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When this metabolic process is impaired, plasma ammonia concentrations typically increase.1, 17, 18, 19, 20 Neurological disorders can thus be a complication of cobalamin deficiency states in dogs due to the increase in systemic MMA concentrations.1, 17, 18, 21 In humans, neurological symptoms also occur in organic acidemias including methylmalonic acidemia.22 2.3

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