Vet Stress Spay and neuter freebies and veterinary opposition

Ever wonder how a group of veterinarians arrives at a conclusion? Stressfully.

Long story short: We had this argument. About fifteen of us went back and forth on the merits of a free spay/neuter event sponsored by a South Florida veterinary group, for which I serve as an officer.

We’d already done one event. (Here’s the post on its success.) Now we were talking about doing it four times a year (in association with Miami-Dade County Animal Services, our local animal control, and The Cat Network, a local feral cat advocacy group).

About five of us Board members rallied for extending the recurring event into perpetuity as a quarterly event. But about ten naysayers nixed it. They urged caution in the face of imminent opposition from the group's veterinarian-only membership.

Why? Because those ten older members of the Board have lived here long enough to remember violent opposition to other events that promised to take money out of local veterinarians' pockets.

Q. So how does an event geared to spaying and neutering feral cats manage to earn a seal of disapproval from a certain faction of the local veterinary community?

A. Because the event is open to the community at large (not negotiable), clients who might otherwise spay their cats at a standard rate might choose to wait for the free event, thereby shortchanging the area’s veterinarians of their expected earnings.

After much discussion and debate in advance of this meeting, it was determined that to preserve the event, ear-tipping of cats was to be deemed a mandatory thing (here’s a post on ear tipping). That would keep the veterinarians concerned about freebies offered to potentially-paying clients at bay––or so we thought.

After all, who would consent to having their personal kitties’ ears deformed just to save a buck? And what veterinarian wouldn’t see our efforts for what they were––true altruism on behalf of our community’s feline population?

Not so according to some of the Board members. After all, our group's constituency is comprised of a wide variety of veterinarian members, not just the ones interested and educated enough to understand that local activism counts for something in this community.

OK, so enough of my self-congratulatory BS. On to the issues:

If our group is to represent its constituency of veterinarians, should it not respect the wishes of a sizable number of community veterinarians in this regard? In other words, perhaps we should, as an organization, restrict our good deeds to our actions as individuals, not to actions conducted on the the group's behalf. That was the idea.

To add another dimension to the argument, it was offered that Miami-Dade Animal Services, as a governmental institution, was looking to the our group for “personal” gain. Despite the fact that we were seeking to improve our own standing in the community through free public events as well, some Board members felt the PR gain wasn’t worth the fight.

If we were “being used” by the local government, it was argued, they’d abuse an inch to take their mile. Next thing we know, we’d be ‘beholden” to the government. They’d consider our volunteer efforts a subsidy and we’d be forever linked to the wrongs perpetuated by the “powers that be.”

And then the “kicker:” One [otherwise lovable] old-timer got on his soap-box and lectured us on the evils of “giving our services away,” arguing that doing so cheapens our profession. Ouch!

(Never mind that the human medical profession is lauded for its free surgeries on “third world” children, that attorneys are required to perform pro-bono work in the course of their duties, and that every other profession engages in low or no-cost work for the betterment of the public at large.)

Sheesh! I didn’t get up in the morning early enough to consider all my arguments on this issue. I would’ve written a personal position statement if I’d known what I’d be facing. As it was, 9:30 PM after a long day of kayaking and driving home from afar was way too late to be mustering the strength to respond to such drivel.

If I’d been “with it,” this is what I’d have said:

We all agree that the current solution to pet overpopulation is low-cost spay and neuter.
Few of us are willing to undertake this effort on a regular basis, intent on feeding our families in the face of a recession as we are.
These are cats...not dogs. The service is one that yields a low-profit margin.
Feral cats are NOT paying patients. As the work we do is allied with the local feral cat association, these are cats that would otherwise not be spayed and neutered through standard veterinary means.
Mandatory ear-tipping (which I admit I was not formerly on board with) should be enough to dissuade the casual cat owner from glomming on to free services they would otherwise be willing to pay for.
Another free service is available for personal cat owners who are MedicAid clients (identifiably low-income citizens) should these individuals call in to our line for an appointment. This allows for low-income owners to receive free spays and neuters sans ear-tip.
How could our volunteer community service be construed as an infringement on veterinary private practice profits?

Luckily, our Board voted for a vote. We’ll put the entire membership to the test, we said. After delineating the pros and cons, we’ll ask our membership to render a decision. That seems reasonable, given enough dissemination of the proposal. But I don't have to like it.

