Wednesday, April 15, 2020

Unconditional Love-Hard to Find-DH DeForge, VMD

Don DeForge, VMD
17 Seemans Lane-Milford, CT 06460
DonDeForge100@gmail.com
SilverSandsVeterinary.com



Can a Person with Dementia Be Left Alone?


Unconditional Love-Hard to Find

During this difficult time..... during COVD-19 when we evidence death and pain all around us, it is important to reflect on love!

Unconditional love is not of human brand.  It is found only in the animal kingdom.  Only infrequently is man able to separate ego and self to return unconditional love to another human.

It is not impossible!  I have been blessed to witness it and meet special "heroes" who did accomplish this awesome task.

But animals.....they are always bringing unconditional love to you and I each and every day!


As we continue in social isolation with anxiety about today and tomorrow, it is time to pick-up the phone and call a friend; a neighbor; a relative; a senior; or a person who just needs to hear the words: "Hello how are you today?"  That is unconditional love!

When done with this call~~~~ seek out the companion pet in your home and say to them....today I am returning the unconditional love that you give to me each hour of each day!

Read the story of Miracle below.  I never met Miracle but the wonder of this dog is now in my heart to share with you!
Dr. Don DeForge 15April2020 ~ 12:00

A Tribute to Miracle:
On Monday 4/13/20 at 11:27 am I had to say goodbye to my best friend. From the moment I met Miracle in a shelter in Cortland, NY in March 2004 I knew he was meant to be mine. He came to me a few months after my mother passed away and 2 years after my sister passed away and I always knew they had sent him to me as my very own fur angel to watch over me since they couldn’t be there. He was a faithful companion for 16 years and almost made it to his 17th birthday at the end of this April. He knew me before I was a veterinarian and was with me through vet school, internship, residency, multiple jobs, and multiple moves. He enriched my life in so many ways and I can’t even begin to describe how grateful and blessed I feel to have had him in my life. He touched the lives of so many other people too, from his younger years as a therapy dog at a nursing home, to my family and friends, and to almost anyone he met. He was often a better human than I was and taught me patience and forgiveness by watching his interactions with other people and pets. He had a gentle spirit and a sweet soul. He loved his cat brothers Frankie and Stewart and they loved him very much. Frankie was so bonded to Miracle and would kiss his face and sleep with him. Frankie was also Miracle’s “seeing eye cat” and would help Miracle navigate around the house after he lost his vision. Over the years people would frequently ask me why his name was Miracle and they would assume something big had happened to him. While he was a stray before the shelter found him, his name wasn’t due to this. Before her passing, my mother had suffered a stroke that affected her speech pathways so there were only a few words she could say clearly. She would say “my miracle” clearly when referring to my sister and I. When I met Miracle, I knew that was the perfect name for him and he lived up to it each day of his life. He will be so very missed by myself and his cat brothers but I know my mom and sister will take great care of him up in heaven until we meet again.
Thank you to everyone who loved Miracle and who helped me take care of him these last few months, and for the special people who helped me on Monday to make his passing peaceful.
❤️🐾❤️🐾❤️🐾❤️🐾❤️🐾❤️🐾❤️🐾❤️🐾❤️

Monday, April 6, 2020

Identifying Pain in the Pet You Love in Difficult Times-COVID-19

Don DeForge, VMD
17 Seemans Lane
Milford, CT 06460
203-877-3221
Silver Sands Veterinary

SilverSandsVeterinary.com

  • A General Companion Animal Practice
  • Urgent Care
  • NEW! Telemedicine Consultations
  • Advanced Veterinary Dentistry

DonDeForge100@gmail.com



6 Most Common Dog Health Problems


Identifying Pain in the Pet You Love during: COVID-19
An Important Journey in helping your friend

We search each day for the end of COVID-19.  It is a time of anxiety and fear!  The media continues to flash headlines and be the first to announce local community death totals and infected totals as though we were completing a score card at a ball game.

Consumers are throwing protective gloves over supermarket parking lots after they pack their cars; not respecting social distancing in the markets; and continue to hoard.

It is a continuation of  the me, myself, and I society that was always present but now is being fueled by panic and anxiety over a virus that no one understands.

Why can't we try to put our heads together and help each other?  Why can't we think WE rather than ME?  

