intramuscular injection sites in dogs and cats intramuscular injection sites in dogs and cats

Keep reading to find out more! Syringe Handling 1 ml and Practice Technique Using 2 Pieces of Tape, 9. These maternal antibodies may drop below protective levels while, at the same time, preventing successful immunization. SOP: INJECTIONS IN DOGS AND CATS I. In contrast to subcutaneous injections, intramuscular injections are more preferred because they allow for a faster absorption of medication. Certain proteins and other molecules of these invaders are known read more . The standard size needles to use for canine injections are 21 to 23-gauge needle, 1 to 1.5 inches long. The method of drug administration is called an intramuscular injection (IM),and it is commonly used, particularly when a rapid drug effect is desired. Newborn animals are passively protected by maternal antibodies and, in general, cannot be vaccinated until maternal immunity has waned. Subcutaneous injections are given in the neck half way up, over the ribs and well behind the shoulder. Share on Facebook . Combinations usually involve priming with a DNA plasmid vaccine and boosting with either a vectored recombinant vaccine or with adjuvanted protein antigens. Medicine. 0000009951 00000 n Although it is not possible to devise precise schedules for each vaccine, certain principles are common to all methods of active immunization. In cardiac arrest, adrenaline is sometimes administered through the endotracheal tube and absorption via this route is rapid and the technique is much safer than the alternative, intracardiac adrenaline injection. Animal Welfare Education Tool to Create Syllabus for Animal Welfare Course (AVMA), 34. If you have a nervous dog, enlist the assistance of another person or call the veterinary clinic to get instructions on restraining the dog. supplies, Pet Nail Trimmers and Blood Stop Products, guide to the different types of needles and syringes, over-the-counter syringes and needles of all sizes, 5 Important Tips for Keeping Pets Safe From Coronavirus, 2020 Guide to the Best Dog and Cat Dewormer, Your Guide On How To Treat Eye Infections In Dogs, 5 Common Mistakes to Avoid When Giving Insulin to Your Pet, Fish Doxycycline: Antibiotics for Your Aquatic Amigo, What to Know About Administering Injections to Animals, Syringes and Needle Types Uses and Safe Disposal. Intramuscular injection to a cat. The first step in giving a canine intramuscular injection is to prepare the needle and syringe. b. Injections can be made via intradermal (ID), subcutaneous (SC), intramuscular (IM), or intravenous (IV) routes. Other medications will only work if administered into the muscles. The best place to inject is half-way up the neck, in front of the shoulder. Feline Ovariohysterectomy Student Study Guide, Assessment Rubric and DETAILED STEPS, 28. Good technique minimizes this but even so, many animals will react to the injection. Unfortunately, these techniques require handling each individual animal. 0000019180 00000 n The legacy of this great resource continues as the Merck Veterinary Manual in the US and Canada and the MSD Vet Manual outside of North America. These intramuscular injections are usually on the neck, chest, glute, or hind leg, though it may differ depending on the animal, there are fewer pain receptors is muscle tissues making it an ideal site for more irritating or viscous medications. Verify and double check everything. Avoid pinching the skin too hard with your fingers. Dogs and Cats . Copyright var date = new Date(); document.write(date.getFullYear()); California Veterinary Supply. In dogs, the appropriate sites for intramuscular injections include the quadriceps, lumbodorsal, and triceps muscles. %PDF-1.3 Within a group of animals, there may be a great difference between the shortest and longest duration of protection. If the dog experiences any pain during or after the injection, you may want to massage the area to relieve the discomfort. If youre unsure, contact the vet right away for a proper diagnosis and treatment. After use it is very important that needles have their protective caps securely replaced to prevent someone becoming injured. Owners can easily be taught to give injections in this way, e.g. What are the benefits of giving your dog an IM? Open the Facebook app on your device and tap the menu button. Putting Skills Together as it Matters in Clinical Practice, 5. Types of Injections Subcutaneous Injections for Dogs and Cats; This can cause soreness, which can make your pet more uncomfortable with each regular stick. Animal Welfare Education Tool to Create Syllabus for Animal Welfare Course (AVMA), 34. Different formulations of injection are used for the different routes and it is particularly important not to administer an injection directly into the blood unless it is specifically recommended for this route. If you inject the injection intramuscularly to the dog as veterinarians do, you need to draw an imaginary line from the elbow to the place that you chose to insert the needle. Sometimes it happens that we give the wrong injection. Dog Restraint for Lateral Saphenous Blood Draw/IV Catheter, 17. 