scott@vtx-cpd.com

Hello Raquel.

I hope you are safe and well. Happy New Year!

I have popped some thoughts under your questions below:

Wanted to double check. The Idexx lab range for cobalamin states that normal is from 284-836ng/L. Is it still recommended to supplement in animals with clinical signs when it has been below 400ng/L as you had advised in your course.

“Short answer… YES! Cobalamin should be supplemented whenever serum cobalamin concentration is subnormal. There is a 12% probability that dogs with low-normal serum cobalamin concentration (ie, less than approximately 400 ng/L) might also benefit from supplementation. Supplementation of Vitamin B12 is recommended when the cobalamin is low or low normal (< 400 ng/L), in addition to treatment of the underlying cause." Second question-1) why is it that Idexx uses a different reference range as normal? "Good question... short answer is... we are still learning. Reference ranges are established as they are, I am sure they will change with time." 2) for animals who have their cobalamin levels rechecked after the parenteral supplementation protocol. If the cobalamin is still below 400 ng/L but within the “284-836 mg/L” normal range. Then do I take it as the cobalamin levels as subnormal or normal at that point? Just in terms of knowing how I should supplement it going forward. "If the levels are still below 400 after supplementation, I would take that as abnormal and continue supplementation" I hope that helps. Scott 🙂