Brainscape's Knowledge GenomeTM

Browse over 1 million classes created by top students, professors, publishers, and experts.


See full index

Y4 exotics > Reproductive disease > Flashcards

Reproductive disease Flashcards

1
Q

Clinical signs of reproductive dz in reptiles

A
  • lethargy
  • anorexia
  • bloated/distended coelomic cavity
  • dyspnoea
  • lameness/leg paresis (tortoises mainly)
  • swelling around the cloaca
  • straining +/- blood or prolapsed tissue from the cloaca
  • behaviour changes e.g. pacing, nesting, digging
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
2
Q

Clinical signs of reproductive dz in birds

A
  • lethargy/depression
  • inappetence/reduced crop fill
  • bloated/distended
  • dyspnoea
  • seizure/tremors
  • separation from the group / being bullied (chickens)
  • lameness / leg paresis, reluctance to move/perch
  • straining +/- blood or prolapsed tissue from the cloaca
  • ‘fluffed up’ appearance, hunched posture, wide legged stance
  • behaviour changes (e.g. feather plucking, aggression, regurgitation)
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
3
Q

Common repro conditions in reptiles

A
  • prolapse (e.g. hemipene/cloaca/oviduct)
  • impactions (e.g. hemipene/femoral pores)
  • hypocalcaemia
  • pre-ovulatory ovarian stasis (POOS)
  • post-ovulatory egg stasis (POES/dystocia)
  • neoplasia
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
4
Q

Common causes of prolapse in reptiles

A
  • constipation
  • endoparasites
  • impaction
  • egg binding
  • egg in the bladder
  • cystitis/bladder stones
  • traumatic copulation
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
5
Q

POOS (reptiles)

A
  • pre-ovulatory ovarian stasis
  • in oviparous reptiles, the ovaries produce follicles, when they ovulate these become eggs
  • some reptiles, like tortoises, are induced ovulators
  • for this reason it’s very common for tortoises to suffer from POOS
  • ovaries produce follicles but they never ovulate so they increase in volume and size each year -> space occupying -> fatal
  • surgical
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
6
Q

POES (reptiles)

A
  • post-ovulatory egg stasis
  • surgical, medical or husbandry
  • obstructive vs non-obstructive dystocia
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
7
Q

Causes of obstructive dystocia (reptiles)

A
  • uroliths (tortoises)
  • egg/foetus oversize
  • pelvic abnormalities
  • renomegaly
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
8
Q

Causes of non-obstructive dystocia (reptiles)

A
  • hypocalcaemia
  • inadequate husbandry, diet, nesting site, etc
  • poor muscle tone
  • dehydration
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
9
Q

Common avian reproductive conditions

A
  • sexual frustration
  • chronic egg laying
  • abnormal eggs
  • egg binding
  • prolapse (e.g. oviduct, phallus)
  • coelomitis (egg yolk peritonitis)
  • salpingitis (inflammation of the oviduct)
  • neoplasia
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
10
Q

Sexual frustration in birds

A
  • very common problem for pet parrots who live alone
  • in the wild they have monogamous pairing that bond for life
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
11
Q

Behaviours that bonded birds display to one another

A
  • stroking
  • beak touching
  • preening/cleaning each other
  • feeding each other
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
12
Q

A bird that is lonely or inappropriately bonded to their owner will be more likely to demonstrate…

A
  • excessive regurgitation (esp if there are mirrors in their cage)
  • feather plucking due to frustration, stress and anxiety
  • jealousy and aggression, esp to spouses of their ‘partner’
  • excessive egg laying
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
13
Q

Prevention of sexual frustration in birds

A
  • share interaction and caring responsibilities equally between members of the household
  • avoid stroking down length of back
  • avoid certain behaviours e.g. mouth to beak feeding
  • don’t positively reinforce courtship behaviours (e.g. regurgitation)
  • remove mirrors from cage so they can’t self-bond
  • keep as pair (depending on spp)
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
14
Q

