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Because the injections are given infrequently with a very small needle (typically a 25-gauge needle is adequate), this is not usually a very unpleasant experience for the cat

Annals of the New York Academy of Sciences , vol

[2] [19] Whilst this procedure does not bypass the small intestine in the way a gastric bypass does, it significantly alters the physiology of digestion in ways that can compromise vitamin B12 absorption