Necessity for B12 injections with IBD?

[Margret]

Hello, all.

As many of you know, my Jasmine has been diagnosed with IBD. After a great deal of searching I've found a novel protein canned food that she loves (Lotus Just Juicy Venison Stew) and she's eating normally and has begun to put weight on (she'd become seriously malnourished before her diagnosis). The vet also prescribed weekly shots of B12, which she's supposed to get on Saturdays.

The problem is she's making it extremely difficult to give her the shots. I just tried and she made it very plain that she won't allow it, short of burrito wrapping, which would make access to the back of her neck difficult.

I tried to call her vet, but they close early on Saturdays and won't be open again until Monday. I don't want to call an emergency vet for this - it doesn't feel like a proper emergency - but I'm at a loss. Does anyone know just how necessary these shots really are? And if they are necessary, does anyone have any insight on how to give them without a major struggle?

Margret

 

[Furballsmom]

she's eating normally and has begun to put weight on

I believe you can consider the shots less than a top priority.

Maybe the next time you're in to the vet's, they can measure the B12, unless they have already?

Vitamin B12 Deficiency in Cats: The Role of the Gut
This site has this information;
Because disorders of the GI tract can interfere with the absorption of B12, the level of this vitamin in the blood is sometimes used as a test of gut health. If your cat suffers from weight loss, lethargy, diarrhea, or vomiting, your veterinarian may measure the level of B12 in your cat’s blood. A low level of B12 in your cat can indicate an unhealthy gut.

Cobalamin for Cats with Digestive Issues | Cobalamin Supplements for GI Problems in Cats | PetMD
This site is also suggesting to test for the B12 levels, and it also mentions that oral versions of the supplement are available.

 

[Margot Lane]

My cat has IBD and I’m a total wuss and he knows it. Fortunately in my case I’ve a traveling vet who goes in this direction anyway. Don’t think it’s a TOP priority, but I find him to be more in fettle with them, and also I think it helps keeps his liver & other organs working well. If you can do oral versions, so much the better! In my case it’s monthly not weekly, so, it might be worth checking out how much you need.

 

[mrsgreenjeens]

Does Jasmine not like to be handled or petted? I'm asking because we used to give Callie her shots during her petting sessions. She would get so into the sessions that she had no idea she was getting the injections since they were given right into her scruff.

 

[Margot Lane]

I admit, the vet does make this look embarrasingly easy to do, and it only takes a second!

 

[catloverfromwayback]

Does the vet inject her in her neck?
My Phoebe also has IBD (at least we think that’s what it is) and has been on Royal Canin Anallergenic dry food for the last three years or so, with a monthly shot of B12. She makes less fuss about that (though she knows the sound of me preparing it and takes off) than about getting her Bravecto drop! But she’s a very obliging cat, overall, and loves being cuddled by anyone.

 

[Margot Lane]

Yup it’s just a quick jab in the scruff and she’s so good he doesn't even seem to register it’s happening.

 

[LTS3]

I have no problem giving my IBD cat his B12 injections. It's a quick poke into the scruff with a 31 gauge needle. Some cats may need to be distracted while eating in order for an injection to be given. When I had a diabetic cat, I gave insulin and tested his blood glucose level while he was stuffing his face with a meal.

 

[catloverfromwayback]

Sorry Margot Lane I meant to ask Margret !

It sounds like something that takes practice, or if Jasmine remains intractable, oral doses - is she any easier to pill?

 

[Margret]

In no particular order:
The first Saturday I messed up the shot - emptied the syringe into her fur. This was because whenever I'd try to get at her scruff she'd turn her head to solicit ear scratches, combined with her long fur obscuring the area.
Last week I messed up the shot again, in a different way. I got it into her, but I believe I didn't make it into the gap between her skin and her muscle; I think it went directly into her skin, and she told me it hurt when I pushed the plunger. So now, on top of thinking that petting should mean ear scratching she's needle-phobic. And today, when I tried to give it she gave an angry/pained meow and jerked away as soon as the needle touched her skin. At the moment I'm considering whether the trick phlebotomists use on humans (fairly hard massage of the area, which overloads the nerves and prevents the patient from feeling the needle) may work on cats.

