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Pharmacokinetics: Cyanocobalamin is administered intranasally, orally, and parenterally, while hydroxocobalamin is administered only parenterally. Once absorbed, vitamin B12 is highly bound to transcobalamin II, a specific B-globulin carrier protein and is distributed and stored primarily in the liver as coenzyme B12. The bone marrow also stores a significant amount of the absorbed vitamin B12. This vitamin crosses the placenta and is distributed into breast milk. Enterohepatic recirculation conserves systemic stores. The half-life is about 6 days (400 days in the liver). Elimination is primarily through the bile; however, excess cyanocobalamin is excreted unchanged in the urine
Hay and other feed may not contain high levels of components essential for equine health, so supplementation helps fill these nutritional gaps
Once your GP establishes the need for ongoing therapy and you complete training, they can issue a repeat prescription for hydroxocobalamin ampoules and injection supplies, which you collect from community pharmacies
Half of the patients even started with two weeks of daily 5 mg B12 injections straight into the blood
This allows the vial to be used for multiple withdrawals over a limited period when handled properly
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