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That is one of the reasons, as the NICE guideline says, that we need to adjust treatment to the patients symptoms, not do a blood test or prescribe a one-size-fits-all dose

[DOI] [PubMed] [Google Scholar] 17.Ramsaransing GS, Fokkema MR, Teelken A, Arutjunyan AV, Koch M, De KJ

1997 May-Oct;91(3-5):173-8

"Subacute Combined Degeneration of the Spinal Cord"

If no improvement is noticeable, consider consulting your vet about treating simultaneously for Listeriosis, which has very similar symptoms but is more common in adult animals