# Medication : Extra Label Use/Conversion tables etc~Saanendoah



## Sondra

EXTRA-LABEL DRUG USE: 
T here are times when the dosage given for goats differs from that found on the bottle, both in volume and in length of time to be used. Many products are developed and available for use, but the Food and Drug Administration has not cleared their use in goats. 
U sing any product which is not approved and labeled for use in goats constitutes Extra Label Drug Usage [ELDU - Veterinary ELDU Q&A ]. Much of the problem is due to the relatively small numbers of goats in the United States. Getting Food and Drug Administration (FDA) approval is a long, costly process, drug companies cannot economically justify going through the testing required to approve a drug for use in goats [considered a minor species]. Drugs are "licensed" for a specific purpose at a specific dose to be administered in a specific way to a specific species. If a drug is determined by the veterinary profession by experience and independent research to be more effective at treating a particular disease safely at double the dose, then that treatment methodology is generally adopted without breaking federal law. So it is simple experience, coupled with information derived from veterinarians that specialize in dairy goats, which determines what doses are effective in the Caprine.

A n unapproved product does not indicate that it is unsafe or ineffective, but rather it has not been approved by the Food and Drug Administration for use in goats. When a drug goes through the approval process, experimentation is typically limited to a relatively narrow usage. In other words, a drug will be evaluated at one specific dosage for a specific use in a specific species. This does not mean that the drug would not be useful for treating a disease in other animals, but the necessary research to determine the best route of administration, dosage, frequency of administration, effectiveness, and side effects has not been done by the company making the drug. With veterinary drugs, a pharmaceutical company usually won't spend the research and development (R&D) money to get a drug through the approval process unless it is for common usage and there is a good chance the company will make a return on its investment.

DRUGS PROHIBITED FROMEXTRA LABEL USE IN FOOD ANIMALS

. DOSES AND OTHER NOTES ABOUT MEDICATIONS:

PAY ATTENTION!

When doses say for mature does, bucks, kids, it refers to the large goat breeds not Nigerian Dwarf, Pygmy, or Angora goats. 
For some drugs and most vaccines "one size fits all", for others it is essential to dose by weight ( weigh chart ), please read the suggested dose material to determine the correct dose for the smaller breeds. A weight chart for Pygmy goats can be found at http://hometown.aol.com/goatlist/weights.htm 
ALWAYS READ THE LABELS to make sure of the medication you are using and for strengths to avoid over or under dosing (many drugs come in more than one strength), as well as additional dosing information, precautions, indications, withdrawal times, etc. If your going to be using the product extra label write those instructions on the bottle. 
Also see extra label (ELDU) information above, and Q&As on the strict ELDU your veterinarian must follow. 
Withdrawal and milk discard times are for FDA approved dose rates and routes of administration, and unless otherwise noted are for cattle. ELDU doses may result in longer withdrawal and milk discard times. Withdrawal information is intended for U.S. residents only. 
Visit FARAD ( Food Animal Residue Avoidance Database) for FDA approved drug information. Also, the FDA Center for Veterinary Medicine 
DO NOT MIX MEDICATIONS TOGETHER IN THE SAME SYRINGE OR OTHER PREPARATION without checking the compatibility of the medications. Drug incompatibilities can change the chemical or physical nature of a medication/drug. Medication/drug incompatibilities can occur between two drugs or between a drug and a carrier, the environment, or even the receptacle (IV tubing, etc). 
Unstable medications usually have a short shelf life when in solution. Reconstituted solutions should always be labeled with the new expiration date. If indicated on the label, refrigeration or freezing can prolong the shelf life. However, DO NOT assume this is true of all medications, READ THE LABEL. Freezing can increase the degradation of some meds (i.e. ampicillin). Refreezing of a previously frozen and defrosted solution increases the risk of efficacy loss. 
When giving antibiotics, always give a full course, making sure to use an adequate dose at the recommended frequency to minimize the development of resistance. Continue at least five days [or more] even though the symptoms may disappear long before then! The hardier bacteria are still present and must be killed or stopped from reproducing. Stopping antibiotics early often causes a recurrence, or allows the stronger bacteria to develop a resistance to the antibiotic. Continue to treat 24-36 after they are asymptomatic (without symptoms). 
BioSecurity 
Liquid medicines and solid medicines, such as pills, capsules, powders, etc., should be flushed down the toilet and the empty containers disposed as household garbage. 
Miscellaneous veterinary medical waste (i.e. bloody/soiled bandages and dressings, medical gloves, infusion syringes) should be contained in a securely fastened plastic bag prior to disposal. If possible, such wastes should be sprayed, but not saturated, with a solution made up of 1 part bleach to 10 parts water. Do not label the containers as "Medical Waste" or Infectious Waste as these terms only apply to licensed veterinary and health care facilities. 
Properly dispose of used needles, syringes and other used "medical" objects. Sharps and piercing objects can puncture regular waste bags, posing both a physical and contamination hazard.

