. But why are the other two not feeling well too? More investigations, I suppose. My poodle turned up her nose at the I/D and she has GOT to be hungry, so I will keep a watchful eye on her. The bichon is doing well. He was the one throwing up.
Thank you for all the information - I am reading all of it! I am hopeful the amoxicillin, carafate, and metronidazole/flagyl and cetring? helps. And the new I/D diet. And no more Bunny Buttons!!!
Quote:
This is the first time Ted has had pancreatitis, right?
Yes. And I am considering a diet change, anyway. Maybe the Halo Stew is just too high in fat or carbs?? I am sure it's not the tomatoes for treats (organic, sparingly) and that is all he/they get! I don't ever want to have to have him in the hospital for two days every again. Never.
And thanks for the info on the pork - I heard turkey skin is bad with fat too.
__________________
TeddE SammE Gisele
Member of Little Gentlemen's Club
BarbaraM is offline   Reply With Quote
Old 07-08-2008, 02:17 PM   #8
YT Addict
 
GoofyBritt's Avatar
 
Join Date: Jun 2008
Location: Grove City, OH
Posts: 328
Default

I'm not sure if it's teh high amount of fat that causes it or the chemical makeup of the pork. Yes I've heard turkey is bad, too, but I'm not sure if they meant the skin or the actual turkey. So I avoid giving turkey to my furbaby as well as all pork products. I hope your babies are back to normal soon. I know it's scary. :/ HUGS

Brittany and Bentley
__________________
Bentley
Bentley is my angel. I never knew I could love a dog so much, he is truly a miracle.
GoofyBritt is offline   Reply With Quote
Old 07-08-2008, 04:08 PM   #9
No Longer a Member
 
Gizmo's Mom's Avatar
 
Join Date: May 2005
Location: Texas
Posts: 1,490
Blog Entries: 7
Default

Barbara, I am sooo glad to hear that Ted is home along with your other babies. If there is a problem feeding the i/d, remember rarely will a dog turn down rice with boiled chicken(white meat). The carafate will keep the tummies coated. Hoping all are tip top in no time.
Gizmo's Mom is offline   Reply With Quote
Old 07-09-2008, 03:29 AM   #10
No Longer a Member
 
Gizmo's Mom's Avatar
 
Join Date: May 2005
Location: Texas
Posts: 1,490
Blog Entries: 7
Default

Hoping the babies are still doing better this morning.
Gizmo's Mom is offline   Reply With Quote
Old 07-09-2008, 04:57 AM   #11
Senior Yorkie Talker
 
BarbaraM's Avatar
 
Join Date: Dec 2007
Location: chicagoland
Posts: 209
Default

They are hungry!! Poodle isn't eating all that well tho. Bichon is doing better. TeddE cries and cries, poor baby. He is on 1/4 c of I/D a day for awhile and ice cubes (along with meds).
I wish I could be certain that Ted DID or DOES have pancreatitis. I wish they would have REPEATED the blood work. All numbers are fine here except the Amyl (2039) and the Lipa (3569), high RBC, high HCT, and high HGB?? Then she did the cPL Snap Test and claims it was abnormal= Positive for pancreatitis.
So, I don't know. My vet says he is unsure of the diagnosis due to Ted NOT vomiting and the white cell count being Normal. The dog acted fine. I almost didn't take him to ER. I was more concerned with Poodle. How can you tell if there is something wrong. The black stool indicates a very irritate intestinal tract and his stomach was inflamed (xray) and that is all. He played, ate, ran around, stole toys, etc. I took him along only because of the black stool. ????
What is the indication or a symptom, if he is not vomiting? His appetite was good. But he was very gassy. ??? Now, I will be running him constantly to have blood work for I will not know. Poodle's blood work was all normal. Did not have Bichon blood work done, he was given subQ fluids and meds for vomiting. I am so confused.

Houston, we have poopoo. I am running it to vet now. Darn TeddE, that's alot of doodoo!!!
__________________
TeddE SammE Gisele
Member of Little Gentlemen's Club

Last edited by BarbaraM; 07-09-2008 at 05:02 AM. Reason: Update!!!
BarbaraM is offline   Reply With Quote
Old 07-09-2008, 06:00 AM   #12
YT Addict
 
JesStang's Avatar
 
Join Date: Jul 2008
Location: Mustang, Oklahoma
Posts: 301
Default

My Yorkie got pancreatitis about 3 years ago & had to stay at the vet 4 days. The vet said not to give him anything w/ a lot of fat in it. We don't give him soft doggy treats anymore because those can be fattening. We never feed them people food anyway but we definitely make sure he doesn't get any now.
Just make sure you watch what your dog eats & gets into. Mine likes to get into whatever he can.
JesStang is offline   Reply With Quote
Old 07-09-2008, 11:06 AM   #13
Crazy about Kacee!
Donating Member
 
yorkieusa's Avatar
 
Join Date: May 2005
Location: Kansas
Posts: 21,173
Default

The pancreas is a V-shaped organ located behind the stomach and the first section of the small intestine, the duodenum. It has two main functions: it aids in metabolism of sugar in the body through the production of insulin, and is necessary for the digestion of nutrients by producing pancreatic enzymes. These enzymes help the body promote the digestion and absorption of fats. Acute pancreatitis is a sudden onset of pancreatic inflammation.