To get through this we must help each other.  Respect the market and chain stores.  Do not litter their parking areas.  Respect the workers who are there to provide for you.  Most importantly, start respecting others!  Explain to your children right from wrong and do not allow your children to grow up accepting wrong is right!

During this time of unrest our pets can be in pain!  

Silver Sands Veterinary continues to be here as a Primary General Care Practice; an Urgent Care Center; and now is offering TELEMEDICINE at a reduced fee to help those pets that need our help when you cannot easily come to our main hospital.

Our main hospital has a SECURED NO SOCIAL CONTACT FOYER for admission and discharge.  You are safe in this FOYER!  You will not meet others in our parking lot because we are staggering appointments for you.

For those who do not want to leave home we now offer TELEMEDICINE CONSULTS.  This is very important if a pet is in pain.

Recognizing Pain in Animals is NOT straightforward! 

Pet advocates and pet lovers are constantly seeking outward expressions of pain.  A dog howling; a cat screeching; an overt inability to use a leg; or an open trauma site.  Yes....these do cause pain.... but pain is most often hidden or occult in pets!

Pet owners may see something but they usually do not know what they are seeing!

Pet owner's must stop searching ONLY for acute signs of clinical pain but MUST start to become a pet detective and note how PET PAIN can be manifested in their pet's behavior.

With COVID-19 many are working from home or are not working at this time. This is the time to spend a moment with your pet or pet[s] and study their behavior.

Behavioral changes can be the beginning of your recognition of "Bad Pain"!  Pain that is present but difficult to interpret.

Study the BehavioralChanges below!  If present call for an out-patient or a Telemedicine Appointment immediately: 

Interpreting "BAD Pain"  
from Behavioral Change 
and Pain Targets*

Do you recognize these changes in your pet?
Somnolence-decreased activity
Hyperexcitability
Increase appetite or increased drinking
Decreased appetite or decreased drinking
Not able to walk up and down stairs
Not wanting to play with toys
A playful jumping toy breed that is now sedintery
Not interested in treats
No interest in exercise or begins lying down after short exercise
Shifting food from one side of the mouth to the other
Dropping food
Not eating dry food or treats
Avoid hard toys
Avoids ball playing
Abnormal posture when lying down
Difficulty getting up from lying down
Hiding in the home
Aggressive when certain part of the body are touched
Not interested in other "pet friends in home"-Avoidance
Ear Rubbing
Anal dragging
Face Rubbing
Paw chewing and biting at flanks
Vomiting and/or diarrhea
Enlarged Belly-abdomen is hard-rock like and enlarged
Forceful retching with no vomit being produced
Coughing
Bloody discharge from mouth or anus
Swollen Mammary Glands
Red or irritated skin
Swollen interdigital area-between toes
Mouth odor
Gum Bleeding
Pustular discharge around teeth
Ulcers in mouth
Bad odor in mouth-Oral malodor
Broken teeth
Discolored teeth-pink-red-purple-blue-brown-or grey
Swellings around the globes
Squinting
Ocular Discharge
Red Eyes
Sunken Eyes
Rubbing of the Eyes
Enlarged Globe[s]
Ulcers in the eye[s]
Nasal discharge-Bloody noses that are frequent
Broken nails
Infected nails
Nails growing into pads
Lumps or bumps that are pustular or bleeding
Limping
Not able to walk normally
Not able to stand
Not able to defecate
Not able to urinate 
Straining to urinate
Straining to defecate
Shortness of Breath
Coughing
Chronic Weight Loss
Acute Weight Loss

*"Identifying the Behavioral Changes and Pain Targets are important but it is up to Dr. DeForge and his consultants to differentiate primary pain from secondary pain caused by other complex medical and/or surgical problems. 
Whether Primary or Secondary, pain is pain and it must be addressed!

If uncertain that your pet is in pain, make use of Dr. DeForge's Telemedicine Consult Service. 

[Call 203-877-3221] to schedule an appointment]!

Let Dr. DeForge be your guide to allow your pet to become pain free with a quality of life that we all seek during these trying times.

God bless and be well!
Dr. Don DeForge and Staff








Tuesday, March 31, 2020

High Blood Pressure in Pets-Hypertension a Hidden Problem

Donald H DeForge, VMD
SilverSandsVeterinary.com
17 Seemans Lane
Milford, CT 06460
203-877-3221
DonDeForge100@gmail.com







AWR400001-K petMAP Manual


High Blood Pressure in Pets
Hypertension: A Hidden Problem


Can the companion pets we love develop High Blood Pressure?  The answer is YES!

