dihexa vs adderall Vyvanse vs. - What's the Difference? Dihexa - Wikipedia
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PCO-02 - Safety and Pharmacokinetics Trial
doi: 10.1038/nm.3882

As clinical signs of cobalamin deficiency include chronic wasting or failure to thrive, malaise, and gastrointestinal signs such as diarrhea, serum cobalamin concentration should be measured in any dog with poor response to enzyme replacement therapy for EPI

You can discuss this with your GP or a qualified wellness practitioner
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It seems that pharmacotherapy is starting to catch up with bariatric surgery with regards to initial weight loss, but long-term data are still not available