PETS: Does DM (Degenerative Myelopathy) and other Neurological issues like Seizures and Doggie Dementia, actually start in the gut? Are we missing a diagnosis based on outdated and improper assumptions?
This article is written concerning DM, but it can be applied to a vast number of situations, illnesses and disorders, many neurological in nature such as seizures, once you truly examine and understand what can be at the core.
**AUGUST 2019 – this article will be updated shortly to amend some relevant information pertaining to muscle wasting and the importance of certain additional nutrients during supplementation. I will alter this text section when the update is completed.
(4/26/18 11:00PM EST This article contains an update toward the very bottom.)
6/6/18 – various updates and further clarifications have been made throughout the article.
DM is a neurological condition, but just as every illness, it starts someplace, somehow, and that place may not be in the spine in all diagnosed cases – it just ends up there.
DM is what is called a diagnosis of elimination. They have identified what they believe to be a gene for it and even a second gene that may be related – though genes don’t cause an illness, the proper conditions and circumstances do. Even the researchers admit they have no idea what triggers the gene or if there are other factors involved with the cause. The problem is, dogs who have been examined upon death that did NOT have that primary gene, were found to have DM. So are we hunting in the wrong place in many cases? And, have we truly tested EVERYTHING to say we have eliminated everything?
This article will provide evidence of the following:
- Symptoms of DM, and other Neurological issues, can be an undiagnosed B12 deficiency. Advanced B12 deficiency causes a Degenerative Myelopathy – ALL of the same “DM” symptoms. (video documentary at bottom of post also provides details) “DM” can even be a specific version of B12 deficiency that cannot be resolved with general B12 supplementation.
- It is now considered improper to assume a B12 status based solely upon viewing results from a standard CBC blood test. Anemia or elevated MCV is NOT required. (Vets RARELY test for B12 unless it is specifically requested)
- Serum B12 tests may not depict the true state of B12 in the body and a dangerous cellular deficiency can still exist within current “normal serum range” result values.
- Without testing Serum B12 and Methylmalonic Acid all possibilities HAVE NOT been eliminated in diagnosing DM. (Methylmalonic Acid tests for deficiency/inactivation of Adenosylcobalamin, a specific form of B12 connected to nerve protection)
- Folate amounts in processed pet food can mask B12 deficiency on a CBC and can increase the likelihood thereof, especially in senior animals. (Folate contained in raw/cooked diets can also mask deficiency)
- Just because a pet eats meat DOES NOT MEAN they cannot be B12 deficient.
- Veterinarians can inadvertently exacerbate symptoms of undiagnosed B12 deficiency, even create a deficiency, simply by taking an X-ray or MRI, or even perform a dental cleaning, if they utilize Nitrous Oxide.
- Prescribing Omega Fatty Acid (Fish Oil) supplements in cases of undiagnosed B12 deficiency can increase symptoms and cause additional harm to the body.
- “Allergy” type symptoms can be caused by abnormal fatty acid conversion due to B12 deficiency.
- Adequate amounts of B12 Reaction Partners, B2, Biotin and Magnesium, during supplementation, may be the missing link to overcoming deficiency and activating recovery and nerve repair.
- Diet alteration to reduce specific amino acids (Valine, Isoleucine, Methionine, Threonine) and Fats may be necessary to help the body correct deficiency, repair and rebuild functionality. Especially if muscle wasting has begun.
In the past few months I have come to realize that there may be a very strong connection between a dog’s GI tract and DM symptoms and its progression. My statement is based upon my own dog as a case study, and hours upon hours spent analyzing text and research about B12 and its effects on the body and how, in just humans alone, its deficiency is GROSSLY misdiagnosed and in many cases, rarely tested against symptoms of neurological issues, even seizures, and simple things like weakness and fatigue and memory problems. Human medicine neurologists have even been found negligent for not diagnosing B12 deficiency in patients, causing irreparable harm. So if humans aren’t properly diagnosed with a deficiency – how often can it happen in dogs? I wanted to understand why Doctors and Veterinarians would not recognize B12 deficiency, and that answer is how this article came to be written. (This brief article explains how doctors and veterinarians don’t believe B12 is a problem and how they can misinterpret results even when they do test. Vitamin B12 – The Reference Range Level is Set too Low Levels under 500 are already deficient, levels under 300 are severe. Though the article does not indicate, levels above 900 could mean inactive B12 due to other nutrient deficiencies.)
I am just a dog owner like many of you who are reading this. I currently have a 15 year old mixed breed pup, Shelby, who has been having specific issues since the beginning of 2015, that would now appear to be DM by any definition and symptom. My house is covered in disposable and washable pee pads and basically I am a 24/7 caregiver for her – particularly in the past year. Though at times she can know she is about to poop, often it will happen in her sleep or even when I go to feed her – in one end and out the other. She no longer even attempts to stand to poop – that essentially stopped many months ago as her legs became weaker. She has some control of her bladder and can at times get down off a dog bed to pee when she feels it coming, but at other times lets it go where ever she may be. Actually it can be funny because as she is laying on her side she will lift her leg and let it shoot. She will also pee in her sleep at times. I have learned over the months how to express her bladder and even to help a poop out of the shoot. Over the past few months she even began to “cup” and knuckle under her front feet, not just when she would walk but as she was laying down I would notice it – just like we cup our hand she would seem to do it to her feet. One leg in particular it seems she will try to stand on her tippy toes. The front legs have been splaying out more and more even when standing on a surface she should be able to grasp well. Essentially, she has been getting weaker.
As I look through postings on DM groups on Facebook, I can see I am not alone in my struggles, lack of sleep, piles of laundry, and deep desire to want to do anything I can to help her if it is still possible. Most would say I am nuts and I should “let her go” – a few friends have said that. It is after all supposed to be about quality and not quantity of life. The problem with that was seeing her “good days” and moments of cognition and the vet never being able to tell me there is anything else significantly wrong with her – no evident cancer or other disease that is causing any other issue besides her weakness and neurological symptoms. But I now know – it is obvious. However, there is just something that has held me back from the end, like there is something I needed to “learn” in this experience, and I did, and this is why I came to write this post.
This post is going to be long, very long, but I want to be detailed in as many things as I can remember so that people understand I didn’t just pull this “theory” out of thin air and that there really can be a basis for the statement. Call this a little case study. If I were to generalize the information, there are those who would want more details and say I am being too general in my statements so my hypothesis is crazy. So for some of you this may get too verbose and more detailed than you would like, but I feel it necessary to give you as many facts as possible. Plus, if a veterinarian were to read this, they would not believe without concrete facts. If you truly want to decipher for yourself if there is a connection and if it is possible to apply it to your dog and your situation and maybe see some positive results…..read on. I have come to know that there are others out there that would rather test for the DM gene so that they know that their dog could truly have it and then I guess rest in the knowledge it is a death sentence. I simply want to provide explanations as to why it may not be diagnosed properly, and doesn’t have to be a death sentence if caught in its early stages. Remember, just having a positive gene test doesn’t mean there isn’t a specific trigger – they don’t know what that gene does – just that many dogs have it in common. And again, dogs have died of DM WITHOUT having even one copy of the gene.
I should first state that I do realize that “officially” DM is only in certain breeds of dogs. I have read the University of Florida (“UoF”) paper on DM in German Shepherds that essentially states any differences between their studies and other breeds of dogs can in and of itself explain differences and can mean that any other dog does not necessarily have DM as they have researched. Shelby is a “mutt” of some sort, so her lineage is not known. She can look like a few different types of dogs. So to generalize the term DM in this case I am certain may bring the ire of those who have purebreds and perhaps for researchers, like Dr. Clemmons who put together the paper from UoF on DM in relation to only German Shepherds. However, we know that the world is filled with mutts. And mutts have been diagnosed with what certainly appears to be DM, and from research, has been proven upon death to be DM.
I may state some things that some veterinarians, doctors or researchers might think absurd at first glance since I am not doing it with all of the technical detailed medical mumbo jumbo – though there will be a good deal of that. Plus, what I am stating will likely challenge, go against, the knowledge and assumptions they have built up over decades. But as many of us know by taking care of dogs or humans with medical needs, you learn some things along the way, and all that technical stuff goes out the window when they tell you something works “this way” and something then proves these experts wrong. You know – those “medical miracle” type things. And then there is that little fact that sometimes the most absurd things, really do make the most sense in the end. The wildest ideas have led to discoveries and advances in medicine and other areas, and they all started with what some described as a crazy thought. After all, how many times have you watched the news and they have a story about medicine that states these experts have changed their view and opinion or protocol on something? But I thought it was science? (Is coffee good or bad for you? I find it hard just to keep track of that latest scientific diagnosis.)
But I do believe in one thing, if you learn something, even in pain and tragedy and watching the deterioration of a loved one – share it. Just because I can’t turn back the hands of time and fix everything for Shelby, what I came to realize may be her legacy and the purpose for which God put her, and I, together on this earth. And even if it does sound crazy right now, it may be proven through others, like yourself, to not be as crazy as first thought. And perhaps, maybe I have stumbled upon something, connected the dots that the doctors and scientists haven’t truly explored and it could hold the key to treatment or prevention. And before you read further, I am not selling anything. I have been to some sites where someone will tell you something and then want you to send a nominal fee to get their recipe or their protocol. I have felt compelled to simply provide my insights and research into something, and how I have seen the effects on my dog. My background isn’t about this type of subject, but when you feel compelled about something, Divinely Inspired one could say, you know you are meant to share it simply for the benefit of others.
I will first tell you the case of my dog, Shelby, and how I dealt with the progression of her symptoms. I will then explain how I discovered connections to various things such as B12 and Biotin. I will also explain how and why vets could be innocently missing the diagnosis, and some, even inadvertently adding to the problem. I provide some links (hyperlinks) to various articles and research papers and try to provide as many concrete facts as possible to back up my statements so that people can understand they are based in verified information, scientific facts. My hope in the end is that, through determined owners and veterinarians and researchers, these facts could very well halt the progression of what is “diagnosed by elimination” as DM in the majority of cases and possibly provide the answers to other pet neurological issues – and even that mystery scratching and biting that some pets go through. It could be the explanation that provides the path to better treatment and research.
If you prefer to cut to the “Nitty Gritty Details” to determine if I provide any facts to back up my claims, then you can scroll down to the “A B12 Connection” section or to the START HERE section. This would allow you to skip over the story of my dog.
This first video was taken on October 31, 2015. At this point she had been having trouble for a while. We noticed over a few months that her foot was dragging a bit on walks as we could always hear her nails scraping the pavement, and she was slower in general. She had been “slowing down” over the past few years prior, as you would assume in old age, and I even noticed a wheezing that developed even when she was laying at rest on a bed. The summer of 2014 she also seemed to have had more “allergy” issues – though things did start as early as a year or two before that. She was scratching, mostly her ears, constantly, though there was nothing evident, no infection, no hot spots or hair loss, no dirt or fleas or ticks. Nothing. I should note that she had her “vaccines” in March of 2014. Rabies and 3-in-1. She was scratching at that point and the vet said I can try Benadryl or if that wasn’t working I could use plain Claritan which I did begin. He also told me to add Fish Oil supplements to help the coat, which I had begun well before that point when she started scratching at times years earlier. However, the scratching continued and it was a precursor to her getting ear hematomas. In September of 2014 she got her first, and her regular vet recommended surgery. The dog I had before Shelby had this issue so I knew the procedure. During that first surgery, since I had been concerned about her breathing – a wheezing – they did x-rays while she was still under anesthesia – nothing unusual found and they had diagnosed the issue as laryngeal weakness that can occur with old age. They also performed a full dental, keeping her under anesthesia for an extended period. (I believe this is actually what started the cascade of events by stressing her liver even more)
Her second hematoma, on the other ear, was in November of 2014 – two months later. They performed surgery on that one and I was told that she was having trouble waking up from the anesthesia. From the morning surgery I wasn’t able to pick her up until after 6pm due to this difficulty. I was told that it can happen in older dogs and that maybe her extensive bout under anesthesia two months prior played a role in her recovery from this surgery.
That set of circumstances made me hesitate a bit when her leg symptoms increased. I actually wondered if there was an issue even with the tick medication I applied to her in the spring of 2015 since my yard does have ticks and the vet always suggests using it, and you get kind of fearful of them getting ticks. I started reading about more stories relating to neurologic symptoms from flea & tick meds and wondered if that triggered anything and maybe it could work its way out, especially if I wasn’t going to apply any further treatments. But as time went on – the symptoms seemed a bit worse – as evident in the video, so it was time to see the vet.
I first brought Shelby to the vet for these symptoms in November of 2015. The day before we brought her in for the visit she actually had a seizure the night before. She was looking toward me and suddenly her eyes rolled back and she fell over. I ran to her and put my hand over her non-focusing fluttering eyes and after a little bit she seemed to be able to refocus and snap out of it. I had decided to take her to a Holistic Vet because I did not want them to just call it old age arthritis and give her Rimadyl or another heavy duty drug – plus I wanted to try some chiropractic adjustment and see if that could help in any way. My original vet didn’t always leave me with a warm fuzzy with some things and I wondered if they dismissed some very early signs. Maybe fresh eyes would have a different perspective. I used the video taken on 10/31/15 to show the vet what had been taking place. I tried to explain how her back leg(s) would “jut” out behind her or she would scrape her toes, even the side of her feet when walking. (she eventually lost a back toenail as a result) How she could be laying down and suddenly her leg would just jerk straight out. How she could lose her footing, like when she would go over certain things, especially areas of rubber or regular wood mulch, or pea gravel, that seemed to trigger something in her foot and she would go down. Often times she would sit on her butt and spin trying to get up. She would also “appear” to be scratching herself, her back leg would just start a scratching motion, but yet it was more like a nerve twitch than a scratch. I also did explain how she had been actually scratching over the past year even though what she was doing now was a bit different. It can be seen in the videos. It could take her more than a minute before she would be able to get back up again and continue walking. I also explained her ear hematomas and extensive bout under anesthesia. I really was convinced it was something neurological in nature.
