#1 Vitamin B12 (cyanocobalamin)
Deficiency correction
Strongest sentence we may publish: “In a randomised controlled trial in 53 dogs with chronic enteropathy and low serum cobalamin, both oral tablets and parenteral injection restored normal concentrations by day 28 (PMID 29428088).”
Evidence and blockers
Toresson et al. 2017, Vet J 232:27-32 (PMID 29428088). Fifty-three dogs with chronic enteropathy and serum cobalamin below 285 ng/L were randomised to daily oral cyanocobalamin tablets (n=27) or parenteral hydroxocobalamin (n=26). Every dog in both arms was within or above the reference interval by day 28. Two further controlled studies agree: Toresson et al. 2018 (PMID 30606444) found no difference between routes in serum methylmalonic acid or homocysteine — the markers of cellular, not just serum, repletion — and Dor et al. 2024 (PMID 38354724) found oral as effective and as well tolerated as parenteral in dogs with severe clinical or biochemical phenotypes.
Species with data: Dog (three controlled trials); cat (clinical practice, no comparable trial)
- The same trial found oral non-inferior to injection — at 90 days the oral arm's median was higher (1244 vs 877 ng/L). The best evidence for B12 undercuts the case for an injectable.
- Deficiency-correction indication requiring a serum cobalamin assay. Not a wellness product.
- GFI #256 distribution bar applies.