What is medical waste - Hypodermic needles and any items that have come in contact with human or animal specimens, culture media, DNA,live and attenuated vaccines. 
Including: 
Needles, razors, and scalpel blades 
Broken glass and plastic 
Pipettes, pipette tips, capillary tubes 
Sharp-cornered objects.

Acceptable Containers - These containers must be sturdy, leakproof, puncture-resistant. Do not put sharps into any container that will be recycled or returned to a store and do not use glass or clear-plastic containers. Use sturdy, lined cardboard boxes or plastic jars. Most hospitals will accept and dispose of your filled containers for you. Or your veterinarian, M.D., dentist, etc. I use regular Sharps Containers, but milk/bleach bottles etc. work well too. 
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## Sondra

*Re: Extra Label Use/Conversion tables etc~Saanendoah *

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ADMINISTRATION OF DRUGS 
amp. = ampule 
a.d. = right ear 
a.s. = left ear 
a.u. = both ears 
c. = with 
cap. = capsule 
disp. = dispense 
gtt(s). = drop(s) 
IM = intramuscular injection 
IN = intranasal 
IP = intraperitoneal (within abdominal cavity) 
IV = intravenous injection 
o.d. = right eye 
o.s. = left eye 
o.u. = both eyes 
PO = per os, meaning given by mouth or orally 
q.s. = a sufficient quantity 
SubQ, SQ or SC = subcutaneous injection 
susp. = suspension 
tab = tablet 
FREQUENCY OF DOSING 
a.c. = before meals 
p.c. = after meals 
h. = hour 
h.s. = at bedtime 
q = every (as in q 8 hours) 
s.i.d. = every day (q day or q 24 hours) 
b.i.d. = twice a day (q 12 hours) 
t.i.d. = three times a day (q 8 hours) 
q.i.d. = four times a day (q 6 hours) 
qld. = every day 
qod = every other day 
qlw = every week 
PRN = as needed 
Sig.: = directions to patient 
stat = immediately 
Ut dict. = as directed 
See below for additional dosing information 
and injection techniques

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ACCESSORIES: 
(See page 2 for proper disposal of used needles and other used materials.)

SYRINGES: 
3mL, 6mL, 12mL, 20mL, 30mL, 60 mL (6ml & 12ml most used) 
I prefer the Luer Lock syringes rather than the Luer Slip. You can buy syringes with a "feeding tip", a larger tapered tip that is used for dosing liquids and or tubing weak newborns (also see catheter below). 
It's a good idea to have one or two 30ml or 60ml feeding tip syringes for giving oral medications. 
NEEDLES: Use the smallest needle (larger number) that will get the job done. This will help avoid tissue damage and leakage from the injection site. Use a short needle, 1/2 inch, for SC (SQ, Sub-Q) injections. 
20 X ¾" or 20 x 1"[most useful, all purpose]. Can take thicker medications. 
22 X ½ " or 22 X 3/4"are less painful, I use for babies and thin liquids. Optional, but handy. 
18 X 1" for very thick medications, can be used for bucks and larger does, and for painful injections where you want to inject rapidly.

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A note on needle size for vaccination in kids (and other small animals and stock): Research has shown that, when vaccinating, the smaller needle (25 ga) causes more swelling and pain when the same volume was administered over the same time as a larger needle (22ga), due to the excess force of administration. If you like to use small gage needles for vaccinating kids, the vaccine should be administered more slowly. 
THERMOMETER:

Perhaps YOUR #1 PIECE OF EQUIPMENT, a window to the inside of your goat. 
Use it whenever an animal is "off" for any reason (temperatures usually rise 24-36 hours before other signs of illness).

