Why they did it
Cobalamin deficiency has been reported at a prevalence
of 6-73% in dogs with chronic enteropathies
(CE). Other documented causes of cobalamin deficiency
in dogs include exocrine pancreatic insufficiency
(EPI), familial cobalamin deficiency of Chinese
Shar Peis, Giant Schnauzers, Border Collies and Beagles
and short bowel syndrome. Hypocobalaminemia
in humans results from many causes such as pernicious
anemia, gastrointestinal disease and cobalamin
deficient diets (vegetarian and vegan).
Historically cobalamin deficiencies in humans and animals
have been treated via parenteral (intramuscular
or subcutaneous) supplementation at monthly intervals.
Several studies in humans have shown that daily
oral cobalamin supplementation is successful in alleviating
the hypocobalaminaemia and avoids side effects
such as painful injection sites and scleroderma.
No studies on oral supplementation of cobalamin are
available in the canine literature. One of the authors of
this paper extrapolated treatment regimens from the
human literature and started using oral cobalamin in
canine patients. This paper represents a retrospective
analysis of the usefulness of oral cobalamin supplementation
in these dogs.
What they did
They examined the records of dogs suffering from
hypocobalaminemia and treated with oral cobalamin
supplementation in the form of tablets.
Dogs with cobalamin concentrations below 270 ng/L
at presentation and subsequent oral cobalamin supplementation
were included in the study. Follow up
measurements of cobalamin were done within 20-
202 days after initiation of therapy.
Dogs included in this study were treated using a 1mg
tablet containing cyanocobalamin. Dogs weighing less
than 10 kg were given
¼ tablet daily; dogs
between 10 and 20
kg were given ½ tablet daily
and dogs weighing more than 20 kg were given 1 tablet daily.
What they found
Fifty-one dogs with CE and hypocobalaminaemia
were included in the analysis. Twenty-two of the
dogs were on immunosuppressive therapy together
with various gastrointestinal medications such as gastric
protectants and antibiotics.
The remaining 29 dogs received supportive gastrointestinal
medication without immunosuppressive
therapy. The difference between serum cobalamin
concentration before and after oral treatment with
cobalamin was statistically significant. Three dogs
did not respond adequately initially, but in two cases
serum cobalamin did increase significantly after prolonged
oral cobalamin supplementation. The third
dog was lost to follow up.
Take home message:
Although prospective studies are required to confirm
these retrospective findings, results suggest that oral
cobalamin supplementation in dogs with hypocobalaminemia
appears to be effective in restoring serum
cobalamin levels in dogs with CE. In some cases the
rise in serum cobalamin may be delayed and follow
up measurements are required to monitor the response.
Why they did it