Chronic egg laying (birds)

A
  • particularly common in captive cockatiels, lovebirds and budgies
  • can lay a large number of eggs in succession
  • can be without the presence of a mate and outside of the correct breeding season
  • removing the eggs as they’re laid can ‘induce’ the bird to lay more (‘double clutching’)
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
15
Q

Chronic egg laying (in birds) can lead to…

A
  • uterine inertia
  • calcium depletion
  • egg binding
  • yolk coelomitis
  • osteoporosis
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
16
Q

Predisposing factors for chronic egg laying (birds)

A
  • increased photoperiod
  • food type (e.g. high fat)
  • presence of actual or perceived mates
  • toys, owners, mirrors, other birds
  • short-circuit in the reproductive hard-wiring?
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
17
Q

Egg binding (birds)

A
  • similar to POES in reptiles
  • more common than POES in reptiles as birds produce eggs more frequently than reptiles
  • can happen in any bird but most common in smaller species (e.g. budgies, cockatiels, finches, canaries, etc)
  • an egg lodged in the pelvic canal can compress the pelvic blood vessels, kidneys, ureters and ischiadic nerves
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
18
Q

Common causes of egg binding in birds

A
  • laying (e.g. chronic egg laying or 1st time layers)
  • eggs (e.g. malformed eggs)
  • disease (e.g. systemic dz, oviductal dz)
  • husbandry (e.g. lack of exercise, low temps, malnutrition [Ca, Vit A & E deficiencies, obesity])
  • genetic predisposition
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
19
Q

An avian egg lodged in the pelvic canal can lead to…

A
  • circulatory disorders
  • lameness, paresis or paralysis
  • pressure necrosis of the oviduct
  • metabolic disturbances by interfering with normal defection and micturition, and cause ileum and renal dz
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
20
Q

Coelomitis in birds

A
  • inflammation of the coelomic cavity
  • mammal equivalent is peritonitis
  • coelomic cavity becomes fluid filled
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
21
Q

Common causes of coelomitis in birds

A
  • ectopic eggs
  • ovarian neoplasia
  • cystic ovarian dz
  • oviductal disease e.g. salpingitis
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
22
Q

Diagnostic tests

A
  • diagnosis can often be made based on clinical exam and history (e.g. prolonged straining and nesting with an egg palpable)
  • diagnostic imaging is most useful when diagnosing reproductive dz (e.g. looking for eggs, follicles, neoplasia)
  • aspiration +/- C&ST & cytology is useful for diagnosing e.g. egg yolk peritonitis and treating infections
  • ex-lap is sometimes used to both diagnose and tx if a lesion is found on a radiograph or abdo palpation - not often performed in birds due to risks associated with coelomic surgery in birds, but is commonly performed in reptiles
  • blood tests can be useful to assess systemic health and ruling out other differentials and body systems (e.g. MBD and renal dz can present with lameness, lethargy, fluffed up, seizures, etc)
  • faecal testing e..g parasitology can be useful to rule in or out other differentials and underlying causes e.g. cloacal prolapse
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
23
Q

Calcium blood testing

A
  • when female birds and reptiles are reproductively active they tend to have increased total Ca levels (not ionised)
  • useful to double check findings that may be incidental (e.g. follicles in reptiles)
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
24
Q

Radiographs

A
  • very useful in birds as gives good detail
  • useful for screening in reptiles, can identify large space occupying lesions but can be hard to identify the organ/structure involved
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
25
Q

Ultrasound

A
  • not very useful in birds due to feather coverage
  • very useful in reptiles, particularly for space occupying lesions that are hard to identify on radiographs e.g. follicles
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
26
Q

CT

A
  • superior for diagnosing in reptiles, esp tortoises, but expensive and often required referral
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
27
Q

POOS diagnosis

A
  • radiograph = lateral view shows reduced lung field but no eggs
  • bloods = increased total calcium (indicates repro cause)
  • US = via pre femoral fossa, can visualise follicles (or CT scan)
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
28
Q

POES diagnosis

A
  • radiograph = eggs
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
29
Q

Coelomitis diagnosis

A
  • history = prior egg laying
  • CE = hugely distended
  • radiograph = fluid filled/soft tissue density throughout the coelomic cavity, displacement of ventriculus and compressed air sacs
  • coelomic aspirate = large volume of cloudy fluid with evidence of egg yolk
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
30
Q

What conditions would an ovocentesis treat?

