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12. 5 Common Senior Cat Emergencies Every Owner Should Know · Senior Pet Talk | for dogs + cats

• Amanda Steffen: You are listening to Senior Pet Talk, the show where we combine Western and Chinese medicine to give senior dog and cat parents the knowledge, the clarity, and the confidence to make sure that your pet's senior years are their best years yet. I'm Dr. Amanda Steffen. Let's get started. Hello, senior pet parents, and thank you for tuning in to another episode of Senior Pet Talk, where we go over everything senior dog and cat, and make sure you are well equipped to take care of your senior pet. If you are tuning in on any of the watching platforms today, like Spotify or YouTube, I am here with my senior dog, Mabel. She is 10 years old. A quick story on her, we got her from a shelter in North Carolina. about eight years ago now. They suspected she was around two when we got her. And she has just been a wonderful, kind, amazing dog to have. So she's done good with our Frenchie when he was a baby and came in. She has been amazing with her two kids. She's just been awesome. So today I wanna talk to you specifically about senior cats. I will do a lot of these episodes where there's gonna be kind of two parts. There's gonna be a senior cat version and then there's gonna be a separate episode on senior dogs. This is also how I run my program. I do this because they're so substantially different and a lot of times I feel like we just clump them together. And typically the one that detriments from that is our senior cats, because they get lumped in with senior dogs and. The way that they present does not look the same. The way that they progress through disease is not the same. And in general, most of the ways that they need to be cared for is not gonna be the same. So I think senior cats deserve their own entity in a lot of these things. And today I wanna talk to you specifically about emergencies with your senior cat. So if you've ever been in a scenario where you... thought you had to go to the emergency hospital or you had to go to your family vet very urgently because you're worried about your senior cat. This is an episode that will be maybe helpful, maybe triggering, just keep all that in mind. And if you have not yet, I urge you to listen into this because this is a good way for you to know a little bit about what could be going on with the signs that you're seeing and what you may expect when you go into the emergency vet, right? So I have a five-year-old daughter and I was talking to her last night and I said, Ellie, what should I do a podcast episode on? And she was like, well, when you work in the ER, then maybe you talk about what happens when the animals come in to see you. And not so many words basically. She said that and I was like, ⁓ that's actually a great idea. So this is on the cusp of that. do run my own in-home integrative clinic, but I also work in general practice and emergency medicine to keep up my skill set in those areas. I've worked in ER on a relief status since I graduated from school 10 years ago. So I really enjoy the emergency room and being able to help in those chaotic situations and kind of calm the chaos. It's always been something I enjoy doing. So I work every Sunday night, not every Sunday night, but quite a few Sunday nights each month in the emergency room. And it is something that always teaches me new things. I work in a specialty center, so there's specialists from surgeons to neurologists to internists to oncologists to cardiologists. We have all those things in veterinary medicine too. And it's really nice to learn from these guys and to get some more information. And it helps me bring that back to my senior pet parents. So today specifically, I wanna talk to you about five different emergencies that I more frequently see in senior cats. Now this may vary based on area that you are, country that you're in, those types of things, right? So for me, I'm on the eastern coast of the US. These emergencies can happen anywhere that I'm gonna talk about today. but there may be other ones that are more common in other areas of the world. So just keep that in mind, okay? So the first emergency that I wanna talk to you about in cats that we often see is cats coming in in respiratory distress. And essentially what that means is that they seem like they can't breathe or they're breathing heavy or they're not able to rest because they're too busy. breathing, you may notice that their belly is breathing. So they have an abdominal component to their breathing. They're breathing in and out with their belly. Those types of things are very concerning for cats. I think of like cats and birds. Whenever they're in respiratory distress or having trouble breathing, that is really scary. And we are usually on the verge of something substantial. So it is not something I ever recommend waiting on. I always recommend these types of scenarios do go into a veterinarian as soon as possible. Ideally, probably an urgent care or an ER or specialty hospital setting because they often need supplementation of oxygen. So those places tend to have like oxygen cages and kennels that are more equipped for those types of things than like your family that who often They have oxygen, but they don't typically have oxygen cages that are available, right? So sometimes there's just a difference in the equipment that we have in emergency medicine versus what we have in general practice. So cats should almost never pant. If your cat is panting or open mouth breathing, to me that is always a red flag. Now, if they've just been having zoomies running around and they pant for like, 30 seconds, that's