A ISOLATED elevated blood pressure is not a reason to begin anti-hypertensive drugs.

A DECISION on the USAGE of anti-hypertensive medicine is based on


  • Multiple High Blood Pressure Readings
  • Differentiating Primary from Secondary Hypertension
  • Diagnostic Testing
  • Consultation with your Local Doctor of Veterinary Medicine and/or an Internal Medicine doctor
Hypertension in Cats:

  • Occurs most frequently in older cats
  • Many times coupled to kidney problems or hyperthyroidism

What are the two numbers that make up a blood pressure reading?

  • Systolic or the first number is the larger of the two numbers and measures the force of blood from the heart into the arteries
  • Diastolic or the smaller number measures the force as the heart relaxes~allowing blood to flow back to the heart
  • In our pet companions, the Diastolic pressure is not as reliable as Systolic~~~so we generally rely on the Systolic measurement 

What are the dangers of long term Hypertension?-i.e. High Blood Pressure in pets:

  • Hypertension can affect the heart, kidneys, eyes, and the nervous system
  • Primary Hypertension means the high blood pressure is the disease itself
  • Secondary Hypertension means some other medical condition[s] are contributing to high blood pressure
Signs noted with High Blood Pressure-Hypertension in Cats

  • Disorientation
  • Dilated Pupils
  • Acute Blindness
  • Weakness in the legs
  • Retinal Detachment
  • Seizures
  • Involuntary rolling of the eyeballs
  • Stroke and Cerebral Vascular Accidents
Normal Systolic Pressure in Dog is 100-150
High Blood Pressure in the dog is greater than 170

Normal Systolic Blood Pressure in the Cat is 100-160
High Blood Pressure in the cat is greater than 180

Remember blood pressure reading is directly related to age, breed, weight, excitement, nervousness, and other medical problems. Consult your local doctor of veterinary medicine if you have a middle aged or older pet............. for a blood pressure check up............... at your next physical exam.

Questions: E-Mail DonDeForge100@gmail.com

Friday, March 27, 2020

COVID-19 Update Dr. Don DeForge

Donald H DeForge, VMD
17 Seemans Lane
Milford, CT 06460
203-877-3221
DonDeForge100@gmail.com


Finding Compassion in an International Emergency
Senior To Senior - Crescent City Cat Club

COVID-19 Update: 
Silver Sands Veterinary~
Milford Veterinary Hospital

During this time of international COVID-19 crisis, Dr. Don DeForge and his staff want to share a positive news story with you about our history.

This year we are celebrating the 90th Birthday of the moniker, Milford Veterinary Hospital.  Milford Veterinary Hospital is our general practice under the umbrella of Silver Sands Veterinary.

Dr. Daniel Patchen after graduating from Ohio State University built Milford Veterinary Hospital on the site that is now Patchen Mews~~ 90 years ago.  His hospital was removed, after his death, to build the present condominium grouping-Patchen Mews!

I am sure many of you pass this site each day without understanding the significance of  Dr. Patchen’s contributions.  He would ride horseback many miles on farm calls each day before the automobile made traveling revolutionary! Dr. Patchen became one of the leaders of veterinary medicine in the State of Connecticut.

I assisted Dr. Patchen when he practiced well into his 80’s and did surgery for him.  His wife after her husband’s death asked me to continue the tradition of the name~ Milford Veterinary Hospital

His wife gave me her husband’s~~ Milford Veterinary Hospital ~~ street sign as a thank you in her husband’s memory and as a remembrance of his contributions to veterinary medicine. 

I do believe Dr. Patchen is watching this COVID-19 crisis and encouraging all of us to do our share to end the spread of the disease. 

COVID-19 UPDATE-updates will continue daily until this crisis ends........

We at Silver Sands Veterinary-Milford Veterinary Hospital~ in conjunction with CDC Guidelines have developed our “Foyer Admission and Discharge Zone” which completely eliminates social contact.

We have developed this for you.....................for your safety…………… so that no patient that is ill or needs diagnostics will ever be alone and lacking professional veterinary care.

