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However, these agents increase risk of intra-operative pulmonary aspiration according to a case report secondary to delayed emptying and presence of gastric residues despite fasting (108, 108) To prevent these events, the recent recommendations from the American Society of Anesthesiology guidelines suggest discontinuing GLP-1 receptor agonists 1 day prior in patients on daily dosing and 1 week prior in patients on weekly injection dosing (108)

For sustained energy, lifestyle foundations such as adequate sleep, nutrient intake, hydration, iron and B12 status, and physical conditioning should take priority, with L-carnitine considered only as an additional support

In summary, melanin pigmentation may be physiologic or pathologic, and may clinically present with focal, multifocal, or diffuse patterns

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Call Your Vet If: Severe side effects are seen (see above) Your pets condition worsens or does not improve with treatment You see or suspect an overdose You have additional questions or concerns about the use of L-carnitine L-Carnitine Overdose Information Higher dosages of L-carnitine may cause diarrhea and gastrointestinal upset

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