It will tell you if your treatment is working or not; an elevated temperature should start to drop in approximately 24-36 hours after beginning antibiotics if the medication(s) is combating the infectious bacteria. If the temperature has not gone down after that time you should consider changing to another medication (note: do not count temperatures reduced by other medications i.e. Banamine, Dipyrone, aspirin, bute, etc.).

Normal temp is 101.5° -103° (degrees), but can be higher in hot weather or following fighting, chasing to catch etc. If in doubt, take temps of several other animals in the herd for comparison.

To convert degrees °F (Fahrenheit) to degrees °C (Centigrade), subtract 32, then multiply by 5/9. To convert degrees C to degrees F, multiply by 9/5, and then add 32. 
°C 
CENTIGRADE °F 
FAHRENHEIT 
36.5 97.7 
37.0 98.6 
37.5 99.5 
38.0 100.4 
38.2 100.8 
38.4 101.1 
38.6 101.5 
38.8 101.8 
39.0 102.2 
39.2 102.6 
39.4 102.9 
39.6 103.3 
39.8 103.6 
40.0 104.0 
40.2 104.4 
40.4 104.7 
40.6 105.1 
40.8 105.4 
41.0 105.8 
41.2 106.2 
41.4 106.6 
41.6 106.8 
41.8 107.2 
42.0 107.6

STETHOSCOPE: To listen to lungs sounds, rumen sounds, for fetal heartbeats on pregnant does. Not necessary, but can come in handy, and with practice you will learn to "hear". Listen to lung and rumen sounds on healthy animals and you will be able to hear unhealthy sounds when they are present, i.e. the lungs of a goat with pneumonia often sounds like an ocean (fluid filled) or raspy, like sand paper rubbing together. Detecting pregnancy by hearing fetal heartbeats is fun.

COTTON BALLS: Kept in sealed container [small Rubbermaid or TupperWare containers work great] filled with 70% ethyl alcohol. For cleaning injection sites, thermometers, medicine bottle tops, equipment etc. 
CATHETER: A must for tubing a weak or premature kid at birth. You can buy catheter & syringe set ups (60 ml syringe and catheter) from most catalogs houses for just a few dollars.

STOMACH TUBE: A foal size stomach tube is handy for tubing larger goats. You can use any small diameter 1/4" - 5/16" hose or tubing, but a standard tube is made of good quality PVC material that is soft and flexible, will last a very long time and has an attached funnel end. Measure the distance from chin to mid abdomen the same as for tubing kids. 
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TYPES OF INJECTIONS: 
Suggestions for type of administration are located on medication vials. However, MOST medications that can be given IM can also be given just as effectively SC (SQ) as well. 
NOTE :Intravenous (IV) injections result in a high drug level in the blood rapidly, but antibiotics injected intravenously also are eliminated more rapidly. Intramuscular (IM) or subcutaneous (SC or SQ) injections require the least skill and last longer.

IM- Intramuscular. Into the muscle - this provides the third fastest absorption rate. There are many sites for injection, the easiest and safest being the heavy neck muscles on either side of the backbone in the neck region (at least three fingers down from the spine and in front of the shoulder blade - you can easily feel the muscle mass there even in young kids). Bottle directions on most medications say to administered this way, but it's now almost universally accepted that SQ injection is just as effective as IM and is actually the preferred route for nearly all medications. Do not administer medications labeled for IV use only (i.e. sulfa) via IM or SQ routes. Not a good route for animals in shock.