My take was that we shouldn't ask permission...and beg for forgiveness later (if need be). But I’d been overruled roughly by a ten to five margin. “Bleeding heart” as my positions are often labeled, my protests weren’t going anywhere this time.

Though I’ve been known to propose and vote for leading edge proposals, figuring my take is a “silent majority” stakeholder’s position, I’ve been overruled before. After all, I live in Miami, a place where runway fashions are first to take off and socially conscious decisions are usually late to the table. But then, living here has the benefit that I can always count on being on top of both, wired as I am. Too bad the animals are so slow to take their rightful place, despite the work of so many others here who do share my ideals.

April 8th, 2009

Add Comment39 Comments

This is one of the great things about shelter medicine programs. Vets who are graduating today, even if they are not working directly in or with shelters, are more aware of companion animal issues that include homelessness and ferals. The shelter medicine professor I worked with was very much in favor of tnr and low-cost or free spay & neuter. He would explain it to his colleagues this way (I'm totally paraphrasing): "If you think these are your clients and if you think you going to make a living off a) spay and neuter and b) the clients who are using the free services, you aren't going to be in business very long."

Veterinarians are often pressed by groups or individuals coming into their practice seeking discounts. While many private practice vets want to oblige it's a tough nut when you want to help out but in doing so you might jeopardize your practice. One of the selling points for events like these is it allows veterinarians to perform philanthropic work without short changing their own practices because it's done through the event, often not even at the practice itself.

You are so right about philanthropic service in other professions. My favorite vets are the ones for whom charitable work is important. Those are the vets who always get my personal referrals for full price paying clients! Forget cheapening the profession - these vets are even more valuable than before - giving pays!

Sue Cosby April 8th, 2009 09:08:42 AM

It seems to me the good PR generated by free or low-cost spay/neuter clinics would more than compensate for any potential profit lost to these services. When our local SPCAs do free vaccination or spay/neuter clinics, they always mention the participating vets in the press releases, thank-you letters published in the papers, etc. Getting your name(s) out there, particularly when associated with altruistic and humane causes, is always good for a vet's business.

If I were a vet, I wouldn't even think twice before saying "yes" to volunteering my services for feral cat or low-income spay/neuter services. Between the ethics, "good karma," and good PR, it's a no-brainer!

JaneA April 8th, 2009 09:37:56 AM

From the AVMA Principles of Veterinary Medical Ethics:

"The responsibilities of the veterinary profession extend beyond individual patients and clients to society in general."

Feral animals are a societal problem. If vets won't work together with volunteers and feral cat rescues to get these cats spayed/neutered... who will?

Megan April 8th, 2009 09:56:55 AM

Nasty stuff Doc. I understand what your up against. Next time ask them. ."What kind of person would oppose service to humanity?"

These Vet's who are enslaved to wealth can never be honest-democritus and there is apparently still no limit sto human greed and folly.

Evet April 8th, 2009 11:05:40 AM

From what I understand, we've faced much the same problem in our own city. Vets may be willing to participate in S/N programs for remote communities where they wouldn't normally practice anyway, but are collectively unwilling to do pro-bono work or participate in low cost programs within the city (and it's not cheap - it cost me almost $300 to spay one in-heat cat at the most affordable clinic in town - not in-heat would have still cost over $200.)

One vet clinic in town does offer our Humane Society a discount on S/Ns (they're still $90-180 per animal though) and some of the individual vets will only charge us for medications, lab work and big procedures, rather than for appointments and check ups, but our vet bills each month are still a large part of our operating costs and our shelter still is only able to S/N animals one at a time, as we're able to raise the funds.

For the general public, there is a private charitable organization that subsidizes S/N for low income families, but that's all there is. As far as I know, there's no participation by local vets in TNR or other charitable S/N work.

I think it's thoroughly ridiculous to argue that doing chariable work infringes on private practise profits or cheapens the profession. I think we all have a responsibility to give back to the community and doing charitable work has its own returns (such as improved reputation and standing in the community). Never mind that doing chariable work *doesn't* turn potential paying clients into freebies - it provides services to those who would otherwise do without. I provide my own professional services (marketing, design & web) free of charge to charities that I know have no budget for them but need them, and I also volunteer my free time to the humane society to improve the lives of animals in our community. And so do other professionals I know - lawyers, doctors, executives, consultants etc.