one thing, if they're comfortable again. But if your cat is not exercising and you notice that they're panting, I urge you to take that very seriously. It is also important, I feel like for clients to know what a normal resting respiratory rate is, so I'm gonna take this moment to give you a little lesson. When... you are watching your cat breathe at rest. So when they're kind of just like laying down, resting, sleeping, whatever it may be. Take a stopwatch, check one minute or you can do 30 seconds and multiply it by two, whatever is easiest for you. But usually I just say for one minute, set the stopwatch for one minute and then watch your cat. Watch their belly rise and fall or their chest rise and fall. and see how many times that happens in that minute. That's how much you're watching them take a breath in, you're watching them release that breath out. You're watching them take a breath in, you're watching them release that breath out. And you count that. A normal for a cat at rest should be somewhere between 16 and 30 breaths per minute, okay? If we're getting over that 30 consistently or we're ever above 40, that is a big red flag for me with cats, okay? So what could be causing respiratory distress in your senior cat? The things that I most commonly see with this are related to heart disease or disease of the lungs like fluid happening around the lungs from potentially a cancer or another disease process. Cats can also get these. They can get fluid buildup around their lungs for a variety of reasons. It can be from a backup of fluid from their lymph nodes. It can be a backup of infection, essentially. It can be backup from heart disease and things like that versus potentially cancers like lymphoma. Cats are very prone to lymphoma and that can happen in the chest, although it's more typical in other areas of the body like the GI tract. So this can also be things like, feel an asthma. Typically, asthma is going to be something that we know a cat has before their seniorhood. If asthma is one of those that I feel like unfortunately goes under diagnosed fairly frequently because a cat too is having an asthma attack may just look like they're kind of doing this coughing type of thing for a few minutes and then they seem fine. And some... Sometimes it's worse than it is other times. And sometimes they do get diagnosed because they're not able to come out of one of those asthma attacks and they do have to have intervention by a practitioner, by a veterinarian. But a lot of times they'll just kind of deal with those things. And that can lead to chronic inflammation of the lungs, just like it does with people. And that can cause some long-term damage to the lungs, right? So cats are very... interesting about heart disease. They can actually have heart disease and not have a murmur that we can hear with a stethoscope, right? So it is important. There is a blood test that can be done on cats with their routine blood work that checks for a BMP. So it's going to check for like muscle strain of the heart muscles themselves. I do recommend that test for most of our spheline cat senior wellness panels. And it is included on most senior cat panels at this time. So it's something that is typically checked, but if it is elevated, that to me would warrant having more of a workup with a cardiologist. But we can see heart disease that has been kind of quiet for a long period of time. We might not notice any symptoms. Unfortunately with cats and heart disease, there are not a lot of symptoms until they're in heart failure. So we may see them just suddenly going to heart failure, have respiratory distress, not be able to compensate anymore. And that is the first sign of true heart disease that we've noticed at all, right? Before that, we might have noticed, they're not playing as much. Maybe they seem like they're getting tired a little faster, but we don't always pick up on those signs. I will say with humans, the same thing can be true. We have plenty of people that wind up with heart failure. and they didn't even know they had heart disease. And that's often because those things just go a little bit pushed to the side because it seems like just an aging change or just something normal. And we don't always think about checking, you know, an echo or an EKG. You're not always gonna go to those depths for something that just seems like maybe they're breathing a little heavier, you know, longer term. So the first emergency that we see is respiratory distress. If this does happen, if your cat has to go into the hospital setting for breathing heavy, it is likely that your cat is going to be rushed into the treatment area and placed into an oxygen chamber where they can be given supplemental oxygen. So I know it is very scary to be away from our pets, but I do want you guys to know that most of the time when this happens, your cat is being treated. Oftentimes they're going to be given like an inhaler. to help with any sort of potential asthma components of things. They may often get an IV catheter placed right away and be given some IV medications depending on whether we think that they need some sedation or maybe that we think that they could be in heart failure and we give them some medications to get fluid off of the lungs, those types of things. this is often a situation where you're gonna get bumped to the top of the line. in an ER setting and your pet is probably going to stay in the treatment area, which can be very scary and I understand. And expectations on the other side of this are often going to be, well, if they're having trouble breathing, probably the first thing that we're going to want to do is take x-rays after we get them stabilized. I think it's very