SC or SQ- Injected subcutaneously (SC, sub-Q, SQ) between the skin and the underlying tissue. It is the fourth fastest rate of absorption. The site for the injection is generally anywhere over the rib cage or shoulder, not too close to bony structure, such as backbone or shoulder blade. It is suitable for nearly all injections, particularly those which are of large dosage, and/or must be given frequently. I've given 99+% of my injection SC (SQ) for that last 7-8 years. Do not administer medications labeled for IV use only (i.e. sulfas) via SC (SQ) or IM routes (one exception is calcium products that can be administered SC (SQ) in smaller doses under certain conditions). Avoid SC (SQ) route if the ambient temperature is very cold or the animal is severely dehydrated. Not a good route for animals in shock. 
IV - Intravenous. Directly into the vein - the jugular vein in the neck is the most suitable in the dairy goat. It is the FASTEST method of getting medication working in the body. It is also used for administering those medication which irritate the tissue when injected by any other method such as the sulfas and calcium-phosphorus solutions. Some medications should only be administered IV while others should never be used via an IV route. Do not administer penicillin IV. When injecting IV, always inject very slowly.

IP or intraperitoneal or IC intracoelomic - Directly into the peritoneal cavity [abdominal cavity] Iinjection inside the membrane that lines the interior wall of the abdomen. On the RIGHT side of the goat, behind the rib cage and in front of the hip bone. The absorption from the peritoneal cavity is fairly rapid. It is used also for administering large amounts of medication, and is easy to do, but not generally recommend due to danger risk of damage to organs, and peritoneal adhesions are not uncommon. Absorption is via the portal system so it is not useful for drugs that are removed by the liver. The introduction of bacteria into the peritoneal cavity can result in serious peritonitis which may be difficult to treat. It is most often used in hypothermic newborn lambs.

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Most injectables need shaking before use. After shaking, inject the same amount of air into the bottle as the amount of liquid you are going to withdraw. This prevents a vacuum from forming as the liquid is withdrawn. If the liquid is thick, 20 or 18-ga. needle will give a faster fill. After filling the syringe, tap the barrel to send air bubbles to the top and expel the bubbles.

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## Sondra

*Re: Extra Label Use/Conversion tables etc~Saanendoah *

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HYPOCALCEMIA 
Teminology: 
hypo- Prefix meaning below or deficient. Hypocalcemia = low calcium 
hyper- Prefix meaning excess. Hypercalcemia = high calcium.

Differentiating Hypocalcemia from Milk Fever, Pregnancy Toxemia, Paturient Paresis and Ketosis By Sue Reith

KETOSIS 
Ketosis: What It Is And How It Happens By Sue Reith

ANAPHYLACTIC REACTION: 
Allergies are hypersensitivity reactions of the immune system to specific substances (allergen, such as pollen, stings, drugs, or foods). The most severe form of allergy is Anaphylactic Shock which is a true emergency. Anaphylactic Shock is classified as a Type I Hypersensitivity (IgE-mediated Hypersensitivity, Immediate Hypersensitivity). Actually the word ' anaphylaxis' is used to mean any immune reaction of this type, even if not serious. But most doctors, veterinarians and lay people use it to mean a life threatening rapid allergic reaction. In animals you'll see it most often following a injection, often a repeated injection of a substance they've had before. The animal collapses within seconds or minutes of an injection. Epinephrine (also known as adrenaline) must be administered immediately. Never give shots of any type without having epinephrine on hand! (note: the only anaphylactic reaction one of my animals ever had was to a vitamin A,D & E injection). (see epinephrine under Misc.Injectables for dose rates).

ENTEROTOXEMIA: 
Usually within 2 hours of ingesting meal. Animal usually cries out in extreme pain, repeating cry every few minutes. Appears to be constipated, stretching abdomen uncomfortably. If help is not received immediately, animal will die within just a few hours. Even with immediate attention the outlook is grave.

