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This is well within community practice and trades a slower start for a smoother body adjustment
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As clinical signs of cobalamin deficiency include chronic wasting or failure to thrive, malaise, and gastrointestinal signs such as diarrhea, serum cobalamin concentration should be measured in any dog with poor response to enzyme replacement therapy for EPI
"Role of hydroxocobalamin in acute cyanide poisoning" (PDF)
The rate goes up as the BAC rises
