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Acknowledgements The authors would like to thank all PIONEER REAL study participants and site staff in Canada, Denmark, Italy, the Netherlands, Sweden, Switzerland, and the UK

For example, Echinacea purpurea has been shown to support immune health in dogs, though it is not the Association of Animal Feed and Control Officials (AAFCO)-defined ingredient

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Missy covers every detail of the program

Medical Supervision Every plan is overseen by our licensed medical team for safety and accountability