B12 Deficiency And Weight Loss

[Guest galwaygirl]

My 9 year old greyhound has had gradual weight loss over the past 10 months. She has been tested for heart problems, EPI and full blood tests. The only thing that has shown up positive is a B12 deficiency.

 

Her poos are fine, appetite is grand. Only symptoms are weight loss and fatigue. She has had extensive xrays which were all fine.

 

May do an ultrasound next.

 

Has anyone had experience with SIBO (small intestinal bacterial overgrowth) and B12 deficiency??

 

Any advice appreciated!!

[Burpdog]

Have you done a TBD panel?

 

Did you start B12 shots & are you giving her acidolphillus?

[Guest galwaygirl]

Yes she is on a probiotic and will start B12 injections next week as soon as vet gets it in. Sorry don't know what TBD panel is?

[Guest galwaygirl]

Does TBD stand for tick-borne disease? If so, she has had only one tick and that was after about 6 months of gradual weight loss. So doubt that it is a factor.

 

She also has loud bowel sounds after she eats. Will do an abdominal ultrasound next Tuesday. Thank you for your advice!

[heartdogs]

Have your vet do a free consult call to Tx A&M gastrology dept for good information on SIBO.. The B12 must have intrinsic factor added to help the dog. You can order the pills from Wonderlabs. If it is SIBO Tylan is needed for 30 days to help clear the gut. You can't send PMs yet but if you want more info e-mail me forevergreys@yahoo.com.

[kudzu]

The B12 must have intrinsic factor added to help the dog.

Not necessarily. OP said dog is getting B12 injections which would bypass that need. Intrinsic factor is only used in GI system as far as I know so. Also, my understanding is that SIBO itself can lead to B12 deficiency. So if OP's dog has SIBO I don't think adding intrinsic factor would significantly improve B12 absorption in this condition. Then again, I'm not in medicine so I may be wrong. To be honest though, if I thought my dog was having difficulties absorbing enough B12 I wouldn't bother adding intrinsic factor & would go straight to injectible, at least for a good while.

 

One of my dog's had SIBO. He was on Tylan & B12 injections for a good while. Because the root of his problem seemed to be GI dysmotility he was prone to relapse of SIBO. We treated with Tylan intermittently but left him on B12 injections for life.

[greyhead]

Spencer developed SIBO and B-12 deficiency at 8. Tylan came into play after he also developed IBD but would not have helped his SIBO. His poop had to have a culture & sensitivity run on it to find out the infectious agent, which turned out to be two strains of Clostridium perfringens. It required three antibiotics to treat it, sequentially, but it was a very severe infection by the time it was diagnosed. The B-12 injections are for life in our case, but they're cheap and easy to give. Don't let anyone tell you that you have to send the poop to Texas A&M for analysis. There's an expected range for most naturally-occurring bacteria, and a decent lab can count the germs to determine the extent of the bacterial overgrowth. I believe the long-untreated SIBO is what led to the IBD, so my advice would be not to dawdle. (On the other hand, your dog's poops are fine; so if there is SIBO, I shouldn't think it's too advanced.) It's good you're getting the ultrasound.

[Guest galwaygirl]

Thank you so much for your advice! To be honest this is the first case the vet has had here of a dog with B12 deficiency.

 

Her symptoms are severe weight loss and loud bowel sounds after eating. Her poos are fine though.

 

Can it be SIBO if her poos are fine?

 

Really grasping at straws. We are in Ireland & they want to do a laparotomy. She has dropped 3kg; I would prefer not to put her through surgery!

 

Actually the vet thinks it's a one time B12 injection that last 3 months. But I have been reading that an injection every week for 6 weeks and then every other week for a month is recommended.

 

Would you agree this is the best way to give B12?

[Burpdog]

B12 injections are usually done as you said. Since you are in Ireland, I doubt you have a tick borne disease problem.

[kudzu]

My dog had near perfect poos but loud gut/bowel sounds. He also had bloating. It was a search for a resolution to that problem that led to his SIBO diagnosis. Treating the SIBO did indeed calm the loud sounds & bloating.

 

Actually the vet thinks it's a one time B12 injection that last 3 months. But I have been reading that an injection every week for 6 weeks and then every other week for a month is recommended.

 

Never heard of a one time B12 injection for this problem. My guy got a shot every week. I did it at home, given subq not intramuscular. He didn't even flinch. It made a world of difference for him.

[greyhead]

After his SIBO, our dog developed IBD. Given his age and weight loss, we diagnosed it by ultrasound instead of a biopsy. The loud bowel sounds developed for him with the IBD, I believe, rather than the SIBO. But others may have different experience.

 

As you may know, a B-12 deficiency probably indicates intestinal malabsorption. Both SIBO and IBD can cause that, I believe, but it surely doesn't develop on its own or for no reason. An ultrasound will show the area(s) of inflammation and/or structural changes that have occurred in the intestine. When you figure out what's going on in that regard, you'll know how to proceed -- or you can come back here and ask us! Take heart, SIBO can be cured and IBD can be managed. But you don't want more weight loss in a 12-year-old, so I'd advise you to do whatever you're going to do soon.

[JJNg]

Why are they wanting to do a laparotomy? I'd definitely try treating for B12 deficiency and SIBO first. And I'd also pursue ultrasound and endoscopy before considering surgery.

[Guest LindsaySF]

Did they culture the stool? How did they diagnose the SIBO?

[Guest galwaygirl]

Thank you all for your support!!! She has only been diagnosed with B12 deficiency so far.

 

Tests done so far are: full bloods, extensive xrays, ECG & echo, TLI (19 - normal) / B12 (163) & folate (8.6 - normal), fecal culture (negative). She has also been on special diet to rule out IBD. I guess the negative fecal culture ruled out SIBO. Sorry grasping at straws.

