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As clinical signs of cobalamin deficiency include chronic wasting or failure to thrive, malaise, and gastrointestinal signs such as diarrhea, serum cobalamin concentration should be measured in any dog with poor response to enzyme replacement therapy for EPI

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For Concentrations often range from 1-10 M (micromolar)

Infectious causes, including brucellosis, HIV/AIDS, and chronic hepatitis, were also considered [22,23,24]