The vet said he didn’t really know the root cause. Her blood work showed some slight elevated liver levels but otherwise there was nothing major that stood out. He said he does often see those kind of levels in older dogs so it is not necessarily a concern. She was started on NeurotrophinPMG to see if that could help since it was something that had worked for Parkinsons and other neurological symptoms, plus she was given Standard Process Canine Hepatic Support for her liver as well as a specific specialized formula of Omega 3s from Squid to see if it helped her joints, the scratching and the start of what seemed to be doggie dementia. A few weeks went by and nothing seemed to be improving at all. I believe I had also given her some general vitamin supplements of some sort, but nothing really changed. Not really worse, but not really better either.
At this point he suggested trying two different treatments. One was Ozone Therapy and Ultraviolet Treatment (O3UV) to super-oxygenate the blood which can cleanse the blood of some kinds of underlying disease and help overall tissues in the body which may provide some energy and strength. It’s not as oddball as it sounds and is something that has been done for decades as a form of natural anti-biotic. The other suggestion was fecal transplant to try to better her gut in general by providing good bacteria from another dog who has only been fed a raw diet. This could help with her “scratching” if gut flora was an issue. This wasn’t an odd thing to me as I had read about it for people and dogs and for quite some time I knew of how important gut functions and good bacteria were in overall health.
So we did both treatments, but it was a “course” of treatments over a few weeks. It knocked the crap out of her body on many levels. It was like dealing with a dog with a severe flu for a few days after each treatment. Oddly it would probably be like chemo treatments for people in some ways.
The one thing I did notice is that for a short period of time she had a bit more strength. Oddly, the fecal transplant treatments ended a week or so after the ozone. On her last fecal I noticed a difference and wondered if it did have to do with the gut.
But alas – it was short-lived. For a few weeks she was stronger, getting up faster when she would “fall down”, but she weakened again. I did have her on probiotics hoping to continue the seemingly positive effect in the gut, but it didn’t last.
After months and months of little to no progress I tried adding and removing a ton of things to Shelby’s diet. All different types of supplements and vitamins – some to address joints and others to see if I could prevent her drippy wet nose. A few years earlier I was giving her a multi vitamin that when I doubled the dose I noticed little improvements in her scratching and biting. But I never pursued anything at that point because she wasn’t really “bad” in any way and I was preoccupied with other life issues. Over time she had begun biting and scratching worse. Oddly, I always looked at the biting, which could be very intense at times, whole paw in the mouth and yanking, more like a reaction to a nerve tingling than to an actual itch. If any of you have ever had a numbing or tingling feeling you might know what I mean. I happen to have herniated a few discs in my back many years ago. I am left with a kind of permanent numbness/tingling in parts of my legs and even my toes. At times it can feel “itchy” but yet it is an itch I just can’t satisfy. It seems the more you scratch the more you want to scratch until you can actually bleed. This is what I saw in what she was doing in biting her feet. Now I realize I was likely right in that it was a tingling, a nerve tingling she was trying to bite away like it was a bug.
This video was taken in April of 2016. At this point it was after she had those special treatments and was on several supplements from the vet as well as other things. She hadn’t made much progress at all since the first video, and in some ways she had gotten worse. The “fall down” times were becoming more frequent and she would get a bit panicky if you tried to help her up. Like her saying “NO, Leave Me Alone I Can Do It Myself”!
After all of the vet treatments and pills and various supplements and herbs and no progress, I decided to see if I could find something on my own. I worked off the assumption it was truly a nerve problem and that it was causing muscle wasting in her legs as a result. In my search for things to help nerves plus address muscles I decided to give her a B Complex like I have been taking for years to help my back. The question of dosage amounts was a concern as this was a new foray into giving her more concentrated vitamins, and then I found B ComplexVET. Specifically made for animals. To address muscle wasting I also got L-Glutamine, verifying its efficacy in dogs. I got it specifically for muscle repair but I had forgotten that it also has a very positive repair effect on the intestinal tract. One more thing I added at that time was a small dose of Magnesium Citrate – too high a dose I know could cause diarrhea symptoms. To see her legs jerk at times, even during the middle of the night, much like restless leg syndrome, I wondered if the magnesium could relax them along with muscles in her back that seemed to “cramp” at times. After a few days on this regimen I already started to notice a difference. She could walk more without her legs giving out – a bit more stamina – and I didn’t need to use a support sling for her back end nearly as much as I had. Over the next few weeks the twitching stopped, the jutting legs stopped and she could walk more normally but far from perfect. It even seemed to stop her heavy labored breathing when she was at rest and she had that since 2014. I can’t say she had extreme strength, but the difference was remarkable in many ways. During this time I also continued fish oil supplementation and/or krill oil as per the recommendation of the vet – this one item becomes negatively pertinent later on in this post.
I started the supplements in October of 2016 – twice a day every day. Interestingly, they also improved her eating, her desire to eat. Since I adopted Shelby in April of 2004 she has never been food centered. EXCEPT, if she could hunt and kill it in the yard. One Thanksgiving I looked out the window to see her feasting on rabbit. More than a few groundhogs and rabbits had met their end in the yard – a few mice too. But I could put a plate of roast beef down in front of her and she could walk away from it and maybe come back later to eat it. That made getting a second dog a challenge as trying to get her to eat regular before the other dog would try to grab the food was difficult to say the least – but we separated them and always made certain she had the time she wanted to eat at her will. However, if it didn’t smell right or interest her….. she could actually go without eating.
But after a few months of improvement, she seemed to be backsliding again. Oddly, not the same twitching and her biting seemed to allay, but the weakness was growing again and her brain fog was increasing. She seemed to be having a bit of “doggie dementia” for almost about a year at that point. She stopped using the dog door about January of 2016. For the most part it seemed due to weakness since she could lose her footing and get stuck so it scared her a little. I am not certain if her brain fog played a role in it too. And the mindless pacing and walking into corners had started around the same time. It had improved a little with the start of the supplements in October, but now it was back as things started to backslide.
By January of 2017 the weakness became greater again. She had been eating regular after starting the pills in October, but now she had begun to go back to having trouble eating, or not really wanting to eat. I would try this and that, or tweak various supplements. I decided to see if I could get a liquid B Complex and found one that was animal specific (RX Vitamins for Dogs) and started to try that on her since getting pills down regularly wasn’t working. Not the exact same ingredients as the pills but the difference had its own benefits in adding in a bit of iron and potassium and some additional amino acids.
Over the course of the months, even at least a year, she would be prone to vomiting back up a meal. At times it was almost like belching it back up. The other weird thing is if she held down dinner all night, the next morning she might puke a bit, sometimes undigested food and I would notice a pill, one supplement in particular that never seemed to digest. But why it wouldn’t digest baffled me.
So it was still hit or miss at this point with giving her supplements on a regular basis and getting her to eat regularly, plus even holding down what she would eat regularly. Some days I would give her the pills and then give her the liquid B Complex too. On one particular occasion, when she seemed even weaker, her face was drawn and she seemed to give me “that” look that she was just too tired of everything, I wondered if this should indeed be the end. I gave her an extra dosage of the liquid B. Every time she seemed weaker and I would change things up, it was kind of like a Hail Mary Pass. If I was at the point where I was going to make “THE” decision, what difference did it make. It wasn’t like I was giving her toxic drugs that could hurt her, this was tweaking the vitamins. A little while later, her energy and strength improved greatly. Now I began to wonder why.
This following video was taken that very same night In March of 2017, the day I thought for certain was the end of the line – one of many of those days to be honest. It is hard to view since it was taken in our backyard at night and the quality is VERY grainy. It is however possible to see her walking, even prancing on top of the ICE coated snow – she has always loved the snow. This dog who had NO strength to get up in the morning and could not stand at all without her back legs giving out, was running. WHY?
I was so confused with all of her symptoms at this point and everything that had taken place that I wrote a post to get out my feelings. Please understand – that just like every other pet lover who knows they have to make “the decision” at some point, I too have cried my eyes out NUMEROUS times over the course of many months trying to come to terms with what has taken place. This is the post I wrote at that point. The Great Debate – Senior Pets – “You’ll Know When It’s Time”
For those who wish to see her test results to know if something was overlooked or if they would have interpreted things differently, these were the tests taken from the first visit until just after the date of the above night video when I thought we had reached the end.
A B12 Connection
I started researching things and delved into B12 which is one of the vitamins in the B Complex mixtures. I learned a great deal about this vitamin and how it affects the body and more importantly, the nervous system, in addition to how it can affect taste and even smell. I wondered if this played more of a key role in some of her progress than I realized. With the B ComplexVET pills she was getting an equal dosage of B12 and Folate – both vital for nerves – plus creating red blood cells needed for energy. Plus it was in the bio-available form for the body – both already in the methylated form – quicker to absorb and utilize. (I will also add that it had an increased amount of Biotin that played more of a crucial role than I realized even when I first began this article) The liquid B Complex wasn’t Methylcobalamin as was in the pills, but it still had the stable form called Cyanocobalamin, plus it had some iron also needed for energy and cell oxygenation, it did not however contain Folate, which becomes significant later in this article.
As a result of my research into the forms and benefits I decided to see if I could get some sublingual forms of B12 to give her and up her dosage of just that – making certain that none of these forms used xylitol as a sweetener. Every time I added more, she responded by getting stronger. But only for so long. I got stronger dosages to which she responded better and stronger. But again, it would seem to die off. I wondered if I was giving too much and held back, but then she would get weaker and weaker again, to the point of thinking the end was truly near. So I would then go back to giving her at least 2 doses a day of a higher concentration of human sublingual liquid B12 in addition to her other supplements and she would get stronger again and have more of the better days. (I now, months later, understand that cellular B12 deficiency is a hard, almost impossible, thing to overcome with just general supplementation and it does require continual daily high dosages for extended periods of time to try to rebuild the body and support the body’s methylation and energy process. Supplemental shots from the vet, even the possibility of giving injections at home plus daily oral dosing of certain forms, would be the best method of attack. However, there are also other vitamins that need to be present in adequate quantities to affect the activation of one form of B12 that is critical to DM dogs.)
But still something was missing in all of this. Somehow, it could still be hit or miss at times and I didn’t know why. The B12 was definitely helping, but perhaps she was still not getting “something”, else I thought she should sustain the positive affect and maintain strength. And, even though completely weak at times, where she really could not walk for more than a few steps, she could get up and down at least for those few steps, but then collapse.
In April of 2015, my sister was operated on for Ampullary Cancer. It is essentially treated as Pancreatic Cancer and they do a special surgery called a Whipple procedure. She pulled through the surgery, with some complications like gastroparesis, but then started on a great liquid multi vitamin and some other things that helped her. Afterward I didn’t think much about it until Shelby was responding to B12 and I found out its effects on taste and smell – two huge problems my sister had after surgery – and of course, the nervous system. I looked up information about my sister’s vitamins (MaryRuth Organics) and her real food feeding tube formula (Liquid Hope) that we decided to put her on against doctor’s wishes, and found out that they both contained the bioavailable forms of B12 – methylcobalamin, as well as other critical vitamins. This made a bell go off in my head.
These two worlds of knowledge began to come together in a very unique way. You see, Whipple patients tend to have gastric absorption issues after surgery – and likely had them even before surgery. I have learned from being a part of a Whipple Surgery Survivors group on FaceBook the extent to how this absorption problem can affect people, even years after surgery. I also learned how seniors (people and pets) are also prone to absorption issues as a natural course of aging. Even the doctors who are trained in this surgery can overlook the symptoms and issues at times, and they even fail to warn their patients of the continuing dangers of B12 deficiency and malabsorption. The intestinal tract is altered and no longer works the exact same way as a normal person. So much so that many people need to take digestive & pancreatic enzymes to help them digest and absorb food since at least a part of their pancreas and stomach is missing along with their duodenum. Even with taking digestive enzymes, they can suddenly begin to have absorption problems that affect the entire body, years removed from surgery. Nutrition deficiencies are actually a dangerous thing and a devious thing too. Long before you begin to see any signs on regular blood tests, or even gross physical signs, the body begins to break down. In the case of something such as B12, if the condition goes on for too long, you can have irreversible nerve damage. Not only do you need to consume B12, but the body has to be able to break it down into its usable format (separate it from protein), and the stomach (and pancreas for dogs) has to be able to produce something called Intrinsic Factor to attach to the methylcobalamin that has been created so that it can then be easily absorbed by the small intestine, else you are relying on passive absorption which could be an issue for any number of reasons. If any part of that process, along with the enzymes produced by the pancreas (trypsin) for further digestion and absorption, isn’t working right, you may not get the true benefit from the food consumed.