Causes

Multiple factors can contribute to the development of pancreatitis. Certain medications, infections; metabolic disorders including hyperlipidemia (high amounts of lipid in the blood) and hypercalcemia (high amounts of calcium in the blood); and trauma and shock can be associated with the development of pancreatitis. Middle-aged dogs appear to be at increased risk of developing pancreatitis; as a breed, Schnauzers and Yorkshire Terriers appear to be more prone to pancreatitis. Nutrition also plays a role. Dogs with diets high in fat, or dogs who 'steal' or are fed greasy 'people food' seem to have a high incidence of the disease.

Symptoms

Common symptoms of the acute form of pancreatitis in dogs include a very painful abdomen, abdominal distention, lack of appetite, depression, dehydration, a 'hunched up' posture, vomiting, diarrhea and yellow, greasy stool. Fever often accompanies these symptoms. Animals with more severe disease can develop heart arrhythmias, sepsis (body-wide infection), difficulty breathing, and a life-threatening condition called disseminated intravascular coagulation (DIC), which results in multiple hemorrhages. If the inflammation is severe, organs surrounding the pancreas could be 'autodigested' by pancreatic enzymes released from the damaged pancreas and become permanently damaged.

Diagnosis

The diagnosis of pancreatitis is made through information obtained from the history, the physical exam, and laboratory testing. Dogs with pancreatitis generally have an increased blood levels of the pancreatic enzymes called amylase and lipase. If the liver also becomes inflamed, liver enzymes as measured in the blood may be increased. A rather new test, serum trypsin-like immunoreactivity, may prove to be a valuable diagnostic aid. The white blood cell count is generally increased in acute pancreatitis. Radiography (x-rays) and ultrasound can also help in making the diagnosis. Biopsy can result in a conclusive diagnosis, but is not commonly performed.

Treatment

The goal of treatment is to rest the pancreas, provide supportive care and control complications. Treatment always begins with a withholding of food, water, and oral medications for at least 24 hours. The lack of oral intake stops the stimulation of the pancreas to produce digestive enzymes. Depending upon the animal's response, food intake can be started again after a few days. The dog is generally fed small meals of a bland, easily digestible, low-fat food. Over the course of a week or more, the size of meals and quantity of food fed are increased. The dog may need to stay on the special diet for life, or it may be possible to gradually reintroduce the former diet.

The second major component of treatment is fluid therapy. Dehydration and electrolyte imbalances are common in dogs with acute pancreatitis, and water intake is often restricted so fluid therapy is usually needed. Fluids are either given subcutaneously or intravenous.

Dogs who are experiencing severe pain can be treated with pain relievers such as meperidine or butorphanol. Antibiotics are often administered prophylactically to protect against infection.

If the pancreatitis was caused by a medication, the medication should be stopped. If it was caused by a toxin, infection, or other condition, appropriate therapy for the underlying condition should be started.

In rare instances, where there are intestinal complications or the development of a pancreatic abscess, surgery may be necessary.

Long-term management and prognosis

Pancreatitis can be a very unpredictable disease. In most cases, if the pancreatitis was mild and the pet only had one episode, chances of recovery are good, and avoiding high fat foods may be all that is necessary to prevent recurrence or complications. In other cases, what appears to be a mild case may progress, or may be treated successfully only to have recurrences, sometimes severe.

Dogs with severe pancreatitis can recover, but may also develop fatal complications. The risk of developing fatal pancreatitis is increased in dogs who are overweight, or have diabetes mellitus, hyperadrenocorticism, hypothyroidism, gastrointestinal tract disease, and epilepsy. Pets who have repeated bouts of pancreatitis may need to be fed low-fat diets to prevent recurrence. Even so, some animals develop chronic pancreatitis, which can lead to diabetes mellitus and/or pancreatic insufficiency, also called 'maldigestion syndrome.'

In pancreatic insufficiency, the nutrients in food are passed out in the feces undigested. An animal with this disease often has a ravenous appetite, diarrhea, and weight loss. Even though he is eating, he could literally starve to death. Treatment for pancreatic insufficiency is lifelong and expensive, but is possible. The pet's digestive enzymes are replaced through a product processed from pancreases of hogs and cattle which contain large quantities of the digestive enzymes. A change in diet with added nutritional supplements may also be necessary.