important to make sure we give them something if we need to or give them some oxygen or give them some time to have some oxygen therapy before we pursue testing. But it is usually gonna be the first recommendation to, we're gonna wanna do some chest x-rays or some radiographs of the chest to see what the heart and lungs look like and what could be causing this damage, right? And then depending on what they see, that will kind of split from there based on what the plan will be. Do they need to hospitalize overnight in oxygen therapy? Do they need to see a cardiologist the next day? Do they need to have fluid drained from their chest? Whatever it may be, right? And I think It can be very scary in these scenarios. Our senior cats, I have these conversations a lot of times because we may say, ⁓ we recommend that they hospitalized. And we may be giving a poor prognosis and it can be difficult to make a decision to let your pet stay in a hospital setting when you know they may not make it out. And that's a realization of emergency with senior pets. So I want you to be front about those things, please don't hesitate to express your concerns to the emergency vets. If they are good emergency vets, which I like to believe we all are, they are going to be very understanding of that because they've probably been in your shoes before. They've probably been right where you are and they're going to do the best they can to try and make you feel more comfortable with it while also helping your pet feel better, right? So emergency number one is respiratory distress. Emergency number two is kidney failure. So this can present in a couple different ways. Oftentimes with kidney failure, I'm going to see a pad that comes in that just has been throwing up for a couple days, not eating, really lethargic, not wanting to get up and move around anymore. Maybe they've got some muscle wasting. Maybe they've had an increase in their urination or in their drinking. but maybe they're drinking and they're still throwing up. Those types of things can happen. Kidney disease can unfortunately cause a lot of varied symptoms. So it can present looking like GI upset or just like general lethargy. And we may be looking down the face of a very high grade kidney disease. Now let's see about 80 % of cats over the age of 15. have kidney disease, right? So they typically have chronic kidney disease, but chronic kidney disease means that there's damage to those kidneys. So something minimal can happen and we can get an acute injury to those kidneys if they get a little dehydrated, they get a little like crystallation or stones or something like that. It can cause this acute basically downfall of the kidneys themselves and they can get really sick really quickly. With kidney disease, unfortunately, there's not a treatment that makes it go away. There's support that we can give to those kidneys, but it's usually involving IV fluid therapy, which usually involves hospitalizing them. GI therapy, a lot of times the reason kidney disease causes GI issues and symptoms is because we're having a high acid buildup in the GI tract from that kidney disease and from it causing damage to and changes in electrolytes and things like that. So a lot of times we can get GI ulcers or stomach ulcers or intestinal ulcers from kidney disease. So that can be something where we can see like a very acute, hey, they were fine yesterday and they're sick today. Or, you know, it can be more progressive or like, hey, they've just been. decreasing in their intake of food over the past week and now they're seem really lethargic. Their little third eyelids and their eyes are kind of up over their eyes themselves and they're just not moving around and not doing very well. So in these scenarios with cats, typically our first test that we're gonna talk about is what work, maybe a urine sample to get us a full concept of what those kidneys look like, right? I will take a moment here to say, Cats are very difficult to do things effectively test-wise. So when you go in and your vet or the emergency vet may say, we recommend x-rays and blood work. If a cat is throwing up and really lethargic, then it's completely valid for us to do both because we're looking for things like cancers. on x-rays. Cancers don't typically show up on blood work, unfortunately. So blood work is going to tell us more about organ function. So how are the kidneys functioning? How's the liver functioning? Do we have signs of like pink or tight? Is there anything crazy like that? And then the x-rays are going to give us more of an indication of like, is there something that looks like a mass in the intestines or kidneys really big or really small or you know what is going on there that could give us more of an indication of what's going on with them, right? So when calves come into the emergency room and they have these non-discreet signs of just some GI upset or something like that, it can get expensive quickly. And this is where I think it's extremely important that you feel comfortable and confident enough to have an open conversation with the veterinarians to say, And I always do this and I say, hey, this is gonna be about 800 to $1,000 to get this testing done here in the emergency room, right? It's always more expensive in the emergency room. It's always more expensive at a specialty hospital. But before we do all this testing, I want to see what we are thinking with that because that is not treating what's going on with Cali, right? That is just. trying to find out what's going on. And we still may not get our answer on the other side of that. She may need an ultrasound or she may need a cardiology workup or she may need something else, right? So I think it's