B12 Dosage

Epi4Dogs Foundation Inc.’s mission is the advancement of science and education relating to EPI (Exocrine Pancreatic Insufficiency), yielding useful insights and positive outcomes in better managing EPI in dogs and cats. Our goals are to support and/or collaborate with veterinary EPI research and researchers, and to promote EPI awareness by educating the general public, pet owners, pet organizations, rescue and shelter organizations, veterinary schools and veterinarians.
afairbairn
Member
Posts: 29
Country: United States
State: Colorado
Pet name: Hana
My name: Andy

B12 Dosage

Post by afairbairn » 10 Dec 2021, 21:23

I haven't posted a question for a while, but the good news is Hana has doing pretty darn good since her diagnosis last March. She is up to about 47 lbs from a low of 32 which is pretty spectacular. We've just finished a house remodel and move so we haven't had much time to try anything different but now that life is getting back to normal I'm curious about b12 dosing opinions. We have been getting shots every 3 weeks and several months ago started adding a daily single table of Pet Factor B12. I'm suspicious that we still aren't in the ideal range for B12 but haven't had a test done lately. The test results on 4/20 were a B12 of 200 and Folate >24 and on 8/7 a B12 of 347 and Folate >24. We started adding the B12 pills right after the 8/7 test.

Stools are a little hit and miss. Sometimes pretty good and sometimes not so much. I'm sure I probably should get another test to see where the B12 level is, but I'm also wondering if it might make sense to add a second daily B12 pill. The instructions have a cut off at 50 lbs and it seems like we are so close to that. Can anyone think of anything bad that would happen if we add a 2nd pill? I thought I remember reading somewhere that more is better than not enough.

Thanks for any input.
Hana is a 1 year old golden doodle who was recently diagnosed with EPI on top of Myasthenia Gravis and Megaesophogus.

User avatar
Olesia711
Founder
Posts: 2435
Location: North Carolina
Country: United States
State: North Carolina
Pet name: Izzy
My name: olesia

Re: B12 Dosage

Post by Olesia711 » 11 Dec 2021, 10:50

Hi Andy... great news to hear that Hanna has gained that weight, especially with Mega E.... has that been a problem with feeding her? That can be such a difficult condition to manage and with some dogs, not too much of a problem... i hope Hanna is one of the later ones!

Okay... based on the B12 tests.. it sure looks like Hanna might very well be one of those dogs that didn't respond as well as expected to the B12 cyanocoblamin shots.... so that is a VERY good thing you started the Wonderlabs since they are the Methylcobalamin version of B12 and what we have observed is that when the Cyanocobalamin fails, the Methylcobalamin usually works much better.

I really don't know if Hanna "needs "more B12, as you mentioned, you really need to have her B12 re-tested.... But... i am curious, what is the reason why you want to give her more??? is she showing lethargic signs? or is it just the sometimes crappy stools? I am just being curious here.

To answer your question though, since Hanna in a the range level... if you still have concerns about her B12 levels....what you might want to do is go ahead and give her 2 pills 3 days a week and 1 pill the remainder of the week and see if that makes a difference in her personality, stamina, poos, etc.

The only thing that i caution folks about using TOO much B12 is if the dog has a kidney issue going on.... then i caution not to over-do not because there are canine studies backing up what i am saying but only because there are human studies that you don't want to way over-do with B12 if there is an existing kidney issue.... so i tend to err on the side of caution... and like to mention this. It is nothing life threatening. But other than this, B12 is water soluble and too much B12 is supposedly peed out, so it shouldn't be a problem.
Olesia, was owned by Izzy, a 35lb Spanish Water Dog (SWD), Diagnosed at 1.5 years old - TLI results 1.. Izzy passed away on February 13, 2020 at 15 years old. She lived with EPI for 13+1/2 years. It was because of Izzy that Epi4Dogs was started... she was the inspiration. May her legacy of helping others with EPI continue for as long as needed.........

