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The importance of maintaining the metabolic health of the carnitine pool is emphasized by the high demand for carnitine in tissues that cannot synthesize carnitine, such as the myocardium and skeletal muscle

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Conditions that can cause cobalamin deficiency include: Inflammatory bowel disease (IBD) Exocrine pancreatic insufficiency (EPI) Pancreatic cancer Chronic enteropathy Alimentary lymphoma Small intestinal dysbiosis Inherited selective cobalamin malabsorption Inherited selective cobalamin malabsorption, which is known as Imerslund-Grsbeck syndrome (IGS) in humans, makes a dog genetically predisposed to have difficulty absorbing cobalamin

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