I find it baffling that vets seem (in my perception at least) to be one of the most resistant groups when it comes to philathropic work for animals. Doing charitable work doesn't have to take away from anyone. There are great individual vets who help out, but it would be nice to see more of a community effort trom vets to get involved in charitable work. True, you may get taken advantage of if you allow it to happen, but it's not difficult to set boundaries.

Anlina April 8th, 2009 01:13:18 PM

If a neutered pet had to be surrendered to a shelter, would a tipped ear make it less likely to be adopted? Call me shallow, but I'm glad my cat (rescued and neutered) has both ears intact, not mutilated.

gmanedit April 8th, 2009 02:11:04 PM

Given that I graduated from veterinary school in 1964, I suppose that I am counted among the "old timers." Nevertheless, I have supported (and helped with) local spay/neuter projects. Based on that experience I still support the principle, but have the following strong reservations: (1) Procedures should be done in accordance with (preferably upper end) local "standard of care." In our area (215, 610,609, 856 area codes), that includes full sterile technique with separate sets for each patient, gown and mask etc. It includes pre-anesthetic physical exam, parasite and blood profile. Patients should have monitoring, fluids, antibiotics, environmental control and analgesia pre, during and post surgery as for the highest paying patients.For feral cats, it should include comfortable indoor housing for at least three days pre and post surgery with remediation of intercurrent health, hygeine and parasite problems. (2) At least a good-faith effort must be made to socialize and re-home any animals that are part of the project. (3) Any organization that has a free or low cost neutering program -- particularly for ferals -- should be compelled to perform rigorous follow-up studies to discern whether the activity is, in actual fact, beneficial to the animals and/or society at large. Although there are anecdotal and very limited survey information, it is far from being proven that TNR, in particular, actually decreases the number or effect of feral cats or dogs in a community. I have some concern that, while clearly beneficial for the health of "homed" animals, neuterin may diminish the ability of released animals to live successfully on the outside. My own limited experience of seeing flea-ridden (and anemic, sick, frenzied ferals brought into a clinic for "quickie" surgery and released while barely awake, much less recuperated, is grossly inhumane; not to mention wasteful of limited resources.

Dr. Steve Dubin April 8th, 2009 03:07:15 PM

Dr. Dubin: Thanks for your insight. We follow the current guidelines recently set by the Association of Shelter Veterinarians (as published in JAVMA). No, the monitoring and bloodwork are not there. And it's up to the individual feral workers to keep the cats confined for a couple of days afterwards.

But if we did all you suggest, we'd be spaying and neutering almost no cats in Miami-Dade County--privately or publicly--as the standard of care here does not dictate that most of those niceties be included (seriously) and few hospitals are able to offer them at what our clientele considers an affordable price.

For my own hospital's low-cost spays and neuters, they get no bloodwork, but the do get the same drugs, monitoring, pain meds, recovery attention, etc. In a shelter event setting that's just not possible. They do get fresh gloves, fresh instruments, pre and post ops including pain meds, but corners are cut. Yet I do not consider it cruel--just more risky.

On the TNR: It's debatable, for sure, but it's my read of the current literature that TNR does work to stabilize populations as long as a critical mass of cats in any given colony are spayed and neutered fast enough. Dr. Juie Levy (our group's medical advisor and a faculty member at the University of Florida) has written several papers with positive findings on the TNR front for individual cats as well as populations of cats.

Considering that extermination of cats is politically untenable at the present, it seems like TNR is the only option anyway.

Dr. Patty Khuly April 8th, 2009 04:55:16 PM

This is another great topic that could be broadened into a lot of other areas of animal care and welfare.

I think there is an old school viewpoint of "not enough to go around."

For instance, in my profession there are free behavior consultation lines and those who will underbid or provide services a low cost or no cost.

Some are pretty good but the questions is the same: Are they cheapening professional services or taking away business?

Perhaps, however in my experience people often delay (or don't bother) to get professional services because of laziness or due simply to pricing issues.

Feral animal issues are not in conflict with professional services and a savvy practitioner will get the local media interested in the story from a good will standpoint--attracting attention (and perhaps funding for supplies) to the issue while gaining media exposure for themselves and/or their clinic.

That goes a long way to creating good will and to attracting clients that might not know about a clinic or the issues faced by a community.

