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Mechanism And Absorption Injections (IM or subcutaneous) Usually given as cyanocobalamin or hydroxocobalamin Absorbed directly from muscle or subcutaneous tissue into circulation Typically administered in a clinic, or self-injected after training B12 nasal spray Absorbed through the nasal mucosa directly into the bloodstream Avoids needles, first-pass metabolism, and GI issues Can be administered at home in seconds A quick side-by-side view can help: Clinical work with prescription cyanocobalamin nasal spray (e.g., Nascobal) shows that nasal B12 reaches effective blood levels and maintains them over time when used on a consistent schedule, with research from the Comparison of the Efficacy demonstrating superior absorption through nasal delivery compared to oral administration

HCPCS J3380 Biologics (IL-23 inhibitor): Risankizumab (Skyrizi, J7999) newer biologic for moderate-to-severe CD

A few practical points if you are considering peptide therapy

This is a simple blood test that gives a very general idea as to the cats cobalamin status