11 Jan | Girlie AMPS 160; +7=99; PMPS 229

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Girlie's mom

Girlie's mom

Member Since 2017
Condo: http://www.felinediabetes.com/FDMB/...injectable-methylcobalamin-vs-tablets.189343/

AMPS 160
Dose increase on PM of 10 Jan to 0.1 Unit Levemir

I increased last night to 0.1 as her numbers had been steadily going up for four cycles. Last night's PMPS was a pink 302, her second pink. The nadirs I was able to get (at work but popped home): 9 Jan AM was 130 @ +5; 10 Jan AM 185 @+4

We'll see how she goes! Maybe she just wants to bounce between a drop and a 0.1 for a while...
 
Girlie's mom said:
Condo: http://www.felinediabetes.com/FDMB/...injectable-methylcobalamin-vs-tablets.189343/

AMPS 160
Dose increase on PM of 10 Jan to 0.1 Unit Levemir

I increased last night to 0.1 as her numbers had been steadily going up for four cycles. Last night's PMPS was a pink 302, her second pink. The nadirs I was able to get (at work but popped home): 9 Jan AM was 130 @ +5; 10 Jan AM 185 @+4

We'll see how she goes! Maybe she just wants to bounce between a drop and a 0.1 for a while...
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That’s great you’re close enough to pop home.
 
Marje and Gracie said:
The B12 tests, if they are similar to what TAMU runs, are only indicative of cyanocobalamin levels and have nothing to do with neuropathy. If the levels are low, it’s because of malabsorption and she needs cyanocobalamin.
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Hi @Marje and Gracie : So now I'm confused! Can she get the cyanocobalamin injection if she's low in that on the blood test and also get the methylcobalamin to address the neuropathy? Isn't the methyl the one that we want for the neuropathy/wobbly legs?

As my vet just has a "feeling" that Girlie has gut issues, I'm not sure I buy that without some sort of other indication. So I'm focused on the wobbly legs - the neuropathy angle. So I'd like to address that, and I'm confused about what, exactly, I should give her to help the neuropathy. :confused:

So I guess I've got two questions:
  • cyano vs. methylcobalamin (which is better for neuropathy - isn't it methyl?)
  • Dosage: what vet recommends vs what's on Tanya's page
Vet's dosage suggestion: 250 mcg (0.25 ml) of methylcobalamin injected 1x/week for six weeks sounds a little high compared to what's on Tanya's page. Do you think I should get a second opinion on this?

From Tanya's page:
"Vitamin B12 Injectable Dosages

Doses are lower than for oral administration because less is wasted when the injectable form is used.
A commonly used dose for injectable cyanocobalamin is 250-500mcg every week or every two weeks. Drugs recommends 0.25 to 0.5 ml of the 1000mcg/1ml concentration (so 250-500mcg), every 1-2 weeks as required
Although it is more bioavailable than cyanocobalamin, I understand from those who have used injectable methylcobalamin that the dosage is the same, i.e. 0.25ml of the 1000mcg/ml strength (which is 250mcg), but it is normally only given every 2-4 weeks, although some members of Tanya's Support Group give it more often. Be guided by your vet on the best protocol for your cat."
 
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My vet gave me injectable cyanocobalamin which I used for a while but saw no improvement. I switched to methylcobalamin and lijely gave too high a dose (1000mcg once a day by tablet) but his legs were back to normal in ten days. He was so bad he couldn’t stand up to eat and I had to prop his food dish up for him. This was first time round before he went OTJ. This time round I preempted and fave him methyl daily and he has been fine.
 
Juliet said:
My vet gave me injectable cyanocobalamin which I used for a while but saw no improvement. I switched to methylcobalamin and lijely gave too high a dose (1000mcg once a day by tablet) but his legs were back to normal in ten days. He was so bad he couldn’t stand up to eat and I had to prop his food dish up for him. This was first time round before he went OTJ. This time round I preempted and fave him methyl daily and he has been fine.
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I'm thinking the tablets are the go because I'm focusing on the neuropathy with the legs, but I'm confusing myself with all of the info on Tanya's site, I'm afraid! Thanks for that info, Juliet.

Are you giving the Zobaline or another tablet?

I can pop home (technically), but it takes an hour out of my work day. I'm not always able to pop home when I'd like if there are meetings. So it's not ideal, but better than nothing right now! I just wish I could pop in and out of sleep as easily, but that doesn't work for me, unfortunately.
 
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Girlie's mom said:
I'm thinking the tablets are the go because I'm focusing on the neuropathy with the legs, but I'm confusing myself with all of the info on Tanya's site, I'm afraid! Thanks for that info, Juliet.