Summary

Acute pancreatitis can be a life-threatening condition, and early recognition and treatment can improve chances of recovery. In dogs, fever, lack of appetite, depression, and vomiting are the most common signs. Treatment is based upon stopping all oral intake to rest the pancreas, correcting the dehydration and maintaining proper fluid and electrolyte balances, and treating any complications or underlying conditions.

http://www.swiftwaterfarms.com/swift...ncreatitis.htm
__________________
Karen Kacee
Muffin 1991-2005 Rest in Peace My Little Angel
yorkieusa is offline   Reply With Quote
Old 07-10-2008, 08:35 AM   #14
Senior Yorkie Talker
 
BarbaraM's Avatar
 
Join Date: Dec 2007
Location: chicagoland
Posts: 209
Default Thank you so much - Everyone.

I have another appt today with a vet (# FOUR) I once used for my very old yorkie and the poodle. I am hopeful she can do an ultrasound on Ted. My vet is still out of town - and I need to know now! He seems ok. Still no vomiting. The stools looked dark again last night. He eats. Then sleeps. Same with the other two. I have not seen any stools from bichon or poodle today at all. They seem out of it as well.
All they have had is a couple Tablespoons of the I/D twice a day and water. Ted is on the meds and I have been giving the carafate to all three. They will prolly be fine and I will just crack up. I am on my way. Worry. worry. worry. I wish they could SPEAK.
What have they picked up? The poodle and Ted's stool was checked yesterday at the vets and they said all clear but maybe have a sample sent to a lab for really thorough testing. Yes something is getting to all three. I have gone outside with them every time. They are not getting into anything outside.
I have changed/washed bedding. Steamed floors. Disinfected paper area they go on when I am not home. I am going to change the stainless steel water dish to a ceramic dish. The plates they eat off of are corelle and washed in dishwasher. I don't know what else? But they are not snapping back. It has been a week. It has to be something else. Purdue is the next stop. I can't take this. I need a conclusive diagnosis--I am running out of local vets.
Thank you for all the info. Please keep it coming. I read it all and make notes and try to remember things they may have gotten into. Thanks again. B. Sam/Ted/Zell thanks you too!!
__________________
TeddE SammE Gisele
Member of Little Gentlemen's Club
BarbaraM is offline   Reply With Quote
Old 07-10-2008, 10:06 AM   #15
Crazy about Kacee!
Donating Member
 
yorkieusa's Avatar
 
Join Date: May 2005
Location: Kansas
Posts: 21,173
Default

Good luck Barbara. I posted that last one in case it would help you. I'll keep my eye out for an update. By the way, you must be exhausted after all of that cleaning.
__________________
Karen Kacee
Muffin 1991-2005 Rest in Peace My Little Angel
yorkieusa is offline   Reply With Quote
Reply

Bookmarks



Thread Tools

Posting Rules
You may not post new threads
You may not post replies
You may not post attachments
You may not edit your posts

BB code is On
Smilies are On
[IMG] code is Off
HTML code is Off
Trackbacks are On
Pingbacks are On
Refbacks are Off




Google
 

SHOP NOW: Amazon :: eBay :: Buy.com :: Newegg :: PetStore :: Petco :: PetSmart


All times are GMT -8. The time now is 10:22 PM.


Powered by vBulletin® Version 3.8.9
Copyright ©2000 - 2021, vBulletin Solutions, Inc.
Copyright ©2003 - 2018 YorkieTalk.com
Privacy Policy - Terms of Use