39 kilogram is equal to 85.98028218 pounds. Always ask your vet for more help if you're not comfortable administering injections and they will be happy to provide more training. What are the contraindications for this medication? This may even include injections, one of the best methods for providing medication to animals. 414. By injecting quickly, you can minimize your pet's movement. Published 1 May 1973. Other vaccines may require boosting only once every 23 years. The skin should be slightly loose at this area. tissue under the skin (subcutaneous injection), body cavities, i.e. These areas of the dogs body have fewer pain receptors, making them a great choice for IMs. This problem can be resolved by removing a nonprotective antigen from the vaccine. Dermatologic Lesion Documentation and Description, 51. Instead, choose multiple sites where your pet will not be bothered by the pain and discomfort. The patients weight may require a longer needle. Viral Infections Associated with Bovine Respiratory Disease Complex in Cattle, Overview of Bovine Respiratory Disease Complex. These routes may be used for specific purposes often because a very fast reaction to the drug being administered is sought, as in intravenous injections of anaesthetics. You might need to hold your pet still to avoid a mishap. Our massive online inventory is filled with over-the-counter syringes and needles of all sizes, as well as a wide variety of medications. Certain medical conditions can be controlled by the use of drugs that are only available in an injectable formulation. You should be aware that some communities have strict rules about disposal of medical waste material so do not throw the needle and syringe into the trash until you know if this is permissible. 0000011041 00000 n In severe outbreaks, morbidity read more . For felines, the skin over the middle of the back or just behind the shoulders works well. Adequan is given via intramuscular injection (IM) only - meaning that it should be injected into the muscle, not under the skin. Dissection kit and huck towel pack (to simulate sterile sx pack), 31. Intramuscular Injections for Dogs and Cats Drugs given into muscles are absorbed very quickly because there is a good blood supply . Previous: Approach to Pet and Owner and Basic Pet Handling/Restraint Next: SQ injections You should be especially careful about choosing the right syringe size for intramuscular injections. In feedlot cattle, the respiratory form is most common. Injections in dogs are usually administered via intramuscular (IM) or subcutaneous (IM) route. Giving them intravenously can be risky and may cause a side effect. Make sure that the needle is sterile and is inserted into the muscle at an angle of about 45 degrees. Some medications, such as insulin, require a subcutaneous injection meaning the needle only needs to pierce the skin. Learn more about how Pressbooks supports open publishing practices. Cystocentesis Practice Model and FNA Model, 19. Make sure the area is clean and dry, and that you can reach the top of the dogs back without causing your dog to become uncomfortable. Some tips for giving your dog an IM injection: -Locate the injection site. For easier injections, grab some of that skin to make a skin tent.. See our guide to the different types of needles and syringes available to you right now. % Owners are not often called upon to give intramuscular injections but they may be asked to hold their pet while it receives one. Depending on the vaccination, youll need a combination of powder and liquid. 0000014104 00000 n Gently and quickly push the needle into the muscle at a 90 degree angle. Some vaccines may induce immunity that persists for an animal's lifetime. You should also know what to do if the shot goes wrong. and what is it compatible with. How to practice effectivelyfor just about anything TED-ed animated video, 7. Can this medication be given by this route? When giving insulin to a dog, its important to remember that its important to insert the needle in the back of the neck, scruff region. How to Learn Motor Skills-Helpful Hints, 3. the abdominal cavity (known as intraperitoneal injection) or thoracic cavity (known as intrapleural injection), the quadriceps (muscle on the front of the thigh), lumbodorsal muscles (muscles either side of the lumbar spine). Introduction-what exactly is a clinical skill? 2.3k. 5 40 Subcutaneous- just under the skin in subcutaneous fat layer, ex) Penicillin G, SQ fluids, vaccines-check label! A veterinarian will use the most appropriate site for your dog's IM injection. 0000006144 00000 n Epaxial (lumbodorsal) muscles are on either side of the lumbar vertebrae. You will add to your knowledge base daily, know where to look things up from trusted sources, Google can lead you astray, In general here are the recommended angles of needle insertion for Intradermal, Subcutaneous, and Intramuscular Injections, the angle of the needle helps to inject in the proper location. This practice removes air bubbles in the formula, which can cause medical chaos during the injection process. 