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口服或注射钴胺素对慢性肠炎或外分泌胰腺功能不全引起低钴胺素血症的犬的影响。

Effect of oral or injectable supplementation with cobalamin in dogs with hypocobalaminemia caused by chronic enteropathy or exocrine pancreatic insufficiency.

机构信息

Department of Small Animal Clinical Sciences, College of Veterinary Medicine & Biomedical Sciences, Texas A&M University, College Station, Texas, USA.

出版信息

J Vet Intern Med. 2022 Sep;36(5):1607-1621. doi: 10.1111/jvim.16528. Epub 2022 Aug 31.

Abstract

BACKGROUND

Recent studies have shown similar efficacy of oral supplementation of cobalamin compared to injectable supplementation in dogs, but few prospective, randomized studies have been published.

OBJECTIVES

To evaluate efficacy of oral or injectable supplementation with cobalamin in normalizing serum cobalamin and methylmalonic acid (MMA) concentrations in dogs with hypocobalaminemia caused by either chronic enteropathy (CE) or exocrine pancreatic insufficiency (EPI).

ANIMALS

Forty-six client owned dogs with hypocobalaminemia.

METHODS

Prospective randomized clinical trial. Dogs were divided into 2 groups (CE or EPI), and randomized to receive oral or injectable supplementation of cobalamin. Each dog had 3 visits and serum cobalamin and MMA concentrations were measured at each visit.

RESULTS

In dogs with CE, serum cobalamin concentrations increased with oral (P = .02; median 149 [range 149-231] to 733 [166-1467] ng/L, median difference 552 [95% CI: 181-899] ng/L) or injectable (P < .01; 168 [149-233] to 563 [234-965] ng/L, 367 [187-623] ng/L) supplementation. In dogs with EPI, serum cobalamin concentrations increased with oral (P = .01; 162 [149-214] to 919 [643-3863] ng/L, 705 [503-3356] ng/L) or injectable (P = .01; 177 [149-217] to 390 [243-907] ng/L, 192 [89-361] ng/L) supplementation. Serum MMA concentrations decreased with oral or injectable supplementation in dogs with CE, but only with oral supplementation in dogs with EPI.

CONCLUSIONS AND CLINICAL IMPORTANCE

Oral supplementation is an alternative for cobalamin supplementation in dogs with hypocobalaminemia caused by CE or EPI.

摘要

背景

最近的研究表明,口服补充钴胺素在犬中的疗效与注射补充相当,但发表的前瞻性、随机研究较少。

目的

评估口服或注射补充钴胺素对由慢性肠炎(CE)或外分泌胰腺功能不全(EPI)引起的低钴胺素血症犬血清钴胺素和甲基丙二酸(MMA)浓度正常化的疗效。

动物

46 只患有低钴胺素血症的患犬。

方法

前瞻性随机临床试验。犬分为 2 组(CE 或 EPI),并随机接受口服或注射钴胺素补充。每只犬有 3 次就诊,每次就诊时测量血清钴胺素和 MMA 浓度。

结果

在患有 CE 的犬中,口服(P = .02;中位数 149 [范围 149-231] 至 733 [166-1467] ng/L,中位数差异 552 [95%CI:181-899] ng/L)或注射(P < .01;168 [149-233] 至 563 [234-965] ng/L,367 [187-623] ng/L)补充均可使血清钴胺素浓度升高。在外分泌胰腺功能不全的犬中,口服(P = .01;162 [149-214] 至 919 [643-3863] ng/L,705 [503-3356] ng/L)或注射(P = .01;177 [149-217] 至 390 [243-907] ng/L,192 [89-361] ng/L)补充均可使血清钴胺素浓度升高。口服或注射补充均可使 CE 犬的血清 MMA 浓度降低,但仅口服补充可使 EPI 犬的血清 MMA 浓度降低。

结论和临床意义

口服补充是治疗由 CE 或 EPI 引起的低钴胺素血症犬的钴胺素补充的一种替代方法。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/b411/9511088/3ee15a5118cb/JVIM-36-1607-g005.jpg

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