Whether or not you chose to participate in such programs is optional but the underlying question is whether or not you are helping the welfare and health of animals in the process--something I don't believe should be blocked because a few people dissent.

Public service programs benefit the community. And I also doubt that those participating in such efforts or taking advantage of offerings would be clients anyway.

Personally, I think the goodwill and generosity of those veterinarians who support such efforts will go a long way.

I think your statement was right on--and hope that the few will pay it forward--instead of focusing on the old fear--lack.

Find me blogging at Ark Animals

Ark Lady April 8th, 2009 05:57:12 PM

Another vote for adding the argument Sue Cosby in comment 1 suggests. to your arsenal As a fully paying customer (and happily, I love my vet) I took her charity work into consideration. The shelter I adopted my two kitties from recommended offices that helped them out and I happily chose the one closest to my house :D It's in the same vein as buying organic, supporting fair trade, etc. I'm happy to support any business that helps the community.

Anne April 8th, 2009 05:58:07 PM

Un-believable! You must sit at some of those meetings aghast. Ok, to get particular on the promotion to quarterly.....was there proposed to be an expansion of what you gracious 4 gals did for the 91 cats?

Ninety-one cats times 4 a year, is going to cause tremendous economic loss to S. FL. veterinarians....most of which are feral, but possibly a lower-income slips in here & there?

And as mentioned above, the PR of names/clinics, should be cause for everyone to take turns volunteering...not say bah-humbug!

Aren't you inundated with mailboc brochures from every hospital & medical facility load with "free screenings, foot clinics, bereavement groups, pregnancy & parenting classes, on & on for free?

Or flu shot clinics sponsored by pharmacies, income-tax clinics, shelter fundraisers & volunteers, eye exams for elderly...are these professions cheapened? The millions of professionals that donate time & expenses to charitible causes: sports figures, public, famous, companies?

Barbara A. Albright/NH

Pocket's Story from NH April 8th, 2009 08:19:22 PM

I have mixed feelings with TNR as a whole. On one hand I see that 'someone has to do it' otherwise it is not likely that these cats will get spayed or neutered, keep numbers down, etc.... But do you do any FELV/FIV testing on any of these cats?? Maybe you do (and you haven't said or I missed it) but I wonder if every program does this? Is it a requirement or not? I have strong feelings about sending positive cats back out -- they don't have to reproduce to infect. I think that positive cats should be euthanized; it is not that I don't care about them any less. Actually I think that we are saving them from a potentially cruel death.

Anyway Dr K. I was just curious as to whether or not you all test and/or your feelings about this aspect of it.

J.C. April 8th, 2009 10:49:55 PM

I think the free spay and neuters are a good thing all around, and I'd love to sit on a board and argue for it. As for the FIV/FeLV issue, there might be a study on the rates of infection in the area, which could be used to build a testing protocol. To test every animal would be a waste of time and resources, so testing could be done on the basis of certain signalment and clinical criteria (yes, some would be missed, but it would be better than none, and better than testing everyone, which would not be feasible). As for the argument of being "beholden" to the government - bah. Small animal vets are private businesspeople, not para-government workers (which large animal vets are). Giving your services away? No. Veterinary services have evolved into something much more sophisticated than spays and neuters. And anyways, if your board doesn't do it, some other entity will end up forming to take up the call, and how will that make you look? I think you're doing a great job Dr Khuly - keep up the great work, staying on the leading edge and reminding everyone of the potential positive impacts of collective efforts by veterinarians.

brebis noire April 9th, 2009 07:29:32 AM

Also, I forgot to mention, and Dr Khuly might have a different viewpoint on this, FeLV and FIV positive cats might not have to reproduct to be infective for their peers, but these diseases are closely linked to reproduction behaviour, so to spay and neuter (particularly young males) should in theory have a positive effect in lowering rates of infection in the local community of cats.

brebis noire April 9th, 2009 07:32:27 AM

I formerly held the view (as recently as three years ago) that I would do no TNR without an FIV/FeLV test...that I would not knowingly spay or neuter a cat who would live a horrible life, die a nasty death and infect his colony-mates.

But I'm now with brebis noire on this one. Not only is it financially untenable to test every cat if we're to spay and neuter in volume, the reproductive behaviors she mentions, along with their associated fighting behaviors, are indeed responsible for the vast majority of the transmission.

