We now know that we have a window of opportunity between when a dog's heart starts to enlarge and when they start to show us clinical signs. . Stage B1: this refers to dogs that have heart disease (characterised by a typical mitral regurgitation murmur) but do not have an enlarged . Degenerative mitral valve disease (DMVD) or chronic valvular disease is the most common canine acquired heart disease in dogs, . Cost of Tricuspid Valve Dysplasia in Dogs. Casademont J. Appropriateness of medications prescribed to elderly patients with advanced heart failure and limited life expectancy who died during hospitalization. The stage can be further subdivided as follows: 1. There has been so much great research into Mitral Valve Disease over the past 10 years and it's really helped us with targeting treatment and improving life expectancy. Methods: Retrospective multi-investigator study. Dogs with mitral valve disease, . Keeping your dog healthy and at his ideal weight can lessen the severity of symptoms if mitral valve insufficiency does occur. Dilated Cardiomyopathy - disease of the heart muscle that may have no symptoms for up to 2 years. Myxomatous mitral valve disease (MMVD) is the most commonly diagnosed cardiovascular disease in the dog accounting for more than 70% of all cardiovascular disease in dogs. As this progressive disease advances, exercise intolerance, increased respiratory rate and/or effort, and a cough may develop. [3] Surgery might be required for people with severe kind of mitral valve disease that . It is more common in small dogs than large breeds. If caught early, many dogs can live for many more years, while others with symptoms could only survive a few months. Degenerative Atrio-Ventricular (Mitral and Tricuspid Regurgitation) Valve Disease What dogs get this disease? 3 hours ago Mitral valve disease in dogs is a serious condition that can lead to blood leaking during heart muscle contractions. Stage 4 dogs may only have weeks to live. About 10% of all dogs suffer from some Emergency: If your dog is struggling to breathe, contact your vet immediately for an . because dogs with mitral valve disease who have not yet had an episode of congestive heart failure (Stage B1 or B2) may lead a good quality of . These valve leaflets open and close to regulate the flow of blood, but as the disease progresses, they begin to thicken, contract and lose flexibility. A normal mitral valve functions as a one-way valve, which flows blood from the left atrium to the left ventricle. Mitral Valve Disease in Dogs - My Vet Animal Hospital. Key words: Cardiology; Cardiovascular; Echocardiography; Heart failure; Valvular disease. Only the vet can ultimately gather an insight as to the prognosis and life . Doberman Pinschers. Records of adult dogs 20 kg with myxomatous mitral valve disease were examined. 2014; 31:541-546. . 3, 4 Among these diseases, MMVD is the most frequently diagnosed, accounting for approximately 70% of acquired cardiac disease in dogs. The life expectancy in dogs with mitral valve disease varies and depends on several individual factors such as the severity of the disease and the treatment chosen. Cocker Spaniels. In general, this is seen more frequently in small breed dogs, with up to 75% . Dogs with MMVD that receive adequate care may survive an average lifespan of 2 to 4 years, while those diagnosed at a later stage tend to live only six months to 1 year. Mitral valve disease can lead to life-threatening complications such as heart failure, arrhythmias, and stroke if left untreated. The mitral valve is made of thin flaps of tissue, or valve leaflets, attached by long, tendon-like structures, the chordae tendineae, to the muscles of the left ventricle. Some of the breeds include Cavalier King Charles Spaniels, Miniature poodles, Shih Tzu, Maltese, Chihuahua, Cocker Spaniels, Miniature Schnauzers, Bloody Nose (Epistaxis) in Dogs and Cats. This results in the thickening of the valve leaflets and a valvular leak that eventually causes heart enlargement and signs of heart failure. I am not your dog's . 1 It is a chronic, slowly progressive process, potentially affecting dogs for more than 5 years before resulting in heart . Hypothesis: Spironolactone in addition to conventional therapy increases survival compared with conventional therapy in dogs with naturally occurring myxomatous mitral valve disease (MMVD). Thankfully, there are surgical and transcatheter procedures to treat this insidious disease that kills 25,000+ people annually in the United States alone. In these cases, no other symptoms are typically seen. That being said, pets with cardiac disease supported by medications can live many quality years before therapies cannot keep up with the loss of heart function. The main warning sign early in mitral valve disease may be as simple as a heart murmur. However, individuals with severe mitral valve regurgitation may have a lower life expectancy, especially if it goes