And herein might just lie the answer for dogs – particularly ones diagnosed with DM. B12 is used by the body in 2 different forms. The body converts it into Methylcobalamin to be used by every cell, but it also then converts it into Adenosylcobalamin to complete certain other functions within cells. Adenosylcobalamin is also used by every cell, but it has one other very important function. Adenosylcobalamin is directly responsible for protecting the myelin sheath of nerves. If the body cannot convert Methylcobalamin into Adenosylcobalamin the breakdown begins to occur and the nerves can begin to degenerate. Degenerative Myelopathy. (This NIH article explains in detail what takes place) Most likely though, it is that the body is either not getting enough B12, or it is not absorbing enough B12 to meet the needs and functions of everything in the body. The brain needs B12 or you can get brain fog and memory problems, perhaps why we see so much “doggie dementia” and that nightly mindless pacing for which B12 plays a role in serotonin creation as well as other hormone production. The list of just some of the symptoms related to B12 deficiency, in humans at least, consists of Muscle Weakness, Fatigue, Ataxia, Peripheral Neuropathy, Loss of Position and Vibration Senses (that wobbly walk or odd foot placement and movement), Breathlessness, Heart Palpitations, Lack of Desire to eat, Tingling (pins and needles feeling) in hands and feet (which can be why so many dogs tend to bite at their paws for seemingly no reason), looking pale or jaundiced (gums and eyes can show these clues in some cases) and even gastrointestinal issues like Acid Reflux and Vomiting, Diarrhea or Constipation, Incontinence (why DM dogs have weewee pads all over their homes), Temperature Regulation (you may see a dog shaking while they are laying down or shivering, almost as if they are cold), and a swollen tongue that can cause issues trying to eat or even taste anything you eat. Deficiency has also lead to functional blindness and deafness in humans and has been linked to cases of vertigo symptoms. There are a host of “mental” issues connected to deficiency like Depression, Dementia, Anxiety, PTSD, Fits of Rage (perhaps why some dogs develop “aggressive” tendencies, some seemingly out of the blue – though some can have it from birth because a deficiency can exist at birth – I discuss this fact in the last sections “The Continuing Questions” and “Those GENETICS”). It is known that B12 deficiency causes Spinal Atrophy and Brain Atrophy. Without B12 a majority of chemical reactions in the body cannot be properly performed since they start with methylation that needs B12. If left untreated, B12 deficiency WILL LEAD TO DEATH. It could certainly then be logically assumed that dogs and other animals would exhibit the same symptoms, but of course we can’t ask them directly, only try to observe what is taking place with them. But that assumption is only IF we can get past a long standing assumption that B12 deficiency doesn’t happen in animals with any frequency.
There is also one other piece of the B12 puzzle that many doctors and vets would not realize or even know that a study once existed on the phenomena, though it is supposedly known of B12’s importance in the process. As we prescribe Omega Fatty Acids to dogs, and even people, to help with brain function and the skin and coat and joints, we may have overlooked an important link. Studies were done, as early as the 1960s and 70s in animals, which proved that when the body is B12 deficient, not mildly but to the point where a toxin called MMA (Methylmalonic Acid) begins to build up as a result of the deficiency, the body is not able to absorb and utilize fatty acids (likely why we believe we need more fatty acids to begin with and start supplementing in high dosages). In fact, the body can then convert these into harmful abnormal fatty acids. These abnormal acids then begin to build up and actually affect and destroy nerves. This is the likely link in the inability of adenosylcobalamin to protect and rebuild the myelin sheath. MMA can even restrict the body’s ability to create adenosylcobalamin. (Perhaps this is part of the toxic buildup that researchers have identified in the spinal column of deceased dogs) It would likely also hasten deterioration of brain function – the brain fog and dementia issues. We certainly mean well by introducing fatty acids (now even added to commercial pet food), but it would explain why some dogs, and people, are not seeing a difference from supplementation and could even have symptoms worsen. Their bodies are at a level of B12 deficiency that has caused a more dangerous level of MMA. Ironically, we extract those beneficial fatty acids from fish, things like mackerel, sardines and salmon. By doing so we left behind one of the most vital components of the fish, and the reason why we should be consuming the “whole fish”, B12. Fish are one of the highest natural sources of B12. So as I supplemented Shelby with Fish Oil, for a good period of time even before she ever had the DM symptoms, I was likely making the issue worse. As I noticed early signs of itching and scratching, back in 2012/2013, I began her on fish oil and vitamin E supplements as per the vet at that time. I observed no difference in her scratching, even an increase. The vet then recommended I add something such as Benedryl to her routine to help with the “allergies”. I was then likely making matters worse as her B12 deficiency increased, in turn making her MMA levels increase. Stressing her liver with the allergy meds, that can also inhibit B12 absorption. That then snowballed to the ear hematomas caused by scratching, and eventually to the other neurological symptoms. The new vet I had gone to was surprised that the Squid Oil, a specialized version of Omega 3, did not improve any of Shelby’s symptoms, including her brain issues. This could be the very reason why nothing worked and may have made issues worse. Fatty acids need B12 in order to be absorbed and utilized by the body. So without including an adequate amount of B12 supplementation they can’t do their magic efficiently. In addition, MMA appears to inactivate an important metabolic pathway in the digestion of Fats and Proteins and to some extent, Carbohydrates – this would lead to a cascade of absorption issues, though the pet could still appear active and energetic since it can utilize carbohydrates. So, even if the pancreas was properly producing enzymes (trypsin), MMA could still block the process and therefore prevent breakdown and absorption of B12 and other essential nutrients. For those who would like to look at that early research on this subject you can examine the following article. The Effect of Vitamin B12 Deprivation on the Enzymes of Fatty Acid Synthesis
Now of course many will state – but they can test for B12 deficiency. Yes, but, serum B12, the most common test, is not necessarily an accurate reflection of the true state of the body because it does not tell you if there is cellular deficiency – the point at which MMA begins to increase. Doctors and vets might even interpret a “low normal” reading as not being an issue because it is within the currently accepted “normal” range – especially in senior pets. And, there is another little hiccup, many veterinarians do not actually, and can refuse to even when asked, including veterinary neurologists, test for B12 unless certain blood work shows specific evidence, like full-blown anemia, a high MCV value on a CBC test which proves Pernicious Anemia, or a younger dog is exhibiting a failure to thrive and they want to verify if it is related to EPI – Exocrine Pancreatic Insufficiency. (This NIH article explains how inaccurate MCV and anemia is to diagnose B12 deficiency – Diagnostic value of the mean corpuscular volume in the detection of vitamin B12 deficiency ) This website link for Exocrine Pancreatic Insufficiency explains in detail how B12 deficiency is linked to EPI as well as causes of deficiency such as SIBO (Small Intestinal Bacteria) and how it becomes dangerous because it can lead to cognitive and neurological issues. Yet another reason as to why vets should run a B12 test, at the very least, when neurological symptoms are present.
This of course isn’t all vets, but just like doctors, no two will run the same tests or think the same way, and they have developed their own assumptions of situations after decades of experience. B12 deficiency is a known possibility to veterinarians, as stated in this article, but most don’t understand, or even believe, how it can be a highly likely diagnosis. This fact might seem on the surface to be negligent, but it is standard practice and something that was established decades earlier as the normal course of thought based on the current situations at that time. I can honestly say that a veterinarian can’t be blamed for not testing – especially considering their knowledge and them possibly thinking it is a waste of money for the owner. However, that thought process was established before new studies proved the practice improper in human medicine, and, before changes to the pet food industry that may be contributing to the improper chain of thought, which I will elaborate on in a moment. Now for any veterinarian who may have checked on their own, it may be because of previous experience or a whim. The thought of an underlying cause for this practice, to make it a standard of practice instead of an oddity, wouldn’t have entered their mind. This would mean then, that the failure to test for B12 deficiency, in and of itself means, diagnosing a dog with DM without actually testing for B12 deficiency, including at a cellular level by testing for Methylmalonic Acid (MMA urine test or at least serum), ruling it definitively in or out, and making an assumption based upon another test, would be completely IMPROPER. It means they HAVE NOT actually eliminated all possibilities. Plus, this doesn’t just apply to diagnosing a dog with DM, it also applies to many other neurological conditions for which a vet assumes B12 deficiency can’t be a part of the issue, and they then make a completely different diagnosis or simply treat symptoms.
Just as I mentioned vets prescribing Fish Oil to help with various skin, joint and brain issues, another supplement that can help in those functions that many prescribe is SAMe. Ironically, they prescribe it for many symptoms associated with B12 deficiency. SAMe is something that is naturally produced by the body during the metabolism of an essential amino acid called Methionine that must be consumed through food. Methionine can’t metabolize in the body without B12. So if vets, and human doctors, are recommending a supplement that the body can’t naturally produce without enough B12, why aren’t they checking B12 levels? (SIDE NOTE – DO NOT supplement SAMe at the same time as giving therapeutic doses of B12 as it can subject the body to over-methylation and will not improve neurological symptoms)
Another dangerous irony to this issue, especially in the case of DM dogs, or those having weakness or neurological issues in the limbs, those same vets who don’t believe B12 could be an issue, could inadvertently worsen the situation in B12 deficient dogs, perhaps even create a severe deficiency for any pet who is borderline. Since the pet comes in with issues that can relate to the spinal column or maybe one dragging leg, most vets will want to take x-rays or even an MRI to rule in or out certain issues, like the possibility of a tumor or disc issue in the spine. In order to perform these tests the vet needs to give anesthesia so that the dog, or cat, won’t move and ruin the test. Though the vet might make certain they give a drug that is considered safer to the liver (especially in older pets), they may give it as an aerosol with either Oxygen or an Oxygen/Nitrous Oxide blend so the pet inhales the anesthesia. NITROUS OXIDE INACTIVATES B12 IN THE BODY. Essentially it kills it in the cells. As much as 20-60% of B12 in the body can be irreversibly inactivated by nitrous oxide depending on length of exposure. Though nitrous oxide is not common to many vets, there are still those who use it due to its added Central Nervous System suppression benefits and an analgesic affect during procedures – the irony to those benefits is that they probably exist due to the “killing” of B12 which then inhibits the nerves from communicating in the body thereby not communicating pain or allowing for movement. (This textbook produced in 2002 contains language regarding use of Nitrous Oxide in Veterinary Medicine. This 2015 article also touts the benefits of its use.) This is also a prevalent anesthesia for dental procedures in humans and in some animal cases. So if the pet is already deficient, the symptoms can become astronomically worse in a short period of time after the examination – within days or weeks. I have seen many owners posting their devastation at how quickly their pet deteriorated (not long after vet visits) so they chose to euthanize – I can only surmise that this may have been the cause for the quick decline. Simple intense B12 treatment could have reversed everything, but the vets were never the wiser for what took place. This article explains this very issue. VITAMIN B12 DEFICIENCY AND ANESTHESIA
B12 is stored in the body because it is desperately needed for it to function – the primary locations are the liver and the kidneys – two organs of which we seem to hear about pets having more and more issues. It is also stored in muscle tissue – the same place we get our B12 when we eat red meat – the likely reason why muscle wasting begins to occur in animals and humans. It creates red blood cells and DNA, without which cells of organs cannot replicate and repair themselves during normal life cycle die off or even in recovery from surgery or injury, nor can they get oxygen and have waste products removed. B12 is also prescribed by doctors to help heart patients since it is known that increases in Homocysteine – a level that can increase when Folate and B12, along with B6, can’t work together due to deficiency – raises the risk for stroke and heart attack and even blood clots and further weakens the heart. It protects the nerves which means the brain and spinal column. Plus, something that is often forgotten, B12 plays a role in creating White Blood Cells (DNA replication is required for that) needed to fight infection and fend off cancer. So unless a veterinarian truly suspects a B12 issue, seeing only “slight” anemia, or even some neurological symptoms, it is rarely the first thought because, in the case of most DM dogs, they are usually dealing with older dogs who have never had issues and they likely ASSUME the dog is getting a proper and stable diet at this stage in life, which may also include meat. Some may even be overweight so the vet figures they need a diet to help correct symptoms and take stress off joints. (diet pet foods could actually make symptoms worse) They also have in the back of their minds that B12 deficiency takes “years” to occur – never realizing we could actually be at THAT point because they have no idea when or why the depletion started to happen. Plus they ASSUME, that kibble fed dogs are indeed getting proper nutrition because the food meets AAFCO “minimum” standards. And, there is a possibility that by the time the dog sees the vet, the owner may indeed have changed the animal’s diet to contain more home cooked meat, maybe even a raw diet, because they wanted the dog to be healthier and try to help improve the symptoms. So it isn’t a lie to say they eat more meat, but was it too late in the process because they were already too deficient to overcome their issues simply with diet? Were they actually feeding kibble for all the years prior?
I must add a vital nuance to the issue with Adenosylcobalamin. According to a research article summarized by this linked webpage http://www.b12-vitamin.com/combinations/ 2 additional factors play a critical role in the body’s use of adenosylcobalamin, Biotin (B7 or called Vitamin H) and Magnesium. In my case I gave Shelby separate Magnesium supplementation and she was getting slightly increased Biotin from the Thorne B ComplexVET when her initial symptoms greatly improved. For the sake of accuracy, I will provide the exact text from that webpage:
“The second bioactive form of vitamin B12, adenosylcobalamin, requires biotin (also known as vitamin B7 or vitamin H) and magnesium, in order to fulfill its important role in aiding the function of the engine room of our cells, otherwise known as the mitochondria. In this case, however, the dependency is indirect.