For now, it's enough for me to test all sick cats and euthanize them if they're deemed unadoptable (which, frankly, most are, if not for behavior reasons then because their active disease means they'd be expensive additions to a household and that they can't be safely housed with healthy cats).

Dr. Patty Khuly April 9th, 2009 07:52:49 AM

I agree with above poster in that the publicity will out wiegh the initial loss of potential income. Are donations requested ? In past charitable events I have witnessed some people donating more than what it would of cost normally just because they want to participate.

I actually fwd your post about your last SN clinic to my vet ;) and told him I would volunteer and I fwd it to a friend in Florida and told her if she is near you she should switch clinics just because you did that event!

Do you have to hold the events in conjunction with HSUS or Miami-Dade Animal Services ? or could you do it yourselves ? that would take the government issue away ?

LC April 9th, 2009 08:58:08 AM

I also recently wrote a letter to oppose a local breeder legislation and I was thinking it would be better if a more positive and preventative approach to breeder legislation & animal control was taken such as -

1)if the government offered a financial incentive to vets such as yourself who donate time, clinic hours, etc to SN clinics - perhaps a B&O credit ? or ability to write off event costs, time, etc as charitable donation ? or both

2) instead of funding more animal control officers they funded educational campagns

3) offered financial incentives to clinics who sponsored Breeder Clinics

just a thought :)

LC April 9th, 2009 09:04:40 AM

I thought a long time about how I felt about this. After all I opted to pay my vet for 20+ spay/neuters from the cats I rescued as opposed to taking them to a low cost (there are no free options here).

I think based on how many animals are put to death simply because there are no homes for them and people don't want to or can't afford or lack the education to have their pets s/n then yes..it should be done for free. Should an owner pet have to be ear tipped?...no because that is harming an animal that doesn't require that harm and it blurs the line between feral and pet especially if that pet was to get loose.

The government pisses away huge quantites of money on things that are not only unnecessary but completely absurd. At least paying for s/n would be money put to a good cause.

for those who are choosing to have it done for free instead of paying for it, well maybe at some point the will "pass it on" in their own lives in another area to someone else. Good deeds have to start some place.

LorriM April 10th, 2009 07:10:51 PM

LorriM: In our area, clients with MedicAid have a resource for free spays and neuters without ear-tipping (for both cats and dogs). Private clients (owners of non-free-roaming cats) who call to make an appointment can therefore be re-routed. Our local veterinary foundation pays for this. These are viewed as true charity (in which case the rest of vets don't outright object--or haven't yet), but it doesn't address the feral problem. It does, however, make me feel a whole lot better about ear-tipping all our cats for our s/n TNR event.

Dr. Patty Khuly April 11th, 2009 07:26:25 AM

Dr. K,

sounds like Fla has a better program than NJ. In NJ if you are on "assistance" you can qualify for a S/N certificate which makes the procedure $20.00 (I think, might have changed). (oh and if you are on assistance, then there is no way you can afford to be in NJ anyway)

There is also a group that "sells" low cost certificates. Those aren't exactly low cost.....the vets that take those certificates charge additional fees such as office visit, iv fluids...so by that time, we're already at what my vet charges minus the occasional gracious discount, so I'd rather just go to him.

It's very difficult in NJ to be moderate income and still try and help like I do. There is not any kind of state funding. There are no big TNR events like you participate in either. Around here they are much more likely to trap all the ferals and kill them.

I'm moving to PA in a few weeks and while I will be driving back to keep my regular vet at least for the first year (we have to see if it is practical to have a vet 1.5 hrs away) I am hoping PA has a program that helps ferals. Because while my days of taking any more in are essentially done, it doesn't mean I can walk away from a stray in need.

It does make it frustating and difficult to help all the animals I come across that need help.

Lorri April 11th, 2009 05:24:43 PM

Perhaps your colleagues that feel they are being cheated out of paying work might be a little less greedy if they spent a day at MDAS giving lethal injections to dozens of perfectly healthy cats and kittens. I have not seen the numbers for 2008, but in 2007 the kill rate for cats was a breathtaking 90%.

Marcy April 12th, 2009 04:25:50 PM

Veterinarians who donate their services to spay/neuter feral cats are a god send. If it were not for ignorant pet owners, we would not have the tremendous problem of feral cats to begin with. Personally, I will support a mandatory spay/neuter law because have to start somewhere.