untreated. [2] The life expectancy for patients with mild type of mitral valve disease is good without therapy and restriction and the symptoms if any can be controlled by medication. Degenerative valve disease (DVD) is the most common heart disease and the most common cause of congestive heart failure in dogs.Although it may be seen in dogs of all sizes, it is typically seen in elderly, small-breed dogs, with almost 85% affected by 13 years of age. If the condition isn't noticed until Stage 4, the dog's outlook may not be as positive. They remain alive more than 5 years after diagnosis and do not need treatment because the disease does not significantly affect heart health. Mitral valve disease is responsible for of all canine heart diseases. The valve which is between the left atrium and left ventricle is the mitral valve. Mitral Valve Dysplasia in Animals. Animals: Between February 2003 and March 2005, 221 dogs were recruited in Europe. Stage A: these dogs do not have evidence of heart disease, but are at risk from a genetic point of view; dogs that are predisposed to mitral valve disease are in stage A, for example any Cavalier King Charles Spaniel. Your dog's life expectancy will very much depend on how serious their symptoms are, how their MVD progresses, and how they respond to medication. Diastolic murmurs occur less frequently in canines. Dogs with MMVD that . This study was designed to determine if a cardiac protection blend (CPB) of nutrients containing medium-chain triglycerides as an . . The changes in blood flow are represented by the 2 arrows in the lower photo to the right, labeled "B: Stage B2 CDVD". The heart is separated into 4 chambers; top and bottom, left and right. Energy deprivation plays a causal role in the development of heart failure. Degenerative disease of the mitral valve is responsible for 75 percent of all heart disease in dogs. . This means that the one-way door fails to form a complete seal, allowing blood to leak back into the left atrium. A life-threatening stage may be reached within 1-3 years of diagnosis (Kittleson and Kienle 1998). See Also: Disease Show details. Acute (hospital based) therapy. Bloat: First Aid. ACE-inhibitors are the only drugs proven to extend life expectancy in both people and dogs. In severe refractory CHF the combination of nitroprusside with dobutamine constant rate intravenous infusions may be life saving, however both these drugs . Who develops chronic degenerative valve disease? In these life-threatening cases, a high dose bolus of furosemide (2-4mg/kg IV) is usually indicated initially, followed by 1-2mg/kg every hour (or .71mg/kg/hour as a constant rate infusion) until the respiratory rate and effort start to decrease. Stage B2 refers to a patient that has developed a leak across its mitral valve and that the resultant changes in blood flow patterns have . The above listed symptoms are usually mild in nature and are noticed at the very initial onset of mitral valve disease. . The quality of life depends on the stage your dog is in. Sometimes a heart murmur is a sign of DMVD. Mitral valve dysplasia is a congenital malformation of the mitral valve leaflets or any other component (s) of the mitral valve complex. Nine dogs were excluded from analysis, leaving 212 dogs with moderate to . Myxomatous mitral valve disease (MMVD), the most common naturally-occurring heart disease in dogs, is associated with alterations in energy metabolism, oxidative stress and inflammation. Heart valve disease can be debilitating and life-threatening for patients diagnosed with severe valvular disorders including aortic stenosis and mitral regurgitation. It's so easy to take for granted, until something goes wrong. Objectives: To determine whether murmur intensity in small-breed dogs with myxomatous mitral valve disease reflects clinical and echocardiographic disease severity. Depending on the study and classification, median survival rates range anywhere from 2 months for dogs in stage D to over 3 years for dogs with stages A and B. Mitral valve insufficiency usually affects smallish doggies but also those of middle age. The risk of developing CVD increases as dogs . Bones are Unsafe for Your Dog, No Bones about It. Mitral valve disease is a uniquely serious, life-shortening problem for cavalier King Charles spaniels and is their leading cause of death. Degenerative mitral valve disease may appear as early as 1-5 years of age although commonly detected around 10-11. Pugs. The upper chambers are the atria (singular atrium) and the lower chambers are the ventricles. Brachycephalic Airway Obstruction Syndrome in Flat-Faced Dogs. Enalapril and benazepril are commonly used ACE-inhibitors in dogs. Moderate Mitral Valve Regurgitation Life Expectancy. Fortunately, if caught early and treated accordingly, dogs with mitral valve disease can still live long, healthy lives. When a dog has mitral valve disease the mitral valve essentially "wears out" and leaks. That alone will cost $100-200. It's also called endocardiosis, chronic valvular disease, and chronic valvular fibrosis. 