Adenosylcobalamin is part of the enzyme methylmalonyl-CoA mutase, which is involved in the conversion of methylmalonyl-CoA to succinyl-CoA. Methylmalonyl-CoA, in turn, is formed from propionyl-CoA in a previous conversion step, a step which is necessary for biotin and magnesium.
In cases of a biotin deficiency, the situation can arise that there is clearly enough adenosylcobalamin available, but that it is useless because its reaction partners cannot be formed. In these cases, the symptoms of a vitamin B12 deficiency can occur, even though the B12 blood level remains normal. An MMA urine test, on the other hand, would show a vitamin B12 deficiency even though there actually isn’t one present. Taking vitamin B12 also wouldn’t bring an end to the corresponding symptoms, since the vitamin B12 simply remains ineffective due to the biotin deficiency.
Biotin reacts very sensitively to free radicals, so taking additional biotin becomes very necessary in cases of stress, high-performance sport and DISEASE, during which the body’s biotin requirement increases enormously.“
I decided to review AAFCO’s requirements for Biotin in processed pet food. As of their 2014/17 listing of required nutrients for dogs – AAFCO has NO Biotin requirement. That means that there is a great chance that the kibble or canned food you are feeding your dog could have NO Biotin after processing. If you think it is a mistake or oversight, that same document does contain a minimal amount listed for cats, but only under certain conditions. I do not know specifically why cats would have at least a minimal requirement and not dogs. This fact just blew my mind. It means if your dog is having health problems, GI problems that can compromise their gut or even took antibiotics that can kill good bacteria, meaning that any natural biotin produced in the gut can be grossly deficient, they may be getting NO additionally significant sources of this nutrient.
The above information could be also of note for any Raw Fed dogs who developed DM or have neurological issues. If you have been feeding raw eggs, it is known that raw egg whites can prevent Biotin absorption due to the Avidin enzyme. Though egg yolk does contain biotin, the raw egg white could then cancel out its benefits and could also negate any additional biotin in other sources, like liver, consumed at the same time, or any biotin naturally produced by gut flora/bacteria – cooked egg white greatly decreases the activation of the enzyme. The avidin enzyme has been noted in some scientific papers to have such a strong binding capacity that it could be at least as great as 1 part avidin to 4 parts biotin. Though, it seems, it would essentially take regular ingestion of whole raw egg to cause continuous concern, for any pets with neurological issues it may be prudent to simply eliminate egg white or cook the egg whites, or whole egg to negate the possibility of issues and ensure the benefits from any biotin intake, or simply avoid eggs or feed them sparingly. Any issue from raw egg white would not be evident immediately and could take months or even years to begin to show up, leading many to believe that raw egg white could not be the issue causing problems since the deficiency takes time to build and affect the overall body. In humans, Biotin deficiency linked to raw eggs (2 eggs every day) has taken anywhere from 6 months to over a year to reveal severe symptoms, so in dogs it would be harder to recognize a link. There is also evidence that raw egg white contains a chemical that can inhibit the pancreatic enzyme Trypsin, vital to overall digestion. This linked article explains these issues.
If the dog is indeed “higher energy”, or even regularly stressed, they could use up their limited daily intake of biotin quickly and leave themselves deficient enough to prevent B12 from being utilized properly. Biotin is water soluble and therefore is removed through urine on a daily basis, meaning it may need regular replenishment from food sources or additional supplementation. Gut bacteria does produce a minimal amount of biotin, however, any GI tract problems, including ingestion of antibiotics or other compromising drugs, would once again affect the utilization and absorption.
This also means that Methylation can still take place in the body which is why anemia would not be detected on a CBC if there are still adequate amounts of B12 in the body. The body can convert Adenosylcobalamin back into Methylcobalamin to keep methylation functioning as deficiency increases and stresses the body even more. This would be why a body could be in critical condition by the time general blood work or serum B12 levels would show any sign of deficiency.
This information could play a crucial part in aiding the possibility of healing nerves by increasing amounts of magnesium and biotin in the diet, along with methyl and/or adenosylcobalamin to facilitate the possibility of regeneration of the myelin sheath.
UPDATE AS OF 4/26/18 At the very bottom of this article is a more intricate section on Biotin’s interaction with digestion and B12. It explains a state of Methylmalonic and Propionic Acidemia (MMA/PA) that can be the catalyst to muscle wasting. Please read it to understand more details about its critical role in this process.
(One quick side note. If for any reason your dog begins taking supplements that contain dosages of B12, a serum B12 test is essentially useless. Serum B12 reflects all forms of B12 in blood – usable or not. Vitamin supplements add B12 to blood thereby invalidating true serum levels from diet unless the patient has been off all supplements for at least a week. This is why a Methylmalonic Acid urine test is more accurate in reflecting the state of the body at a cellular level. The MMA test would also provide a clue in neurological issues being caused by possible biotin insufficiency if the MMA is high and B12 serum comes back in the normal range. Texas A&M University does not appear to list an MMA urine test, they do however perform a Serum MMA blood test which could at least provide a better marker to check for cellular deficiency. UPDATE – Norman Labs www.B12.com has used their human urine testing method on dogs/animals. They have not been able to verify/compare results with animal testing labs as of this writing, but have stated that since it is standardized that the results should reflect accurately for dogs.)
If you do begin Biotin supplementation on your pet – tell your vet before any general blood work. Some processes used in obtaining figures for various values are affected by Biotin and could be inaccurate as a result. This is common knowledge in medical labs and the vet can notify them when testing is done. Ideally a pet should be off Biotin supplementation for a week prior to testing for accurate results.
Is Folate (Folic Acid) To Blame?
This linked post of 2012 explains how Folate can mask evidence of B12 deficiency on standard blood tests: (six-commonly-missed-diagnoses-b12-deficiency) This describes an issue with relying on just a CBC to diagnose B12 issues. The video link I provide at the bottom of this post goes into details in a MUCH greater fashion as to why the practice is improper in human medicine, but sadly, still exists. If you watch the video and think of symptoms you have seen in your pet, it can be quite eye opening. There are a host of articles available on this fact easily searched on the internet. This article gives an easier to read description of how the masking happens between Folate and B12 – Folate “corrects” the signs of B12 deficiency so it is referred to as “masking”. It is technical in many ways, but it is a bit easier for a novice to understand. http://veganhealth.org/b12/coenz
For those who would like another written source this was published in 2003 on the website for the US National Library For Medicine, National Institutes of Health: https://www.ncbi.nlm.nih.gov/pubmed/17972439
The reason I brought up kibble is because B12 deficiency can be masked on tests by increased Folate intake. The synthetic form, known as simply Folic Acid, could even make this issue worse. Folate combines with B12, so increased intake of Folate, or even regular Folate intake, will cause the body, during deficiency or with lack of dietary intake, to take from its B12 stores to combine with the Folate since it is this combination that helps to create new red blood cells and even white blood cells and repair nerves, and keep organs healthy by regenerating their cells, among other things. This means there is a level of B12 present in blood serum, but it does not mean you do not have a B12 deficiency at the cellular level, where it is most critical, nor does it mean you can’t have neurological symptoms. Folate is present in beans, legumes and lentils as well as other green veggies, but it is also present in corn, which has been a staple in kibble for decades, and in the US and Canada it has been added, “enriched”, as Folic Acid to other flours like wheat used in dog biscuits and now even in corn meal. With the buzz today of grain free kibble being used, which means they need other fillers besides grain, it is often peas, beans, lentils and legumes of some sort since they are higher in protein which can boost protein levels in food. Even potatoes that are used liberally in pet food contain folate along with a nominal amount of protein, but do not contain B12. Dog/pet feed companies began changing their formulas to cut back on the expense and logistics for using meat and bulk them up with cheaper stable protein like beans and legumes and such. (this eye-opening article explains the way pet food can contain various ingredients) It is therefore possible to have an abundance of Folate in these foods without there being enough added B12 as a counterbalance. Despite that bag of food stating “MEAT” is the #1 ingredient, you should understand that meat, though having B12, does not contain the same amount of B12 as an equal amount of peas has folate. And, even though meat is the first ingredient, or even first few ingredients on a bag, it would mean it could only be as much as one 1/4 ounce more, if that, to be legally listed as the first few ingredients. (This article explains how pet food could contain as little as 3% meat, or even NO meat, it’s all in how they “word it”) What consumers also do not quickly grasp is that the ingredients are listed by weight. Meat listed at the top is measured as raw so it contains all of its moisture when weighed. So if the next few ingredients on the bag are peas, beans or lentils or even potatoes, they could actually have been measured when dry so that they have less weight, but are in actuality denser and would outweigh the meat contents by extreme amounts if re-hydrated. Even if the amount of peas, beans, lentils and/or grains were half the amount of meat content, it would still not be even close to equal in amounts of B12 versus Folate. So in essence, dogs, even cats, are actually eating what could amount to a vegetarian diet because of all the vegetable protein, and consuming very little meat based B12, if even any at all depending on ingredients. Vegetarians, as is common knowledge, are at EXTREMELY high risk of B12 deficiencies.
To be fair though, Folate is also present in diets of raw fed dogs and cats. However, it is likely in a more balanced level, and the diet has a naturally higher level of B12 from meat and organs. Though this “should” prevent a pet from becoming B12 deficient, it does not rule out the possibility in cases where there can be an underlying genetic issue, or the possibility of some disease, injury or organ damage of known or unknown cause that may have affected the GI tract (bones or toys that could have been ingested and scraped or caused damage), preventing the breakdown of B12 or the absorption thereof. This can also include anything that affects trypsin like EPI, or even raw egg white. This also includes chemical ingestion from vaccines, anesthesia (perhaps from dental work which can even mean a broken tooth, or any injury for which sedation was necessary), medication, antibiotics or pesticides. This then means that, the Folate intake in the diet would still mask any detection on standard blood tests. A raw fed dog could indeed still be B12 deficient just like a human can who eats meat, dairy and seafood.
Since pet feed companies have varied formulas and “tricks” to get you to purchase their products, in particular the ones with the highest profit margin for them, there is no way to give you an easy breakdown of what could be the nutrients in a bag/can of food you use. What I can provide as analysis is a listing of common ingredients in many foods and their Folate versus B12 breakdown. Please try to understand that in our minds we envision wonderful cuts of meat as being included in pet food, but Rib Eye or Chuck Roast is hardly the version of Beef included in a product. Some even use soy (tofu) or other tricks like carrageenan and other starches to make it look like chunks of actual meat are included when in fact it can again be a vegetable based product. (Think Tofurkey to understand how they can form the “meat look” used in canned food) That being stated, the following figures are generalized and taken from the USDA Food Database for Nutrient information – estimated upon a generalized cut of cooked meat. Despite knowing that pet food ingredients are listed with the meat as raw to weight them higher on the list, I am going to use cooked values to actually give the benefit of the doubt to the feed companies to concentrate values as they might be after processing. That would also even the playing field between using raw meat and using concentrated dried vegetables in the ingredients. It doesn’t negate the fact that those two things, raw and dry, could exist and contribute to out of balance values.
|Food Source||B12 mcg / 100g||Folate mcg / 100g||Food Source||B12 mcg / 100g||Folate mcg / 100g|
|Deboned Beef||1-2.5||Peas (green/yellow)||63|
|Deboned Chicken*||.3||5||Pinto Beans||34|
|Deboned Pork||.6||Chickpeas (garbanzo)||172|
|Deboned Lamb||1.8||Lentils (red or green)||181|
|Liver – Beef||70.5||253||Sweet Potatoes||6|
|Liver – Chicken||16.8||578||Corn||23|
|Horse (original petfood product)||3.16||Pearl Barley||23|
All amounts are approximate values of cooked content at 100g size. *Turkey and Duck are equivalent
If kibble is the primary diet of the animal, without added raw or cooked meats, the imbalance problem would likely build over an extended period of time, especially if their favorite dog biscuits could have even more from either wheat or corn or other flours – or those grain free biscuits that use pea and bean flours. If owners like to give their dogs certain veggies as treats to help keep that slim figure, even carrots, it would conceivably add even more Folate. Dogs given real meat based treats, like dehydrated or freeze-dried meats or bones, especially beef or fish or liver, may be helping the diet to fend off, or at least delay the onset of, the most severe B12 deficiency issues and symptoms by giving additional sources of B12. Liver is essentially the highest source of natural B12. However, there is an irony, it also has a good dose of folate, and there is also a risk of giving too much liver as it can cause an overdose of something such as Vitamin A that can have toxic affects, which is why a diet has to be balanced in certain things like organ meats. But, the benefits of it as a B12 source are very important. Interestingly, if you use a kibble that is primarily chicken, turkey or duck based, (as I did for Shelby starting around 2012 – around the time she started having more scratching issues) you could be further behind in deficiency. Because poultry has a very low natural quantity of B12, much less than 1 mcg per 100g, it has to be added to the kibble as a synthetic vitamin since the kibble likely does not contain a large dose of giblet material (liver, gizzards) to add in some additional natural B12. If the company only has to meet a “minimum” requirement, do you think they would add “more than” they have to and affect their profit margin?