also very important that you feel comfortable enough to have an open conversation with your vet of saying, hey, I don't know that I can fund more than $800 today. And it's not putting up price tag on your love for your pet or anything like that. I those are all really hard things to hear and to think about. And as veterinarians, we're not judging you. We also have budgets. It just helps us a lot because the thing that I hate is if someone says, yes, to all these tests, and then we get on the other side of these tests and now I'm like, okay, well now you need... Now you need GI support. Now you need hospitalization with oxygen therapy or now you need XYZ. And we can't afford that. So we're not even so afford the treatment because we ran all these tests that were rather extensive. And are we just treating based on our best educated guests without doing those tests? Yes, a lot of times we are. And as veterinarians, we tend to be pretty good at that. We don't usually always get to run all the tests and do all the things. And part of what I enjoy about being a veterinarian is figuring out the puzzle without having all the pieces. And it is important for us to make sure we're having an open conversation about that with pet parents and pet parents with veterinarians, because we're not in any way judging you for that, but it is extremely helpful for us to know so that we can say, okay, well, I really need this part of the blood work so I can see what this number looks like because I'm really worried about this number. But maybe we just do a mini panel knowing that we won't know this other information over here. But it's enough for me to know what I need to know to support Callie's body tonight and to get you to your family that tomorrow morning, right? That's a lot of what we're doing, especially on the weekends and ER is just them the best we can to get them to their family vet so they can do more of that testing potentially at a cheaper cost or to be able to do more of that treatment, right? So I want what's best for your pet just like you do. And I know that not everyone has in less pockets. I don't either. So it's important for us to make sure we're having that financial conversation with these things too, right? Okay. Another side note on kidney disease in cats, there are a lot of toxic plants to cats. Lilies are the big one that we think about. Never get lilies. Just if you have a cat, no, they don't come in your house. Someone buys them for you, tell them, really appreciate that. You can take them home with you or give them away to someone else. That's why. You still bring them in your house. Even a little bit on like a pollen on their nose can cause kidney failure. It's just not worth bringing them into the home, right? So that is our second emergency that I frequently see. The third emergency is just this general not eating for a day or more. I typically see this because I work Sunday nights. So maybe a cat stopped eating as well on Friday night and was still eating a little bit just that lot. then Saturday, like didn't eat all day. And then Sunday, they were like really trying to wait and try and get to their family about on Monday, but they didn't make it. you know, there's something else going on that just that that wasn't gonna work. So that being said, we see this general like, inappetence or vomiting or these types of things that have been going on for a day. And it may seem not as concerning when you go in, obviously, you're going into Fever, Steve, but but you're saying like, ⁓ he just hasn't been eating for a day. And to you, that may seem like, okay, he's been sick. for a day, right? Well, to me, what I'm thinking in my head is, well, he's been sick for a week or months and he didn't tell us, he didn't show us until now his body can't handle anymore and now he's really sick. I've had patients who do this with things like triaditis where they're actually having inflammation of their liver, inflammation of their pancreas. information up their galt letter, everything is just ticked off at one time. And that is a super painful, hard to treat process in cats. And they will come in for just like, they haven't been eating for a day. Because cats are just really good at hiding things. I've seen cats come in. And that is the story. And they have kidney failure, heart failure, bladder stones. diabetes, and like five things at one time. And that's not uncommon. know, they just, their body compensates really well until it doesn't. And then when it doesn't, it just starts to cascade and we start to notice this like cascade of things. So when you take your pet in for not eating for 24 hours, it may seem a little extreme that the doctor wants to run multiple different tests. And I just want you to understand this is why. Because frequently, Cats are not showing us until they're really sick and then we're very concerned. If our cats have a low temperature, that is directly correlated with an increased mortality or death rate. So normal temperature for cats is about 99 to 102. Senior cats, I do notice tend to run a little lower on that 99 type area just because they have muscle lesion, they're usually pretty frail. it's not uncommon for them to be a little lower, but if we have a cat whose temperature is 97, they're very sick and their body is already starting to shut down. So a low temperature is always an indication to me that something big is going on and we have to get this countered quickly if we're gonna be able to come out on the other side of this, right? So sometimes, not eating for 24 hours can progress too. So say we have an overweight cat. If we have an overweight cat, they can actually get what we call hepatic lipidosis, which is essentially