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In some cases, it can lead to vision impairment, including blindness, if left untreated
The incidence of epistaxis was also higher in sildenafil-treated patients with a concomitant oral vitamin K antagonist (9% versus 2% in those not treated with concomitant vitamin K antagonist)
Veterinarians may choose injections when deficiency is significant or absorption is compromised, and injectable hydroxocobalamin has been used effectively in cats with GI-related deficiency(Kook PH, 2020)
