B12 Deficiency?

[Guest chaoran22]

So my greyhound has always had sort of funny liver enzyme levels - nothing of concern but odd. He also occasionally gets mild diarrhea (which usually resolve on their own after 2-3 days, although his poops are never THAT great, unlike my other dog). My vet just mentioned that both of these might be connected to a B12 deficiency. We need to schedule a blood draw. Anyone have any experience with this? I'm opening to hearing all suggestions and anecdotes - just looking for any info. The internet has been surprisingly unhelpful in this (mostly pulling up links on where to purchase B12 , not info on the deficiency in dogs). Thanks!

[tbhounds]

Dogs with ibd may respond well with B12 injections. Before I started the injections on my hound I would want a few baseline values first. I would run a bile acids test and a TLI folate test first. B-12 in itself is water soluable, so basically your pup will urinate any excess but, honestly I would want to know the health of my hounds liver first.

[JohnF]

If the dog is not gluten-intolerant then giving something as simple as 1/2 a teaspoon per day of Cold Pressed Wheatgerm Oil will help. Not only is it rich in Vit E, but it also has the B's which are essentital for healthy new cell growth; and with irritable bowels that new cell growth needs all the help it can get. Oh, and as a bonus there will be a lovely shiny coat soon too.

[Guest Stripeyfan]

If your dog's poops aren't great even when he doesn't have diarrhea, it would be worth trying to find out why that is, as soft poop is not normal. Have you looked into the possibility that he may have IBD or SIBO?

 

 

When Kelly got sick with both of these conditions last year, he was diagnosed with malabsorption in the small intestine after having the folate/cobalamin blood test. Damage to this part of the intestine, which we think he sustained due to parasites, can cause low levels of B12 as this is where it's absorbed - I'm not sure about those symptoms being a result of it, though. FWIW we did not supplement B12 for Kelly, instead he gets an easy-to-digest home-cooked diet plus omega 3 fish oil and a multi-vitamin/mineral supplement and has done just fine on it for almost a year now. Omega 3 fish oil can help with intestinal inflammation and is a recommended supplement for IBD dogs if they can tolerate it.

 

As for the liver values, I have no idea, sorry.

 

Hopefully Greyhead will chime in at some point as she is far more knowledgeable about all this than I am!

[Guest mcsheltie]

Liver, kidney and small intestine disease (such as IBD) can trigger a B Vitamin deficiency.

 

Make sure you get a full Chem panel done. You want pancreatic function checked too.

 

If IBD could possibly be a problem, do not start adding any type of oil. Many can't tolerate it. Find put what the problem is before that.

 

If the dog has a deficiency resulting from disease, oral B Vits will be of no use, as it is an absorption issue. Injectable will be needed.

Edited February 23, 2011 by mcsheltie

[kudzu]

Ditto what mcsheltie & tbhounds said.

 

My first thought, based on vet's mention of B12 & the symptoms you list, was SIBO. It can cause the symptoms you are seeing & some others that resemble IBS/IBD. And some GI probs, like IBS,IBD or EPI can contribute to SIBO. Some of the tests suggested above, like TLI & folate, can help determine if SIBO is possible. Even if it is caused by some other underlying factor you are not likely to get relief without treating the SIBO.

 

Will add that though I understand wanting to know the serum cobalamin levels these may not necessarily determine if there is a deficiency. don't ask me to explain the whole thing because it's an old & largely forgotten topic for me. It has to do with types of cobalamin tests & levels & whether the serum levels are high because the body isn't able to process that type... oh, some such as that which I am no doubt misexplaining. Anyway, my vet's comment was that it could tell us if there was a deficiency or it could tell us there may or may not be a deficiency. Either way it was cheapest just to try B-12 supplementation in the form of sub-q injections & see if it works. She wasn't against the other testing, far from it. Just felt the cobalamin test was not worth the money when a bottle of B-12 was cheaper & in many ways the response to therapy more conclusive than a cobalamin test.

[greyhead]

Spencer gets B12 injections every few weeks at home. We had the cobalamin/folate test, which indicated intestinal malabsorption. What's telling is the relationship between those two B vitamins, as well as the absolute amounts. Or so I understand. And it meant that he had lost the ability to process B12 in the gut, which is why supplementing by mouth wouldn't work.

 

After this we found that he indeed had a serious small bowel infection. After treating that, we did an ultrasound that showed IBD.

 

The bounce he got within a day of his first B12 shot was amazing. Didn't cure his troubles, because low B12 is a symptom more than a disease itself. But still, the dog gets a big lift from it.

 

Your vet should sell you a bottle, and syringes, cheap! And I would want to do more tests (like a fecal culture) to find out what the underlying problem is.

 

ETA: Here's a link on cobalamin and its testing, and I'll find you another one in a minute, I think.

http://www.cvm.tamu....b12folate.shtml and

http://vetmed.tamu.edu/gilab/research/cobalamin-information

Edited February 24, 2011 by greyhead

[greyhead]

I did a GT archive search using "cobalamin" as the term and found this post I made back in 2009. You might find it interesting!

 

 

Posted 20 January 2009 - 05:04 PM

 

OMG! DH just came back from walking the pups. He said Spencer's poop was mostly formed! And mostly brown! it was runny and yellower at the very end. Nonetheless, we haven't seen anything that good from him in six months!

 

Could yesterday's cobalamin injection have accomplished this? Is it possible that the malabsorption IS the problem, and there is nothing else (other than hookworm damage, for instance)?

Of course, we later learned that malabsorption was not the only problem, by a long shot. But B-12 is powerful stuff.