BUT, I want to state something, there are a few companies out there that manufacture kibble that does not appear to meet the profile I stated above. These companies are not the ones sold in supermarkets and warehouses. Some brands actually do seem to contain more meat and organ ingredients than any other item, though some still do contain the above mentioned high folate ingredients. Some even contain green lipped mussels, another highly concentrated B12 food and second only to liver in pet food. On the surface they do indeed seem to be of superior quality. They are also not cheap in price. If your pet consumes one of these, they may not be affected by the information I am providing if that is their sole diet. Some of these same foods however, are currently under investigation after having been found to include harmful levels of chemicals such as lead.
There is a great deal of debate on the subject of kibble for many reasons beside what I am stating, much having to do with the possible inclusion of harmful chemicals during processing and the hidden amount of high carbohydrates, along with the clever wording on labels. I will not go into that argument in this posting – my goal is simply to inform people why their dogs (and cats) could be misdiagnosed for a very simple, logical reason. As I am writing this post, Hurricane Harvey has caused mass destruction in the Houston Texas area, Hurricane Irma did the same to Florida, and Hurricane Maria decimated Puerto Rico. I realized that, especially in cases such as emergencies, kibble serves a very important purpose. As individual pet owners, we can and should improve upon our pet’s diet to keep them healthier, and knowing what I now know, I for one will. However, for places that need to house and feed hundreds and hundreds of animals, just to keep them alive, kibble is the most necessary and cost effective form of nutrition. Nothing needed, no water, no heat, no refrigeration, just dump it into a bowl – though moisture seepage can cause bacterial growth which is always a threat. But, it doesn’t mean we can’t make it safer and healthier for longer term use. That is what many are fighting about. (TruthAboutPetFood.com is a great source for information on issues and warnings about processed pet food recalls and issues) Now back to the subject of this post.
The likely problem then appears to relate to either ingestion of B12 – or rather its lack of, conversion of B12 within the body (getting from cyano to methyl to adenosyl when synthetic forms are used), or simply the absorption of B12 in the gut. There are gene mutations that can signal problems, at least in humans. The MTHFR gene, that can depict issues with the methylation process in the body in humans, could be responsible for problems – though I have not found specific research on this gene in dogs. People who have this mutation cannot convert Folic Acid (synthetic Folate) and need to consume bioavailable forms, such as that found in whole foods like peas and beans, or utilize supplements, such as the B ComplexVET, that includes a bioavailable form of Methylfolate. This is important because B12 (methylcobalamin) and methylfolate need one another to make everything else in the body work. (A side note in regard to the Methylation Process – it plays a part in turning genes on and off – so if the body is deficient in any nutrient needed for methylation, this DNA relevant process can’t work and could be the very trigger involved in the “DM Gene”) That would be a case for the researchers to investigate to see if that mutation, or a few others, are part of DM dogs and how it could affect B12 conversion and could hold further clues. The mutation would then allow for a toxic buildup in the body of unused, unconverted synthetic vitamins (Folic Acid) consumed in cheap supplements or fortified products such as kibble and other treats, and might make it harder for the body to utilize the bioavailable vitamin forms when ingested. Grain Free kibble or canned would likely contain more natural folate if it is using peas, beans and lentils, but, the kibble itself would still be B12 deficient leading to the overall issues. But, many forms of kibble, especially the even cheaper forms, do supposedly add in the synthetic Folic Acid supplement, especially when they use potatoes as a base, so the issue is still out there. Interestingly, another test that a vet should/could run is Homocysteine. This test essentially signifies how well B12 and Folate are working together in the body. High levels would likely indicate an issue with one or the other and should signal a reason for a vet to perform further testing. However, like a simple B12 test, it is not often run except maybe in the case of certain dogs with heart issues or other suspected problems.
In the case of a dog, who it is “assumed” would be getting a fair amount of meat in their diet, which normally contains B12 (that assumption is mostly because people equate protein to meat and don’t realize it can be vegetable based) – absorption could be the #1 issue. However, if the dog is eating a more, or even all, kibble or canned based diet, things like grain and peas and beans and simply poor quality synthetic vitamin additives, at the “minimum” standard, can prevent them from getting the nutrition they need – it could actually distort the natural balance of vitamins needed. Dogs fed a raw diet or even a cooked one get a benefit of natural enzymes along with a good portion of natural B12 in the meat – depending on the type. Chicken and turkey do not actually have large quantities of B12. The #1 source used in dog food is liver and beef, and an even more abundant source is contained in fish like mackerel. They then will eat grass in the yard (if available year round) to get their leafy greens, or intake of Folate and other vitamins in case their diet is deficient and they crave added nutrients. Perhaps why Shelby has loved to hunt and used to eat grass when she was well – though she has never liked raw or even cooked veggies in general. These enzymes help the breakdown of food which aid the absorption of all vitamins and minerals to balance out a body. Another small thing to note, dogs often have “allergies” to poultry based food. Poultry based food has the lowest natural content of B12. Rabbit is stated to be better for “allergy” prone dogs – it has one of larger concentrations of natural B12. Though some dogs do have immediate reactions to consuming chicken in general, a true allergy, adverse reactions that build over time by simply consuming chicken based products can make one wonder if the reaction some dogs get is allergies at all….
Something additional to note about AAFCO standards – they are primarily a “minimum”. So when a dog food company creates their food, they only have to meet a minimum standard of nutrients. It also allows them to put the statement on a bag or can that states “Meets or Exceeds AAFCO requirements”. It sounds like a positive statement, but, it can actually have a negative connotation if nutrients are out of balance. They also are not required to list the actual nutritional information breakdown on a bag or can of product. This means we have NO WAY to actually know the vitamin and mineral content in one serving size except to guess. We have NO WAY to know how “out of balance” those nutrient amounts may be. Just because you see the ingredients listing, doesn’t mean the nutritional content is completely balanced. It only means they have a minimum amount of certain nutrients that is considered necessary for the “average pet” – and we all know that not every pet is equal to the next, just as not every human is equal in what they need to “thrive”. Some of our pets are extremely active and others are couch potatoes – meaning they have different nutritional needs to make them thrive. Ironically, the more active the pet, the more likely they are to need an increased B12 amount in their diet to keep their cells regenerating efficiently and support their increased oxygenation level. Many of the dogs affected with DM tend to have had a higher activity level for most of their lives, perhaps why deficiency in senior years hit them very hard. This could be where the link to B12, Biotin and Magnesium becomes more crucial.
Ingredients in pet food may have a larger dosage amount than the minimum, but some don’t even meet that minimum. There are a few exceptions in which AAFCO has a maximum cutoff amount, but Folate, nor B12 is one of those. This is why you will see certain vitamins or minerals added to the ingredient list. In a bag of food that is poultry based you will often see them list B12. Usually FAR DOWN on the ingredient list meaning they only add what they have to in order to meet that minimum standard. This in and of itself can mean that the Folate to B12 ratio is HUGE and in turn, potentially harmful if that is the only food your pet consumes for extended periods of time. Yes, some pets do adapt to what they consume and can thrive for their entire life, but that is rare. As is evidenced by the increasing amount of disease that pets are getting, including cancer and even doggie dementia. In humans, there have been studies that have shown that high doses of Folic Acid and, along with less than equal doses of B12, have been linked to some forms of cancer. Though there can be variables to this study that may have been excluded or overlooked, such as if this was Folic Acid as opposed to natural Folate, or even if gene mutations were checked, what form of B12, and there does not appear to be an equivalent study showing equal B12 to Folic Acid for comparison, the findings do create many questions in my mind at least. For years the focus in a pet’s diet has been on Protein to Fat to Carbohydrates, very important indeed – but where is the nutrient distribution in this?
The other little quirk for owners. We consider this food as a “meal”. In medicine, if the food source is considered a meal (meal replacement), actual nutritional breakdown is usually required and placed on the label so that a person can know the calories, fat, protein, and vitamin breakdown. A human diet is varied and we therefore can consume many different items to vary our nutrition – these labels allow us to know what exactly we consumed. Though we can vary a diet for animals, kibble or canned food for many, especially shelter pets, is their sole source diet. That could mean that some with medical conditions could be taking in higher amounts of some vitamins than would be recommended. But again, we don’t know because there is no breakdown.
I also have to be fair in my statements on B12 versus Folate. Current RDA/AAFCO standards, for both Dogs and for Humans, allows for a larger dosage of Folate versus B12. Dog figures can actually be 8 to 1 and cats are allowed to be higher. The figures were based on how it is perceived a “normal” body will utilize and need these nutrients, and most were established decades ago. However, with the amount of things that affect the body today such as medications, chemicals, anesthesia, vaccines, etc., and that doesn’t even account for any injury or disease that the body might battle – all these things that cause stress on the liver, the place where B12 is stored and processed and needed to function – are those figures even close to what is needed by a body to “thrive” in today’s world? Just look at any FaceBook group that is centered on pets and you will see the never-ending posts of pets afflicted with issues that center around the liver and/or kidneys, another place that stores and utilizes B12 to filter toxins – even GI tract issues that need regular B12 to regenerate the intestinal wall. Even neurological disorders such as seizures. And, B12 even plays a role in sugar digestion which would be linked to diabetes. And what about skin conditions? That scratching and biting – the things that could be connected to MMA. How many times have you read or heard comments from people stating “the vet said their liver levels are a bit elevated but he doesn’t really know why”? Shouldn’t that make us think?
Additionally, it is known that not all B12 that is consumed is capable of being absorbed and utilized by the body, especially if there are any digestive issues that cause a problem with the body’s ability to separate B12 from protein and/or GI issues that prevent absorption. So if pet food only contains the “minimum”, it may mean that it could pass through the body without it ever being absorbed. Further depleting the cellular storage. This is the reason that B12 supplements contain much higher dosages. Higher doses increase the chances for the body to get some benefit from “passive” absorption in case there are issues with Intrinsic Factor, or in case of intestinal wall damage. Something people might find interesting, for humans, in the case of heavy metal poisoning, extremely huge doses of B12 are administered to “filter out” the toxin. The liver needs the “extra fuel” to help it perform its job. So if we barely give enough to pets now, how can they fight off times of stress in their bodies?
I did a cursory figure extrapolation on a bag of food in my possession, comparing what I guessed to be the possible B12 content versus Folic Acid. This food had what “appears” to be good and varied meat content, DeBoned Beef, Deboned Pork, Beef Meal, Pork Meal, Deboned Lamb, but it also used Green Peas, Yellow Peas, Pinto Beans, Garbanzo Beans (Chickpeas), Red Lentils and Green Lentils. My quick figures using the USDA database estimated that the ratio of Folic Acid to B12 could conceivably be at least as much as 40 to 1, likely even greater than that. I can’t prove it, but it opened my eyes. Since Folic Acid masks any chance of detecting B12 deficiency on blood tests, this would be the explanation of why a veterinarian would never detect or assume a deficiency.
An irony to some of the pet food advertising is when they state they “add vitamins and minerals” to make certain your pet is healthy. Uh, not really. They add them because the food itself is deficient in these items and in order to pass those AAFCO “MINIMUM” standards, they have to add a synthetic blend. It really isn’t because they care extra about your pet. Though, there are a few companies that do say they throw in a few extra things that AAFCO doesn’t require.
Another thing to consider…. We know that recalls have happened because things such as chemicals, salmonella or even shards of metal and plastic have gotten into foods. But, what if things were never actually put INTO the food? “What if” the actual vitamins were never “sprayed on” the food for any reason – a machine broke down, they ran out of what was needed, spray head got clogged, the chemical mixture was inadequate or bad? Many companies even sub out their manufacturing to another company that may then cut corners in some fashion to increase their own profit margin. That added minimal B12 may never have made it into a bag of food. Pretty safe guess they may not test for that after processing. And so what? Who would be the wiser? So this food people are using to solely sustain life for their pets, may not actually be providing what we think. But since it isn’t a chemical that will immediately kill or cause injury – no big deal right?
Now I will admit – Shelby’s diet has been hit or miss over the years – mostly because of her peculiar eating habits. And maybe those were driven by deficiencies I never realized. At one point in recent years it seemed I could only get her to eat a cooked hamburger and mix it with a little bit a kibble since I wanted to give her “added nutrients”. And, I originally had a funkiness about doing raw. Also, she DOES NOT like veggies or fruits or anything along those lines. She has had kibble over the years – never “just” kibble unless that is the only thing she wanted to eat. But often it meant mixing kibble with canned processed food. But – even throughout this illness period, she has had kibble mixed with some form of food, be it plain meat or my own wet food. And, there have been times that we would give her some pieces to see if she would eat something and when she showed an interest we would give her a “meals” worth thinking at least she is getting nutrition into her. We did switch to, what I believed was, high quality grain free food as a result of our other dog, Trinity, having digestive issues. I then began canning my own wet food. I would make a huge pressure cooker of beef and chicken food, with added veggies and usually even organ meats and it would be based in bone broth. We would mix that with dry. I resisted full raw food for the longest time, but now I have embraced it since Trinity developed Cushings and the added kibble seemed to make her bloat even more and aggravate her condition. However, I also still make my own wet that we will use too. I will even cook some specific recipes for them I have obtained through a vet developed cookbook. When Shelby eats cooked food it seems to have a better effect on her digestion overall. No more kibble – but is it too late in the progression, at least for Shelby?