Call Dr. DeForge or one of his staff about our  “Foyer Safety Zone for Veterinary Care.”  Phone 203-877-3221

God bless; be safe; and be well! 


We are OPEN and are here for you!  We are condensing hours during this crisis. 

All appointments are one hour apart to limit any parking lot social interaction. 

Do not come in for a medicine refill; to set up an appointment; for a general exam; or urgent care visit without:
FIRST calling us at 203-877-3221
Thank you-Dr. Don DeForge

Tuesday, March 24, 2020

Loving Our Senior Cats

Donald H DeForge, VMD
SilverSandsVeterinary.com
1-800-838-3368
DonDeForge100@gmail.com




Image result for Photo of a senior cat



Loving Our Senior Cats


Senior cats aren't necessarily at the end of their life — they're just learning how to live it differently, so you and your cat still have plenty of time to do all the human-cat things that best friends like to do.
Be proactive~~~not reactive!
Talk to Dr. DeForge about basic testing for Senior Cats to rule out problems that can be minor now but major if left unattended.
The testing recommended is not complicated.  
Start with a Senior Profile and Complete Blood Count for cats.  These tests look at common problems found in older cats: kidney; liver; pre-diabetes; hyperthyroidism etc. The Complete Blood Cell Count looks at hematology.  
It review Red Blood Cells, White Blood Cells, checks for infection and inflammation in the body; looks at your platelets etc.  These are the same tests run on humans but they are veterinary species centered.  
The SDMA biomarker can pick up early kidney disease; 40% earlier than other biomarkers we have used for years.
So the question is not.... why should I run these tests?......the question.... is WHY NOT?
An Electrocardiogram is an excellent way to diagnose early heart issues.  Telemedicine is a vehicle through which we can send your ECG to a Cardiologist for Interpretation!  Chest X-rays and Echocardiograms-i.e. a sonogram of the heart] are readily available at Silver Sands Veterinary with our visiting Radiologist. 
Is Your Cat a Senior?
At one time, cats were considered "senior" at the ripe old age of eight! Now with advancements in nutrition and with more and more cats being kept indoors; it's no longer unusual for a cat to live well into their teens or even into their twenties. 
Despite the lengthened lifespan, cats still reach their, early, senior years around the age of NINE. 
While this seems very young for a cat that might have more than half of their life left to live, it is important to realize the changes in their biology. Think of it this way: even though humans are living longer these days (some into their 90s or 100s), they are still considered a senior citizen between the ages of 60 and 65. 
Even if you do not see any physical changes, it is still important to think of your cat in their proper cycle of life.
Signs of Aging in Cats
Typically, as a cat heads into the senior years they begins to show signs of slowing down. 
They might also be less inclined to jump or climb, and might even have difficulty getting to hard-to-reach places. 
Older cats are more prone to weight gain, although some aging cats lose weight instead. Any such weight change could be signs of a serious health issue and should be discussed with Dr. DeForge.  
Diabetes, Hyperthyroidism, Cancer, Liver Disease, and Kidney Disease must be reviewed with Dr. DeForge in both the overweight and underweight Senior Cat.
Common Senior Cat Problems
Aging cat issues are often similar to those faced by humans. Older cats are susceptible to such problems as arthritis, obesity, vision and hearing problems and dementia..............as well as a host of diseases such as diabetes, cancer, kidney, liver disease, and thyroid problems. 
All cats are prone to periodontal disease. Without proper cleanings and oral x-rays by Dr. DeForge problems are likely. All cats, and especially aging cats, are susceptible to dental issues like gum disease.  Feline tooth resporption is common in all cats and cause pain and difficulty eating in cats.  Seniors could be affected by multiple cat caries- i.e.resportive lesions. 
Become a Senior Advocate and Detective! 
Look for any of the below signs and report them to Dr. DeForge. 
·       Difficulty or reluctance to try jumping or climbing
·       Changes in weight
·       Strange lumps or bumps
·       Failing to use the litter box or excessive urination
·       Appetite loss
·       Diarrhea or constipation
·       Incontinence or lack of urination
·       Lethargy or listlessness
·       Not able to play with toys or remember tricks that were taught
·       Excessive meowing, yowling, or other vocalizations
·       Runny nose or eyes
·       Cloudy eyes
·       Bumping into objects
·       Pawing at the face
·       Excessive howling-dropping food-chewing on one side of the mouth

