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For researchers concerned about cardiovascular risk, practical strategies to minimize TMAO production include supporting a healthy gut microbiome through prebiotic and probiotic use, monitoring TMAO levels if testing is available, and keeping total levocarnitine exposure within studied safety ranges

Barrueto F Jr, Hack JB: Hyperammonemia and coma without hepatic dysfunction induced by valproate therapy

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Practical, pragmatic and flexible Offer choices, where appropriate (for example, formulation of medications, management options, and so forth) Make a plan together Know that at any time the plan can be changed Long-term monitoring Regular check ups are important especially in those cats managed with reversible options