User avatar
Olesia711
Founder
Posts: 2435
Location: North Carolina
Country: United States
State: North Carolina
Pet name: Izzy
My name: olesia

Re: B12 Dosage

Post by Olesia711 » 11 Dec 2021, 10:53

just a thought here..... the iffy stools could be that the food is not optimal. I know that you have to give preference to the Mega E.... when it comes to diet.... but if you want.... maybe try adding a little slippery elm powder to the meals for a few days and see if that improves the stools to where they are more consistent. If yes, then most likely the food is not optimal for the EPI condition..... here is the link to the Slippery Elm page... it gives information about SLippery elm and dosing suggestions: https://epi4dogs.com/slippery-elm/
Olesia, was owned by Izzy, a 35lb Spanish Water Dog (SWD), Diagnosed at 1.5 years old - TLI results 1.. Izzy passed away on February 13, 2020 at 15 years old. She lived with EPI for 13+1/2 years. It was because of Izzy that Epi4Dogs was started... she was the inspiration. May her legacy of helping others with EPI continue for as long as needed.........

Barb
Staff
Posts: 766
Country: United States
State: New Jersey

Re: B12 Dosage

Post by Barb » 11 Dec 2021, 11:47

I will just add my personal experience with the Pet Factor B12, but we know that each dog is unique. I had given Kolby the injections here at home for a couple of years and began to transiition to maintenance with Pet Factor, one pill a day. Someone here (I believe it was Madelon, but you can correct me) mentioned that she had great success when she began giving her dog, Doc, 2 pills a day. Keep in mind that Doc and Kolby are larger dogs. I decided to try the 2 pills and Kolby's appetite improved and he began to gain weight and eventually got back to his target weight of 85 pounds. I was amazed that the extra pill seemed to be having such a positive effect. So I would agree with Olesia that it is worth a try to give your pup the extra pill on a modified basis and see what happens. Let us know.

Barb

User avatar
Olesia711
Founder
Posts: 2435
Location: North Carolina
Country: United States
State: North Carolina
Pet name: Izzy
My name: olesia

Re: B12 Dosage

Post by Olesia711 » 11 Dec 2021, 11:48

thanks Barb for sharing Kolby's experience with Pet Factor B12...... very helpful!!!!
Olesia, was owned by Izzy, a 35lb Spanish Water Dog (SWD), Diagnosed at 1.5 years old - TLI results 1.. Izzy passed away on February 13, 2020 at 15 years old. She lived with EPI for 13+1/2 years. It was because of Izzy that Epi4Dogs was started... she was the inspiration. May her legacy of helping others with EPI continue for as long as needed.........

afairbairn
Member
Posts: 29
Country: United States
State: Colorado
Pet name: Hana
My name: Andy

Re: B12 Dosage

Post by afairbairn » 11 Dec 2021, 13:21

Thanks for all the tips and insight! I think it probably makes sense to go ahead and try another B12 test first and see where things are and then maybe adjust the B12 plan from there. If there may be some kidney risk, things aren't so terrible now that I can't wait until another test.

To answer your question Olesia, at this stage my only reasoning for messing with the B12 dose is the inconsistent stools and just wondering if maybe the B12 might be part of that? Based on an earlier recommendation from you, we have been using the slippery elm for a while now giving 1/4 teaspoon in the morning and then again in the evening. It has seemed to help, but just for fun I tried stopping yesterday to see what happens. Its a little too early to know, but the first indication is the consistency seems the same but the color seems more brown. I'm suspicious that we end up getting back on the SE but just wondering what happens without it.

I think the food is still a big wildcard that we're not quite ready to mess with. We have been using wet hydrolyzed protein shaped up in meatballs to deal with the Mega E. Fortunately we haven't been needing a Bailey chair and feed her with her front paws up 2 steps on the stairs and then hold her upright for 5 minutes after a meal. She has been drinking water from an elevated dish with no upright time after which is much easier. We are going back to the mega E specialist next week to have that looked at again. The last x rays from the summer indicated that the esophagus was closer to normal size. It sounds like a swallow study would be the next step to possibly convincing ourselves that the Mega E has resolved, but in her weakened state the vet didn't want to do that test a while ago. Maybe now that she is stronger we may be able to do that test? If so, I'm cautiously optimistic that the Mega E may be resolved since we haven't seen any regurgitation at all for a while now. If we end up being so lucky, that would really open up options to switching to a kibble and finding a better food option.
Hana is a 1 year old golden doodle who was recently diagnosed with EPI on top of Myasthenia Gravis and Megaesophogus.

