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With the normal values (given in Methods) of V max for the four glucoronosyl tranferases, there is almost no liver damage (the black curve in Figure9)

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However, if accompanied by severe abdominal pain, persistent vomiting, or other concerning symptoms, contact your healthcare team for advice on whether dose adjustment or further assessment is needed

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There is also debate regarding the potential for harm associated with PCSK9i use in patients with a history of HF, possibly mediated via unwanted effects on cardiac metabolism

However, this review should provide you with some information on choosing the best supplement for your horse