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The protocol (Supplementary Appendix A) was developed in accordance with Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) 2020 guidelines [6] and has been published on PROSPERO (ID: CRD420251051447)

L-Carnitine is generally safe for dogs when used responsibly under veterinary supervision

The active molecule, semaglutide, is identical

Hormone pellet therapy involves the insertion of tiny, custom-compounded pellets typically made from bioidentical estrogen or testosterone just beneath the skin, usually in the hip or buttock area

Your DAO Enzyme: The Histamine Handler The diamine oxidase (DAO) enzyme is your bodys natural histamine breakdown system