Caring for Your Senior Cat
 All cats should have plenty of clean, fresh water available to help improve kidney function and prevent dehydration.  This is even more important in the aged cat with early kidney problems. Be sure water is plentiful and easily accessible. Older cats may sometimes forget to drink, so consider either adding wet food to your cat's meals or switching to canned Senior diets to ensure plenty of fluids.
Despite their tendency to be less active, older cats still benefit from regular exercise. Encourage your cat to move and play as much as she's willing to. Don't push, especially, if your cat shows signs of joint pain or discomfort.
You can help reduce the risk of arthritis and joint problems by adding supplements that contains omega-3 fatty acids as well as glucosamine and chondroitin. Their is a plethora of supplements on the intervet.  Do not purchase any supplements without a consult with Dr. DeForge and orthopedic x-rays at Silver Sands Veterinary.  
Health Checks: Cats are masters at hiding their pain, so any signs of problems might go unnoticed until they become too pronounced to ignore. 
This is why it's important to take your aging cat for regular health checks to Dr. DeForge. Pay close attention to your aging cat's behavior patterns and report any changes to Dr. DeForge.
Common Problems in Older Cats:
·        Diabetes
·        Kidney Disease
·        Liver Disease
·        Heart Disease
·        Lung Disease
·        Hyperthyroidism
·        Osteoarthritis
·        Dental Disease
·        Bartonella Infection
·        Leukemia and Immunodeficiency
·        Primary v. Secondary Hypertension-High Blood Pressure
·        Cancer
·        Intestinal Obstruction
 Testing Advised:
  1.           Chest  X-rays
  2.            Electrocardiogram
  3.           Comprehensive Chemistry Profile and CBC with Urinalysis
  4.            Screening for Cat Bartonella-Immunodeficiency-and Leukemia
  5.       Blood Pressure Screening

Senior cats aren't necessarily at the end of their life — they're just learning how to live it differently
Be proactive and schedule the testing that Dr. DeForge feels is necessary to bring a pain free quality of life to the cat you love.

Question[s]: E-Mail Dr. DeForge at:  DonDeForge100@gmail.com


Wednesday, March 11, 2020

CATS HAVE ANAL SACS TWO-Valuable Information for the Cat Lover-DR. DON DEFORGE

Silver Sands Veterinary
www.SilverSandsVeterinary.com
Donald H DeForge, VMD
DonDeForge100@gmail.com
1-800-838-3368




Image result for Diagram of a dog or cat anal sac


CATS HAVE ANAL SACS "TWO"
~A SCOOTING PET 
SHOULD BE EXAMINED BY A VET~

The anal sacs are paired sacs located on either side of the anus of dogs and also-CATS!  Anal sacs collect the oily secretion of the glandular tissue that lines the sacs. [i.e. anal glands].

Sebaceous glands within the lining secrete a liquid which smells foul.  The anal sacs have no function.  

It is hypothesized that in the "historical-wild undomesticated species" the liquid being expressed during "fright; fight; and/or flight"[i.e. when being attacked] was a warning system to the pack.

Dog and cat feces is firm and the anal gland liquid plays a part in lubricating the anal opening during defecation.

In the dog and cat, many times, the sac fails to empty during defecation, leading to impaction. Anal gland impaction results from blockage of the duct leading from the sac to the anal rim orifice. Secondary infection can occur if the problem is not treated.  Infection; sac rupture; and cellulitis are all sequels to an untreated impaction.

Signs of Anal Sac Impaction in the dog are cat are:


Difficulty sitting or standing

Chasing the tail

Trying to bite or lick the anal area if reachable

Sitting in an abnormal position

Constipation

Perianal Pain

Scooting

Anal itch

Malodor as the secretion leaks from the sac but never empties 

Cats defecating outside litter box

Pungent Anal Odor

Blood or Pus in the perianal area


Anal Sac impaction and abscessation are painful!  

Many pet owners and groomers try to express the sac manually by pressing on the outer anal ring at the three/four and eight/nine positions on the face of a clock.  

The danger of having the sacs emptied [i.e. external expression] by a person not cognitive of anal sac anatomy has been documented by veterinarians.  

If the lay person presses too hard, it can lead to sac rupture and abscessation in the area of the internal and external sphincter muscles.  This can lead to painful complications and unnecessary surgery for your pet.

