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Primary IMHA Primary IMHA is what we in veterinary medicine call a diagnosis of exclusion. This means the vet must first rule out all the potential triggers listed below

If pain continues or returns, the underlying cause should be evaluated

In practice, using bacteriostatic water as a diluent for a single-dose medication in a nursing mother is unlikely to pose significant risk, but caution is still advised

This makes it nearly impossible to overdose on the nutrient

Women with certain medical conditions may require specific B12 supplementation approaches

Diagnosis of cobalamin malabsorption usually involves bloodwork to measure serum cobalamin levels and may include genetic tests, especially for informed breeding decisions