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The FDA does not approve compounded medications for safety, quality, or manufacturing

Flowchart from BSH Cobalamin and Folate Guidelines stichtingb12tekort.nl/weten

Repeatability is essential for long-term scientific testing

Consider discussing B12 testing with your vet if your dog has: Had chronic or intermittent diarrhoea for more than a few weeks without a clear resolved cause Lost weight progressively despite adequate food intake Been diagnosed with a chronic gut condition, such as inflammatory bowel disease or exocrine pancreatic insufficiency A history of poor early nutrition, such as a recently rescued stray or previously malnourished dog Been through multiple courses of treatment for digestive symptoms without sustained improvement A young dog or puppy that is not developing or gaining weight as expected Causes of Vitamin B12 Deficiency in Dogs Vitamin B12 deficiency in dogs is almost always caused by a problem with absorption rather than a lack of B12 in the diet

Even then, not everyone absorbs it well