Table 1.
Clinical features of 11 cats with hypocobalaminaemia
| Case number | Age | Sex | Breed | B12 (290–1500 ng/l) | Duration signs (mths) | Duodenal WSAVA score (max 30) | Duodenal morphological score (max 9) | Intestinal disease | Pancreatic disease fPLI (2–7 µg/l) TLI (35–130 µg/l) | Hepatic disease | Treatment and outcome |
|---|---|---|---|---|---|---|---|---|---|---|---|
| 1 | 10 yrs | MN | DSH | <150 ng/l | 2 | 3 | 1 | Neutrophilic enteritis | Not measured | No hepatic disease detected | Signs controlled with fenbendazole, diet, pot. amoxicillin for 4 wks. Died 1 year later, unrelated to GI disease |
| 2 | 8 yrs | FN | DLH | <150 ng/l | 1 | 3 | 1 | Lymphoplasmacytic enteritis | Pancreatitis fPLI 8.1 µg/l Diabetes mellitus |
No hepatic disease detected | Signs controlled with diet, fenbendazole and buprenorphine. Died 2 yrs later diabetic ketoacidosis |
| 3 | 4 yrs | FN | Burmese | <150 ng/l | 4 | 12 | 4 | Mixed inflammatory enteritis (lymphocytes, plasma cells, neutrophils, macrophages) | fPLI 1.5 µg/l | No hepatic disease detected | Signs controlled with dietary management alone in the long term, with metronidazole initially for 4 wks |
| 4 | 9 mths | M | Siamese | <150 ng/l | 5 | 1 | 0 | Neutrophilic enteritis | fPLI 6 µg/l | No hepatic disease detected | Signs controlled with ranitidine and sucralfate for 4 wks, diet for 6 mths. No treatment 12 mths later |
| 5 | 5 yrs | MN | Persian | <150 ng/l | 6 | 10 | 7 | Ulcerative enteritis (lymphocytic plasmacytic) and villous atrophy | Not measured | Chronic neutrophilic cholangitis, portal fibrosis, bile duct proliferation | Signs controlled with metronidazole, prednisolone and diet for 12 mths then lost to follow-up |
| 6 | 7 mths | FN | Siamese | <150 ng/l | 6 | 2 | 1 | Lymphoplasmacytic enteritis | TLI 136 µg/l | No hepatic disease detected | Signs controlled with fenbendazole, diet for 2 mths, then prednisolone and metronidazole for 2 yrs |
| 7 | 8 yrs | MN | BSH | <150 ng/l | 12 | 1 | 0 | Neutrophilic enteritis | TLI 44 µg/l | No hepatic disease detected | Poor response to diet, prednisolone, metronidazole for 4 wks, chlorambucil for 2 wks then euthanasia |
| 8 | 11 yrs | MN | DSH | <150 ng/l | 1.5 | Not applicable | 2 | Lymphoblastic lymphoma | Not measured | No hepatic disease detected | Euthanasia |
| 9 | 13 yrs | MN | DSH | 200 ng/l | 3 | Not applicable | 7 | Small lymphocytic lymphoma | Not measured | Chronic neutrophilic cholangitis, portal fibrosis, bile duct proliferation | Euthanasia |
| 10 | 3 yrs | M | DSH | <150 ng/l | 7 | Not applicable | 8 | Lymphoblastic lymphoma | Not measured | No hepatic disease detected | Euthanasia |
| 11 | 7 yrs | FN | Singapura | 224 ng/l | 0.5 | 0 | 0 | No enteritis detected | fPLI 2.6µg/l | Chronic neutrophilic cholangitis | Pot. amoxicillin, enrofloxacin for 6 wks. No signs 18 mths later |
fPLI = feline pancreatic lipase immunoreactivity, TLI = trypsin-like immunoreactivity, MN = male neutered, DSH = domestic shorthair, pot. amoxicillin = potentiated amoxicillin, FN = female neutered, DHL = domestic longhair, M = male, BSH = British Shorthair