1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 17 18 19 20 21 22 23 24 25 26 27 28 29 30 31 32 33 34 35 36 37 38 39 40 41 42 43 44 45 46 47 48 49 50 51 52 53 54 55 56 57 58 59 60 61 62 63 64 65 66 67 68 69 70 71 72 73 74 75 76 77 78 79 80 81 82 83 84 85 86 87 88 89 90 91 92 93 94 95 96 97 98 99 100 101 102 103 104 105 106 107 108 109 110 111 112 113 114 115 116 117 118 119 120 121 122 123 124 125 126 127 128 129 130 131 132 133 134 135 136 137 138 139 140 141 142 143 144 145 146 147 148 149 150 151 152 153 154 155 156 157 158 159 160 161 162 163 164 165 166 167 168 169 170 171 172 173 174 175 176 177 178 179 180 181 182 183 184 185 186 187 188 189 190 191 192 193 194 195 196 197 198 199 200 201 202 203 204 205 206 207 208 209 210 211 212 213 214 215 216 217 218 219 220 221 222 223 224 225 226 227 228 229 230 231 232 233 234 235 236 237 238 239 240 241 242 243 244 245 246 247 248 249 250 251 252 253 254 255 256 257 258 259 260 261 262 263 264 265 266 267 268 269 270 271 272 273 274 275 276 277 278 279 280 281 282 283 284 285 286 287 288 289 290 291 292 293 294 295 296 297 298 299 300 301 302 303 304 305 306 307 308 309 310 311 312 313 314 315 316 317 318 319 320 321 322 323 324 325 326 327 328 329 330 331 332 333 334 335 336 337 338 339 340 341 342 343 344 345 346 347 348 349 350 351 352 353 354 355 356 357 358 359 360 361 362 363 364 365 366 367 368 369 370 371 372 373 374 375 376 377 378 379 380 381 382 383 384 385 386 387 388 389 390 391 392 393 394 395 396 397 398 399 400 401 402 403 404 405 406 407 408 409 410 411 412 413 414 415 416 417 418 419 420 421 422 423 424 425 426 427 428 429 430 431 432 433 434 435 436 437 438 439 440 441 442 443 444 445 446 447 448 449 450 451 452 453 454 455 456 457 458 459 460 461 462 463 464 465 466 467 468 469 470 471 472 473 474 475 476 477 478 479 480 481 482 483 484 485 486 487 488 489 490 491 492 493 494 495 496 497 498 499 500 501 502 503 504 505 506 507 508 509 510 511 512 513 514 515 516 517 518 519 520 521 522 523 524 525 526 527 528 529 530 531 532 533 534 535 536 537 538 539 540 541 542 543 544 545 546 547 548 549 550 551 552 553 554 555 556 557 558 559 560 561 562 563 564 565 566 567 568 569 570 571 572 573 574 575 576 577 578 579 580 581 582 583 584 585 586 587 588 589 590 591 592 593 594 595 596 597 598 599 600 601 602 603 604 605 606 607 608 609 610 611 612 613 614 615 616 617 618 619 620 621 622 623 624 625 626 627 628 629 630 631 632 633 634 635 636 637 638 639 640 641 642 643 644 645 646 647 648 649 650 651 652 653 654 655 656 657 658 659 660 661 662 663 664 665 666 667 668 669 670 671 672 673 674 675 676 677 678 679 680 681 682 683 684 685 686 687 688 689 690 691 692 693 694 695 696 697 698 699 700 701 702 703 704 705 706 707 708 709 710 711 712 713 714 715 716 717 718 719 720 721 722 723 724 725 726 727 728 729 730 731 732 733 734 735 736 737 738 739 740 741 742 743 744 745 746 747 748 749 750 751 752 753 754 755 756 757 758 759 760 761 762 763 764 765 766 767 768 769 770 771 772 773 774 775 776 777 778 779 780 781 782 783 784 785 786 787 788 789 790 791 792 793 794 795 796 797 798 799 800 801 802 803 804 805 806 807 808 809 810 811 812 813 814 815 816 817 818 819 820 821 822 823 824 825 826 827 828 829 830 831 832 833 834 835 836 837 838 839 840 841 842 843 844 845 846 847 848 849 850 851 852 853 854 855 856 857 858 859 860 861 862 863 864 865 866 867 868 869 870 871 872 873 874 875 876 877 878 879 880 881 882 883 884 885 886 887 888 889 890 891 892 893 894 895 896 897 898 899 900 901 902 903 904 905 906 907 908 909 910 911 912 913 914 915 916 917 918 919 920 921 922 923 924 925 926 927 928 929 930 931 932 933 934 935 936 937 938 939 940 941 942 943 944 945 946 947 948 949 950 951 952 953 954 955 956 957 958 959 960 961 962 963 964 965 966 967 968 969 970 971 972 973 974 975 976 977 978 979 980 981 982 983 984 985 986 987 988 989 990 991 992 993 994 995 996 997 998 999 1000 1001 1002 1003 1004 1005 1006 1007 1008 1009 1010 1011 1012 1013 1014 1015 1016 1017 1018 1019 1020 1021 1022 1023 1024 1025 1026 1027 1028 1029 1030 1031 1032 1033 1034 1035 1036 1037 1038 1039 1040 1041 1042 1043 1044 1045 1046 1047 1048 1049 1050 1051 1052 1053 1054 1055 1056 1057 1058 1059 1060 1061 1062 1063 1064 1065 1066 1067 1068 1069 1070 1071 1072 1073 1074 1075 1076 1077 1078 1079 1080 1081 1082 1083 1084 1085 1086 1087 1088 1089 1090 1091 1092 1093 1094 1095 1096 1097 1098 1099 1100 1101 1102 1103 1104 1105 1106 1107 1108 1109 1110 1111 1112 1113 1114 1115 1116 1117 1118 1119 1120 1121 1122 1123 1124 1125 1126 1127 1128 1129 1130 1131 1132 1133 1134 1135 1136 1137 1138 1139 1140 1141 1142 1143 1144 1145 1146 1147 1148 1149 1150 1151 1152 1153 1154 1155 1156 1157 1158 1159 1160 1161 1162 1163 1164 1165 1166