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JVIM Toresson L (2016) Oral cobalamin supplementation in dogs with chronic enteropathies and hypocobalaminemia

More serious deficiencies have the potential to impair heart and neurological function, leading to a wide range of serious symptoms, including but not limited to tinnitus, severe joint pain, memory problems, depression, anxiety, poor muscle function, ataxia and changes in reflexes

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Kossiakoff A, Li WH (July 2002)