The vet did a whole bunch of blood tests, as well as at least one urine test, when trying to figure out why Jasmine was losing weight, but I don't know whether a specific B12 test was included. To the best of my knowledge no new tests were done after the diagnosis, and I should know if they had because they'd have asked me to pay for them.

Online research gave me three major pieces of information:

1. So many cats do well on B12 shots that vets suspect that most cats have a slight deficit.
2. The time when Jasmine was losing weight, because her food wasn't being properly digested, followed by the time when she simply wasn't eating anything but kibble, was a time when she wasn't getting B12 in her food, and therefore it's almost certain that she needs it.
3. B12 injections are easier for the cat's body to use than oral supplements.

However, none of that was mentioned by the vet; she just said that the B12 was meant to improve Jasmine's appetite.

As for pills, Jasmine is none too fond of them but I can usually get them into her, though it isn't easy. Which takes us back to point 3 above....

This feels like one of those jobs that require four hands, but Roger is gone, and although I do have a new roommate Jasmine hasn't yet taken to her enough to trust her, and I don't want to forever poison her relationship with Jasmine by getting her assistance. The other thing I'm considering is this: How to trim your cat`s claws (I'd simply post the video but TCS says it can't be embedded, for some reason - I think it has trouble with YouTube shorts).

Margret

 

[catloverfromwayback]

In no particular order:
The first Saturday I messed up the shot - emptied the syringe into her fur. This was because whenever I'd try to get at her scruff she'd turn her head to solicit ear scratches, combined with her long fur obscuring the area.
Last week I messed up the shot again, in a different way. I got it into her, but I believe I didn't make it into the gap between her skin and her muscle; I think it went directly into her skin, and she told me it hurt when I pushed the plunger. So now, on top of thinking that petting should mean ear scratching she's needle-phobic. And today, when I tried to give it she gave an angry/pained meow and jerked away as soon as the needle touched her skin. At the moment I'm considering whether the trick phlebotomists use on humans (fairly hard massage of the area, which overloads the nerves and prevents the patient from feeling the needle) may work on cats.

The vet did a whole bunch of blood tests, as well as at least one urine test, when trying to figure out why Jasmine was losing weight, but I don't know whether a specific B12 test was included. To the best of my knowledge no new tests were done after the diagnosis, and I should know if they had because they'd have asked me to pay for them.

Online research gave me three major pieces of information:

1. So many cats do well on B12 shots that vets suspect that most cats have a slight deficit.
2. The time when Jasmine was losing weight, because her food wasn't being properly digested, followed by the time when she simply wasn't eating anything but kibble, was a time when she wasn't getting B12 in her food, and therefore it's almost certain that she needs it.
3. B12 injections are easier for the cat's body to use than oral supplements.

However, none of that was mentioned by the vet; she just said that the B12 was meant to improve Jasmine's appetite.

As for pills, Jasmine is none too fond of them but I can usually get them into her, though it isn't easy. Which takes us back to point 3 above....

This feels like one of those jobs that require four hands, but Roger is gone, and although I do have a new roommate Jasmine hasn't yet taken to her enough to trust her, and I don't want to forever poison her relationship with Jasmine by getting her assistance. The other thing I'm considering is this: How to trim your cat`s claws (I'd simply post the video but TCS says it can't be embedded, for some reason - I think it has trouble with YouTube shorts).

Margret

I still mess up Phoebe’s shots occasionally - same thing, not getting the needle right into her skin and squirting the contents onto her fur. She doesn’t usually cry when I’m doing it, so presumably it doesn’t hurt much.Jasmine having long fur does make it harder! That’s a bummer about the oral doses being harder on cats’ bodies than the shots. I don’t think missng a dose until your vet is back on Monday will do any great harm, though. How much does she have per dose? Phoebe has 1ml every four weeks.

