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==Consequences of Cobalamin Deficiency==

==Consequences of Cobalamin Deficiency==

====Dogs:====  

====Dogs:====  

Puppies affected by an inherited defect in cobalamin absorption develop inappetance and lethargy; hyperammonaemia and associate neurological signs<ref>Battersby IA, et al. Hyperammonaemic encephalopathy secondary to selective cobalamin deficiency in a juvenile Border collie. JSAP 2005;46:339-344.</ref>; [[neutropenia]] with hypersegmentation and megablastic anaemia<ref>Fyfe JC, et al. Inherited selective intestinal cobalamin malabsorption and cobalamin deficiency on the dog. Pediatr Res 1991;29:24-31.</ref>. Adult dogs with chronic intestinal disease can develop impaired cobalamin absorption either due to the primary intestinal disease or [[Nutrition Glossary#Bacterial Dysbiosis|bacterial dysbiosis]]<ref>Berghoff N, et al. Serum cobalamin and methylmalonic acid concentrations in dogs with chronic gastrointestinal disease. AJVR 2013;74:84-89.</ref>. Clinical signs of hypocobalaminaemia in adult dogs are similar to that of the underlying intestinal disorder (e.g., [[diarrhoea]] and weight loss); the presence of hypocobalaminaemia in dogs with chronic enteropathies is a negative prognostic indicator<ref>Allenspach K, et al. Chronic enteropathies in dogs: evaluation of risk factors for negative outcome. JVIM 2007;21:700-708.</ref>.

Puppies affected by an inherited defect in cobalamin absorption develop inappetance and lethargy; hyperammonaemia and associate neurological signs<ref>Battersby IA, et al. Hyperammonaemic encephalopathy secondary to selective cobalamin deficiency in a juvenile Border collie. JSAP 2005;46:339-344.</ref>; [[neutropenia]] with hypersegmentation and [[Nutrition Glossary#Megaloblastic Anaemia|megaloblastic anaemia]]<ref>Fyfe JC, et al. Inherited selective intestinal cobalamin malabsorption and cobalamin deficiency on the dog. Pediatr Res 1991;29:24-31.</ref>. Adult dogs with chronic intestinal disease can develop impaired cobalamin absorption either due to the primary intestinal disease or [[Nutrition Glossary#Bacterial Dysbiosis|bacterial dysbiosis]]<ref>Berghoff N, et al. Serum cobalamin and methylmalonic acid concentrations in dogs with chronic gastrointestinal disease. AJVR 2013;74:84-89.</ref>. Clinical signs of hypocobalaminaemia in adult dogs are similar to that of the underlying intestinal disorder (e.g. [[diarrhoea]] and weight loss); the presence of hypocobalaminaemia in dogs with chronic enteropathies is a negative prognostic indicator<ref>Allenspach K, et al. Chronic enteropathies in dogs: evaluation of risk factors for negative outcome. JVIM 2007;21:700-708.</ref>.

 

====Cats:====  

====Cats:====  

Kittens weaned onto a cobalamin deficient diet will initially grow normally, then will cease growing and begin lose weight after 3-4 weeks<ref>Morris, J.G. Idiosyncratic nutrient requirements of cats appear to be diet-induced evolutionary adaptations. Nutr Res Rev 2002;15; 153-168.</ref>. Similar to dogs, adult cats with chronic intestinal disease can develop cobalamin deficiency resulting in worsening [[vomiting]], diarrhoea, and weight loss<ref>Vaden SL, et al. Cobalamin deficiency associated with methymalonic aciduria in a cat. JAVMA 1992;200:1101-1103.</ref><ref>Simpson KW, et al. Subnormal concentrations of serum cobalamin (vitamin B₁₂) in cats with gastrointestinal disease. JVIM 2001;15:26-32.</ref><ref>Ruaux CG, et al. Early biochemical and clinical responses to cobalamin supplementation in cats with signs of gastrointestinal disease and severe hypocobalaminemia. JVIM 2005;19:155-160.</ref>.

Kittens weaned onto a cobalamin deficient diet will initially grow normally, then will cease growing and begin lose weight after 3-4 weeks<ref>Morris, J.G. Idiosyncratic nutrient requirements of cats appear to be diet-induced evolutionary adaptations. Nutr Res Rev 2002;15; 153-168.</ref>. Similar to dogs, adult cats with chronic intestinal disease can develop cobalamin deficiency resulting in worsening [[vomiting]], diarrhoea, and weight loss<ref>Vaden SL, et al. Cobalamin deficiency associated with methymalonic aciduria in a cat. JAVMA 1992;200:1101-1103.</ref><ref>Simpson KW, et al. Subnormal concentrations of serum cobalamin (vitamin B₁₂) in cats with gastrointestinal disease. JVIM 2001;15:26-32.</ref><ref>Ruaux CG, et al. Early biochemical and clinical responses to cobalamin supplementation in cats with signs of gastrointestinal disease and severe hypocobalaminemia. JVIM 2005;19:155-160.</ref>.

==Diagnosing Cobalamin Deficiency==

==Diagnosing Cobalamin Deficiency==

Diagnosis of cobalamin deficiency is based on presence of low fasted serum cobalamin level. If the patient is not fasted prior to testing, falsely increased cobalamin concentrations may be noted. [[Nutrition Glossary#Megaloblastic Anaemia|Megaloblastic anaemia]] and [[neutropenia]] with hypersegmentation may be seen on haematology profile.   

Diagnosis of cobalamin deficiency is based on presence of low fasted serum cobalamin level. If the patient is not fasted prior to testing, falsely increased cobalamin concentrations may be noted. [[Nutrition Glossary#Megaloblastic Anaemia|Megaloblastic anaemia]] and [[neutropenia]] with hypersegmentation may be seen on haematology profile.  Diagnosis is also made on clinical signs consistent with deficiency and evaluation of diet.  

Diagnosis is also made on clinical signs consistent with deficiency and evaluation of diet.  

==References==

==References==

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[[Category:Vitamins]]

[[Category:Vitamins]]