The veterinarian uses internal sac expression  

With an understanding of anatomy and anal sac pathology, the veterinarian can safely empty the impacted sacs.  This procedure is accomplished with twilight anesthesia; sedatives; analgesics; and at times local anesthesia of the anal area.

Key Point:

Routine emptying, when the patient is showing no sign of discomfort, is contraindicated.  Frequent unnecessary expression can lead to inflammation; infection; or increased filling of the sacs from operator induced trauma to the site.

Co-Morbidities and Anal Sac Impaction

Obesity can lead to anal sac problems. Watch you pet's weight and seek help from your Primary Care Doctor of Veterinary Medicine on techniques for weight control. 

Allergy, anal impaction, and anal sacculitis are definitely linked.  Patients with flea allergy dermatitis; food allergy; and atopic dermatitis are commonly affected with anal sac impactions.  See your veterinarian and discuss a dermatologist referral and/or a dermatology work up at your general practice if allergy is in question.

Other Causes for Scooting and Anal Discomfort

Perianal Tumors-benign and malignant

Pruritic Anal Syndrome from diarrhea

Intestinal Parasites

Matted Hair from poor grooming

Flea Allergy, Food Allergy and/or Atopic Dermatitis

Colitis-Irritable Bowel Syndrome


Cat Anal Sac Mythology

Cats with chronic anal impaction and sacculitis are commonly diagnosed as "behavior induced problems"!  That is not always the case!  Behavioral problems can cause obscessive-compusive disorders but they are not always the cause of anal impaction and sacculitis.

You have been told or read that cats do not have anal sacs! This is totally INCORRECT!

Cat anal sacs being expressed externally is as effective as internal expression by a veterinarian with sedation.  This is totally INCORRECT.  The lay person or pet owner can cause severe pain to their pet trying to empty a sac that is impacted or infected.  Even worse, the lay person can cause rupture and abscesstion requiring surgery.

How often should my dog or cat's Anal Sacs be expressed?  What else can I do?

As stated earlier, let your veterinarian be your guide.
Ask for a diagnostic work-up to rule out allergy and other bowel problems that could be contributing to the frequent anal sac impactions.  

Follow the Companion Animal Parasite Council recommendations on deworming of your pet to rule out parasites as a cause of anal impactions and sacculitis.  Utilize a prescription flea control product, for ALL outdoor cats, as outlined by your General Doctor of Veterinary Medicine.

Anecdotal reports have recommended adding fiber to the diet to help keep the anal orifice open during bowel movements.  A good source of fiber for dogs and cats is unflavored-unseasoned canned pumpkin puree.
  
A cat would be given 1 tsp twice daily.  Some cats love pumpkin-others need the pumpkin mixed with honey.  For the finicky cat purchase a high quality cat treat and pulverize it into a granular consistency.  Coat the pumpkin puree with this topping to entice your cat to try the pumpkin.

For Small Dogs add 1 tsp pumpkin puree twice daily to the diet.
For Medium Dogs add 2 tsp. pumpkin puree twice daily to the diet.
For Large and Giant Breeds add two tbsp. of a pumpkin puree twice daily to the diet.

The Future Is Now!
Rather than simple internal expression of the anal sacs with sedation/twilight anesthesia, veterinarians are now proposing a new technique~~~The Anal Sac Infusion.

With twilight sedation/analgesia, the veterinarian with a special curved tip syringe flushes debris and infected material from the sac with a normal saline solution.

The veterinarian then removes the saline and replaces it with an infusion of an antibiotic and anti-inflammatory medicine.  

This infusion is absorbed and the remainder naturally eliminated by the dog or cat over a 30 day period.

Ask your Regular Doctor of Veterinary Medicine about Anal Sac Infusions if you find yourself constantly or frequenlty returning to your local doctor of veterinary medicine for internal expression.  

These infusions can decrease the number of follow-up visits to your veterinarian as long as all co-morbidities have been examined and eliminated as causative factors of anal sac pathology.

Questions:
E-Mail DonDeForge100@gmail.com
Don DeForge, VMD



Unconditional Love-Hard to Find-DH DeForge, VMD

Don DeForge, VMD 17 Seemans Lane-Milford, CT 06460 DonDeForge100@gmail.com SilverSandsVeterinary.com Unconditional Love-Hard to F...