Treatment: Inject 20 ml Enterotoxemia Antitoxin SQ (for young kids) up to 40 ml for mature animals, ½ ml Banamine , 3-5ml Dexamethasone 2mg/ml [Azium], and 5 ml Penicillin injected along with 2-3ml orally [for young kids - dose increased for larger animals]. Repeat Banamine and Dexamethasone every 4-8 hours the first day, and give Penicillin (both injected and oral) twice a day for 2 days, then injected twice a day for 5 additional days. Decrease milk consumption by half to unweaned kids followed at least an hour later with an electrolyte solution for the first 24-36 hours. 
Give NO GRAIN for at least a week after an Entero attack. 
PREMATURE OR WEAK KIDS: 
Tube, with human catheter. Lay kid out on side, and stretch neck and head gently so jaw is in straight line with neck. Using catheter, measure distance from mouth to mid stomach and mark with tape or marking pen. Oil catheter with vegetable oil. Have 60 ml [2oz] feeding tip syringe filled with warm colostrum ready to attach to catheter once it is in place. Slowly insert catheter into mouth; it will slide in easily, aided by kid's periodic swallowing. If kid begins to cough, remove and reinsert [you are in a lung]. When tube is inserted to marked distance/end of rib cage blow very gently on open end of catheter; your assistant should feel bubbles in stomach and gurgle can be heard, you can also put open end into a glass of water; if in lungs air will bubble water in glass. Quickly attach syringe full of colostrum to catheter and slowly plunge liquid into stomach. Kid can be held up in a semi-sitting position for this part of the tubing. After liquid is administered, remove tube at once.

FOR TOXIC SUBSTANCE INGESTION: 
ToxiBan TM

ToxiBan Granules contains 47.5% MedCharTM (activated charcoal) 10% Kaolin and 42.5% wetting and dispersing agents, including sorbitol, and is free-flowing and wettable for rapid constitution in water.

Activated charcoal adsorbs toxins in the gastrointestinal tract 
Kaolin acts both as an adsorbent and as an intestinal protectant 
Sorbitol acts as a mild osmotic cathartic. 
May use as a powder in food or in a suspension 
ToxiBan Suspension contains 10% MedCharTM (activated charcoal) and 6.25% Kaolin in an aqueous base. It is a stable suspension intended for use as a convenient emergency treatment of small animals or small numbers of large animals.

Activated charcoal is the single most valuable antidote 
Kaolin protects inflamed GI mucosa and removes bacteria and endotoxins. 
Convenient for small animal and single large animal use 
Allows multiple dose use without catharsis

ToxiBan Suspension with Sorbitol is a ready-to-use activated charcoal suspension containing 10% MedCharTM (activated charcoal) 10% Sorbitol and 6.25% Kaolin in an aqueous base with special suspending agents and preservatives intended for use as an emergency treatment of small animals.

Activated charcoal has been called the universal antidote 
Kaolin is powdered and refined for pharmaceutical use 
Sorbitol is a hyperosmotic cathartic which promotes passage of activated charcoal and its adsorbed toxin 
For use when adsorption and catharsis are desired 
Indications and Usage: ToxiBan Granules, ToxiBan Suspension and ToxiBan Suspension with Sorbitol are most effective when administered as soon as ingestion of a toxicant is suspected. They can also be used in some toxic emergencies when absorption of the toxicant is nearly complete or the exposure was via a parenteral route. This application usually involves repetitive or multiple dose activated charcoal use. Multiple doses of charcoal may be used in adsorbing toxins which undergo enterohepatic circulation. Frequent doses of activated charcoal can adsorb those toxins, interrupt the enterohepatic circulation, thereby preventing their reabsorption, and enhance toxicant elimination from the body into the gastrointestinal tract. (See package insert for more detailed information.)

Toxicants That Bind to Activated Charcoal 
Acetaminophen 
Amphetamines 
Anthelmintics 
Antibiotics 
Aspirin 
Atropine 
Barbiturates 
Camphor 
Cantharides 
Carbamazepine 
Carbamates 
Chlordane 
Chloroquine 
Chlorpheniramine 
Cocaine 
Diazepam 
2,4-D (dichlorophenoxy acetic acid) 
Digitalis 
DigitoxinEthylene glycol* 
Fungicides 
Hexachlorophene 
Ipecac 
Isoniazid 
Malathion 
Mefenamic acid 
Meprobamate Methylene blue 
Methyl salicylate 
Morphine 
Muscarine Narcotics 
Nicotine 
Nortriptyline 
Organic iodine 
Organic metal compounds 
Organochlorine insecticides 
Organophosphorus insecticides 
Parathion 
Phenobarbitol 
Phenothiazine 
Phenylbutazone 
Phenylpropanolamine hydrochloride 
Phenytoin 
Quinacrine hydrochloride 
Quinidine 
Quinine 
Rodenticides 
Salicylamide 
Salicylates 
Strychnine 
Sulfonamides 
Theophylline 
Tricyclic antidepressants

* TESTS FOR ETHYLENE GLYCOL MUST BE CONDUCTED BEFORE TOXIBAN IS ADMINISTERED TO PREVENT FALSE POSITIVE REACTIONS. 
Contraindications: There are no known absolute contraindications to the use of activated charcoal (see package insert). It should not be given simultaneously or shortly before the oral administration of other therapeutic agents such as antibiotics, vitamins, or amino acids. Antibiotic therapy should be administered parenterally when ToxiBan is used.