 

[Margret]

According to the label on the amber needle cap, it's 2.5G. Judging by the marks on the side of the syringe it appears to be 0.2 ml' which seems an extremely tiny dose. The liquid inside the syringe is hot pink (my first thought when it went into her fur was that I'd somehow injured her and she was bleeding, before I realized it was the wrong shade of red).

I've tried to clip the fur between her shoulder blades and she got extremely protective of it. Sigh.

I think I'll see whether I can find some 1 inch grommets and try to make that device in the video. It's not a bad design, and could come in very handy for a lot of things (starting with clipping that fur!).

The scale I ordered from eBay arrived yesterday; it says she's up to 9 pounds. If it's inaccurate it's measuring lower than actual weight, not higher, judging by how much it thinks I weigh.

Margret.

 

[catloverfromwayback]

According to the label on the amber needle cap, it's 2.5G. Judging by the marks on the side of the syringe it appears to be 0.2 ml' which seems an extremely tiny dose. The liquid inside the syringe is hot pink (my first thought when it went into her fur was that I'd somehow injured her and she was bleeding, before I realized it was the wrong shade of red).

I've tried to clip the fur between her shoulder blades and she got extremely protective of it. Sigh.

I think I'll see whether I can find some 1 inch grommets and try to make that device in the video. It's not a bad design, and could come in very handy for a lot of things (starting with clipping that fur!).

The scale I ordered from eBay arrived yesterday; it says she's up to 9 pounds. If it's inaccurate it's measuring lower than actual weight, not higher, judging by how much it thinks I weigh.

Margret.

Yep, the fluid’s a real hot pink, almost cerise. Makes a fine mess when it spills!

So are you injecting between Jasmine’s shoulderblades? I do it into Phoebe’s scruff, next to where I’m holding her. Of course she doesn’t fight like Jasmine does.

That tiny dose is much what I thought, given it’s weekly.

 

[Kflowers]

when I had a dibetic cat, after the second injection, she'd jump on the counter for it followed by a meal. Didn't have to hold her, did for the first two. Insulin gives an almost immediate improvement in feeling for cat, so that was part of it. She always squeaked when I gave her the shot. It was sort of her "got it, now dinner" announcment. The one time she didn't, I discovered I'd missed and the insulin was in her fur not her. It's also important to give the injection slowly. When you do it fast it feels more, like there isn't room inside for the liquid (speaking from my personal past experience and cat reactions)

It's okay to barrito, the trick is to do the same thing every time. this helps kitty relax in that she knows what's going to happen. Fear comes from the unknown.

 

[Astragal14]

Does anyone know just how necessary these shots really are?

The shots are very necessary overall but not an immediate need if you can't get to your vet right away. B12 builds up over time and you have several days' worth (or more) of wiggle room to administer the injection. But it does have to be an injection and not give orally.

Vitamin B12 Deficiency in Cats: The Role of the Gut

The absorption of this vitamin is a complex process that involves the stomach, pancreas, small intestine, and liver, so if any one of those organs isn’t functioning well, less B12 gets absorbed...
If your cat suffers from chronic digestive or gastrointestinal problems, oral B12 supplements are unlikely to help. This is because their digestive tissue cannot absorb the nutrient very well, no matter how much they ingest through diet.

Ixnay on the IBD: An update on handling patients with chronic enteropathies

Cobalamin is only absorbed from the distal small intestine and is a very specific marker for distal ileal mucosal disease. Low cobalamin and folate concentrations are indicative of severe diffuse disease, and this will limit the efficacy of oral therapy for IIBD. Supplement with cobalamin and folate before instituting therapy.

The Importance of B12 – IBDKitties

A B12 deficiency can cause poor cell formation in the digestive tract and lead to nausea, vomiting, loss of appetite, poor absorption of food (malabsorption syndrome), constipation, gas, weight loss, fatigue, lethargy, abdominal pain, and/or diarrhea. Absorption of B12 requires normal function of the stomach, pancreas and small intestine... Because a healthy liver is able to store many years worth of B12, signs of deficiency may not be obvious for a long time.

