B-12 doses and frequency

[FeebysOwner]

Feeby (18+ yo, Hyper-T, CKD, arthritis, and recent SC lymphoma diagnosis) had her B-12 level checked. Came out at 170 with a range of 290 - 1500. Regular vet said to give her B-12 shots twice a week at a rate of 0.25ml (1000mcg/ml) for 6 weeks. Since the oncologist is the one who suggested the B-12 test, I asked her opinion, and she said she would not tell another vet what to do. All I wanted was her opinion, to see what alternative options might be since I really don't want to take Feeby to the vet twice a week. I would prefer a once-a-week regimen, even if I end up choosing to give her the shots myself. She said there are many different regimens but would not elaborate. I even explained that my regular vet was amenable to me checking with the oncologist, but that did not change the oncologist's mind about sharing her perspective.

Is there a 'norm'/standard for B-12 injections? Thanks.

 

[white shadow]

.
Hey there! 'Been a while!

Have you thought of asking "Tanya"? She has a lot of info here including a section on cats w/lymphoma (at the bottom)....and her own opinion at the very end.

How about asking your Vet to speak with the oncologist directly? Surely she's aware of your're being scrupulous, your dedication and attention.....she shouldn't have a problem with it. Really.

'Hope you're taking care of yourself too.
.

 

[CHIKITTIES]

Hello

I saw these and quite confused myself! (I am probably not helping at all ...) If I am reading conversion correctly, your vet's recommendation sounds rather high?


Cobalamin Information

For parenteral cobalamin supplementation:

Protocol: weekly injections for 6 weeks, then one dose a month later, and retesting one month after the last dose.

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

Effects of 6 Weeks of Parenteral Cobalamin Supplementation on Clinical and Biochemical Variables in Cats with Gastrointestinal Disease

Parenteral administration of Cbl to cats with subnormal Cbl values is currently considered a routine therapeutic procedure,7, 9, 11, 16 and various doses and dose frequencies have been described. It was initially recommended that cats with subnormal Cbl absorption receive 1,000 μg Cbl parenterally every 2 weeks.6 A more recent supplementation regime suggested 250 μg cyanocobalamin administered parenterally once weekly, for 6 weeks, followed by one dose every 2 weeks, for 6 weeks, and then one dose monthly.17

 

[daftcat75]

Definitely do them yourself. It will be less expensive and less stressful than taking Feeby down once or twice a week.

I hadn't heard twice a week. Maybe twice a week is to get over that learning curve I had with Krista. Krista wore a number of doses before I finally got reliably good at it.

 

[FeebysOwner]

Protocol: weekly injections for 6 weeks, then one dose a month later, and retesting one month after the last dose. Dose: SC injection of 250 µg per injection in cats

As I understand it, that would be the 0.25ml dose. So, the only difference is the once a week vs. twice a week.

I hadn't heard twice a week. Maybe twice a week is to get over that learning curve I had with Krista. Krista wore a number of doses before I finally got reliably good at it.

Nope, the twice a week was recommended on the assumption that they would be giving the injections.

I think I will stick with once a week, whoever gives it to her.

 

[FeebysOwner]

Have you thought of asking "Tanya"? She has a lot of info here including a section on cats w/lymphoma (at the bottom)....and her own opinion at the very end. How about asking your Vet to speak with the oncologist directly? Surely she's aware of your're being scrupulous, your dedication and attention.....she shouldn't have a problem with it. Really.

I read through Tanya's web site but haven't gone to the related forum - yet.

'My vet' seems to be changing by the week. Something (more) going on with the practice, so I don't really think I have a dedicated vet any longer. But I will ask anyway.

 

[Antonio65]

What I always heard about B12 is that a shot is to be given once a week for 6 to 8 weeks, then once a month, or even less down the road.
What I do know is that it stings.

 

[sivyaleah]

I seem to recall Casper would get B12 more frequently at the beginning and then went down to about every couple of weeks or a bit longer. But it's been a while for me too.

 

[Astragal14]

Five to thirteen days is the only specific data I've seen related to how long B12 lasts in a cat's body. Every other source I know of has stated weekly injections, later moving to bi-monthly and monthly (which is the protocol we followed when we began B12 injections for our IBD cat).

Vitamin B12 Deficiency in Cats: The Role of the Gut

In addition, vitamin B12 only stays in the body for a limited time. In a healthy cat, the tissues retain B12 for an average of 13 days, but in a cat with gastrointestinal disease or other health problems, B12 may stay in the body for only about 5 days. So reserves of this vitamin get depleted quickly in cats and this causes low B12 levels.

B12 for cats - Feline Infectious Peritonitis

Even though vitamin B12 is water soluble, tissue half-life (how long it stays in the body) averages 13 days in healthy cats and is reduced to approximately 5 days in cats with gastrointestinal diseases or poor overall health.

I'd consider what would be worse - missing a dose on day 5/6 and administering on day 7, or the stress of twice weekly appointments/injections vs just weekly.

One option could be scheduling B12 injections every 5-6 days for a few weeks, that way it's less than 7 days without being twice a week. And then after a few weeks it may be fine to go every 7 days.