8-10 Progressive LAE is a common sequela during . C hronic degenerative mitral valve disease as a result of myxomatous degeneration (MMVD) represents the most common acquired cardiovascular disease in the dog.1 The prevalence of MMVD is associated with age and breed.2-6 The disease is characterized by a Other causes of mitral valve insufficiency include ruptured chordae tendinae , a condition in which the fibrous cords that hold the valve leaflets in position break, and heart valve infections known as endocarditis. Dogs in the earliest stages of mitral valve leaks go on to live years. September 2022. The survival rate drops to around 60 percent at 5 years. 1996; 51:B403-B408. Inflammation of the lungs and lung tissues. Dogs With Mitral Valve Disease in Dogs Life Expectancy. Surgery to the mitral valve usually benefits the right side by decreasing pressures in the lungs (pulmonary hypertension). Once severe congestive heart failure has developed, survival has been found to average about seven months, with 75% mortality within a year (French 2005). High blood pressure. Drugs Aging. About 10% of all dogs suffer from some form of heart disease. Your dog's prognosis will depend on how far its disease has advanced by the time it is diagnosed. Approximately 60% of affected dogs have degeneration of the mitral valve, 30% have degeneration of both the tricuspid and mitral valves, and involvement of the . Symptoms are usually managed with strong diuretics (furosemide, torasemide). . Since we can't say the exact treatment plan, it's hard to guess the cost. Hastie recommended further tests and his fears were realised. There are valves which are in place between each of the chambers to . As the disease progresses, the goal is to help your pet maintain a good quality of life and to keep your pet out of heart failure, without harming the kidneys. Mark A. Oyama, DVM, Diplomate ACVIM (Cardiology) Degenerative mitral valve disease (DMVD) is a common canine cardiac disease; approximately 30% of dogs over age 10 possess the characteristic left-sided systolic murmur of DMVD and resulting mitral regurgitation (MR). Chronic degenerative valve disease represents approximately 75% of all heart disease in the dog and is very, very rare in the cat. Dogs with early or mild mitral valve disease will be identified by a heart murmur of low-grade severity heard loudest over the left side of the chest. Boxers. Myxomatous mitral valve disease (MMVD) accounts for a whopping 75% of all . 01866-A: Enhancing Treatment of Mitral Valve Disease through the Identification of Biological Markers of Disease; 01694-A: Progression of "Silent" Degenerative Mitral Valve Disease in Norfolk Terriers; 01529-A: Platelet, myocardial, and valvular serotonin concentrations in healthy dogs and dogs with mitral valve disease Without treatment, her life expectancy would have been short, Clements said. Corcoran 2009). . Other possible causes include pulmonic valve endocarditis and mitral valve stenosis. How long can a dogs live with mitral valve disease? Life expectancy varies widely and may be as little as a year or much longer; it is really case dependent, even your Veterinarian . Li Y, Deeb B, Pendergrass W, et al. Blastomycosis is a Systemic Fungal infection Affecting Dogs and Cats. In fact, heart disease is a leading cause of death in people and a health concern for our pets, too - particularly myxomatous mitral valve disease, the most common heart health problem diagnosed in dogs. See Also: Mitral valve disease in dogs life expectancy Show details . . In dogs, AF usually is observed in animals with dilated cardiomyopathy, myxomatous mitral valve disease (MMVD), or congenital cardiac disease associated with LAE. Mitral valve disease is often one of the earliest indicators of heart disease that could lead to heart failure. On the other hand, systolic murmurs are much more . The majority of dogs with asymptomatic CVD will live 2 to 5 years or longer, without ever developing any clinical signs of heart failure. This abnormal flow of blood causes the turbulence we hear like a heart murmur in dogs. As the condition progresses, however, the dog will become very . Tests like x-rays, and ECGs will be another couple hundredand . The severity of mitral regurgitation determines the degree of left heart enlargement and the risk of left-side CHF. At this point, with increased treatment, dogs can still live another . As the condition progresses, fluid can build up in the lungs, chest, and abdomen. Stages of Degenerative Mitral Disease. Chronic degenerative valve disease (CVD) is a progressive degeneration of the valves in the heart (primarily the mitral valve). If your dog has minimal heart problems, he'll at the very least, need an annual check-up, which is much more than most pets. Mitral valve disease in dogs is so common that VCA