Serum cobalamin and methylmalonic acid concentrations in dogs with chronic gastrointestinal disease

Abstract

These data indicated the prevalence of hypocobalaminemia in dogs with chronic gastrointestinal disease was 20 of 56 (36%). Five of 20 (25%) hypocobalaminemic dogs had increased serum MMA concentrations, which indicated that although hypocobalaminemia was common in these dogs, it did not always appear to be associated with a deficiency of cobalamin on a cellular level. Hypocobalaminemia is a risk factor for negative outcome in dogs with chronic gastrointestinal disease and should be considered in every patient with corresponding clinical signs.

Clinical utility of currently available biomarkers in inflammatory enteropathies of dogs

“…Thus, increased MMA production is a useful marker for cobalamin deficiency at the cellular level as a result of cobalamin malabsorption, decreased cobalamin transport, or both 53, 54. Concentrations of MMA can be determined in serum and urine samples,49, 53, 54 and measurement of both serum cobalamin and serum or urine MMA appears to be superior to serum cobalamin concentration alone for proper assessment of cobalamin status in dogs. However, measurement of MMA currently is not routinely performed in companion animals51 because of the cost and technical difficulty of the assay, but it might be a reasonable future strategy.…”

“…However, measurement of MMA currently is not routinely performed in companion animals51 because of the cost and technical difficulty of the assay, but it might be a reasonable future strategy. Serum MMA concentrations can be increased in patients with renal insufficiency49 and must be interpreted in light of the serum creatinine or symmetric dimethylarginine (SDMA) concentration.…”

“…48 Cobalamin is exclusively absorbed in the distal small intestine (ileum) where specific receptors internalize the intrinsic factorcobalamin complex. Hypocobalaminemia frequently is detected in dogs with chronic enteropathies (19%-54%) 5,9,43,45,49,50 and is presumed to reflect distal small intestinal malabsorption, secondary small intestinal dysbiosis (with increased utilization of cobalamin by the intestinal microbiota), or both. Hypocobalaminemia is a negative prognostic factor in dogs with CIE and is associated with hypoalbuminemia.…”

Oral Cobalamin Supplementation in Dogs with Chronic Enteropathies and Hypocobalaminemia

“…7,8 Cobalamin deficiency in dogs is commonly associated with canine CE with a reported prevalence of 6-73%. [9][10][11][12][13] Hypocobalaminemia has also been reported to be a negative prognostic factor in dogs with CE or EPI, associated with an increased risk of euthanasia. 9,14 Suggested mechanisms of cobalamin deficiency in canine CE are damage to the ileal mucosal receptors for binding of cobalamin-intrinsic factor (IF) complexes or bacterial competition for nutrients in small intestinal dysbiosis resulting in decreased amounts of cobalamin available for absorption.…”

In dogs with chronic enteropathy that have hypocobalaminaemia, can oral tablets be used instead of injectable protocols?

“…Cobalamin is necessary for the methylmalonyl CoA mutase (MCM) system (Solomon, 2007) and deficiencies can result in the production of methylmalonic acid (Stabler et al, 1986). Berghoff et al (2013) showed that the prevalence of hypocobalaminaemia in dogs with CE was 36%, while a quarter of these dogs had increased levels of methylmalonic acid. It has been recommended that all dogs showing signs of chronic gastrointestinal disease should have cobalamin levels assessed (Dossin, 2011).…”