 

[sidneykitty]

Similar to others, I'm only familiar with a once a week dose for 4-8 weeks to build it up in their system, then once a month. However, it may be different given her SC lymphoma diagnosis...

As far as I know, there is no danger in giving too much B12 (though maybe different for a CKD cat? I'm not sure sorry!) as they will just excrete the excess in urine so if she tolerates it and you're able to do it at home, I don't see any harm in giving it twice a week.

If you already give her subQ fluids regularly, you can also add the B12 to those to reduce the number of pokes.

Best wishes to you and Feeby!!

 

[FeebysOwner]

If you already give her subQ fluids regularly, you can also add the B12 to those to reduce the number of pokes.

Knock on wood - she had yet to require sub-Q fluids, but yes, I did read that!

it may be different given her SC lymphoma diagnosis.

I don't think there would be a difference related to the lymphoma, especially since she has no outward signs of lymphoma, and it looks to be mostly affecting her intestinal lymph nodes, not her intestines - yet.

 

[maggie101]

Similar to others, I'm only familiar with a once a week dose for 4-8 weeks to build it up in their system, then once a month. However, it may be different given her SC lymphoma diagnosis...

As far as I know, there is no danger in giving too much B12 (though maybe different for a CKD cat? I'm not sure sorry!) as they will just excrete the excess in urine so if she tolerates it and you're able to do it at home, I don't see any harm in giving it twice a week.

If you already give her subQ fluids regularly, you can also add the B12 to those to reduce the number of pokes.

Best wishes to you and Feeby!!

I give my cat Maggie a b12 pill cut by vet. She eats it like a treat. There is no harm in taking too much. My cat Peaches ate most of the b12 pills and there was no reaction.

 

[FeebysOwner]

I give my cat Maggie a b12 pill cut by vet. She eats it like a treat. There is no harm in taking too much. My cat Peaches ate most of the b12 pills and there was no reaction.

Mosty of the time it is deemed that oral B-12 doesn't do much since it has to be absorbed by the very digestive system that is incapable of absorbing B-12 to begin with. Of course, that all depends on why there is a malabsorption issue in the first place.

 

[sidneykitty]

Knock on wood - she had yet to require sub-Q fluids, but yes, I did read that!

I don't think there would be a difference related to the lymphoma, especially since she has no outward signs of lymphoma, and it looks to be mostly affecting her intestinal lymph nodes, not her intestines - yet.

I am so happy to hear both of those things! that's great news!

 

[FeebysOwner]

What I do know is that it stings.

I seem to recall someone else - in another thread - saying the same thing about B-12 shots, but I asked my husband about this since he gives himself B-12 shots, and he said he does not experience anything other than the standard 'needle prick' feeling that would happen with most any injection/blood draw.

I wonder how anyone call tell if it stings on a cat, and why that would be different from a human being?

 

[daftcat75]

I always wondered if it stings. Often I was able to get the needle into Krista's scruff without issue. But on a number of occasions, she would squeak or jump when I pushed the plunger. I thought about taking one for the team for research purposes. But I'm too much of a wuss around needles for myself. I have to look away when I get jabbed for a shot or a draw , or I will pass out.

 

[FeebysOwner]

I always wondered if it stings. Often I was able to get the needle into Krista's scruff without issue. But on a number of occasions, she would squeak or jump when I pushed the plunger. I thought about taking one for the team for research purposes. But I'm too much of a wuss around needles for myself. I have to look away when I get jabbed for a shot or a draw , or I will pass out.

All I can go on is my husband who said there is no sting when the fluid goes in. I also don't know if the B-12 for a cat is supposed to be stored in the fridge - haven't gone that far in research, but I do know my husband's meds do not require refrigeration. Maybe it has to do with the location, my husband's goes into his belly - not quite the same as the neck scruff on a cat!

 

[daftcat75]

I can't say I always got it right with Krista. Maybe the squeaks and jumps were her way of telling me I was doing it wrong.

 

[Antonio65]

I seem to recall someone else - in another thread - saying the same thing about B-12 shots, but I asked my husband about this since he gives himself B-12 shots, and he said he does not experience anything other than the standard 'needle prick' feeling that would happen with most any injection/blood draw.

I wonder how anyone call tell if it stings on a cat, and why that would be different from a human being?

I know that from direct experience at the local shelter, where sometimes some elder cats need a B-12 shot, and the reaction they have says it all.
We also tried to dilute it in about 5 ml of saline solution, but this only makes the torture longer!

As for storing the vitamin in the fridge, I think it depend on the directions.
We use the same vials intended for human use (they cost much less), and they have to be stored in the fridge because the vial has enough product for several injections on a cat (a lesser dose for a cat than for a human). Once the vial has been opened, it is better to store it in a cool place.

 

[maggie101]

Mosty of the time it is deemed that oral B-12 doesn't do much since it has to be absorbed by the very digestive system that is incapable of absorbing B-12 to begin with. Of course, that all depends on why there is a malabsorption issue in the first place.

She uses cobalamin b12. She saw her internal medacine doctor yesterday. She said her b12 is high so it must be working