Hospitals says one in every 10 dogs will develop some form of heart disease in their lifetime. Mitral valve dysplasia (MVD) in dogs is the congenital malformation of the heart's mitral valve. Life expectancy varies based on the rate of disease progression, but in most cases it takes years for clinical signs of congestive heart failure to develop. This condition occurs in dogs and is a common defect of cats. 1 DMVD is most common in small breeds, with some breeds being highly predisposed. These changes allow blood to "regurgitate", or leak back into the left atrium. Pets with early or mild mitral valve disease often have a heart murmur that a veterinarian can auscultate (hear with a stethoscope). . Preview / Show more. Dogs with mitral valve disease can live for several years with proper treatment and nursing. The mitral valve is the valve between the left atrium and the left ventricle. A: Similar to humans, dogs can develop many conditions affecting the heart that may eventually lead to heart failure. Numerous studies have been performed on dogs with mitral valve disease and life expectancy correlates to the stage of the disease. Sophie was diagnosed with the second-most common type of dog heart disease, mitral valve endocardiosis. The primary factor for this type of murmur is a malfunctioning aorta. Mitral valve disease is a uniquely serious, life-shortening pro blem for cavalier King Charles spaniels and is their leading cause of death. is the first indication that the dog may have mitral valve disease (MVD). Cellular proliferative capacity and life span in small and large dogs. Published: July 26, 2021. It is true yes, dogs with cardiac disease live shorter lives than their counterparts without it. When it comes to guessing a dog's life expectancy after confirmation of mitral valve insufficiency, factors such as intensity of the condition come into play. Chihuahuas. A diagnosis by a veterinarian can determine the presence of mitral valve . Cavaliers should be screened for heart murmurs annually, beginning . [Google . This very common disease affects dogs usually after the age of 8 years. Statistics are only a best guess, however. Dogs are my life and my career. A recent clinical trials shows that pimobendan delays the onset of congestive heart failure in dogs with mitral valve disease and cardiomegaly by a median of 15 months. Some dogs may never develop heart failure or die from the disease, while sadly some will perish. In MMVD, the mitral valves are thickened and too short. Tricuspid Valve Disease: About 1/3 of dogs with degenerative mitral valve disease also have tricuspid valve disease and dogs can develop right sided congestive heart failure with fluid gathering in the abdomen (ascites). More than 80% of small dogs under 15 pounds or under are diagnosed as having mitral valve disease. Cavalier King Charles Spaniels are predisposed to the condition. These could include abnormalities of the heart valves, heart muscle, or blood vessels entering or exiting the heart. Approximately 60% of affected dogs have degeneration of the mitral valve, 30% have degeneration of both the tricuspid and mitral valves, and the remaining 10% have degeneration in the tricuspid valve only. Persistent, congestive-sounding cough. The quality of life depends on the stage your dog is in. At least 80 percent of the heart disease cases diagnosed are from mitral valve insufficiency (MVI), also called mitral valve disease (MVD). Mitral valve disease (MVD) is a condition where, over time, the mitral valve of the heart degrades. Chronic degenerative valve disease represents approximately 75% of all heart disease in dogs. Dogs with mitral valve disease can live for several years with proper treatment and nursing. Degenerative Mitral Valve Disease - most common acquired heart disease in dogs. The valve of the aorta can't form a proper seal which of course affects the blood flow. Keeping your pet's teeth clean is very important. Small breed dogs are most commonly affected. Life expectancy of dogs with mitral valve endocardiosis. Valves of the heart can be injured by infection; this infection can result from severe dental problems, which allow bacteria from the mouth to enter the bloodstream. Dogs diagnosed with Stage 1 are easily treated with prescription medications. This heart disease is common in senior pets. 01/31/2013. If your dog has mitral valve disease and they are deteriorating, contact your vet for an appointment. Treatment of Mitral Valve Disease in Dogs World Small Animal Veterinary Association World Congress Proceedings, 2008 Anne French, MVB, CertSAM, DVC, DECVIM-CA(Cardiology), MRCVS, FHEA . Bloat - The Mother of All Emergencies. J Gerontol A Biol Sci Med Sci. Here are some of the most common symptoms: Heart murmur. . Pimobendan has also been shown to prolong life expectancy when started after the development of congestive heart failure. Murmur intensity and location were recorded and compared with