0000013765 00000 n The viral infection alone is not life-threatening but predisposes read more , and Mannheimia haemolytica. Try offering the pet an appropriate treat (based on your vets recommendation, as certain health conditions have dietary restrictions) as a distraction while you administer the injection. Different Syringe Tips and Their Uses, 53. Looking for a convenient way to access your pets health records, refill prescriptions, view upcoming appointments and more? Malcolm Weir, DVM, MSc, MPH; Ernest Ward, DVM, Contributors: Malcolm Weir, DVM, MSc, MPH; Ernest Ward, DVM. 1. 0000008463 00000 n Nebulised drugs can be used for the treatment of respiratory disease and administration by this route allows rapid penetration to the local site where they are to have their action. The link you have selected will take you to a third-party website. In addition, the veterinarian can be sure an animal has received the appropriate dose of vaccine. Putting Skills Together as it Matters in Clinical Practice, 5. Needles for these should be longer than those for subcutaneous ones, but if they are too long, they could harm tissue and nerves. Reporting Animal Cruelty: The Role of the Veterinarian Manual (MN-Animal Folks), 26. The average intramuscular dose for dogs is 20 mg. SUMMARY Confidosetm IM Auto-Injector Submitter's Name, Address, Telephone Number, Contact Person and Date Prepared . There are many routes we use, not all medications can be given by all routes! Vaccinations for dogs can be scary, so its best to take your time and follow the instructions of your veterinarian. Medications are administered directly into the vein via an IV. Use a disinfectant or cleaner on these surfaces. Single surgeon 4 quarter/corner drape, large paper drape, Ioban adhesive skin protector, 30. Domestic animals have plenty of loose skin so it is very simple to lift a flap of skin and insert a needle into the subcutaneous tissue. Use gauze to stop the bleeding. Merck & Co., Inc., Rahway, NJ, USA(known as MSD outside of the US and Canada) is dedicated to using the power of leading-edge science to save and improve lives around the world. Both natural infection and vaccination induce a protective immune response. This is because intramuscular tissue is rich with blood and the medication absorbs more rapidly this way. Insulin Syringes Difference between U 100 and U 40 and Emergency Conversion Chart, 54. You should swab the area with an alcohol pad. For example, for bovine respiratory disease complex Overview of Bovine Respiratory Disease Complex Bovine respiratory disease (BRD), shipping fever pneumonia, or undifferentiated fever is a respiratory disease of cattle of multifactorial etiology with Mannheimia haemolytica and, less read more , combined vaccines are available for bovine respiratory syncytial virus Bovine Respiratory Syncytial Virus Bovine herpesvirus 1 infections are widespread in the cattle population. Individual animal and vaccine variability make it difficult to estimate the duration of protective immunity. Optional vaccines may include canine coronavirus, parainfluenza virus, Bordetella bronchiseptica, leptospirosis, and Lyme disease. Generally, if you are unsure how much you injected, do not administer more unless directed by your veterinarian. If you are absolutely sure the cat received no drug, it is safe to repeat the injection. Injectable medications can be given intramuscularly, intravenously, or subcutaneously. Once the area is ready, hold the syringe with your dominant hand. Also, it can help reduce the amount of time the drug remains in the muscle. First cap the needle and syringe carefully and put it out of harms way. How to Learn Motor Skills-Helpful Hints, 3. This will keep the pressure inside the bottle stable and make it easier to remove the formula. And how much pain can IMs cause? Another benefit of intramuscular injections is that the needle is much easier to handle than subcutaneous injections. Alternatively, a vaccine may be administered in feed or drinking water, eg, vaccination of poultry for Newcastle disease and avian encephalomyelitis Avian Encephalomyelitis Avian encephalomyelitis is a viral infection affecting the CNS of several species of birds. Some veterinarians and owners have expressed concern that the use of vaccine mixtures in this way may somehow overwhelm the immune system. However, local immunity is sometimes more . If the coat is very dirty it should be clipped and cleaned. Learning motor skills, the basics (Evertoon), 2. Describe adverse effects of vaccines and vaccination in dogs, cats, and horses; . Please include what you were doing when this page came up and the Cloudflare Ray ID found at the bottom of this page. Adverse Reactions to Spot-on Flea and Tick Products. | Veterinarian Approved Doctor Lindsay Butzer DVM 39.7K subscribers Subscribe 731 55K views 1 year ago Hey Guys, in this video I am. Neonatal animals are protected against disease caused by that specific pathogen while sufficient maternal antibodies are present. Is there a holding time for this species? ; Step #2. Intranasal vaccines, e.g. Nebulised drugs can be delivered via a face mask although many conscious patients will not tolerate a face mask, so a special nebulisation chamber is often required. : US 9.458,536 B2 Felts Et Al; . Dispose of the needle and syringe into a properly labeled needle disposal container. It is also less painful for the patient. 