A
  • egg binding
  • post-ovulatory stasis
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
30
Q

What conditions would a salpingohysterectomy/otomy treat?

A
  • egg binding
  • oviductal dz
  • ovarian tumours
  • chronic egg laying
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
31
Q

What condition would an orchidectomy treat?

A
  • tumours
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
32
Q

Prolapse tx

A
  • lubricate and replace or amputate prolapses
  • can place stay sutures to prevent further prolapses
  • treat underlying cause
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
33
Q

Hormone implants (use and examples)

A
  • stops reproduction
  • expensive and short duration
  • leuprolide acetate (Lupron)
  • GnRH-agonist (deslorelin implant)
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
34
Q

Hormone injection example use

A
  • repeat oxytocin injections for egg binding/post-ovulatory stasis +/- prostaglandin
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
35
Q

Calcium injection use

A
  • hypocalcaemia (use after blood test)
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
36
Q

Treatment of ascites

A
  • abdominocentesis
  • treat with NSAIDs if celomitis
  • +/- ABs (only if secondary infection has tracked up from vent)
37
Q

POOS tx

A
  • in reptiles only
  • ovariectomy needed - always surgical
  • mating and hormone injections are ineffective once symptoms begin
38
Q

POES (reptiles) / egg binding (birds) tx

A
  • obstructive dystocia -> surgical tx needed (or ovocentesis)
  • non-obstructive dystocia -> husbandry changes +/- medical tx 1st
39
Q

Surgical tx for POES/egg binding

A
  • salpingostomy = remove eggs (can breed again)
  • ovariosalpingectomy = remove oviduct and ovaries
  • for both place an oesophagostomy tube in all tortoises for post op feeds and meds
  • ovocentesis
40
Q

Ovocentesis

A
  • needle inserted into an egg and its contents aspirated under GA (via cloaca or percutaneous)
  • followed by manually moving the egg (milking it along) or deliberately collapsing the egg shell and removing it piece by piece (or let it be passed piece by piece by the pt)
  • 1st opinion option (not tortoises or ectopic eggs)
41
Q

Husbandry corrections in reptiles

A
  • correct husbandry and dietary deficiencies
  • temperature and humidity requirements may be difference / more specific when gravid
  • bathe and keep hydrated e.g. misting for chameleons and large shallow bowls for tortoises
  • ensure access to an appropriate substrate/nesting site for the species
42
Q

Husbandry corrections in birds

A
  • decrease photoperiod (8-10h)
  • remove real/perceived mates, discourage territorial behaviour
  • prevent nesting by removing all shredable/nesting material
  • reduce the amount and calorie (fat) content of food
  • increase exercise and foraging time
  • stop stroking and petting, and mouth-mouth actions
43
Q

Neutering reptiles

A
  • not routinely done
  • only performed when there’s a problem that requires surgery as tx
  • apart from prolapses, males rarely have problems with their repro tract
  • outside breeding season/reproductive activity he reproductive tract in reptiles can be very hard to find
  • ovaries are diffuse in reptiles, so can be difficult to remove all ovarian tissue/follicles, so no guarantee of future problems
  • husbandry is key to healthy reproduction
44
Q

Neutering birds

A
  • not often routinely performed
  • usually only performed when there’s a problem that requires surgery as tx
  • particularly risky procedure in birds
  • the ovaries are firmly attached to the dorsal abdo wall, the cranial renal artery and the common iliac vein overlay them
  • lacerating the common iliac vein can cause life threatening haemorrhage during ovariectomy
  • birds can still get egg yolk peritonitis after a salpingohysterectomy because ovaries remain
  • hormone implants are seen as the alternative to surgery nowadays
  • castrating a cockerel is illegal in the UK
45
Q