called fatty liver disease. And that can happen after just like two days of not eating. And basically the fat is going to mobilize faster than the liver will process it. So the liver starts to attack itself. that can lead again to like fangirist getting mad or the gallbladder getting mad or all these other things happening. And they can get very sick very quickly. So if you have an overweight cat that's not been eating for a day or two, that's a big concern to me. We may think, ⁓ well, they have more reserves, they're going to be okay. And like in reality, that abrupt change for anyone is actually worse than it can be for some of our skinnier cats. Sometimes these guys want to be feeding tubes. for a period of time and some substantial hospitalization. So I never want you to wait when we're talking about a cat over the age of 12 dealing with any sort of these potentially vague looking signs because if a cat is showing us signs, then we need to trust them because they don't show us those outward changes of like not eating or vomiting or. lethargy or not moving around and those types of things very frequently until they're pretty sick. So it's really important to take that seriously, okay? The fourth emergency that I frequently see is one of the saddest ones. This is what we deem a saddle thrombus is the best way to describe it, but it's called an aortic thromboembolism. So essentially what happens in these cats is you will come home or they'll come out from under the bed or something like that and they are dragging their back legs. Like it almost looks like they've been hit by a car. They cannot use their back legs or one of their back legs. These cats are often also making this awful yowling sound. Like it is like, wow. Like they're doing this very visceral moaning, yowling. And that specific sound in cats in the emergency room usually only happens for one of two reasons. One is the saddle thrombus, the other is a urinary obstruction. Urinary obstructions are more common in our middle to younger male cats. So not super common in our senior cats, but this very high pitched moan associated with this as well as like dragging a back leg or not using a back leg. You may notice that one of the back legs or feet pads feels colder than the other or the back feels colder than the front. What has happened in this situation is these cats had some aspect of heart disease that we didn't know about. Again, cats don't show a lot of symptoms of heart disease and they have had this basically these little blood clots form in the heart. So if the heart is not pumping exactly how it needs to, basically we get some swirling of blood that happens in the heart chambers and that blood swirling around can eventually form a blood clot. And that blood clot, surprisingly, is not harmful until it leaves the heart. And then once it comes out of the heart and goes through the tube called the aorta that feeds to the rest of the body, and basically it's supposed to take that blood and pump the rest of the body, it goes into that tube and it comes down to the back legs and when it gets to the back legs, it breaks into two. So it'll bifurcate and it will go to each back leg and then basically it all swirls back up and comes up to the rest of the body. Well, at that break, if that blood clot is big enough, it basically will go down to where that trade-off is, that the spin-off is between the two back legs and it will stick right there between those two back legs. and it will cut off circulation to those two back legs, which is why we see this acute, not able to use their back legs or one back leg if it just goes into one side. And it's very painful. It feels like if you sit on your leg for a long time and then you get that tingling sensation and that painful sensation that comes along with it, imagine that we're probably like 10 times worse. And that's what they're gonna be feeling with this. So it is very painful process. Unfortunately with cats, There's not really anything we have to break up a blood clot that's already there. We basically just put them on blood thinners and treat them like heart disease and see whether, and pain medications, and we see whether the body can break it down on its own. But there's a lot of problems that can happen with that. We get this thing called re-perfusion injury, which basically means as the blood flow, if it does go back to the back legs, which is a big question mark, if it does, then when we start to get that, you have all this stagnated blood that's been sitting in the back legs and it is pretty toxic blood. So then all that blood finally starts flowing and we're pushing a bunch of toxins into the body at one time because they have been able to be filtered out. So then we can have a lot of problems that happen on the other side of this. Pets can get really sick and they get this thing called a reperfusion injury, which can kill them. A saddle thrombus is unfortunately often something where we are having a quality of life conversation on the other side of this. It is more common in male cats and it's typically between like eight to 12 years of age. So it's not as common in our like 12 plus cats, but it's what we would deem like that later middle to senior stage of cats. Have you ever left the vet with more questions than answers and then you drive home and you go straight onto Google? Yeah, I hear that a lot. And honestly, it's exactly why I created my Senior Pet Virtual Consultations. Imagine we have 45 minutes where we go through everything, your pet's full history, their specific challenges, their daily life, no rushing, we're gonna cover nutrition, integrative options, whole modifications and quality of life. and I send you a personalized