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[6] The only notable exception is that biotin should not be used in anyone with a known hypersensitivity or allergy to biotin or any ingredients in the injection formulation (such as the diluent or preservatives), though such cases are exceedingly rare

Low levels of SAM in the liver prevent the formation of VLDL and cause lipid accumulation in the liver, often known as fatty liver

PubMed 10

Fat transfer and facelift surgery would be 2 other options that work well, if plastic surgery is something youre open to exploring

In this case the dose for intramuscular injection is typically 100 to 1,000 mcg every day or alternate day, for one to two weeks

Your vet wants what is best for your dog and will weigh the potential risk of IMHA (or other adverse events) with the benefits of the care he or she is suggesting