Reasons for ovariohysterectomy

A
  • prevent unwanted litters (e.g. siblings, pelvic closure in GPs)
  • protect against common dz of the repro tract
  • allow for rabbit pairing (m&f) and for groups of animals to live together e.g. single male GP with many females
46
Q

Reasons for castration

A
  • prevents unwanted litters
  • prevent spaying
  • can help with aggression?
  • allow for rabbit pairing (m&f) and for groups of animals to live together e.g. single male GP with many females
  • protect against common dz of repro tract?
47
Q

Reasons against ovariohysterectomy and castration

A
  • risk of GA
  • ferrets -> related to hyperadrenocorticism/adrenal dz
  • behaviour -> aggression may not be changed by neutering if there’s another cause, neutering can be worse – removing oestrogen can make females worse, and testosterone removal can make males less brave
  • can the O provide post-op care?
48
Q

Ovariohysterectomy in GPs and rabbits

A
  • abdo approach between umbilicus and pubic symphysis
  • incision 2cm long
  • careful tissue handling, esp with the gut as adhesions easily form
  • haemostatic clips or suture to ligate
  • always use intradermal suture to close skin
  • monofilament suture for ligatures, muscle, sc and skin = less adhesion to/between internal organs
  • avoid skin glue if possible
  • rabbits have 2 cervix but this doesn’t change the procedure
  • they can be hard to locate if young - look for the fat attached to the reproductive tract: it’s more dense than other body rate
49
Q

What castration method to use?

A
  • scrotal (open/closed): not advised – thin skin, hard to stitch, more likely to be traumatised by the animal
  • pre-scrotal (open/closed) – not GPs. issue in rats as penis is cranial to scrotum so want do 1 incision in midline (have to do 2 incisions), rabbits, hamsters, mice better for 1 incision
  • abdominal: GPs
50
Q

Scrotal castration

A
  • similar to cat but inguinal canals must be closed if an open technique is used
51
Q

Why is scrotal castration not a preferred method?

A
  • increases the chances of some post-op complications -> wound breakdown, infection/abscessation, scrotal haematoma / self trauma, gut stasis/ileus
52
Q

Pre-scrotal castration

A
  • similar to dog, except have open inguinal ring
53
Q

Abdominal castration

A
  • 1 midline incision going through linea alba (at cranial pole of bladder)
  • testicle is pushed up into abdo, visualised and exteriorised
  • tail of epididymis is dissected from the everted hemiscrotal sac to exteriorise
  • tunic closure is the same with all 3 techniques
54
Q

Why are pre-scrotal and abdominal castration the preferred methods?

A
  • they reduce the chances of some post-op complications because: 1 incision vs 2, wound is further away form the ground so infection less likely, less sensitive skin so self-trauma less likely, can suture the skin closed so can avoid itching skin with glue
55
Q

Common reproductive conditions in rabbits

A
  • testicular neoplasia
  • cryptorchidism
  • scrotal trauma
  • inguinal hernia
  • uterine adenocarcinoma
  • pregnancy toxaemia
  • pseudopregnancy
  • syphilis
56
Q

Uterine adenocarcinoma in rabbits

A
  • commonly accepted to have 80% incidence in does >4y
  • studies showed ^ not representative and related to groups of large bred rabbits
  • not as common in clinical practice as studies suggest
57
Q

Clinical considerations for uterine adenocarcinoma

A
  • mets by direct contact, blood & lymph
  • endometrial hyperplasia/endometritis/pyo might be present
  • endometrial venous aneurisms cause potentially life-threatening bleeding
58
Q