[Guest chaoran22]

Thanks for the info! My vet suspects EPI, and I've managed to find more about it online now (I didn't have the proper name before). His ALT levels have always been SLIGHTLY higher than normal and we just thought it was just the way he was since it was so slight. We've already done basic bloodwork, which came back great (except for the slightly elevated ALT levels) and now we will be testing for EPI. But the reading I've done on EPI lists so many symptoms that he just does not have. He is a very healthy weight and has the most beautiful thick coat of any greyhound I have ever seen (we get compliments on it all the time) so he certainly does not look or act malnourished at all. As for his poops, they're almost always decently formed, just softer than my other dog's poops.

 

We've never considered even looking into any of these illnesses before because he looks fantastic, acts like he feels great (lots of energy still at 7.5 yrs), and has never shown any cause for concern during his annual exams other than corns and a bit of arthritis in one leg. The idea of him having a chronic illness is both shocking to me because it seems so unlikely and also very worrying because if EPI or some other disease IS the cause of his elevated ALT levels, then he's had this for YEARS and it's scary to me that we've never treated it.

[tbhounds]

Usually with EPI they tend to drop weight like crazy and have light colored stool that may look greasy. Have you de-wormed your pup recently or tried a food change? I'm not a huge fan of the Hills diets but, they do have there place when dealing with a sick hound. Hills W/D is a great food for diarrhea or chronic soft stools. It's a food high in fiber-- bulks the stool slowing the gi tract down. I have seen it work over and over. Sometimes all you need to do is add a few taespoons of the can food to your exiting kibble. Just a thought-- it would sure be easy enough to try before getting involved with expensive testing.

[Batmom]

How funky are the liver values? Might want to see here: http://www.animalmedicalcentreofmedina.com/files/vet/21/92f103fa.pdf

 

Most times, soft poop / occasional diarrhea resolve with worming and/or food change. It can be a trial to find just the right food, tho.

[JJNg]

But the reading I've done on EPI lists so many symptoms that he just does not have. He is a very healthy weight and has the most beautiful thick coat of any greyhound I have ever seen .... As for his poops, they're almost always decently formed, just softer than my other dog's poops.

Just wondering, if your boy is doing well and not showing any symptoms of the suspected illnesses, why the current interest in pursuing additional diagnostic testing? Has there been any change or worsening of elevated ALT and soft stools over the years? Any other signs besides those very mild ones? Does he require more food than you'd expect to maintain weight? B12 deficiency is usually a secondary result of other disease processes that interfere with absorption of cobalamin, such as IBD or EPI. These conditions usually also cause other GI signs like persistent diarrhea, weight loss, low blood protein levels, and changes in appetite.

 

A persistently elevated ALT might make me suspicious of liver disease, depending on how high the numbers are. Workup would include bile acid testing, abdominal ultrasound to assess the liver, and possibly liver biopsy. Especially if not more than twice the high end of the reference range, there's a good chance it may just be normal for that particular individual. Reference ranges are just based on statistical averages, and some dogs may be normal with levels outside of the range.

 

With mild intermittent diarrhea and soft stools, I'd be more inclined to try changes in diet and things like fiber and probiotics first before pursuing more aggressively. Not sure how much you've already tried in this area.

 

The idea of him having a chronic illness is both shocking to me because it seems so unlikely and also very worrying because if EPI or some other disease IS the cause of his elevated ALT levels, then he's had this for YEARS and it's scary to me that we've never treated it.

A rule of thumb that is mentioned in both veterinary, as well as human, medicine is to treat the patient, not the labwork. Before spending a client's money on expensive testing, I look at 2 criteria - 1) does it change what we do and 2) does the owner just want to know for peace of mind or for prognostic purposes.

 

For example, if the testing does come back as consistent with EPI, are you going to start your grey on the expensive medication (pancreatic enzymes) used to treat EPI? With most dogs with EPI, we monitor progress based on weight and appetite, since uncontrolled EPI dogs have a ravenous appetite but lose weight. In your pup's case, I'm not sure what parameter you'd be monitoring to see if the medication is helping. Other than maybe his stool consistency, but using expensive pancreatic enzymes to treat such mild signs would seem a bit overboard to me. Same thought process with giving B12 injections if he does come back low on bloodwork - what would you be looking at to monitor response?

 

I imagine you could also monitor ALT levels, but if it's not related to liver disease, the ALT value itself is not a problem. When ALT is mildly elevated due to other factors, like GI disease, it may or may not change with treatment of the underlying disease, and it's not something to be worried about. Anyway, just some thoughts on the issue. Maybe there are details and other concerns you haven't shared with us. But from the info on hand, I'm not sure if I would be pursuing a lot of testing if your grey is doing so well, but that's JMO.

[Mystella]

this is a timely topic for me! The whole gastrointestinal issues thing can be so hard to pinpoint

 

Jeffy (my stripedy sweet 3 year old) has lost weight despite having his food increased to 6 cups a day (good foods)and acting hungry all the time. Vet's first thought was malabsorption and EPI but wanted to do a fecal first. Came back clear, but she wanted to do another one, a 3 day sample, we did that and it came back giardia. Did his flagyl run and then another 3 day fecal, all clear but she also wanted me to try an allergy trial on him, so we are on a LID right now, when it is done (another week) I have to take him back in for a weight check and if he hasn't been gaining then we will test for the EPI.

 

He doesn't have major poop issues though, just hungry and eating a lot (though not loving the LID - Bison), weight loss and a lot of itching and scratching with some skin sores from that. Poop isn't great but certainly isn't the 'yellow plop' description the EPI usually gives.

 

I wanted to test for EPI right away but she said not to rush, when we hear hoofbeats think horses not zebras but that if things haven't approved a month post giardia free then we'll have to look for the zebras.

 

I was taking a good look at him last night and I don't think he has gained weight, DH thinks he has.