Sept 2022: New B12 protocol
Posted: 28 Sep 2022, 20:12
Hi everyone,
Just want to share with everyone that the B12 protocol by TAMU has been updated:
September 2022 COBALAMIN DOSING update and revision (TAMU recommendations):
https://vetmed.tamu.edu/gilab/research/ ... formation/
Cobalamin should be supplemented whenever serum cobalamin concentration is in the low normal range (i.e., less than approximately 400 ng/L) in both dogs and cats. Most commonly, cyanocobalamin is chosen for supplementation, as it is both widely available and inexpensive. Very little evidence-based information about the route and dose of cobalamin supplementation in dogs and cats is available. Recent studies in humans, dogs, and cats suggest that oral supplementation is as equally effective as parenteral supplementation.
We currently recommend either oral or parenteral cobalamin supplementation and the recommended protocol and dose for each route is as below.
ORAL
Protocol: daily administration for a total of 12 weeks and re-check serum cobalamin concentration one week after finishing supplementation.
Dose: 250 µg in cats and 250 – 2000 µg in dogs, depending on the size of the patient:
Dogs weight (lb)
Below 22 lbs (give 250 µg)
22 to 100 lbs (give 1000 µg)
Above 100 lbs (give 2000 µg)
INJECTABLE
Protocol: weekly injections for 6 weeks, then one dose a month later, and retesting one month after the last dose.
For either oral or parenteral supplementation, if the underlying disease process has resolved and cobalamin body stores have been replenished, serum cobalamin concentration should be supranormal at the time of reevaluation. However, if serum cobalamin concentration is within the normal range, treatment should be continued at least monthly (for parenteral supplementation) and the owner should be forewarned that clinical signs may recur sometime in the future. Finally, if the serum cobalamin concentration at the time of reevaluation is subnormal, further work-up is required to definitively diagnose the underlying disease process and cobalamin supplementation should be continued weekly or bi-weekly (for parenteral supplementation) or daily (for oral supplementation).
Dose: SC injection of 250 µg per injection in cats and, 250-1500 µg per injection in dogs, depending on the size of the patient:
Canine B-12 Table for injectable (See pic below)
Cobalamin
It should be pointed out that in rare cases cobalamin supplementation fails to increase serum cobalamin concentration for reasons that are not currently understood. In these patients, another formulation of cobalamin, such as hydroxocobalamin (only available as an injectable formulation), might be effective.
Just want to share with everyone that the B12 protocol by TAMU has been updated:
September 2022 COBALAMIN DOSING update and revision (TAMU recommendations):
https://vetmed.tamu.edu/gilab/research/ ... formation/
Cobalamin should be supplemented whenever serum cobalamin concentration is in the low normal range (i.e., less than approximately 400 ng/L) in both dogs and cats. Most commonly, cyanocobalamin is chosen for supplementation, as it is both widely available and inexpensive. Very little evidence-based information about the route and dose of cobalamin supplementation in dogs and cats is available. Recent studies in humans, dogs, and cats suggest that oral supplementation is as equally effective as parenteral supplementation.
We currently recommend either oral or parenteral cobalamin supplementation and the recommended protocol and dose for each route is as below.
ORAL
Protocol: daily administration for a total of 12 weeks and re-check serum cobalamin concentration one week after finishing supplementation.
Dose: 250 µg in cats and 250 – 2000 µg in dogs, depending on the size of the patient:
Dogs weight (lb)
Below 22 lbs (give 250 µg)
22 to 100 lbs (give 1000 µg)
Above 100 lbs (give 2000 µg)
INJECTABLE
Protocol: weekly injections for 6 weeks, then one dose a month later, and retesting one month after the last dose.
For either oral or parenteral supplementation, if the underlying disease process has resolved and cobalamin body stores have been replenished, serum cobalamin concentration should be supranormal at the time of reevaluation. However, if serum cobalamin concentration is within the normal range, treatment should be continued at least monthly (for parenteral supplementation) and the owner should be forewarned that clinical signs may recur sometime in the future. Finally, if the serum cobalamin concentration at the time of reevaluation is subnormal, further work-up is required to definitively diagnose the underlying disease process and cobalamin supplementation should be continued weekly or bi-weekly (for parenteral supplementation) or daily (for oral supplementation).
Dose: SC injection of 250 µg per injection in cats and, 250-1500 µg per injection in dogs, depending on the size of the patient:
Canine B-12 Table for injectable (See pic below)
Cobalamin
It should be pointed out that in rare cases cobalamin supplementation fails to increase serum cobalamin concentration for reasons that are not currently understood. In these patients, another formulation of cobalamin, such as hydroxocobalamin (only available as an injectable formulation), might be effective.