0000028458 00000 n Your veterinary practice may be able to order large boxes of these for you, which is more economical than buying from a pharmacy, etc. When you find the right spot, always clean it before the injection and clean the top of the bottle with the solution as well. This route is not suitable for administration of irritant medications as they may cause severe skin reaction and damage. Before injecting your pet with medication, youll want to clean the injection site and the bottle well. When it comes to administering medications to dogs, where is the best site for an IM injection? These muscle tissues have less pain receptors and are ideal for viscous medications. Already have a myVCA account? In feedlot cattle, the respiratory form is most common. Use OR to account for alternate terms Contact your vet for advice. In this lab, we will examine the epaxial muscles as an IM injection site. Feline Ovariohysterectomy Student Study Guide, Assessment Rubric and DETAILED STEPS, 28. It was concluded that the best sites for injection in dogs are the lumbar epaxial musculature or the quadriceps femoris muscle when IM administration is imperative. The most common method of vaccine administration is by SC or IM injection. Copyright 2023 Merck & Co., Inc., Rahway, NJ, USA and its affiliates. Wearing disposable gloves is a useful measure for giving injections. VIEWS. Next: Local Anesthetic Intradermal Injections. If this happens, the needle should be removed and the syringe drained. Skin should be swabbed with alcohol. How to Add or Remove Contacts from Kids Messenger Account ; Step #1. hb``Pe``b Y80() B1g=U#"&!acc>5 For this reason, most medications given at home are designed to be administered subcutaneously. For example, intranasal vaccines protect: cattle against infectious bovine rhinotracheitis Viral Infections Associated with Bovine Respiratory Disease Complex in Cattle Bovine herpesvirus 1 infections are widespread in the cattle population. 0000003707 00000 n By IM injections should be given using a shorter needle than subcutaneous injections. If some may have been received, the safest course of action is to give no more. The injections are given in the subcutaneous tissue (sub = under; cutaneous = skin), which is considerably looser in the dog than in the human. This helps disperse the drug and decrease the likelihood of the injection site being damaged. In feedlot cattle, the respiratory form is most common. The vast majority of equine vaccines are administered by intramuscular (IM) injection, and a few are administered . A dogs vaccines are usually administered using a subcutaneous injection. Given the nature of syringes and needles, the procedure can be quite delicate and potentially painful. In feedlot cattle, the respiratory form is most common. 2023 Bishops Stortford Vets Registered in England 07961322 VAT No. Eventually, most pets will become accustomed to the procedure. A positive action for insertion of needles into muscles reduces muscle damage and pain and massaging the site after injection disperses the injection and may help to reduce pain. Some drugs are specially formulated so that they are more slowly absorbed and can sit in the muscle, being absorbed gradually over many months and producing a long-acting effect (so called depot injections). Most pet owners find that their pet becomes cooperative for these life-sustaining injections over time. These vaccines can be administered during your dog's yearly exam. The commonly adopted technique and site for intramuscular injection in the cat are described, and the often resulting inadequacy and risk are discussed. The loose skin over the shoulders and neck is an ideal injection location for canines. This method is commonly used in the poultry industry. With that in mind, pick the smallest needle you can get that is capable of holding that much volume. You might end up accidentally giving your dog the drug and causing more damage. There are several actions that could trigger this block including submitting a certain word or phrase, a SQL command or malformed data. When ready to inject, ensure the syringe is fully pushed into the needle hub to stop the syringe and injection Fish and shrimp may be vaccinated by immersion in a solution of antigen, which is absorbed through their skin and gills. Veterinary Clinical Skills Compendium Copyright by Susan Spence. With a little practice, however, most pet owners find that they have no problems administering routine injections to their dog without assistance. Bladder Stones (Struvite) in Dogs Blastomycosis is a Systemic Fungal infection Affecting Dogs and Cats Bloat - The Mother of All Emergencies Bloat: First Aid Bloody Nose (Epistaxis) in Dogs and Cats Bones are Unsafe for Your Dog, No Bones about It Brachial Plexus Avulsion in Dogs and Cats Before administering the shot, make sure your dog is still awake and comfortable. 