The severity and duration of deficiency are primary determinantspatients with mild, recently developed deficiency typically respond more rapidly than those with longstanding, severe depletion
The deltoid is a smaller muscle, which leaves less room for error, and reaching it on your own at the correct angle can be awkward
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However, if serum cobalamin concentration is within the normal range, treatment should be continued at least monthly and the owner should be forewarned that clinical signs may recur sometime in the future
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Cofactor for L-methylmalonyl-coenzyme A mutase 5-Deoxyadenosylcobalamin is required by the enzyme that catalyzes the conversion of L-methylmalonyl-coenzyme A to succinyl-coenzyme A (succinyl-CoA), which then enters the citric acid cycle ( Figure 2 )