I do want to state that I am not saying Folate (natural Folate, not necessarily synthetic Folic Acid) is a bad thing. In fact it is NOT. It is needed by the body in concert with B12 and other nutrients to recreate cells (DNA) during the natural progression of cell death and regeneration in the body and help nerves and to create white blood cells needed to attack and fend off disease and infection. It is VITAL to the body. The majority of chemical reactions in a body start with Methylation of which Folate is a critical part. If you were to need to take a Folate supplement separately, there is sometimes a warning on the bottle that taking the supplement when you are B12 deficient can cause serious side effects. In fact, it can exacerbate neurological conditions and cognitive impairment. (If high folic acid aggravates vitamin B12 deficiency what should be done about it?) So much so, that some supplements even include a nominal amount of B12 “just in case”. Folate actually has a recommended “UPPER” daily limit, likely due to this very fact. But since B12 and Folate work TOGETHER, they need to be more equal than out of balance, especially since B12 is the hardest vitamin for the body to absorb from food. Folate is not stored in the body in the same amount as B12, probably because there is an abundance of foods that contain folate so bodies are usually able to get what is needed if a diet is better-rounded – it is generally absorbed better than B12. The same cannot be said for B12, as its main sources are animal meats and dairy and seafood and the body must separate it from being bound to protein. This is probably why a dog can thrive during their younger years but many fade quickly as they age, if they are mostly on a kibble diet, as their B12 storage gets reduced by out of balance nutritional intake.
The UofF paper referred to a waxing and waning effect of symptoms of DM. I think the answer to this can simply be found in how we might treat our dogs as we see them struggle. We forego that dry kibble for a few days, perhaps giving them a hamburger or steak or some eggs. We eliminate the high folate intake for a few days by giving them a higher concentration of B12 foods. This temporarily replenishes their system if their GI tract is still functioning and helps to at least temporarily balance out the body. Their symptoms improve and we believe them to be getting better. We go back to feeding them their regular diet and notice within days that the symptoms return. The high folate intake once again takes over, likely in the absence of any significant absorbable B12.
One more little side note. For those pets that have had kidney issues and have been directed by their vets to be fed a limited/low protein diet, this usually means the vet has required you to purchase a kibble or canned version through their office. Reducing protein, can in some ways, reduce the availability of B12 in the diet. B12 is bound to protein – again this is seafood, meat, liver, dairy and eggs. By reducing “natural” B12 protein content, unless the food is supplemented with a high quality B12 supplement, there is an increased risk of causing deficiency which can then lead to GI problems that snowball to more absorption issues. Not in “every” case, but still, the risk exists. Plus, there have been studies that have shown that reduced protein without sufficient B12 can cause decreased muscle mass and have adverse effects overall on the body. Something to keep in mind if your pet was in this situation prior to neurological issues beginning. It is a fact, that B12 deficiency in and of itself can actually be causing the kidney issues – but again, no one tests for this at a serum and cellular level to know.
(6/6/18 – in the comment section of this article are two comments by CHORDLOW. His dog, after battling NEOSPOROSIS, which required heavy doses of antibiotics and other medication, was testing repeatedly for kidney disease issues. After starting supplementation he reversed Oscar’s kidney issues which were verified through testing. He continues dosing to wait and see if neurological function will begin to rebuild. Even if MMA levels get reduced, it DOES NOT MEAN deficiency has been overcome. It only means that the body may finally be in a state that makes it able to rebuild storage, enable cell repair and in turn increase functionality – and that can take as long as 6 months to a year depending on level of deficiency. Plus, this may only be able to be done by following the information I provide in the 4/26/18 update below discussing diet.)
The DING DING DING Moment
But back to the “missing link” in things for Shelby. As a result of my knowledge of Whipple patients and talking with some people in the FB group, I suddenly realized that Shelby could have all along been having her own nutritional deficiencies – like B12 and other vitamins in general – a malabsorption. One of the things I never thought about in all of the supplements I tried on her at different times, and why certain things seemed to work better on her than others – even something like a natural aches and pains supplement I give her – came down to ENZYMES. I would often give her these certain supplements at the same time as food, and they contained things such as Bromelain or “Digestive Enzymes”, or just say “Enzymes” on the ingredient list. There are some differences between Digestive Enzymes and Pancreatic Enzymes, but she was at least getting something that could help in the breakdown and absorption of food. They were never in a great amount, but there was at least a tiny bit. Quite possible the missing piece and why, after all this time, when I would switch from one supplement to another, that didn’t contain any enzymes, she seemed worse. Though it could have been some other things in her diet if she wasn’t getting enough B12 also at those times.
This was a LIGHTBULB moment. It would explain why she was throwing up full meals at times, and why I could see some pills never got digested.
What also came to mind is an odd connection. DM is most prevalent in German Shepherds. An interesting tidbit is that GS are also prone to another disease called EPI. Exocrine Pancreatic Insufficiency. At one time I had researched EPI in relation to B12 but Shelby’s symptoms did not mimic that of full-blown EPI in that she was not losing a ton of weight (at THAT time), nor was she regularly hungry or eating large amounts and not gaining weight.
Oddly, some of the things recommended for EPI treatment, Glutamine being one, B12 supplementation and also providing easily digestible protein were something I had done inadvertently. Besides my wet food which is easier for digestion, I would add Collagen Hydrolysate. I take it as a supplement in my coffee so I added it to the wet food of the dogs, besides my wet food having bone broth on its own. When Shelby was having worse days, especially if I couldn’t get her to eat much, I would add it to all of the water bowls and it seemed to help a bit. It is also great for joints, skin, coat and bones and more importantly it is loaded with some vital amino acids to aid the body in many functions, including digestion.
Another interesting thing to note, dogs with DM, according to the UoF paper, are said to possibly benefit from certain supplements. E, B Complex, Bromelain among some. Dogs who have diagnosed EPI are said to be deficient in E, B12, Bromelain being a digestive enzyme needed to break down food for better absorption and it helps with inflammation. It would be interesting to know if any GS diagnosed and treated for EPI, which usually includes B12 supplementation, has ever developed DM. Since EPI is usually diagnosed at a younger age, likely the body was in better shape and did not have enough time to deteriorate in natural ways like a senior animal and was therefore able to fend off some of the neurological symptoms until supplementation was started. A senior dog having symptoms and losing weight would happen more gradually and not be as noticeable as a younger dog having a failure to thrive. Therefore, would they just be considered to have DM and not recognized as actually having EPI as the underlying cause? And for those who don’t know, EPI is said to cause B12 deficiency and therefore dogs are supplemented with Enzymes and B12 usually with added Intrinsic Factor to aid absorption.
I did not originally believe Shelby had full EPI, (though she did eventually lose about 20 pounds during the span from her initial vet visit until this point – much of it muscle wasting) nor do I know if she has full DM. Her symptoms however do mimic DM in virtually every way. I provide the videos for people to examine and make determinations for themselves. Dogs, just as in humans, can have “mild” cases of diseases. Perhaps Shelby has a mild case of EPI, or at the very least a malabsorption digestive disorder helped by digestive enzymes and now added B12 supplementation. But, is it fair to say she now has DM as a result of the deficiency? As I also stated earlier, in the study done on MMA increases due to B12 deficiency, the MMA can actually contribute to the malabsorption issue. So even if the pancreas was properly producing enzymes, meaning no abnormality would show up on any pancreatic enzyme tests, the body itself may have been blocking the nutritional breakdown process because MMA inhibits the chemical reaction necessary, thereby inhibiting nutritional absorption – all without the vet suspecting any issue, especially if they never test for B12 deficiency. Adding in digestive enzymes simply allowed the food to break down a little further so that she could get some passive nutritional benefit.
In the case of B12 deficiency and symptoms – the overall effects on so many things in the body – it really is hard to know what came first – the chicken or the egg? as they say…… Was it the lack of B12 intake that led to all the problems including the malabsorption and damage to organs including the GI tract, or was it the malabsorption because of damaged organs that led to further deficiency? I personally lean toward the lack of necessary B12 intake to overcome cellular deficiency starting the entire series of issues, but that is my personal opinion.
Can You Relate?
After reading through my experiences with Shelby, can anyone relate to symptoms or things that have happened to their dog before being diagnosed with, or rather when the symptoms of DM (or other neurological issues) started? Is there any chance things began shortly after their “yearly” shots? Perhaps you thinking it was coincidental to a “seasonal” thing, such as allergy symptoms if they began getting itchy? Maybe your dog always got their shots around Fall or Spring or Summer and then symptoms started shortly after that? Did they have to be put under for an x-ray or maybe get a dental procedure prior to the onset of symptoms – even if it was by a few weeks or even a month or two?
Did the dog have any symptoms whatsoever that could be related to the digestive tract? Such as bouts of vomiting or belching up food, no matter how small it seemed? There are also small intestinal bacteria (SIBO) that can cause EPI related symptoms and affect absorption of B12 and other nutrients. In Shelby’s case, for the most part, she has always seem to have “normal” poop. There have been bouts of both hard and watery poops, but sometimes you ignore them based upon other factors that could have affected the dog’s system.
It was only recently that I was able to reflect on the timeline of things and could recognize the deeper triggers that may have set the neurological symptoms in motion – the extra stress to her system. I could even go back to a small surgery in 2011 for a polyp/cyst/skin tag type thing on her eye. It was just after that time when we noticed her getting more winded and tired on walks and her allergy symptoms started not long after. It could be possible that the anesthesia used on her at that time was administered with Nitrous Oxide thereby creating the original deficiency that her body was never able to properly recover from due to her diet and minimal B12 intake. But, even chemicals used at the time, even antibiotics in general could have caused the extra stress and deficiency.
Is there any chance that when your dog got worse you decided to give them “special things” like steak or roast beef or added meat as treats, out of love and guilt for how they were feeling and thinking your time could be coming to an end? And then, you saw some slight improvement in their symptoms, maybe walking better or seeming a bit stronger. Never realizing that it could actually be that you gave them more B12.
The one thing I do believe however, is that the intense anesthesia load that Shelby had in 2014 for her surgeries accelerated her B12 deficiency. The liver had to take time to process the chemical loads from the anesthesia, perhaps even being Nitrous Oxide, along with every other toxic chemical she had ingested, such as Flea & Tick medications, Heartworm, and the Rabies and 3-in-1 vaccine she had in March of 2014 that likely started the cascade of issues that caused her skin itching that led to the scratching of her ears that led to the hematomas, and anesthesia and so on and so on. (she had another 3-in-1 in March of 2015 during her “annual” visit) System overload against an underlying B12 deficiency. My original vet was also one who, despite doing the rabies vaccine every 3 years starting a little later in Shelby’s life (I believe they did it every year when she was young), was still requiring the annual visit to get the 3-in-1 vaccine – which I have now been told is completely unnecessary but many traditional vets still give it on this cycle. So her system, her liver, was getting bombarded every year with not just the vaccine, but also getting Flea & Tick treatments, even heartworm, allergy meds, all within the course of a few months since they coincided with springtime.
Dancing Around The Edges
For the past few years, actually since maybe about 2011, I was likely dancing around the edges of an absorption issue with Shelby. It was around that time that I noticed she would get tired more easily. We would go for long walks which she normally loved, but her breathing would be more labored and one time my husband even stated that she laid down and had a hard time getting back up so he had to carry her a little way. Was the weakness starting back then? Any doctor who has diagnosed a B12 deficiency will tell you that to get to the point of severity it will have started even years before, but won’t show up on a blood test, if it even does at all, until it is at a critical point – possibly near death. The irony to that is – if a vet assumes that a dog can’t be B12 deficient because they have so much storage available so it’s rare, how the heck can a vet know that we aren’t at that point of storage drain, especially if they don’t run specific tests? Especially when a dog is older??
Shelby didn’t show any signs of “anemia” until the second blood test in January of 2016 – 2 months after I took her to the new vet for the first time. Anemia, though I was told it was “slight”, appeared on each blood test thereafter, but never triggered a thought of B12 deficiency. When I discovered B12 was at the heart of her issues in March of 2017, when I thought we had reached the end, her blood work showed Toxicosis – her kidney levels were, or had been, elevating. I never had blood drawn after that time because the vet was never able to assist in diagnosing her previously and whatever path things took I figured, at this point, were in my hands.
I think all of us likely do it, the dancing, in one way or another, simply by trying to add supplements to address the symptoms we may see pop up. Veterinarians do it too, all the time, just like doctors. They give a drug to treat a symptom, or suggest a supplement, but never look at the heart of an issue – what exactly is happening with the consumption and absorption of nutrients of an animal. But then, it is not an easy thing to do, nor can they ask their patient directly, and we owners may not give the best answers and vets don’t even know the right questions to ask since they never believe B12 intake could be an issue. We give them something that puts a band-aid on the problem, a little extra of this or that nutrient, but never fully address, or even identify and understand, the underlying issue. Many supplements can actually be the end result of Methylation problems in the body – so we increase the end product, but never realize the beginning started with B12 deficiency.
Now, we know it is true that the older the animal, or human gets, the slower and worse their digestion can become, affecting absorption, reducing B12 and even something like CoQ10, which by the way, is connected to B12. (without adequate B12 the body cannot produce CoQ10) But what is weird is – instead of addressing aiding absorption, we give “some” supplements to increase the volume instead of increasing the absorptive nature of what they consume – we should likely be doing both. And even weirder still, as a body breaks down further in specific ways, vets start prescribing “prescription KIBBLE” or canned. Maybe some of the added nutrients change – but the heart of the matter still exists in that bag or can.
