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They are sold online, often labeled not for human use, and exist in a regulatory gray zone that the 2026 reclassification is specifically designed to address through legitimate pharmacy channels

Dog breeds that benefit most from cobalamin supplements are Giant Schnauzers, Chinese Shar-Peis, Border Collies, Beagles, and Australian Shepherds, as they have a genetic predisposition to selective cobalamin malabsorption

Ten of 14 subjects (71%) survived, following administration of hydroxocobalamin

Inadequate initial treatment may result in suboptimal responses and persistent symptoms

For convenience, these injections can be safely given by the patient themselves at home