B12/Folate Question

The vet says that low B12 and high folate usually indicates a bacterial overgrowth the digestive tract. One further indication of bacterial overgrowth is failure to respond to medication. This is not the case with Franklin. His symptoms disappeared with the first dose of prednisolone and he has been steadily gaining weight. My vet is going to speak with a vet that specializes in bacterial overgrowth before treating with antibiotics.

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Increased folate and/or decreased cobalamin can be indicative of small intestinal bacterial overgrowth (SIBO), also known as “antibiotic-responsive enteropathyâ€. SIBO is a particularly common cause of cobalamin deficiency in dogs, large numbers of bacteria in the proximal small intestine binding and internalising cobalamin so that it is unavailable for uptake in the distal SI. These bacteria may also synthesise large amounts of folate which is then absorbed in the proximal small intestine. However, while an increased serum folate concentration alone may be suggestive, this does not provide definitive evidence of SIBO.
SIBO is not typically a clinical syndrome in the cat, but potentially intestinal bacteria could bind B12 and contribute to a low serum B12. However, provided pancreatic insufficiency (EPI) has been eliminated, low serum cobalamin is most likely to be indicative of small intestinal disease (including inflammatory bowel disease and lymphosarcoma) in the cat.

Exocrine pancreatic insufficiency (EPI) can also have major effects on these vitamins, particularly cobalamin, and it is essential to eliminate EPI by assay of cTLI or fTLI before interpretation of abnormal results. Understanding how EPI can result in cobalamin deficiency depends on knowledge of the key role of the pancreas in the physiology of cobalamin uptake in dogs and cats illustrated here:

Cobalamin is a very large molecule that cannot cross the intestinal epithelial barrier without help from a specific cobalamin-binding protein called “intrinsic factor†(IF). A second site on intrinsic factor subsequently binds to specific receptors present only on the surface of ileal epithelial cells. This binding induces cell-mediated endocytosis of the IF-cobalamin complex and hence transport of cobalamin into the blood.

IF is synthesised by the stomach in most mammals including humans. However, the pancreas is an important site of IF synthesis in the dog, and is the sole site of IF synthesis in the cat. Pancreatic proteases also degrade non-specific R proteins from the stomach which would otherwise bind cobalamin and prevent binding to IF. Interference with production of pancreatic IF and pancreatic proteases in EPI can therefore result in cobalamin deficiency in dogs and particularly severe cobalamin deficiency in cats.

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i gave the injections at home and they were not exposed to direct sunlight.

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Originally Posted by Violet

I get them from the vet and give them at home.

I asked Kyle where the injections were administered because when used at home it's extremely important to protect the vial or individual syringes from light at all times. (Not a concern when the injections are given at the vet.)
I wanted to make sure B12 possibly exposed to light was not part of their problem.

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Originally Posted by Violet

When it comes to storing B12 I've been taught to store it away from light, in a dark place. It makes sense to me.
Overly cautious maybe, but I do this even with a vial.

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This is why many of the "better" companies use brown bottles.

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Store at room temperature. Protect from light and freezing. Keep out of reach of children and pets.

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Originally Posted by Violet

Yes. And since I store those brown bottles in a dark place too.....sigh............

However, it's interesting that the Doctors Foster and Smith web site
http://www.drsfostersmith.com/produc...m?pcatid=10630
for instance shows a brown bottle, yet it still recommends

It doesn't say that with a brown bottle protecting from light is an unnecessary precaution.
I know, I know, you don't have to say anything.........lol........

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Originally Posted by Violet

Trust me, there was no little dig. Can't imagine what reason I could have possibly had for doing something like that and no such thought even crossed my mind. I was having fun with words and making fun of my own overly cautious, fussy ways. Peace?

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