I did just take note of one of the most recent supplements that vets have been using. Green Lipped Mussel has become a big thing for joint supplements. Supposedly it is because of its good fatty acid content. What is more interesting is that mussels have one of the highest concentrations of B12 in food that you can consume – liver is really the only higher source. They also have a wealth of other vitamins and minerals. So could that good joint affect really just be a good dose of B12 helping the body regain its energy? Helping the body rebuild and regenerate cells and tissue? B12 also helps to increase fatty acid absorption, as I noted earlier, so it works hand in hand. But, we still have to remember, if there is an underlying cellular deficiency, it may not work for our particular dog. We don’t immediately see a change or improvement so we think it was a waste of money. Maybe the reason it’s not immediately evident is because the body is already too deficient in B12.
In the case of an animal, especially a dog, it is possible they could have ingested things in a form that can damage their stomach, which could start their issues. I think about the fact that in my younger and less wise days, I would give my dogs rawhide. I know for a fact that Shelby, especially with little mini bones, has swallowed the ends whole. Same goes for certain biscuits and other treats. Is there a chance that this has actually scraped and damaged parts of the stomach lining and therefore damaged parietal cells needed to produce Intrinsic Factor and stomach acid? In dogs, they do say that the pancreas also supplies intrinsic factor, so they are likely a bit more resilient in overcoming damage. Early in life the body may have repaired them, possibly due to better B12 storage, but with age, and lack of B12, the body may not have done that. Stomach acid can naturally reduce with age, which one can assume means the body doesn’t repair cells or something else takes place. So in seniors does this contribute to the cause? And what about all those added chemicals in food and treats – have they affected the stomach or intestinal tract or overwhelmed the liver in filtering it? Those chemical coatings on treats and food, that basted on glue used to hold rawhide together and all the other chemicals used in processing? Even pieces of nylon consumed from the most popular dog chewing toys?
Shelby, as I am certain happens with many other dogs, when eating kibble would swallow it whole – I know this since vomit will contain pieces of whole food. I always tried to get small-sized kibble for this very reason as early in her life I noticed she was not fond of larger sized pieces. So if there aren’t enough means within the stomach, such as acid and enzymes along with intrinsic factor, and the kibble manages to get into the small intestine, where there stands a chance of further issues with pancreatic enzymes, is there a chance the food isn’t broken down fully and nutrients don’t get absorbed? Can the larger pieces of rough food then damage the intestinal tract causing even more absorption issues? Even if a dog is given pieces of meat – how many fully chew before swallowing? I know for certain those chunks of meat go down whole – and that is actually how a carnivore is designed to eat, but with lack of digestive means to break down the food the benefits of the nutrients consumed are lost in the digestive process. Shelby has always eaten slower than any other dog I have had in my life. I joked that many times she actually seemed to be chewing and savoring. But as weakness began, did her lack of any chewing, along with a potential lack of digestive enzymes then contribute to the digestive issues?
Yes – all hypothesis. But then, in some ways, makes a great deal of sense. After all, what exists now for DM thought is in itself all hypothesis, and UoF even uses that term in their own paper.
A dog in the wild, or even, a dog of 30-40 years ago, did not have this same sort of issue. When I was a kid we fed more canned food, along with table food. The first canned dog food, which was still prevalent back in the 60s and 70s, was Ken-L Ration. I now know that it was horse meat based. But – it was actually meat based, and ironically, horse meat has a higher B12 content than beef, 3.6mcg/100g. There certainly were not as many chemicals and grains added to foods as there are today to bulk it up and keep the cost down and the profit margin high. Nor as many varied treat options that also contain chemicals and other questionable ingredients.
And, to bring up the subject of a dog in the wild, they have the ability to not only hunt for their meat, but satisfy nutritional cravings. We can watch our dogs eat grass in the yard and wonder why. Perhaps, they are trying to get additional enzymes to break down their food. If they eat a raw diet, maybe they are getting their natural folate along with extra enzymes. They at least have the opportunity to try to satisfy their body’s craving for the nutrients it needs. Domesticated dogs, those house bound all day, don’t. We provide them with essentially everything they consume. We control their diet and don’t allow them to satisfy their missing nutritional components.
Humans get to satisfy these things, these cravings. Those days when we feel like a good steak, or a nice seafood dinner perhaps? Sometimes even a good salad or something dairy. If we need more magnesium in our diet we are likely craving chocolate. I personally craved herring on a regular basis, until I began additional B12 supplementation. Cravings are our nutritional deficiencies in almost every case, and in some conditions can signify disease or special circumstances in the body. We have laughed at pregnant women having odd cravings, but these are simply the need to fulfill nutritional requirements for the growing baby and for mom.
So does DM start by bad digestion? Can it be caught in its early stages by fixing/supporting digestive issues and giving supplements, such as liquid multi vitamins for better absorption, and higher doses of specific vitamins, such as B12, to allow for better absorption and use by the body? Did UoF cross the right path, when they suggested B Complex, but in a very low dosage, but not go far enough by addressing the underlying cause and by not increasing certain supplements to a range that would help rebuild the body instead of just maintaining it or only giving it a small boost?
And – have vets, and AAFCO, and the FDA, forgotten to take into account that dogs, companion animals in general, today face far more things that can stress their liver and use up B12 stores? Including medications, antibiotics and anesthesia that kill off B12 or prevent its absorption – like Prednisone. Those “minimum” amounts should be adjusted to allow for a better chance of absorption in compromised animals, and perhaps, there should be a “maximum” for things such as folate, or synthetic folic acid, to make certain an imbalance doesn’t create a medical condition after years of use.
There is also another solution. We should be feeding our dogs a whole food diet. Real food with real vitamins and minerals. Then maybe we wouldn’t see as much disease as we are seeing now on a regular basis.
What Is The Hierarchy In The Body?
I began to wonder something….. if we, and animals, store certain vitamins in our bodies for “emergency” use, what is the hierarchy in the body for use when we begin not to absorb enough? For something like B12 we apparently know that the body keeps stores that can keep us going for months, some claim years. What does that mean? Months with minimal exercise? Will extra activity or disease or medications use up our storage faster? To build muscle, or even repair tissue damage from cuts and injury or surgery, we would need B12, and Folate, to replicate DNA. If we drink alcohol every night or take in chemicals that the body needs to filter out, even smoking, will it use up our storage quicker since the liver has to work harder? Alcohol can even damage the liver limiting its storage capacity and smoking damages Intrinsic Factor. The food and drink we consume today is hardly equivalent to what we consumed 20, 30, 40 years ago, loaded with processed chemicals to sustain shelf life along with dyes and flavorings that can hardly be called natural. Wine today is not the wine naturally produced years ago and has added chemical enhancers. Everything even contains “mold inhibitors”, special chemicals used to kill off bacteria, living organisms in the food. Hmmmm, will it then try to kill off things in the body when consumed like good bacteria?
The exact same thing can be said for what animals consume with new foods and treats and exposure to toxic flea and tick repellents as well as things they encounter just walking on a lawn coated with weed killers and fertilizers – which they could even ingest when they eat grasses and weeds. Dog vaccinations, just as in humans, have increased over the years, getting far more varied vaccinations based in chemicals instead of the natural substances first used to create vaccines, and the body needs to adapt, and yes, even filter out the toxins – more stress on the liver and kidneys. Then we add heartworm medications since mosquitos are a never-ending problem – more toxins – flea & tick preventatives – more toxins. Even laundry and cleaning chemicals can affect them when they lick a blanket or the floor for food that fell. And think of things loaded with chemicals like room air fresheners and even those spray on fabric fresheners. I cringe every time I see a commercial showing the liberal application of these sprays on dog beds and blankets and couches. I use to use them constantly – no more. In addition, the easy ability to perform things like x-rays, MRIs, CT Scans and even dental cleanings, on a regular basis, means a dog can get anesthesia that the body then needs to filter out which can stress the liver during vulnerable times like after getting vaccines or flea & tick treatments or heartworm meds. And, is there any way to deny the amount of food and treat recalls for toxic chemicals and other questionable ingredients making pets sick? Including high lead levels.
Every cell in the body needs B12 and other vitamins. Without B12 cells cannot regenerate and therefore as old cells die off, new ones needed to continue functionality, cannot be replicated, even white blood cells needed to fight infection. If the body can’t replicate healthy cells, how does it then fight off “bad cells” or “cancer cells”? Could the body even produce abnormal cells or mutated cells that create the issues? Wouldn’t this be the heart of human and animal immunity? Healthy DNA replication because of healthy and continual amounts of the very nutrients needed to replicate DNA. The body is still a mystery in how it can fix itself and maintain itself, but yet we know it does. Now if the body realizes that it is not getting enough of a certain vitamin or mineral on a regular basis, or that it is using up what it stores, what does it sacrifice in order to sustain basic life?
I began wondering if it was like using a generator during a power outage. When a house is without power, and you have a generator and just so much gas to keep it running, what do you power? For most of us the one thing that we make certain has power is the refrigerator. This contains the good stuff, hopefully real whole food, that we know will go bad without it being kept cool. So to keep the fridge going, what do we sacrifice, how do we “conserve” the gas that we have not knowing if we can get more or for how long we have to maintain what is taking place? That would be things like lights, or air conditioning, even heat. We don’t run extraneous or peripheral things that consume power.
Does the body do the same? Without a steady intake of nutrients, for whatever reason, how does the body begin to conserve itself? It might be getting some nutrients still through some absorption, depending on the nutrient, but it is only to maintain, not to THRIVE. Much like putting someone on a feeding tube. The supplements they take in are the recommended daily dose, of calories and vitamins, to “maintain” a body or get it to a specific weight. Not in all cases, but most. So how does a body get past just maintenance into full rebuild and thrive? Oddly, when my sister was on a feeding tube after the whipple procedure, she began on liquid vitamins and we added in some additional natural things. Her digestive tract wasn’t able to always intake the amount of food (calories) the doctor required so I wanted to make certain she was getting vitamins to fill in the gaps and some other things like bio-available protein and amino acids through collagen hydrolysate and kefir for probiotics. In essence, she got an “extra dose” of things that could help her rebuild her body faster and make up for the deficit in her diet. Bridging the gaps until she could eat regularly which gave her more nutrients, but we never stopped the vitamins. So it became, the more she took in from eating, plus the feeding tube, plus the vitamins, the faster she could rebuild.
Does the body begin to sacrifice “peripheral” things in order to keep itself going? We know that B12 is necessary to replace red blood cells and white blood cells and rebuild DNA for every cell and also replenish and repair the heart and organs and muscle and nerves and to filter toxins and waste from the body. Does it then begin to sacrifice things like peripheral nerves and muscle and brain function to conserve its reserves in order to continue to do the absolute necessary functions of the body? What is the hierarchy for breakdown? If the body knows it isn’t getting enough of something, does it then try to prevent the body from using up its natural resources – like turning out lights it doesn’t need? Does it affect nerves that provide movement because more movement uses up resources that vital organs need to sustain themselves? Could it actually create its own auto-immune response to a lack of nutrition simply to sustain life? Is MMA attacking nerves actually like an immune response? Perhaps there is already research on this phenomena. Or is it that the nerves that are dying off naturally are simply not able to be replaced, replicated, because there is not enough B12 to perform the function that is not as necessary as keeping the heart pumping, the lungs breathing, or the liver and kidneys working? When the kidneys, liver and lungs begin to shut down is when we die. Our body fills with toxins or fluids that lead to death.
A few weeks ago Shelby began to have more trouble eating – chewing anything – I thought it actually was related to her teeth since I knew a few were cracked back in 2014 when she had a complete dental cleaning, plus her breath does stink and I know for certain some look in questionable condition. Hand feeding became the preferable method for her, else she didn’t have the coordination to seem to be able to do it much on her own. Now many of us know when we are sick, eating takes work. One reason most of us have so much trouble with the flu, even if we don’t have a fever, is that we don’t have the strength to eat. For many in final stages of disease, or old age, the inability to eat becomes one of the last signs. If a body is young and healthy then we automatically supplement nutrition because this isn’t normal. In end stage disease and old age we tend to think the opposite – that it is normal progression. Maybe it isn’t. Is it just normal progression of a vitamin deficiency taking over a body?
Months ago when Shelby would have her “good days” it seemed she could eat with vigor – so it actually could come and go. I would hand feed her still, but she could take the food in and swallow without issue. Sometimes I would even bring her pills on a plate, coated with something, and ironically, often liverwurst since she has always preferred that. (liverwurst/braunschweiger, despite some other additives, has a good dose of B12, Iron and even Folate and other vitamins – dancing around the edges again with something already in a better digestible format). But if I would leave the plate in front of her to go get something and come back – they could be gone as she took initiative to eat them on her own.
I kept giving her nutrients, things that would/should sustain a healthy dog, but apparently she just wasn’t getting the full benefit of everything and not enough to overcome. So my desire to tweak things is what kept her going. But I never broke over that line that made her thrive.
So is the body allowing the breakdown of things that it doesn’t need because it simply isn’t getting enough to make everything thrive? It allows the breakdown of nerves to restrict movement. It then allows the breakdown of muscle because it doesn’t waste the energy to rebuild the muscle, plus it is likely taking nutrients from the muscle to sustain other functions. Oddly, could strengthening muscle actually break the body down quicker since it needs to use reserves to rebuild? The muscle appears to stay stronger longer, but the body may suffer in other ways not easily seen.