plan after so that nothing slips through the cracks here. But don't just take my word for it. Chelsea called it a senior pup therapy session and said she felt so much better afterwards. Adiba got recommendations her own vet had never thought to suggest, and Denise said that the consult was incredibly informative and helpful, giving her many options to help her dog, Loki, feel better. This is the conversation that your senior pet deserves. And honestly, the one you deserve to. The link is in the description. I'd love to help you. All right, and then, so this is something where regardless, know, obviously anytime your cat is making this awful yelling sound or your cat is not able to use one or both of their back legs, that is a medical emergency. We should definitely make sure we get that seen and taken care of. The last one that I want to talk to you about is a little more specific, but I think it's important. It's called diabetic ketoacidosis. This is more common in older cats that may already be diagnosed as diabetic or we may be diagnosing them that day with diabetes. Basically, just like diabetes, we think about not having the amount of insulin that they need and then their body burns fat and they get this buildup of ketones. There's a lot of ketosis diets going around and basically what that means is you're building up these things that are going to break down fat cells but can also start to break down your organs. So ketosis is not something we really want to have in our senior cats happen. And it's something that can make them very sick. So with diabetes, we could also get things like hankeryitis on the other side of that. We can have them get more that hepatitis or inflammation of the liver. We can have them get gallbladder inflammation and things like that. Like there's a lot of other things that can go along with diabetes in cats, especially this diabetes that's not been diagnosed or not controlled very well. So we get this ketosis stage and these guys, I mean, anytime we diagnose ketosis in a cat that has diabetes, whether it's new or new diabetic or, you know, a previously known diabetic, we typically recommend hospitalizing these guys. So this is going to be something where they're typically like really lethargic. They have repeated vomiting. They have a loss of appetite. Some people can smell like a sweet or like an acetone type of smell to their breath. Another interesting topic about diabetes if they've never been diagnosed before is they get this like their back legs almost look flat to the ground. Instead of they stand up on their tiptoes, they'll kind of have their whole back leg almost flat down. This can be extremely life threatening. So this is something that can cause progression and death if not treated appropriately. If you have a cat that's diabetic and you should have a protocol going forward with like, if they're not eating, how frequently, how long do I wait or what do I do versus, are we going to be monitoring or decreasing their dose of insulin or should we be going into the ER? Do I have a way to monitor their glucose at home, their types of things? But DKAs or diabetic ketoacidosis, a lot of times we see newly diagnosed in these guys like a cat who's previously been overweight and now they've lost a lot of weight in a short amount of time and they're throwing up and not eating well and those sorts of things. Survival with quick treatment can be up to 80 % in these guys. So that is important to know getting them in sooner and quicker is going to help them more. So those are five emergencies that I frequently see. We have respiratory distress, total breathing, kidney failure, changes in our urination habits, changes in our overall demeanor, lethargy, types of things, changes in our appetite, not eating for more than 24 hours, a saddle thrombus or something that happens with the heart, and then diabetic ketoacidosis. All right? So you guys are doing a really good job with your cats. Cats are so hard to read. I just want to let you know that if you come in, I see every single week when I work, someone who comes in with their cat and they say, I swear he was fine yesterday. And now I'm telling them that he's in stage three kidney failure. And was he fine last week? I don't know. But did he show any clinical signs that anything was wrong? No, probably not. pets are just really good at hiding things. So I don't want you to ever go into these scenarios blaming yourself or thinking there are things you should have picked up on earlier or, you know, beating yourself up for it. I see that so much and it's just not your fault. It's just how they are made to deal with things and not show signs of distress and problems. So remember that you were doing a good job. Please Never be afraid to speak up. Whether it's about symptoms that your pet is having or if you have an intuition about something or about financial budgets and things like that. Those are all very important things that we should have over conversations about. Okay? Okay. You are doing an amazing job with the information that you have. And I am always here. If you have any other questions, please feel free to reach out to me. You can find me on social media or on my website. Okay, thank you. That's it for today. If this episode helped you, please leave a review or rate this podcast so we can get the word out to more pet parents who need to hear that they are doing a good job. And if you're interested in working more with me, you can find me on social media or at seniorpetconnection.com because we all need to stay connected. Remember that you are doing a great job with the information that you have in this moment. and I am just here to give you more of it. See you next week.