Syphilis in rabbits

A
  • caused by the spirochete Treponema funiculi
  • spread during copulation and close contact
  • crusting lesions on the mucocutaneous junction of nose, lips, eyelids, genitalia and anus
  • can be confused with myxomatosis lesions - but these tend to be bigger and hyperplastic
59
Q

Common reproductive conditions in guinea pigs

A
  • testicular neoplasia
  • spermatic plugs
  • inguinal hernia
  • orchitis
  • uterine and ovarian neoplasia
  • uterine prolapse
  • pregnancy toxaemia
  • ovarian cysts
  • dystocia
60
Q

Ovarian cysts in GPs

A
  • common in entire females (>75% incidence in sows over 18m)
  • easily palpated on physical exam
  • confirm with US or just CS
  • can be confused with cystic/irregular kidneys or other masses on radiography
  • commonly <2cm but can exceed 8cm
  • feel for both kidneys in addition to the mass to figure out what the mass might be
  • often incidental finding
61
Q

Clinical signs of ovarian cysts in GPs

A
  • hair loss over flanks (bilaterally symmetrical) without pruritus and normal skin
  • pear shaped
  • behaviour: mounting/aggression
  • lethargy, reduced appetite, discomfort when handled
  • can cause abdo discomfort, gut stasis and anorexia due to a large SOL
62
Q

Dystocia in GPs

A
  • occurs during the last week of pregnancy generally
  • if GPs don’t give birth before 8m the pelvis symphysis fuses and they won’t be able to breed again
  • presented during the day -> likely dystocia
  • other causes: obesity, large foetuses, uterine inertia
63
Q

Normal birth in GPs

A
  • relaxin from pituitary and endometrium causes fibrocartilage of the pubic symphysis to disintegrate = pubic symphysis widens to 3cm
  • parturition is normally in early hours
  • once they have bred they an give birth normally every time past this 8m age
64
Q

Common reproductive conditions in chinchillas

A
  • fur ring (parapimosis)
  • spermatic plugs
  • inguinal hernia
  • uterine neoplasia
  • pyometra
  • dystocia (similar to GP but pubic symphysis doesn’t separate)
65
Q

Common reproductive conditions in gerbils

A
  • cystic ovaries
  • neoplasia
66
Q

Common reproductive conditions in hamsters

A
  • cystic ovaries
  • neoplasia
  • pyometra (normal creamy vulvar discharge occurs following oestrus)
67
Q

Common reproductive conditions in rats

A
  • pyometra
  • neoplasia (e.g. mammary adenomas)
68
Q

Common reproductive conditions in hedgehogs

A
  • pyometra
  • neoplasia
69
Q

Mammary tumours in GPs

A
  • benign hyperplasia most likely diagnosis in females
  • males higher chance of malignancy
70
Q

Mammary tumours in rats

A
  • carcinomas = less than 10% of mammary tumours, adenocarcinomas can develop from cystic mammary glands
  • fibroadenoma = 85-90% of all mammary tumours – can become very large, ulcerate, and infiltrate locally but they rarely mets
  • many mammary tumours are caused by prolactin-secreting brain tumours (pituitary adenomas) – genetic predisposition
    (- mouse mammary tumour virus can cause mammary adenocarcinoma [passed through placenta and dams milk])
71
Q

Mammary tumours in mice & gerbils

A
  • adenocarcinoma most common – highly malignant, common mets, poor prognosis
  • fibrosarcoma only account for up to 6% of mouse tumours
72
Q

Mammary tumours in hamsters

A
  • most are benign
73
Q

Common reproductive conditions in ferrets

A
  • testicular neoplasia
  • prostate hyperplasia
  • ovarian neoplasia
  • pyometra
  • pregnancy toxaemia
  • persistent oestrus
  • hyperadrenocorticism
74
Q

Ferret persistent oestrus

A
  • jills are induced ovulators
  • about 50% of jills will remain in oestrus (oestrus behaviours but will not ovulate) unless mated
  • prolonged oestrus results in oestrogen-induced bone marrow toxicosis/hyperoestrogenism
  • results in pancytopenia (RBCs, WBCs, platelets affected) and eventually death
  • only happens when entire, but can happen with retained ovarian remnants so factor this in before removing it from ddx
75
Q

