Return to product's list Supplementation of vitamin B12 Folic Acid & Folic Acid Vitamin B12 Aug16.pdf Vitamin B12 Injection_Dec14.pdf COMPOSITIONCyanocobalamin (Vitamin B12) 1mg/mL ACTIONSSupplementation of Vitamin B12INDICATIONSVitamin B12 supplement for the treatment of macrocytic anaemia in horses and dogsDOSAGE AND ADMINISTRATIONAdminister intramuscularly twice weekly or as directed by a veterinary surgeon. Horses : 5 to 10 mL Dogs : 1 to 2 mL PRESENTATION100 mL sterile multi-dose glass vialSTORAGEStore below 25°C (Air Conditioning). Protect from light (always store in box). AVAILABILITYFor General Sale (APVMA 51345)WARNINGSExport Slaughter Interval (Horses): NilSigning up for MypetMD is easy, free and puts the most relevant content at your fingertips. 1. Tell us your name.: 2. How do you like to be called?: 3. What's your email address?: 5. You have a:: By joining petMD, you agree to the Privacy Policy. Home » Dog Care Center Exocrine pancreatic insufficiency (EPI) impairs an animal’s ability to digest and absorb the nutrients available in food.
Because there are insufficient digestive enzymes created by the pancreas, food passes through the body basically undigested. The affected animal will begin to lose weight and have loose, foul-smelling diarrhea. Animals with EPI eat voraciously because they are not able to gain nourishment from the food they do ingest. Treatment for this condition focuses on the use of enzyme replacements in the food. Replacements are typically required for the remainder of the animal’s life. Other factors will play a role in this disease condition, and your veterinarian will need to monitor your pet long-term to see if additional supplements, such as vitamin B12, or medications are necessary to maintain control. Vitamin B12 (Cobalamin) Deficiency Both dogs and cats with exocrine pancreatic insufficiency (EPI) are at risk of developing a vitamin deficiency at some point. Vitamin B12 (cobalamin) deficiency is extremely common in cats with EPI, and is seen in more than half of dogs with the condition.
Because the body can store up the vitamin under normal conditions, it may take some time before it reaches a critically low point. The reason an animal becomes deficient is that vitamin B12 is not absorbed from the food eaten by animals suffering from EPI. Dogs and cats with EPI may be additionally compromised by decreased production of a substance called intrinsic factor (IF) by the cells of the pancreas. This substance helps the body to absorb the vitamin into the bloodstream. Without sufficient IF, the animal will have even greater difficulty in getting enough vitamin B12. In the cat, the pancreas is the only site of intrinsic factor production. and when the pancreas is compromised, IF deficiency (and thus B12 deficiency) results. Once a deficiency of B12 does occur, the animal will have difficulty gaining (or maintaining) weight, even when he or she may have been doing well on enzyme replacement therapy. The dog or cat will also become lethargic and confused. This is because vitamin B12 plays an important role in intestinal health, as well as brain function.
Because of this, any animal that is not improving on enzyme replacement therapy should be checked for B12 deficiency to determine if supplementation is necessary. Your veterinarian will need to run blood tests to check your pet’s levels of B12 in the blood. Low levels of vitamin B12 are sometimes associated with another condition called small intestinal bacterial overgrowth (SIBO). This build-up of bacteria can lead to B12 deficiency in dogs as the organisms bind the vitamin and make it unavailable for absorption by the intestine. Treating Vitamin B12 Deficiency Those animals who are not properly treated for B12 deficiency will have a very poor prognosis and will not show improvement when only treated for EPI. Because animals with EPI are unable to absorb certain nutrients and have a diminished capacity to produce intrinsic factor, giving them oral supplementation of B12 doesn’t help. Thus, the most effective method of vitamin B12 supplementation is by injection. Doses are typically given weekly for many weeks, followed by every two weeks for many weeks, then monthly.
Your veterinarian may consider teaching you to give your pet these injections at home, depending on the situation. Blood tests will be taken again after the course of injections has been given. This will allow your veterinarian to determine if the animal has reached sufficient levels of B12. Your pet will continue to receive injections of B12 until levels are high enough and any secondary intestinal problems are improved. Once an animal has a normal level of B12 in the bloodstream, he or she should begin to gain weight and improve considerably, even in the face of EPI. Image: aspen rock / via Shutterstock Hydroxocobalamin, also known as vitamin B12a and hydroxycobalamin, is vitamin found in food and used as a dietary supplement.[2] As a supplement it is used to treat vitamin B12 deficiency including pernicious anemia.[3] Other uses include cyanide poisoning, Leber's optic atrophy, and toxic amblyopia.[5] It is given by injection into a muscle or vein. Side effects are generally few.
They may include diarrhea, low blood potassium, allergic reactions, and high blood pressure.[3] Normal doses are considered safe in pregnancy.[1] Hydroxocobalamin is the natural form of vitamin B12 and a member of the cobalamin family of compounds.[7] Hydroxocobalamin, or another form of vitamin B12, are required for the body to make DNA. Foods that naturally contain vitamin B12 include meat, eggs, and dairy products. Hydroxocobalamin was first isolated in 1949.[8] It is on the World Health Organization's List of Essential Medicines, the most effective and safe medicines needed in a health system.[9] Hydroxocobalamin is available as a generic medication.[3] The wholesale cost in the developing world is about 0.12 to 0.84 USD per dose.[10] In the United States this amount wholesale costs about 0.84 USD.[11] Commercially it is made from one of a number of different types of bacteria. Hydroxocobalamin at standard conditions is a solid composed of dark red crystals. Hydroxocobalamin injection USP (1000 mcg/mL) is a clear red liquid solution.