 

Her only symptoms are fatigue, weight loss (over about 10 months) and loud bowel sounds after eating. She lost 3kg; a lot for a skinny girl.Otherwise she is very content in herself. She's a lovely lovely girl.

 

When the vet told me she had a B12 deficiency, I asked if she could have an injection. She wasn't aware there was a B12 injection. So that's when I decided to sign on this forum. I really appreciate your advice. Thank you!

 

She will have an ultrasound Tuesday.

[Guest galwaygirl]

They don't have endoscopy here. No, I really don't want them to do a laparotomy on my skinny 9yr old girl.

[Guest LindsaySF]

Have you tried treating for parasites or bacterial infections? Even if fecal tests were negative, I would treat in case something came up falsely negative before I would pursue more expensive diagnostics or surgery.

[Guest galwaygirl]

She has had diarrhea only once for two weeks in the 10 months of gradual weight loss. She was on flagyl for 2 weeks then. And she is wormed regularly.

 

I asked the vet if it was worth redoing the fecal culture & she said 'if there was anything there it would have showed up'.

 

Which treatments would you recommend for parasites & bacteria? Thank you!!!

[greyhead]

I'm sure Lindsay will pop back in with useful info. Meanwhile, let me ask, what kind of regular wormer do you use? Is it something from the vet, and does it address tapeworms? Do you see her stools soon after she deposits them? That's the easiest way to diagnose tapeworms, in my experience, as then they are bright white segments; in less than an hour, they dry up into dull beige segments that look like grains of rice and are harder to see. And one negative fecal test does not mean the dog has no worms. It took three fecal exams to find the hookworms our first greyhound came with.

 

A fecal "culture" is a different thing from a fecal exam for worms. And a culture & sensitivity procedure on poop is like what they do with urine: the culture sees what specific germ(s) grow(s) in the petri dishes, and the sensitivity then finds which antibiotic(s) will kill them. It's important for you to know which tests are done, a "fecal" or a "culture and sensitivity." The term "fecal test" is ambiguous in that regard.

 

I know there have been explanations in other threads about which meds are used to treat which worms -- the generic chemical names, because the brands may be different where you are. I'll see if I can find a link and post it here for you. If so, I'll post it as an edit to this post.

 

ETA: Here it is, entitled Worms, Worms, Worms: http://forum.greytalk.com/index.php/topic/282746-worms-worms-worms/page__hl__+worm%20+treatment?do=findComment&comment=5158324 Post #17 there is by JJNg, a vet, and lists which chemicals work for which worms.

Edited August 27, 2012 by greyhead

[Guest LindsaySF]

Several parasites can be missed on fecal exams (whipworms, hookworms, giardia) but they are actually there. It's also possible that if they are treated, the treatment is not used for long enough duration to really knock them out. What dewormer are you using? I would do at least 2 rounds of Panacur approx 3 weeks apart. I really like Panacur because it kills almost everything, including Giardia. The only thing it doesn't get is the flea tapeworm, but you would see those segments in the stool.

 

Chronic parasite infestation has been shown to affect intestinal absorption of nutrients. The dog does not need to have diarrhea. I'm not saying your dog definitely has parasites, she might not at all, but treating just in case is what I would do. If the treatment has no effect, at least you tried.

 

Usually a bacterial infection would show up in a fecal culture, but false negatives happen from time to time. I would try a broad-spectrum antibiotic before I would pursue surgery or expensive diagnostics. In the meantime the B12 injections will surely help.

[Guest galwaygirl]

Apologies for delay. A 2cm mass was found by ultrasound. The mass and 4 inches of the small intestine were removed. Surgery was successful. She is recovering well.

 

The mass was found to be cancerous although the type of cancer was not diagnosed. Cancer was found in the lymph tubules near the tumour but not present in the lymph node.We do not have chemotherapy in Ireland for dogs.

 

I am quite disheartened by this news. But I am determined to keep her comfortable and content for as long as possible.

 

Thank you for all your knowledge and support.

[Batmom]

Oh my word. Sending prayers for a long time of comfort and happiness with you.

[galgrey]

I'm so sorry to hear this news. I hope the two of you have a lot of quality time together.

[greyhead]

Oh dear, I'm so sorry to hear it was so major but happy to hear she's doing well. I two hope you have lots of good time together. Sending lots of gentle hugs and prayers.

[JJNg]

The mass was found to be cancerous although the type of cancer was not diagnosed. Cancer was found in the lymph tubules near the tumour but not present in the lymph node.

 

Glad to hear she is recovering well from surgery. Are they doing any additional testing, such as special stains, to diagnose the type of cancer? Hopefully it is a form of cancer that is not likely to spread, and if they got it all with good margins, she may do fine for a long time.

 

My mixed breed Corey had a cancerous tumor removed from his cecum (appendix) over 4 years ago. The cancer recurred 2 years later, and he had another surgery to remove several masses along with a couple sections of small intestine. After the 2nd surgery, we started him on a cancer medication called Palladia, and he's still doing great now at about 11 years old. We follow up periodically with bloodwork, chest x-rays, and abdominal ultrasound. Hopefully your girl will do just as well!

[Guest galwaygirl]

Thank you for the lovely thoughts everyone,

 

And thank you Jennifer! I feel a little more hopeful now. Yes the mass was well-contained but not sure what it means that the cancer was in the lymph tubules but not the node.

 

She will have stitches removed Wednesday. She's eating really well & went for a 30 minute walk today.

 

She seems very content. Stools still only liquid but I think that takes time? I presume she will have a routine ultrasound. My heart's still in my throat though.

 

She's the best pet, a real dote!