And if they are necessary, does anyone have any insight on how to give them without a major struggle?

I'm considering whether the trick phlebotomists use on humans (fairly hard massage of the area, which overloads the nerves and prevents the patient from feeling the needle) may work on cats.

I wish I knew how to easily give B12 injections! My IBD cat still gets monthly B12 injections from our vet. We tried (& failed at) administering them at home. We'll try again at some point, I'd like to wait for our vet to fully return to in-person appointments so we can have a proper tutorial. The massage trick is very interesting and I will definitely look into that! I watched several videos and read many guides and the only one I thought was helpful was this one: Giving Your Cat a Vitamin B12 Boost.

 

[LTS3]

According to the label on the amber needle cap, it's 2.5G. Judging by the marks on the side of the syringe it appears to be 0.2 ml' which seems an extremely tiny dose.

Do you mean 25 gauge? There is no needle size that is 2.5G. 25 gauge is a standard size to use for cats. I use 31 gauge needles because of preference. You can ask your vet for a higher gauge (thinner) needle like 27 gauge or 30 gauge if you think 25 is causing a bit of discomfort.

Can you confirm with the vet what your cat's dose is? That's important to know and for when you are measuring the B12 into the syringe.

Cat doses are tiny so don't let that fool you into thinking the dose is wrong or something. Medicine and injections of vitamins can pack a punch in a tiny dose. My cat only gets 0.25 ml of B12 once a month.

 

[Margret]

Yes, that must mean 25 gauge; I was thinking "grams," or "grains," but "gauge" makes much more sense.

I'm not loading the B12 into the syringe. The vet gave me 6 pre-loaded disposable syringes and told me to keep them in a dark place. I'm diabetic and Roger was insulin-dependent so I already have a sharps container for disposing of the needles. (Actually, I got it before Roger started on insulin so I'd have a safe place to put used lancets - that's most of what's in there.)

I'm pretty sure that it's 2.5ml; the only other possibility is 2ml. It's hard to be certain because there's a bit of air in the syringe as well (not really important since the injection isn't supposed to go directly into the bloodstream).

Margret

 

[LTS3]

I'm pretty sure that it's 2.5ml; the only other possibility is 2ml. It's hard to be certain because there's a bit of air in the syringe as well.

It can't be 2.5 ml. That would be two full 1 ml syringes plus half of another 1 ml syringe.

0.2 ml is a more accurate dose for a cat. I would double check with the vet to be 100% sure.

The air bubbles means that your cat isn't getting the full 0.2 ml dose. If you find air bubbles in syringes, ask the vet to make sure all air bubbles are gone when they pre-load the syringes for you. Or buy the B12 vial and syringes from the vet and load the syringes yourself at home when needed. That's what I do and I know that 'm getting all the air bubbles out.

 

[Margret]

Sorry, decimal place error. Make that .25ml or possibly .2ml.

I should know better; after all, I learned to use a slide rule in high school (yes, I'm that old), and it's always the responsibility of the user to keep track of the decimal point.

Margret

 

[Margret]

So, I spoke with the vet this morning. She said that now that Jasmine is eating normally and regaining the weight she lost, the B12 isn't necessary so I shouldn't worry about it. Apparently she meant it strictly as an appetite stimulant, and Jasmine's appetite was never the problem. As long as I fed her something she considered to be "food," she ate it, enthusiastically. It was the fact that she was losing weight despite eating normally that made me take her in for a diagnosis in the first place.

I'd still like to be able to get the B12 into her - I think she probably needs it - but the pressure to do it now is off.

(Incidentally, Jasmine threw up the other day. During cleanup I realized that she's been stealing chicken whenever I eat it. I need to be more careful about that. It also means that chicken is the most likely culprit in her IBD.)

Margret