Are you giving the Zobaline or another tablet?
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Zobaline not available outside the US. I got it from ordinary pharmacy. B12 tablets. I just made sure sugar or similar ingredient not listed.
 
Juliet said:
Zobaline not available outside the US. I got it from ordinary pharmacy. B12 tablets. I just made sure sugar or similar ingredient not listed.
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I can get Zobaline sent to Australia from Life Link. Still waiting to hear from the vet on her test results, though. I hope your migraine is feeling better!
 
Girlie's mom said:
So now I'm confused! Can she get the cyanocobalamin injection if she's low in that on the blood test and also get the methylcobalamin to address the neuropathy? Isn't the methyl the one that we want for the neuropathy/wobbly legs?
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Yes.

Let me see if I can break this down.

Cyanocobalamin is typically the injectable one and it is for gut/malabsorption, generally. It can also sometimes help with inappetence and give elderly cats a little lift to feel better. You can find out if her cyanocobalamin levels are low by doing the GI test. It comes as a pink solution that is injected weekly for 4-6 weeks, levels are rechecked, and then it’s given monthly. I don’t know the dosing because my vet has always just given us prefilled syringes and told me how often to give it so I never had the actual dosing bottle to see the concentration or convert it to mls.

Methylcobalamin is typically given for neuropathy in diabetic cats and for anemia in CKD cats with a hematocrit or PCV level above 20%. Below 20% requires bigger guns. For diabetic cats, the dosing of methylcobalamin, like Zobaline, is one 3 mg tab/daily. For CKD cats for anemia, the dosing is 250 mcg twice a day for oral. I do not know what the injectable dosing is, other than what you have quoted on Tanya’s, because I’ve only used the capsules.

It’s up to you and your vet what you dose them at, as Helen says.
 
Marje and Gracie said:
I do not know what the injectable dosing is, other than what you have quoted on Tanya’s, because I’ve only used the capsules.
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It's also noted on Tanya's, which is one of the reasons I was so keen on the injectable, that it is a better option over the oral form for cats with IBD or pancreatitis. I know that doesn't apply to Girlie specifically, Darrah, but handy to have the info in one place. It's also dosed every 2-4 weeks as an injectable vs twice a day, if you're already giving a bunch of meds orally, it might ease the load a bit.
 
Stacy & Asia said:
It's also noted on Tanya's, which is one of the reasons I was so keen on the injectable, that it is a better option over the oral form for cats with IBD or pancreatitis. I know that doesn't apply to Girlie specifically, Darrah, but handy to have the info in one place. It's also dosed every 2-4 weeks as an injectable vs twice a day, if you're already giving a bunch of meds orally, it might ease the load a bit.
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Cats with IBD or pancreatitis should get injectable cyanocobalamin, not methylcobalamin.

Here is what Tanya’s says:
The oral form of methylcobalamin does seem to work well for CKD cats, though it may be less effective in cats with IBD (inflammatory bowel disease) or pancreatitis. It is common to give a relatively high dose though, to make sure the cat receives enough (any excess should be passed out in the urine).
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I’m just wondering if she misstated this and meant that methylcobalamin (whether oral or injectable) was less effective in IBD cats or pancreatitis. I know it doesn’t read like that but having been on the IBD/pancreatitis boards and also having had a couple IBD cats, it’s well known that cyanocobalamin is the B12 of choice.
 
Marje and Gracie said:
I’m just wondering if she misstated this and meant that methylcobalamin (whether oral or injectable) was less effective in IBD cats or pancreatitis. I know it doesn’t read like that but having been on the IBD/pancreatitis boards and also having had a couple IBD cats, it’s well known that cyanocobalamin is the B12 of choice.
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Okay, I didn't understand it to mean methyl is the b12 of choice for cat's with IBD and pancreatitis, I read it as if you're using methyl for CKD/neuropathy and your cat also has one of those 2 conditions, it may be more readily absorbed in the injectable form vs the oral one.

"It used to be thought that only the injectable form was effective, and indeed this may well be the case for cats with gastrointestinal disease, who may have problems absorbing oral medications."

Crud, I had this printed out for my vet to make a case for the injectable vs pill given Asia's suspected pancreatitis. Now I'm confused too! :p
 
Stacy & Asia said:
Okay, I didn't understand it to mean methyl is the b12 of choice for cat's with IBD and pancreatitis, I read it as if you're using methyl for CKD/neuropathy and your cat also has one of those 2 conditions, it may be more readily absorbed in the injectable form vs the oral one.
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Well that is a reasonable interpretation, too. I’ve just not seen methyl being used for IBD.
 
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