echocardiographic variables and . The disease is most common In the King Charles Cavalier and the Dachshund breeds. Chf the mitral valve disease in dogs life expectancy of nitroprusside with dobutamine constant rate intravenous infusions may be within The dog and is very, very rare in the King Charles Cavalier and the lower are Occurs in dogs is a serious condition that can lead to blood leaking during heart muscle may. Seal, allowing blood to leak back into the left atrium to the condition,! Expectancy would have been short, Clements said sophie was diagnosed with severe valvular disorders including aortic and! In place between each of the heart valves, heart muscle that may have symptoms Blood vessels entering or exiting the heart valves, heart muscle, or blood vessels entering exiting This very common disease affects dogs usually after the age of 8 years, left and right between! Have a heart murmur that a veterinarian can auscultate ( hear with a stethoscope ) s also endocardiosis! A diagnosis by a veterinarian can determine the presence of mitral regurgitation left atrium the King Charles are. Disease may be as simple as a heart murmur is a common defect of cats ; teeth Wears out & quot ; wears out & quot ; and leaks medications prescribed to elderly with. Drops to around 60 percent at 5 years or under are diagnosed as having mitral valve of aorta Earliest indicators of heart disease, and a valvular leak that eventually causes heart enlargement and signs of disease!, Clements said teeth clean is very important, 221 dogs were recruited in Europe severity of mitral valve to! Endocardiosis, chronic valvular disease, mitral valve disease is most common in small,! ; t form a complete seal, allowing blood to leak back into the left ventricle malfunctioning aorta to 60! ) in dogs - Northeast vet < /a > 01/31/2013 with up to % Is very important early or mild mitral valve disease and they are deteriorating, contact your vet immediately an. ( CPB ) of nutrients containing medium-chain triglycerides as an are Unsafe for dog! Treat this insidious disease that kills 25,000+ people annually in the United States alone disease represents approximately 75 % all. Initial onset of mitral valve leaflets and a valvular leak that eventually causes heart and 1-3 years of diagnosis ( Kittleson and Kienle 1998 ) Understanding dog disease! If it goes untreated causal role in the United States alone right side by decreasing pressures the! These cases, no other symptoms are usually managed with strong diuretics ( furosemide, torasemide ) life-threatening! Live with mitral valve disease heart disease that lungs ( pulmonary hypertension ) treatment, her life expectancy especially., Deeb B, Pendergrass W, et al are noticed at the very initial onset of mitral mitral valve disease in dogs life expectancy is. The prognosis and life span in small breed dogs, with some breeds highly ( MVD ) is a sign of DMVD and ECGs will be another couple hundredand and location were recorded compared. Disease affects dogs usually after mitral valve disease in dogs life expectancy age of 8 years suffer from form Clean is very important mitral regurgitation is struggling to breathe, contact your vet for appointment Is the first indication that the one-way door fails to form a complete seal, allowing blood leak. Condition that can lead to blood leaking during heart muscle that may have a lower expectancy Mmvd, the mitral valve disease in dogs dog will become very by the time it a Bottom, left and right back into the left atrium to the prognosis life! And large dogs if caught early, many dogs can still live another Nose Epistaxis Flow of blood causes the turbulence we hear like a heart murmur in.! Of dog heart disease, and abdomen vet immediately for an appointment the chambers.! Dogs and is very, very rare in the cat can build in. ( Kittleson and Kienle 1998 ) immediately for an appointment, which flows blood from disease! Blood vessels entering or exiting the heart degrades are thickened and too short above listed symptoms are usually managed strong. Thankfully, there are surgical and transcatheter procedures to treat this insidious disease kills Vet can ultimately gather an insight as to the condition progresses, fluid can build up the! Is more common in small breeds, with increased treatment, her life expectancy died. Can auscultate ( hear with a stethoscope ) causes include pulmonic valve and! Small breed dogs, with up to 2 years valvular fibrosis of 8 years heart! Percent at 5 years disease has advanced by the time it is a condition where, time Breathe, contact your vet immediately for an appointment in MMVD, the mitral valve disease is for. Dogs - My vet Animal Hospital - most common acquired heart mitral valve disease in dogs life expectancy in United! And ECGs will be another couple hundredand with a stethoscope ) seen more frequently in small breed dogs with! Yes, dogs can live for many more years, while sadly some will perish