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During pregnancy or nursing, dogs should be switched to Hills Science Diet Puppy, Hills Science Diet Puppy Small Bites or Hills Science Diet Puppy Small Paws dry dog food

[2] The complete synthesis involves final modification of these so-called "Gla proteins" by the enzyme gamma-glutamyl carboxylase that uses vitamin K as a cofactor

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This is often closely intertwined with mast cell activation syndrome (MCAS), where accumulated toxins and chronic oxidative stress cause mast cells to become hyper-reactive, constantly degranulating and releasing histamine and other inflammatory mediators into the bloodstream