Kempf J, Hersberger M, Melliger R H, Reusch C E, Kook P H
Clinic for Small Animal Internal Medicine, Vetsuisse Faculty, University of Zurich, Zurich, Switzerland.
Department of Clinical Chemistry, University Children's Hospital Zurich, Zurich, Switzerland.
J Vet Intern Med. 2017 Nov;31(6):1664-1672. doi: 10.1111/jvim.14830. Epub 2017 Sep 12.
Effects and duration of commonly used protocols for cobalamin (Cbl) supplementation on cellular Cbl deficiency have not been determined in hypocobalaminemic cats.
HYPOTHESIS/OBJECTIVES: To evaluate effect of Cbl supplementation on clinical signs, serum and urine methylmalonic acid (MMA) concentrations over 16 weeks.
Twenty client-owned hypocobalaminemic cats with enteropathy.
Prospective study. Serum Cbl and serum and urine MMA concentrations were determined prospectively in cats at enrollment (t0), immediately before (t6), and 4 (t10) and 10 weeks (t16) after 6th Cbl injection (250 μg, IM q 7 days). Clinical signs severity (activity, appetite, vomiting, diarrhea, body weight) graded at each time point and expressed as clinical disease activity score.
Clinical disease activity score decreased during supplementation and increased after treatment discontinuation. Median serum Cbl concentration increased significantly from t0 (111 pmol/L, range 111-212) to t6 (2,332.5 pmol/L, range 123-22,730) (P < 0.01). Values at t10 were 610.5 pmol/L (range, 111-2,527) and 180.5 pmol/L (range, 111-2,262) at t16 (P < 0.01). Median baseline serum MMA concentration (372 μmol/L, range 0.39-147,000) decreased significantly to 1.62 μmol/L (range, 0.18-806) at t6 (P < 0.01) and gradually increased to 5.34 μmol/L (range, 0.13-1,730) at t10 and 189 μmol/L (range, 0.4-983) at t16. Similar, nonsignificant, pattern observed for urine MMA concentration. Serum and urine MMA concentrations had not normalized in 12 and 6 cats, respectively, at t6.
The Cbl supplementation protocol used here did not lead to complete normalization of cellular Cbl deficiency in all examined cats, and biochemical improvements were transient.
在钴胺素缺乏的猫中,常用的钴胺素(Cbl)补充方案对细胞内Cbl缺乏的影响及持续时间尚未确定。
假设/目的:评估Cbl补充对16周内临床症状、血清和尿液甲基丙二酸(MMA)浓度的影响。
20只客户拥有的患有肠病的钴胺素缺乏猫。
前瞻性研究。在入组时(t0)、第6次注射Cbl(250μg,肌肉注射,每周1次)前即刻(t6)、注射后4周(t10)和10周(t16)前瞻性地测定猫的血清Cbl、血清和尿液MMA浓度。在每个时间点对临床症状严重程度(活动、食欲、呕吐、腹泻、体重)进行评分,并表示为临床疾病活动评分。
补充期间临床疾病活动评分降低,治疗中断后升高。血清Cbl中位数浓度从t0时的111pmol/L(范围111 - 212)显著增加至t6时的2332.5pmol/L(范围123 - 22730)(P < 0.01)。t10时的值为610.5pmol/L(范围111 - 2527),t16时为180.5pmol/L(范围111 - 2262)(P < 0.01)。基线血清MMA中位数浓度(372μmol/L,范围0.39 - 147000)在t6时显著降至1.62μmol/L(范围0.18 - 806)(P < 0.01),并在t10时逐渐升至5.34μmol/L(范围0.13 - 1730),t16时升至189μmol/L(范围0.4 - 983)。尿液MMA浓度观察到类似但不显著的模式。在t6时,分别有12只和6只猫的血清和尿液MMA浓度未恢复正常。
此处使用的Cbl补充方案并未使所有检查的猫的细胞内Cbl缺乏完全恢复正常,生化改善是短暂的。