Gina May 4th, 2009 04:37:47 PM

شات

amal_ May 22nd, 2009 09:49:02 AM

Lovely cat.

wholesale jewelry

handmade jewelry

fashion jewelry

wholesale jewelry June 15th, 2009 10:06:03 PM

دردشة

منتديات

يوتيوب

fggd June 26th, 2009 10:15:53 AM

The only ones ghd hair iron among you who will be really happy ghd mk4 iron are those who will have sought and foundhow to serve. When the fight begins ghd iv dark styler within ghd iv kiss styler himself, a man's worth something ghd hair iron .

GHD Hair Iron September 12th, 2009 04:59:14 AM

هدف ماجد عبدالله</a> | <a target="_blank" href="http://youtube.4444n.com/c-29-قصائد">ناصر الفراعنة</a> | <a target="_blank" href="http://youtube.4444n.com/c-27-سيارات">سيارات سريعة</a> |<a target="_blank" href="عدنان'>http://youtube.4444n.com/c-10-عدنان-ولينا">عدنان ولينا</a> |  <a target="_blank" href="http://youtube.4444n.com/c-7-توم-و-جيري">توم وجيري</a> |  <a target="_blank" href="http://youtube.4444n.com/c-8-كابتن-ماجد">كابتن ماجد</a> |<a target="_blank" href="http://youtube.4444n.com/c-22-كورة-سلة">كورة سلة</a><a target="_blank" href="طبخ'>http://youtube.4444n.com/c-4-فيديو-طبخ">طبخ للمرأة</a> |  <a target="_blank" href="http://youtube.4444n.com/c-14-مستر-بن">مستر بن</a> |  <a target="_blank" href="http://youtube.4444n.com/c-30-مسرحية-شاهد-ماشفش-حاجه">شاهد ماشفش حاجه</a> |  <a target="_blank" href="http://youtube.4444n.com/c-31-مسرحية-العيال-كبرت">العيال كبرت</a><a target="_blank" href="http://youtube.4444n.com/c-21-مسرحية-يواش-يواش">بواش بواش</a> | <a target="_blank" href="http://youtube.4444n.com/c-17-مسرحية-البيت-بيتك">البيت بيتك</a>| <a target="_blank" href="http://youtube.4444n.com/c-16-مسرحية-حاميها-حراميها-">حاميها حراميها</a> |<a target="_blank" href="http://youtube.4444n.com/c-19-كاميرا-خفية">كاميرا خفيه</a> |<a target="_blank" href="http://youtube.4444n.com/c-33-عالم-الحيوانات">قرد مضحك</a>| <a target="_blank" href="http://youtube.4444n.com/c-3-مقاطع-مضحكة">ضحك و وناسة</a><a target="_blank" href="http://youtube.4444n.com/c-20-كليب-اغاني">ياغداره الأماكن</a> |  <a target="_blank" href="http://youtube.4444n.com/c-28-english-clips-song">أغاني اجنبية</a> |  <a target="_blank" href="http://topic.4444n.com/">توبيكات 2010 للماسنجر و ملونه</a> |  <a target="_blank" href="توبيكات'>http://topic.4444n.com/cat.php?cat_id=1">توبيكات حزينة</a><a target="_blank" href="توبيكات'>http://topic.4444n.com/cat.php?cat_id=2">توبيكات جديدة انجليزية</a> |  <a target="_blank" href="http://topic.4444n.com/cat.php?cat_id=3">توبيكات رومانسية</a>| <a target="_blank" href="توبيكات'>http://topic.4444n.com/cat.php?cat_id=4">توبيكات مضحكة</a>| <a target="_blank" href="توبيكات'>http://topic.4444n.com/cat.php?cat_id=5">توبيكات إسلامية</a><a target="_blank" href="توبيكات'>http://topic.4444n.com/cat.php?cat_id=6">توبيكات شعرية</a> | <a target="_blank" href="توبيكات'>http://topic.4444n.com/cat.php?cat_id=7">توبيكات منوعة</a> |  <a target="_blank" href="توبيكات'>http://topic.4444n.com/cat.php?cat_id=8">توبيكات أغاني</a> |  <a target="_blank" href="توبيكات'>http://topic.4444n.com/cat.php?cat_id=9">توبيكات أسماء</a> |  <a target="_blank" href="توبيكات'>http://topic.4444n.com/cat.php?cat_id=10">توبيكات أسماء</a> |<a target="_blank" href="شاتhttp://chat.4444n.com">شات</a><a target="_blank" href="الدليلhttp://dir.4444n.com/">الدليل</a> | <a target="_blank" href="http://www.4444n.com/">موقع دليل

