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This means that despite consuming a balanced diet, affected dogs might still face a B12 deficiency

While their mechanisms are different, they complement each other when stacked.

Hyperammonemia and Encephalopathy Associated with Concomitant Topiramate Use:  Clinical symptoms of hyperammonemic encephalopathy often include acute alterations in level of consciousness and/or cognitive function with lethargy or vomiting

However, they rely on proper digestive absorption and conversion to the active form, which might be compromised in some individuals