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When to Reconsider Your Approach Two cortisone injections with only temporary relief consider alcohol sclerosing injection series or surgical consultation Symptoms worsening despite injections and shoe changes the neuroma may be larger than expected

In unstable hemodynamic patients, inotrope drug and cardiogenic shock management might be required (204, 205, 207)

If requirement becomes less, this shows the success of vitamin b12 injection for dogs therapy and decision of administering maintenance dose is dependent on results of laboratory tests

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