faaaaa November 8th, 2009 01:58:24 PM

هدف ماجد عبدالله</a> <a target="_blank" href="http://youtube.4444n.com/c-29-قصائد">ناصر الفراعنة</a> <a target="_blank" href="http://youtube.4444n.com/c-27-سيارات">سيارات سريعة</a> <a target="_blank" href="http://youtube.4444n.com/c-6-مسلسل-كونان">كونان</a><a target="_blank" href="http://youtube.4444n.com/c-10-عدنان-ولينا">عدنان ولينا</a><a target="_blank" href="http://youtube.4444n.com/c-7-توم-و-جيري">توم وجيري</a><a target="_blank" href="http://youtube.4444n.com/c-8-كابتن-ماجد">كابتن ماجد</a><a target="_blank" href="http://youtube.4444n.com/c-22-كورة-سلة">كورة سلة</a><a target="_blank" href="http://youtube.4444n.com/c-23-التنس-الأرضي">ندال</a><a target="_blank" href="http://youtube.4444n.com/c-32-الدوريات-الأوربية">انترميلان تشلسي المان يونايتد</a><a target="_blank" href="http://youtube.4444n.com/c-4-فيديو-طبخ">طبخ للمرأة</a><a target="_blank" href="http://youtube.4444n.com/c-14-مستر-بن">مستر بن</a><a target="_blank" href="http://youtube.4444n.com/c-30-مسرحية-شاهد-ماشفش-حاجه">شاهد ماشفش حاجه</a><a target="_blank" href="http://youtube.4444n.com/c-31-مسرحية-العيال-كبرت">العيال كبرت</a><a target="_blank" href="http://youtube.4444n.com/c-21-مسرحية-يواش-يواش">بواش بواش</a><a target="_blank" href="http://youtube.4444n.com/c-17-مسرحية-البيت-بيتك">البيت بيتك</a><a target="_blank" href="http://youtube.4444n.com/c-16-مسرحية-حاميها-حراميها-">حاميها حراميها</a><a target="_blank" href="http://youtube.4444n.com/c-19-كاميرا-خفية">كاميرا خفيه</a><a target="_blank" href="http://youtube.4444n.com/c-33-عالم-الحيوانات">قرد مضحك</a><a target="_blank" href="http://youtube.4444n.com/c-3-مقاطع-مضحكة">ضحك و وناسة</a><a target="_blank" href="http://youtube.4444n.com/c-20-كليب-اغاني">ياغداره الأماكن</a><a target="_blank" href="http://youtube.4444n.com/c-28-english-clips-song">أغاني اجنبية</a> <a target="_blank" href="http://topic.4444n.com/">توبيكات 2010 للماسنجر و ملونه</a><a target="_blank" href="http://topic.4444n.com/cat.php?cat_id=1">توبيكات حزينة</a><a target="_blank" href="http://topic.4444n.com/cat.php?cat_id=2">توبيكات جديدة انجليزية</a> <a target="_blank" href="http://topic.4444n.com/cat.php?cat_id=3">توبيكات رومانسية</a><a target="_blank" href="http://topic.4444n.com/cat.php?cat_id=4">توبيكات مضحكة</a><a target="_blank" href="http://topic.4444n.com/cat.php?cat_id=5">توبيكات إسلامية</a><a target="_blank" href="http://topic.4444n.com/cat.php?cat_id=6">توبيكات شعرية</a><a target="_blank" href="http://topic.4444n.com/cat.php?cat_id=7">توبيكات منوعة</a><a target="_blank" href="http://topic.4444n.com/cat.php?cat_id=8">توبيكات أغاني</a><a target="_blank" href="http://topic.4444n.com/cat.php?cat_id=9">توبيكات أسماء</a><a target="_blank" href="http://topic.4444n.com/cat.php?cat_id=10">توبيكات أسماء</a><a target="_blank" href="http://chat.4444n.com">شات</a><a target="_blank" href="http://dlil.4444n.com/">دليل</a><a target="_blank" href="http://dir.4444n.com/">الدليل</a><a target="_blank" href="http://www.4444n.com/">موقع دليل</a>