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Once a repeated-entry vial is opened, a time limit applies, and that limit is usually 28 days unless the label states another period

chronic liver disease and hepatitis may present with elevated levels Renal impairment : Reduced clearance can contribute to accumulation, though this is rarely clinically significant Solid tumours : Certain malignancies, particularly hepatocellular carcinoma and metastatic disease, may elevate B12 levels [3] Evidence suggests that unexplained markedly elevated B12 levels without supplementation may sometimes be associated with underlying disease

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Appropriate diet, preventive medicine, and timely treatment of medical concerns benefits individual dogs regardless of breed

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