Precautions: All three ToxiBan products are adjuncts in the management of poisoning emergencies. Prior to their use proper basic life support measures must be implemented as well as the appropriate gastric emptying technique if indicated. Since more than an hour may pass before activated charcoal can be administered without regurgitation after an emetic has been given, it may be more effective to give ToxiBan immediately because adsorption of a toxicant may be a more effective removal than vomition.

When ToxiBan therapy is used, it should be noted the products will produce black stools. These stools may have a diarrhea consistency and may persist for several hours. Since a profound cathartic effect may occur following the use of ToxiBan Suspension with Sorbitol, proper attention should be provided to the animal's fluid and electrolyte needs.

ToxiBan Suspension with Sorbitol should be used cautiously in animals receiving multiple dose activated charcoal therapy. If ToxiBan Suspension with Sorbitol is used at each dosage interval, profound catharsis may develop resulting in dehydration and even hypotension. ToxiBan Suspension should be used for multiple use, and cathartics should only be used intermittently during multiple dose activated charcoal use.

Administration: Administration: ToxiBan Suspension or ToxiBan Suspension with Sorbitol may be given as is or mixed with a small amount of cold water to reduce viscosity and improve flow. Dilute suspensions of ToxiBan Granules should be stirred or agitated frequently during administration to keep the liquid uniform and prevent equipment clogging. A stomach tube is preferred for administration in all animals, but an oral drench may be used in emergency. Rinse the liquid receptacle with cold water and administer the rinsing.

Dosage:

ToxiBan Granules - To make a thin suspension mix one volume measure with 5 to 7 parts of cold water (Ex: one level cup ToxiBan Granules to 6 cupfuls water) and shake or stir vigorously for 10 to 30 seconds until good suspension is obtained.

Large Animals- The recommended dosage is 0.75 to 2.0 grams per kilogram (0.35 to 0.9 grams per pound) body weight. One pound (453.6 grams) will normally treat an animal weighing 225 to 600 kilograms (500 to 1300 pounds). 
Small Animals - 2 to 4 grams per kg (1 to 2 grams per pound) body weight.

ToxiBan Suspension or ToxiBan Suspension with Sorbitol - 
Small Animals -10 to 20 mL per kg (5 to 10 mL per pound) body weight. 
Large Animals - 4 to 12 mL per kg (2 to 6 mL per pound) body weight.

How Supplied: 
ToxiBan Granules, 454 g (1 pound) 
ToxiBan Granules, 5 kg (11 pound) 
ToxiBan Suspension, 240 milliliters 
ToxiBan Suspension with Sorbitol, 240 milliliters

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Updated July 2003 
This has been complied as information only, it is not intended as a means of diagnosing and treating an animal or to replace professional veterinary advice or care for your animals. This information is not intended to be a comprehensive review of any drugs, their uses, side effects, or special considerations. Veterinary consultation is vital when treating sick animals. Responsible decisions concerning treatments and drug safety or effectiveness must be made by each individual and their veterinarian. Never disregard veterinary advice or delay in seeking it as a result of information provided on this site. The administration of any medication should be taken very seriously.Medications given in the wrong circumstance, via the wrong route, or in the wrong combination can hurt or kill. The anecdotal information, experiences and thoughts are my own or those I've personal knowledge of and are not meant to represent the management practices or thinking of goat breeders in general or the veterinary community. This information is presented without guarantees, and the author disclaims all liability in connection with the use of this information. The extra-label use of any product in a food producing animal is illegal without a prescription from a veterinarian the includes the milk and meat withdrawal information (seeELDU Q&A ).


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