User avatar
Olesia711
Founder
Posts: 2435
Location: North Carolina
Country: United States
State: North Carolina
Pet name: Izzy
My name: olesia

Re: B12 Dosage

Post by Olesia711 » 11 Dec 2021, 14:42

ahhh... so the poo appears more brown off the Slippery ELm? hmmmmmmmm.... give it a few more days and let us know what transpires. The wee bit more yellow in the poo while on slippery elm could either indicate SID getting or being a little out of control... OR the stools could be lighter because of the food protein (fowl and some fish, even hydrolyzed would produce lighter stools vs. beef, venison, lamb and oily fish hydrolyzed will product darker stools).

SO maybe less slippery elm is needed.............
or no slippery elm
or it has nothing to do with the slippery elm, but rather the type of protein in the food
or (big picture) you are starting to see SID get a little out of control.

quite honestly if you can keep her on wet food or wholesome food and not resort to kibble, i suspect that would be better than trying to get her on kibble..........or maybe just do a combo, if she ever gets to that point.

Like i said... give the no-slippery elm a few more days and lets see what happens...........................
Olesia, was owned by Izzy, a 35lb Spanish Water Dog (SWD), Diagnosed at 1.5 years old - TLI results 1.. Izzy passed away on February 13, 2020 at 15 years old. She lived with EPI for 13+1/2 years. It was because of Izzy that Epi4Dogs was started... she was the inspiration. May her legacy of helping others with EPI continue for as long as needed.........

afairbairn
Member
Posts: 29
Country: United States
State: Colorado
Pet name: Hana
My name: Andy

Re: B12 Dosage

Post by afairbairn » 05 Jan 2022, 22:49

I haven't updated this post for a bit, so here's what I know today. Hopefully some smart folks can help me sort it out?

We had the results from the bloodwork done the other week and they are:
- Cobalamine: >1000 ng/L
- Folate: >24 ug/L

So that seems like really good news on a high number for the B12! Based on that the vet recommended stopping the shots and we are now just doing daily Wonderlabs b12 pills. Since we are right on the edge weight wise the vet said there shouldn't be an issue going with two capsules per day so we do one in the morning and one in the evening.

Another thing that came out of the visit was the recommendation to stop Omeprazole which we had been using to help mitigate any issues from potential regurgitation due to MegaE. But with the MegaE under control it seems like there can be some b12 issues caused by long term Omeprazole so it makes sense to stop that and I guess we see where that goes.

So here's where things get a little interesting. The quality of poo is much improved, which we like! But the number of times she is pooping seems to have drastically increased. I'm guessing she is going 6-8 times per day. We stopped keeping a chart a while ago so I think we need to reinstate that process. It's kind of reminding me of when we first starting seeing the signs of EPI but weren't diagnosed yet where we were in a terrible of cycle of losing weight, which led to feeding more, which just led to pooping more. Anybody have any thoughts on what might be causing an apparent increase in number of poo trips?

I'm also going to start weighing her every few days to get a feel for what's going on with her weight.
Hana is a 1 year old golden doodle who was recently diagnosed with EPI on top of Myasthenia Gravis and Megaesophogus.

User avatar
Olesia711
Founder
Posts: 2435
Location: North Carolina
Country: United States
State: North Carolina
Pet name: Izzy
My name: olesia

Re: B12 Dosage

Post by Olesia711 » 05 Jan 2022, 23:54

Great new on the re-checked B12 levels. WAHOO!!!!
And glad the vet is now stopping the shots and suggesting 2 pills a day....