Normal breeding season for ferrets

A
  • March-September
76
Q

Clinical signs of ferret persistent oestrus

A
  • swollen vulva
  • pale mm (anaemia)
  • symmetrical bilateral alopecia of flanks and tail
  • petechiae +/- ecchymoses
  • lethargy & anorexia
77
Q

Ferret hyperadrenocorticism

A
  • NOT cushings -> no excess of glucocorticoids
  • in ferrets HAC is related to sex hormones
  • symptoms start in spring, may regress and return next year
78
Q

Suspected causes of ferret hyperadrenocorticism

A
  • <12h daylight hours (indoor ferrets)
  • early neutering (never seen in entire ferrets)
  • genetic component
79
Q

Theory for ferret hyperadrenocorticism

A
  1. in ferrets sex hormones are produced by the gonads mostly, but also the adrenal gland
  2. when the gonads are removed, there’s a reduction in sex hormone production, therefore the negative feedback is removed
  3. so more FSH/LH is released and the adrenal glands take over sex hormone production, but they have a reduced capacity
  4. adrenal gland hyperplasia to produce more sex hormone
  5. uncontrolled sex hormone produced = hyperadrenocorticism
80
Q

Clinical signs of ferret hyperadrenocorticism

A
  • symmetrical/bilateral alopecia and ‘rat tail’
  • valvular swelling in neutered jills
  • sexual behaviour in neutered hobs
  • pruritus
  • dysuria/urinary obstruction in males (prostate hyperplasia)
  • mammary hyperplasia
81
Q

What conditions with ovariohysterectomy treat?

A
  • uterine adenocarcinoma
  • cystic ovaries
  • pyometra
82
Q

What will a c-section tx?

A
  • dystocia
83
Q

How to treat cystic ovaries?

A
  • GnRH injection
84
Q

Why do GnRH agonists work for ferret hyperadrenocorticism?

A
  • pulse release GnRH over a long period of time
  • this desensitises GnRH receptors on the pituitary so less FSH/LH is produced
  • temporarily the clinical signs may worsen before desensitisation occurs
85
Q

Surgical tx of ferret hyperadrenocorticism

A
  • left adrenalectomy relatively straightforward
  • right adrenalectomy more difficult as more vascular
  • some advocate partial right adrenalectomy
  • post-op medical tx for HAC required if partial adrenalectomy performed
  • quicker response to tx
86
Q

Tx for early (prolonged) oestrus in ferrets

A
  • stimulate ovulation = hCG
  • GnRH agonist impact e.g. Deslorelin (Suprelorin)
  • but these both take time to work (10-14d) and bone marrow suppression occurs 4w into season, death occurs at ~8w
87
Q

Treatment for severe (prolonged) oestrus in ferrets

A
  • blood transfusion may be required
  • ovariohysterectomy but must stabilise 1st (pts often poor surgical candidates) and causes HAC risk
88
Q

Reproductive control in female ferrets

A
  • keep females with a vasectomised hob to induce ovulation
  • leave entire and give a yearly ‘Jill jab’ to bring females out of season (proligestone injections as soon as they come into heat)
  • use the hormone implant to chemically neuter on its own (deslorelin)
  • surgical neutering -> UK ferrets may still be neutered in charity practices due to the expense of alternatives
89
Q

Reproductive control in male ferrets

A
  • vasectomised hobs -> considered permanent, only prevents reproduction, still have malodour as hormones still present
  • use the hormone implant to chemically neuter
  • castration??
  • deslorelin implant can chemically neuter males and females for up to 4y (9.4mg implant)

Y4 exotics (9 decks)

Brainscape helps you reach your goals faster, through stronger study habits.
© 2024 Bold Learning Solutions. Terms and Conditions