Shown is 500 mcg B-12 prepared for subcutaneous injection. Vitamin B12 compounds are used as a prescription medicine (injection) for vitamin B12 replacement therapy, usually at 100 µg/dose. In the UK, 1,000 µg (1 mg) per dose is generally used.[] Damage that results from vitamin B12 deficiency can be prevented with early diagnosis and adequate treatment. For most, the standard therapy for treatment of vitamin B12 deficiency has been intramuscular (IM) injections in the form of cyanocobalamin (CNCbl) or hydroxocobalamin (OHCbl). Cyanocobalamin is traditionally prescribed in the United States. Outside of the United States, hydroxocobalamin is most generally used for vitamin B12 replacement therapy and is considered the “drug of choice” for vitamin B12 deficiency by the Martindale Extra Pharmacopoeia (Sweetman, 2002) and the World Health Organization (WHO) Model List of Essential Drugs. This preference for hydroxocobalamin in many countries is due to its long retention in the body and the need for less-frequent IM injections in restoring vitamin B12 (cobalamin) serum levels.
Furthermore, IM administration of hydroxocobalamin is also the preferred treatment for pediatric patients with intrinsic cobalamin metabolic diseases; vitamin B12-deficient patients with tobacco amblyopia due to cyanide poisoning; and patients with pernicious anemia who have optic neuropathy. In a newly diagnosed vitamin B12-deficient patient, normally defined as when serum levels are less than 200 pg/ml, daily IM injections of hydroxocobalamin up to 1,000 μg (1 mg) per day are given to replenish the body’s depleted cobalamin stores. In the presence of neurological symptoms, following daily treatment, injections up to weekly or biweekly are indicated for six months before initiating monthly IM injections. Once clinical improvement is confirmed, maintenance supplementation of B12 will generally be needed for life. Hydroxocobalamin has also been used in the treatment of cyanide poisoning. Cyanide displaces the hydroxo ligand forming a stable cyanocobalamin. The literature data on the acute toxicity profile of hydroxocobalamin show it is generally regarded as safe with local and systemic exposure.
The ability of hydroxocobalamin to rapidly scavenge and detoxify cyanide by chelation has resulted in several acute animal and human studies using systemic hydroxocobalamin doses at suprapharmacological doses as high as 140 mg/kg to support its use as an intravenous (IV) treatment for cyanide exposure.[19] The US FDA at the end of 2006 approved the use hydroxocobalamin as an injection for the treatment of cyanide poisoning. Hydroxocobalamin acetate occurs as odorless, dark-red orthorhombic needles. The injection formulations appear as clear, dark-red solutions. It has a distribution coefficient of 1.133 × 10-5 and a pKa of 7.65. Injection of hydroxocobalamin is used to rectify the following causes of vitamin B12 deficiency (list taken from the drug prescription label published by the U.S. Food and Drug Administration) Pernicious anemia, is not a cause of vitamin B12 deficiency, but rather the result of vitamin B12 deficiency. While it technically refers to anemia caused specifically by autoimmune deficiency of intrinsic factor, it is commonly used to refer to B12-deficient anemia as a whole, regardless of cause.
Vitamin B12 refers to a group of compounds called cobalamins that are available in the human body in a variety of mostly interconvertible forms. Together with folate, cobalamins are essential cofactors required for DNA synthesis in cells where chromosomal replication and division are occurring—most notably the bone marrow and myeloid cells. As a cofactor, cobalamins are essential for two cellular reactions: Cobalamins are characterized by a porphyrin-like corrin nucleus that contains a single cobalt atom bound to a benzimidazolyl nucleotide and a variable residue (R) group. The variable R group gives rise to the four most commonly known cobalamins: CNCbl, methylcobalamin, 5-deoxyadenosylcobalamin, and OHCbl. In the serum, hydroxocobalamin and cyanocobalamin are believed to function as storage or transport forms of the molecule, whereas methylcobalamin and 5-deoxyadenosylcobalamin are the active forms of the coenzyme required for cell growth and replication.[] Cyanocobalamin is usually converted to hydroxocobalamin in the serum, whereas hydroxocobalamin is converted to either methylcobalamin or 5-deoxyadenosyl cobalamin.
Cobalamins circulate bound to serum proteins called transcobalamins (TC) and haptocorrins. Hydroxocobalamin has a higher affinity to the TC II transport protein than cyanocobalamin, or 5-deoxyadenosylcobalamin. From a biochemical point of view, two essential enzymatic reactions require vitamin B12 (cobalamin). Intracellular vitamin B12 is maintained in two active coenzymes, methylcobalamin and 5-deoxyadenosylcobalamin, which are both involved in specific enzymatic reactions. In the face of vitamin B12 deficiency, conversion of methylmalonyl-CoA to succinyl-CoA cannot take place, which results in accumulation of methylmalonyl-CoA and aberrant fatty acid synthesis. In the other enzymatic reaction, methylcobalamin supports the methionine synthase reaction, which is essential for normal metabolism of folate. The folate-cobalamin interaction is pivotal for normal synthesis of purines and pyrimidines and the transfer of the methyl group to cobalamin is essential for the adequate supply of tetrahydrofolate, the substrate for metabolic steps that require folate.