Your vet is correct about the omeprazole long term... some dogs need it and simply can't stop it, but long term it does eat away at the B12 levels.. so if not needed, or at least that's what it looks like...by all means stop. You can always start it up again If you need to .

A little tidbit. Some dogs, when on the acid reflux meds... all goes well for a long while and then it appears that the reflux med stop working... so they actually ahve to stop the reflux meds for a month and then go back on it at a later date... just giving you this piece of information in case you need it in the future.

When you say that the poo quality is improved.... is it really good normal poo, like tootsie roll logs??? but then eliminating 6-8 times a day.... OR.. is the poo large volume , or soft piles and/or light colored??? If the later (large volume, soft piles or light colored).... then this sounds like SID out of control and if everything else is correct like getting enough of the right kind of enzymes, and you now know the B2 level is great..... then a lot of times the SID is triggered out of control by food that is okay but not the best or optimal for your dog. SOmetimes it is just 1 ingredient in the food that just doesn't agree with the dog that is triggering this and other times it is not so much a particular ingredient but rather too much of an ingredient or ingredients. I see the later as a cause more often than not.

The way to figure this out is rather tedious, but works. Go back to keeping a log and record EVERY ingredient in a diet and what ingredients are "more" (higher on the list) then try changing the food and recording the ingredients and comparing and see if you see an improvement or not... What you do is keep comparing the ingredients from one food to the next and a pattern will start to emerge of what foods appear to work and what doesn't. Like i said... this is real tedious, but it works.
Olesia, was owned by Izzy, a 35lb Spanish Water Dog (SWD), Diagnosed at 1.5 years old - TLI results 1.. Izzy passed away on February 13, 2020 at 15 years old. She lived with EPI for 13+1/2 years. It was because of Izzy that Epi4Dogs was started... she was the inspiration. May her legacy of helping others with EPI continue for as long as needed.........

afairbairn
Member
Posts: 29
Country: United States
State: Colorado
Pet name: Hana
My name: Andy

Re: B12 Dosage

Post by afairbairn » 06 Jan 2022, 21:56

Thanks for the tips Olessia!

We've had a bunch of snow in Colorado so I haven't been brave enough to dig around to get a good look at. But I think its more of good consistency but larger volume. They seem to pretty big pieces but the color seems okay. We haven't changed anything with the food since all this craziness happened in March. She is currently on prescription HA Hydrolyzed Protein which.

I should add that we were only using the omeprazole as a recommendation to mitigate the effects of regurgitation when the MegaE was the major concern. Now that the MegaE seems to be going the right direction it doesn't seem like its needed. I'm hopefully there is never a need to go back on it.

What I was starting to think about today is that we made the same mistake again that we have in the past by changing more than one thing at a time. We really just need to one thing at a time. Someday I'll learn. I wish we wouldn't have skipped a b12 shot and just stopped the Omeprazole first to see what happened. But oh well, here we are. My guess is that with the b12 levels we had it seems like that shouldn't be an issue?

So now what I'm wondering is if maybe removing the Omeprazole has changed the chemical balance of the stomach and its making me question if maybe our enzyme amount needs adjusting? We experimented around in the past with different enzyme amounts and it seemed like the 3/4 tsp per cup was the best amount, but that was always with omeprazole in the mix. Do you have any thoughts about how the omeprazole and the enzymes interact and if we should start playing around with a different amount of enzymes? We're using enzyme Diane 6x.

We also did get this statement from the vet with the results " Her folate is also high, which usually indicates dysbiosis. This may be exacerbated by chronic omeprazole use, so I think we should discontinue it. Also, consider Visbiome as a probiotic (she may have been on it before)." So I don't know, maybe we try some probiotic? This sure would be easier if there weren't so many pieces to the puzzle.....
Hana is a 1 year old golden doodle who was recently diagnosed with EPI on top of Myasthenia Gravis and Megaesophogus.

Post Reply

Who is online

Users browsing this forum: No registered users and 24 guests