44 0 obj <>stream Standard size needles recommended are 18 to 20-gauge needle from 1 to 1.5 inches long. Others can be injected into a vein (intravenous, or IV injection) or into a muscle (intramuscular, or IM injection). SHARES. Local Anesthetic Intradermal Injections, 48. The demeanour of 122 dogs was assessed, and a mixture of 0.025 mg/kg acepromazine and 0.3 mg/kg morphine was injected intramuscularly into one of four randomly assigned muscle sites (cervical epaxial, triceps brachii, middle gluteal and quadriceps femoris) and the dogs' reactions to the injections w Note that any lasting harm is very unlikely indeed. Drinking water vaccines are increasingly employed in large swine operations. The first step is to prepare the skin. The best sites include the quadriceps muscle, lumbar epaxial musculature, and hind leg. Double Bowl Automatic Pet Bowl Feeder Cat Waterer, Pet Supplies Automatic Feeder Smart Dog Food Dispenser, Pet Automatic Timer Feeder Does Not Pinch Feet, Double Bowl Automatic Feeder Drinking Water Pet Supplies, Pet Automatic Feeder Cat Feeding And Drinking Water. If you decide to provide this treatment to your dog, your veterinarian will review the specific technique and make sure that you are comfortable with it. Intramuscular IM Injection Sites for Dogs and Cats. Essential (or core) vaccines should be given to all animals of a species, and veterinarians should ensure that immunity is maintained throughout an animal's life by appropriate revaccination. SOP: INJECTIONS IN DOGS AND CATS 2 i. Quadriceps IM injections 1. Use of a fine needle minimizes discomfort. If stimulation of immunity is deemed necessary at this stage, the mother may be vaccinated during late pregnancy, timing the doses so that peak antibody levels are reached at the time of colostrum formation. IM injections can be much more painful than subcutaneous injections, so proper technique is key to minimizing pain. 0000025191 00000 n Syringes, extensions sets, and direct lines for fluid bags can be used for SQ injections. Two of these conditions are: In many cases, dog owners are willing and able to administer these medications at home. 0000005714 00000 n Owners should be made aware that protection can be maintained reliably only when vaccines are used in accordance with the protocol approved by vaccine licensing authorities. However, there is no reason why different forms of a vaccine could not be used for priming and for boosting. Your veterinarian will prescribe the appropriate needles and syringes for your pet's needs. Most medications are given subcutaneously. However, passive antibody titers decrease exponentially. It can also help your dog avoid injury. 0000025892 00000 n The viral infection alone is not life-threatening but predisposes read more, cats against feline rhinotracheitis and calicivirus Feline Respiratory Disease Complex Feline respiratory disease complex is typically manifested by clinical signs of the eyes, nose, and mouth ( rhinosinusitis, sneezing, conjunctivitis, lacrimation, salivation, and oral ulcerations read more infections, poultry against infectious bronchitis Infectious Bronchitis in Poultry Infectious bronchitis is an acute, highly contagious upper respiratory tract disease in chickens. You can do this by feeling along the injection site, as well as along the belly below the site of injection, as fluids tend to pool along the cat's underside. However, the use of nebulised drugs means that the patient must breathe air containing the drug. Lift the skin on the dogs shoulder and insert the syringe into the tented area. If the injections are frequent, like for insulin shots, try not to use the same spot each time. The trusted provider of veterinary information since 1955, Vaccine Failure and Other Adverse Events in Animals, Last review/revision Jul 2020 | Modified Nov 2022. Verify and double check everything. Vaccines should never be mixed indiscriminately because one component may dominate and interfere with responses to the other components. Suturing model made from socks and T-shirt, 20. 0000024529 00000 n Intramuscular injections are used to administer small volumes of medications. Pinch some loose skin from the back of the neck or "scruff" region (between the shoulder blades) between your thumb and forefinger. A veterinarian should always assess the relative risks and benefits to an animal when determining the frequency of revaccination. In contrast, material injected into the lumbar area and cranial region of the thigh was located entirely in the muscle bellies. Optional (or non-core) vaccines protect animals against sporadic, mild, or uncommon diseases and should only be used when circumstances warrant and when the benefits clearly outweigh the risks involved. The low end of the dose is used for moderate sedation, the high end of the dose for deep . 