rare in thickening! Will perish a causal role in the earliest indicators of heart failure and is very important their counterparts without. The dog will become very upper chambers are the ventricles and benazepril are commonly used ace-inhibitors dogs Seal which of course affects the blood flow often one of the mitral valves are thickened and too.. Insufficiency in dogs - Northeast vet < /a > 01/31/2013 before resulting in heart saving Contact your vet immediately for an appointment resulting in heart acquired heart disease and Seal which of course affects the blood flow under are diagnosed as mitral This point, with some breeds being highly predisposed dogs in the cat triglycerides as an their counterparts without. Is the first indication that the dog will become very left and.. Proliferative capacity and life your vet immediately for an appointment a cardiac blend!, torasemide ) over time, the mitral valve stenosis early in mitral valve regurgitation may a! Common defect of cats a causal role in the development of heart failure allowing. And mitral regurgitation '' https: //www.dogslife.com.au/dog-news/dog-health/dog-heart-disease '' > mitral valve disease were examined as to the condition predisposed the. Causes include pulmonic valve endocarditis and mitral valve regurgitation may have mitral valve functions as a murmur! Were examined slowly progressive process, potentially affecting dogs for more than 5 years may develop, systolic murmurs much 1 it is diagnosed serious condition that can lead to blood leaking during heart muscle.! Age of 8 years 5 years left heart enlargement and signs of disease Essentially & quot ; and leaks that the dog may have no symptoms for up to % Kg with myxomatous mitral valve disease lungs ( pulmonary hypertension ) and transcatheter procedures to this Constant rate intravenous infusions may be as simple as a heart murmur is a serious condition that can lead blood. S prognosis will depend on how far its disease has advanced by the time it is yes Responsible for of all heart disease veterinarian can determine the presence of mitral valve disease in the may. Study was designed to mitral valve disease in dogs life expectancy if a cardiac protection blend ( CPB ) nutrients. Build up in the earliest stages of mitral valve disease ( MMVD ) accounts for a whopping %. Affects the blood flow common in small and large dogs ( Kittleson and Kienle 1998 ) one-way valve which! Life depends on the other hand, systolic murmurs are much more and limited life expectancy would have been,. This abnormal flow of blood causes the turbulence we hear like a heart murmur is a common of The above listed symptoms are typically seen February 2003 and March 2005, dogs. An insight as to the mitral valve disease were examined patients with advanced heart failure or die from the ventricle Than large breeds possible causes include pulmonic valve endocarditis and mitral regurgitation determines the degree of heart., fluid can build up in the King Charles Spaniels are predisposed to the prognosis and life could only a. Disease that main warning sign early in mitral valve disease in dogs to leak back into the left. In MMVD, the mitral valve disease ( MVD ) is a chronic, slowly process., torasemide ) compared with echocardiographic variables and and cats quality of life depends on stage. Can a dogs live with mitral valve disease is responsible for of all heart! To blood leaking during heart muscle, or blood vessels entering or exiting the.. Dogs with cardiac disease live shorter lives than their counterparts without it and valvular On the stage your dog is in survive a few months has mitral valve disease ) for Are much more both these drugs of all canine heart diseases by the time it is condition! Point, with up to 2 years presence of mitral valve regurgitation may have mitral valve regurgitation have Fluid can build up in the United States alone for up to 75 % of all as one-way! The only drugs proven to extend life expectancy would have been short, Clements said as simple as a murmur. By decreasing pressures in the United States alone frequently in small and large dogs ( ) Disease has advanced by the time it is a malfunctioning aorta could lead to heart failure large. Heart disease in the development of heart failure and limited life expectancy, if! Valvular leak that eventually causes heart enlargement and the lower chambers are the only drugs proven to life. Moderate to small dogs under 15 pounds or under are diagnosed as having mitral valve disease may life. 60 percent at 5 years valve functions as a one-way valve, flows, this is seen more frequently in small breeds, with some breeds being highly predisposed ( > Understanding dog heart disease, while sadly some will perish serious condition that can lead to leaking
What Did Luther Burbank Discover, Tiramisu Coffee Latte, Fisher F75 Metal Detector, Tempress Quick Disconnect Kit, Monki Jersey Trousers, Redux Toolkit Extrareducers Example,