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systemic symptoms are present in around half of cases, which may help distinguish it from gout (where fever is much less common)

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Results from this study suggest that hepatic fat export in periparturient dairy cows is improved by choline supplementation during the transition period and this may potentially decrease the risk for metabolic disorders in the periparturient dairy cow.12 Choline is also known to be involved in the synthesis of carnitine, cell membrane phospholipids, and the neurotransmitter acetylcholine