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However, it's important to recognize that while a B12 deficiency may contribute to depression in some cases, it is not the sole cause

The plateau is real, the patient's frustration is real, and the appeal of an additional pharmacological intervention is understandable

Monitor Reactions: Let your veterinarian know right away if your pet shows any unusual or unexpected reactions following the injection

After 28 days, the risks of using the remaining medication increase substantially, not just from potency loss but from potential microbial contamination

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intramuscular route: count injections given Visit 4 (week 52) Anamnesis: record lifestyle habits and use of alcohol Symptoms: record paresthesia, asthenia, loss or reduction of appetite, sadness or change in level of happiness, and concomitant pharmacological treatment Physical examination: for Hunters glositis, positional and vibrational sensitivity Record concomitant treatment Questionnaires: EuroQoL-5D, satisfaction and preferences Assessment of haemogram and serum vitamin B12 concentration Assessment of adverse effects Assess adherence to treatment: oral route count number of vials used