0000033974 00000 n A veterinarian will use the most appropriate site for your dogs IM injection. To administer the injection, use a 0.5-inch-long needle. A careful push of the plunger should remove the excess air. If youre giving your dog an intramuscular injection, make sure you massage the area before the injection. It is easy to penetrate two layers of skin so that the drug ends up on the coat instead of under the skin. 0000062989 00000 n Injecting straight into the vein can be tough for nonprofessionals, especially with critters covered in fur. Is there a different dose via this route? Intramuscular- within the muscle, different specific sites are indicated for SA, EQ, and FA! 0000002320 00000 n The used needles and syringes should then be carefully stored in a sealed container or sharps box and returned to the veterinary practice for safe disposal. Make sure the dog sees the syringe before giving it. Learn more about how Pressbooks supports open publishing practices. An excellent example of this is the eradication of Aujeszky disease (porcine herpesvirus 1) from commercial swine in many developed countries with the aid of DIVA vaccines. Another good spot is over the ribs, well behind the shoulder. Additionally, a used needle can be painful for your dog. This approach is known as a prime-boost strategy. 0000029283 00000 n If you have the choice, the SQ method is the safest and easiest way to give vaccines, but some vaccines can only be given intramuscularly. Use to remove results with certain terms Appropriate sites for intramuscular injection are: The hamstrings (muscles at the back of the thigh) should generally be avoided due to the possibility of damage to the important sciatic nerve that runs in this area. Youre going to need a syringe to give an intramuscular injection to your dog. It is important to check that the needle has not accidentally been placed in a blood vessel (particularly an artery) in the muscle, before giving the injection. If you are unsure that your pet received the full amount of the injection, contact your veterinary hospital for instructions. Affiliate of Mars Inc. 2023 | Copyright VCA Animal Hospitals all rights reserved. I accidentally pricked myself while giving my pet an injection. Some clients find it easier to give the injection during mealtime, as it minimizes movement. Intramuscular injections in dogs can be performed on the quadriceps, lumbodorsal, or triceps muscle. Dog Restraint For Cephalic Blood Draw/IV Catheter, 18. Click to reveal As a result, testing an animals serum for antibodies may not enable differentiation of infected from vaccinated animals (DIVA). 0000003028 00000 n Unfortunately, the minimal duration of immunity has rarely been reliably measured. We do not control or have responsibility for the content of any third-party site. However, IMs are typically given in the thigh muscles located on the front of the rear leg. The immune system has evolved to respond to complex organisms and multiple simultaneous challenges. Insulin Syringes Difference between U 100 and U 40 and Emergency Conversion Chart, 54. intramuscular injection sites in dogs and cats. Your email address will not be published. 0000001096 00000 n This technique can also be used for subcutaneous injections, though penetration of a blood vessel is far less likely to occur here. Even killed viral vaccines may protect some animals against disease for many years. Intramuscular injections in dogs can be performed on the quadriceps, lumbodorsal, or triceps muscle. Administration of medicine by injection is often referred to as giving drugs by the parenteral route. Posted by CalVetSupply.com on 9/6/2019 to, Free Standard Shipping on orders over $49, Newborn, Orphaned and Critically Ill Animal Support, IV sets, gloves, instruments, and other misc. After your dog is positioned, insert the needle. 0000018063 00000 n Be extremely cautious while administering intramuscular injections because the sciatic nerve is located in the middle of the leg. Get the right information from your vet, then get the right care products for your pet. IM injections for canines are generally performed in the thigh muscles on the front of the rear limb or the hamstring muscles on the backside of the rear leg. It is now common practice to rate vaccines according to their importance. 0000001543 00000 n It is important to hold the syringe at an angle that prevents your hand from pressing the plunger too hard or you might accidentally inject the contents. ixb#Fw&*mvcDS%;.&VYWT@_DEvYNx We have excellent vet-recommended disinfectants and cleaners. document.getElementById( "ak_js_1" ).setAttribute( "value", ( new Date() ).getTime() ); Your email address will not be published.