Cobalequin contains an oral cobalamin form that is bioavailable and has been shown in studies to increase serum
cobalamin concentrations in dogs and cats.
Serum cobalamin and folate concentrations should be routinely evaluated in small animals with suspected EPI, and dogs and cats with severely decreased serum
cobalamin concentrations should be treated with cobalamin parenterally.
Dogs with exocrine pancreatic insufficiency will commonly present with subnormal serum
cobalamin concentrations.
Cats appear highly susceptible to cobalamin deficiency, partly as a result of the very rapid turnover of this vitamin compared with humans.49 Cats with decreased serum
cobalamin concentrations should be supplemented with subcutaneously administered cobalamin at a dose of 1000 μg per cat once weekly for 6 weeks, with reassessment of the serum cobalamin concentration approximately one month after discontinuing therapy.
Serum cobalamin can be assayed and if decreased, administered cubcutaneously at a dose of 500 μg per dog once weekly for 6 weeks, with the dosing schedule decreased to once every 6 to 12 months depending on serum
cobalamin concentrations.
These patients may be identified on basis of abnormalities in serum folate and / or
cobalamin concentrations, a positive hydrogen breath test, or by culture of duodenal juice aspirated in the course of other investigations.
Cobalamin supplementation had a positive impact on treatment response, potentially even in cases that had serum
cobalamin concentrations within the reference interval.
Serum feline trypsin - like immunoreactivity concentrations in cats with normal serum
cobalamin concentrations and cats with low serum
cobalamin concentrations.
It is not clear why cobalamin supplementation may have a positive effect on hypocobalaminemic cats with EPI, but these cats may have depleted tissue
cobalamin concentrations before hypocobalaminemia develops.
Serum
cobalamin concentrations in cats with exocrine pancreatic insufficiency.
[1, 11, 16] Cats with hypocobalaminemia were found to have significantly lower serum fTLI concentrations compared to cats with normal serum
cobalamin concentrations.
Many cats with EPI have low serum
cobalamin concentrations, which impairs their response to treatment.
This finding was not unexpected because the pancreas is the main source of intrinsic factor in cats, and in previous reports, almost all cats with EPI in which cobalamin had been measured were reported to have low serum
cobalamin concentrations.
[19, 21] Therefore, it may be helpful to supplement cats with EPI with cobalamin regardless of their serum
cobalamin concentration.
Progressive decreases in serum
cobalamin concentration in dogs with asymptomatic SIBO often precede development of clinical signs.
If pancreatic function is normal (i.e., serum TLI is normal) then finding a decreased serum
cobalamin concentration or increased serum folate is supportive of SIBO.
Not exact matches
In addition to containing 35 % good quality oil and 25 % protein, they also boast high
concentrations of phosphorus - 123 % of the daily requirement - as well as manganese, magnesium, iron, calcium, zinc, selenium, and vitamin B12 (
cobalamin).
Inclusion criteria for the study were cats with clinical signs of chronic enteropathy, an initial serum
concentration of less than or equal to 250 pmol / L (reference 214 - 738 pmol / L)
cobalamin, and oral treatment with
cobalamin tablets.
Historically SIBO was first identified in a group of dogs with chronic diarrhea all showing increased folate and decreased
cobalamin serum
concentrations.
Vitamin Supplementation Serum
concentrations of
cobalamin (vitamin B12) and vitamin E are often subnormal in dogs with EPI and do not necessarily increase in response to treatment with enzymes, even though the clinical response may otherwise be excellent.
Disorders that may affect serum
cobalamin and / or folate
concentrations include small intestinal inflammation, exocrine pancreatic insufficiency (EPI), and small intestinal bacterial overgrowth (SIBO).
Subnormal
concentrations of serum
cobalamin (vitamin B12) in cats with gastrointestinal disease.
Simpson KW, Fyfe J, Cornetta A, Sachs A, Strauss - Ayali D, Lamb SV, Reimers TJ (2001), Subnormal
concentrations of serum
cobalamin (Vitamin B12) in cats with gastrointestinal disease, Journal of Veterinary Internal Medicine 15: 26 - 32
The presence of an abnormal flora can not be predicted accurately by measuring serum
concentrations of
cobalamin and folate, so a trial with an antibiotic such as oxytetracycline (20 mg / kg PO TID 28d), ortylosin (10 mg / kg PO TID) can be undertaken.
Subnormal serum
concentrations of
cobalamin are frequently documented (approximately 75 % of cases) in dogs with EPI and are likely a consequence of intrinsic factor deficiency, disrupted binding of
cobalamin to IF (by intestinal pH, lack of proteases) and bacterial consumption of
cobalamin (Batt et al 1989; Simpson et al 1989a; Simpson et al 1993).