Frankly, I hope we don’t find that out and simply start to see a difference if B12, Methylmalonic Acid and Homocysteine levels get tested regularly for any dog with neurologic symptoms, or even other unexplained symptoms, and DM stops progressing at all because it truly could be at the heart of the disease. B12 is likely at the heart of many things, even things such as general seizures that seem to be having an uptick in cases with dogs of all breeds and ages. Too many “odd” diseases are becoming commonplace in all pets, including Cushings which I now suspect has a larger link than I first understood. If we put every disease or symptom through a “B12 Filter”, a “Methylation Filter”, is there a chance deficiency could be the start of the downfall? If we can’t rely on the old method of assuming deficiency, then we need to go back to checking these levels on a more routine basis for the health of our pets. And, any owner willing to pay for the tests, should not be denied the ability to get them run simply because a doctor doesn’t believe it could be the issue.
The Continuing Questions
I am in no position, nor am I trying to say, that every case of DM is a B12 deficiency, but wouldn’t YOU want to know if it was possible? For one, I don’t personally have the ability to test my “theory”. Only veterinarians, researchers, and persistent dog owners can push to do that. And of course, DM, in its original diagnosed format, could still exist. But if veterinarians do care about their patients and about the possibility of helping not only them, but of gaining that feeling of “curing” them if possible, which is why one assumes they get into the practice, then this is an opportunity to check and test thoroughly. Even if veterinary laboratories won’t check for Methylmalonic Acid urine (MMA) levels, the now standard in testing actual levels of B12 at the cellular level, then maybe vets can simply start B12 therapy to see if it indeed makes a difference. (But keep in mind, cellular deficiency WILL NOT BE RESOLVED with one B12 shot a month or a week, and it should be Hydroxocobalamin at the very least to stand a chance at affecting symptoms – not cyanocobalamin) It is not something that can hurt an animal, and can make the vet a hero if it turns out to be the right guess instead of guessing it is DM. For humans there is now a urinary test available to check MMA levels, even without doctor prescription. Perhaps one exists or the existing standard can be utilized for animals since any abnormal increase would signal issues. (UPDATE – this standard test from Norman Laboratories has been used for animals, though at the time of this article it has not been verified against Animal Serum Lab Testing)
I realize that it is possible that I have not found the cases of research that might exist on some of the things I mentioned. But, if I don’t speak about them then I do not provide a means for someone to state whether or not there is an argument against my statements. I simply want to give owners the ability to ask better questions of their vets, with ammunition to back up those questions, and to learn and make a determination on their own. There is too much evidence in human medicine to prove the oversight of B12 deficiency to think that it isn’t the same in veterinary medicine.
That being stated, I have thought of some questions that might be prudent to verify some connection between B12 and DM. For instance…..
Do dogs diagnosed and treated for EPI (with B12 supplementation) ever get DM? Since the concern and focus is based on breed specific tendencies – maybe this information is kept someplace and could answer some questions, or further expand the gene isolation testing. Perhaps that is the reason that some dogs who tested negative for the DM gene were found at death to have DM. Essentially looking in the wrong place for the answer, or rather the cause.
If dogs currently diagnosed or assumed to have DM are treated as if they have EPI, or simply a malabsorption disorder, along with B12 deficiency, will they show any significant improvement?
This is probably the easiest method to determine if the theory could be valid and there is indeed an underlying gastric problem – perhaps stemming from MMA blocking the breakdown and absorption of food. Despite any tests that might be run for nutritional deficiencies, begin treating the animal with a bio-available vitamin/mineral supplement. Liquid form would ensure the highest absorption possible. An easily digestible diet with natural whole foods, no kibble, in addition to digestive/pancreatic enzymes to increase absorption. All of this should also be supplemented with B12 shots and/or oral forms of B12, along with making certain that the diet has adequate amounts of Magnesium and add greatly increased dosages of Biotin to ensure activation of Adenosylcobalamin. (True B12 deficiency requires intense B12 supplementation to have any chance at rectification. If muscle wasting has already occurred DAILY supplementation with shots and/or oral is necessary) Additionally, a veterinarian can recommend other supplements that can be taken in safe higher doses that can bring the body back quicker and support other functions related to energy. A high dose B Complex, as I mentioned earlier, would provide other reaction partners since B Vitamins work synergistically with one another and could further improve symptoms and recovery. A body may still have to recover in stages. But it may need additional doses of certain things to support and recover faster. Some supplements would need to be supplied in incremental doses since as the body rebuilds in certain ways it will need more and more to sustain any improvement. Just as an athlete needs better nutritional intake to sustain their muscle and other physical attributes, a dog trying to rebuild muscles is going to get drained in other ways and likely “feel the burn” of rebuilding those muscles. It could be why Shelby improved on supplements for a certain period of time, but, once the body reached a better level it regressed because it couldn’t sustain that higher level of functioning nor could it get even better without more supplementation – those “Hail Mary Passes” that increased dosages.
One should remember however, that some nerve damage, spinal and brain, even muscle or organ damage, may never be able to be repaired – possibly dependent on the age of the animal. It is known that some nerve damage that results from B12 deficiency may be permanent, such as the spinal and brain atrophy that can take place. It can all depend on the length of time the disease has been progressing, and perhaps, what supplementation has been given that danced around the edges of maintaining the body at that point. Just as malnutrition in humans can leave permanent issues – so too would it do for animals. Strength and stamina could return, but some functionality damage could be irreversible. Some resulting organ damage could also be permanent.
Have dogs who have been fed ONLY a raw diet or whole food diet, no kibble, been diagnosed with DM? (I have subsequently found out through various feedback for owners that this is the case, but it was before I understood other factors that could have been involved – even raw eggs and anesthesia issues)
This however would likely need to include treats and other things. Though, as a main source of diet, it would be prudent to know, if for any length of time prior to the disease beginning, if kibble was a main source of nutrition. If it was, we can go back to the questions of whether kibble, of whatever quality, may have contributed to the disease. Did it indeed contain poor quality synthetic vitamins, very little meat, and ingredients that masked B12 deficiency, or prevented digestibility of nutrients in general? Regardless if it was grain free or corn-based did it, according to guesstimates, contain more Folate than B12 allowing for a draining of reserves from the body?
There is however one slight nuance to this, was the raw diet one of primarily chicken, turkey or duck? (most raw feeders do rotate proteins an include organ meat, but some feed one source for various reasons) It is known that these meats contain much less B12, however, if giblets or liver of the animals was included in the raw diet it will increase the levels of B12 available in the food. The above mentioned issue with Biotin and Magnesium inhibiting the reactions of adenosylcobalamin would also need to be known in case the diet wasn’t as balanced as it should have been, or possibly contained regular raw egg that could have contributed to issues.
In all of this, one cannot forget that an animal can have their B12 stores drained by toxins, chemicals, vaccines, medications, antibiotics for various infections, flea/tick/heartworm treatments and anesthesia given for any procedure including x-rays, dental or injury repair – all of which could override the benefits of a raw diet by stressing the liver and draining B12 resources.
Are our “normal ranges” for bloodwork inaccurate due to changes over the past decades in vaccination requirements and various treatments? Should the veterinary profession as a whole establish new thresholds based upon the new stresses pets must meet in modern society?
The video link I provide below describes how mothers who are vegetarian and who may have lacked sufficient B12 stores prior to conception, can pass on a lack of B12 supplies to their infants, especially after birth when nursing. Would this then be the same for dogs? Could deficiency start at birth and be affected by continuing deficiency in milk consumption because their mother was fed a poor quality kibble diet, and then the puppy continued with a kibble diet increasing the deficiency with unbalanced nutrient levels? And then to add insult to injury, a puppy is subjected to vaccines and de-wormers that can stress the liver even more. A growing body will need adequate supply of B12 to produce new cells as the old die off and as the organs and other tissue grow and exercise increases. Much emphasis has always been on protein in food for both adults and puppies, rightly so, but perhaps we have forgotten about something just as, or even more, vital. That the protein NEEDS to come from MEAT. And, perhaps this is why EPI shows up in young dogs as a failure to thrive, but only after severe damage to the pancreas. However, later in life could become the symptoms and basis for a “DM” diagnosis because the pet wasn’t losing weight drastically, or even needed to lose some weight so slowing down and losing weight was not looked at as a failure to thrive. A younger dog would be assumed to have an issue that needs resolve, an older dog not treated the same exact way. There actually are some articles that state that dogs shown to have some forms of EPI, after treatment for a period of time, then have symptoms reverse and their pancreatic enzyme levels go back to normal. Is it possible that supplementing B12 then allowed the body to restore normal cell production that regenerated the acinar cells of the pancreas? The MMA levels normalized and allowed the pancreas to not work as hard to try and overcome the blocking effects of nutrient breakdown. Maybe the “genetics” that have been used to explain EPI and DM are true, but not necessarily in the way we have been thinking. That old saying, “you are what you eat” can come into play. Just as we know human babies can be born addicted to drugs or have other issues, like spina bifida when the mother didn’t get enough folate. Will not consuming enough B12 lay the groundwork for disease in puppies and kittens? Could it affect the immune system of the puppy and that is why so many fight life threatening diseases at early ages?
Perhaps then, puppies should be screened for deficiency at an early age. Or perhaps just given a B12 shot, or two or three along with their vaccines. And, part of a yearly or bi-yearly vet checkup should indeed include detailed blood screening for deficiency. Or maybe at those points they should just be given a preventative B12 shot at regular vet visits. For the price of a few blood tests, or even a cheap B12 shot, it could conceivably save Thousands in later diseases and issues and diagnostic tests. Later in life it should definitely be a part of “senior” screening for pets since that may be when they are most vulnerable to the cumulative effects of a deficient diet.
Above I mentioned puppies and how it could be possible that they received a B12 deficiency at birth. There is something to consider in that statement.
Has our desire for certain breeds of dogs created the deficiency? There are many “reputable” breeders of dogs – those who are likely treating their breeding pups like kings and queens with meat rich and whole food diets. But, we do know puppy mills exist. We have seen the videos of absolutely horrid conditions that the animals are forced to breed within.
Many people who breed dogs do it for money – supplemental income. Not all, but many, as in the case of puppy mills and “backyard breeders”. If you are doing something for the money, not for the love of the animal and breed, what kind of food are you feeding those breeding pairs? I am going to venture a guess that it is the cheapest bulk dry food you can get so that your profit margin in the end is as high as possible. Based upon the analysis I gave earlier, do you think the food would be high in B12 content? Do you think those dogs are supplemented with real meat? Many barely have clean water on a regular basis.
So, could this be why so many have issues upon being bought by unsuspecting owners? Those puppies, already deficient, are then given vaccines and other drugs that “assault” their system, their liver, and some start to develop seizures and other neurological problems. They have a failure to thrive and become ill regularly, possibly kidney and liver issues, even heart issues. If they aren’t show dogs they are then subjected to spay and neuter procedures adding further stress to their system. Then there are those certain breeds accused of being more “vicious”. Is it simply possible that they are more susceptible to a B12 deficiency that causes the aggressive tendency? Vets have been accusing “genetics” for many illnesses. Could it all be as simple as B12 deficiency?
This however, doesn’t rule out the possibility that years of breeding with poor diet could have created an inherited susceptibility, even in future raw fed dogs. Again, the only way to truly know would be to test specifically for deficiency to make certain it is or isn’t part of the disease.
I will end by stating I am not naïve, nor am I arrogant in my beliefs in what I have written. I am not stating that B12 will solve every disease in a dog, though the possibility of a link is mind blowing. My goal was to address how an actual problem, B12 deficiency, is not even thought about in terms of dogs, and cats, with neurological problems. Heck, it’s not even regularly looked at in humans who go through years of struggles before someone “might” decide to check for the issue – especially in the elderly diagnosed with dementia. If however, they don’t die before it is ever even considered.
Additionally, my goal was to inform pet owners, and in turn veterinarians, about what could be the case for their pets. To not stand by and allow a diagnosis of DM to be an automatic death sentence for their dogs and to try to supplement their dogs with B12, and Biotin, and even digestive and or pancreatic enzymes, to see if there can be improvement – and by supplement, it can’t be a shot a week, it must be daily intense supplementation. Even to improve their diets to contain more B12 foods and perhaps enough added biotin and magnesium and other nutrients to aid B12 metabolism, more whole foods instead of kibble, since we have no way of knowing if the processed food could indeed be deficient in B12 or have gross imbalances of nutrients, or even dangerous chemicals. To get your vets to give B12 shots, a very inexpensive preventative and safeguard, and think twice on a regular basis that there can be another underlying cause that they are dismissing based upon outdated assumptions.
For a vet to not think about B12 deficiency as even a possibility, is simply wrong. Regardless if your pet is on a processed diet or even a raw or cooked diet, there are circumstances that can still prevent the breakdown and absorption of B12, or drain B12 storage in the body, that the vet cannot know simply by looking at a general blood test. Vets also need to consider the draining of vitamins and minerals when they prescribe certain drugs and give anesthesia. There are known deficiencies that can occur from certain medications. For instance, vets should know that many seizure drugs can drain B12 from the body. The catch 22 is that B12 supplementation can decrease effectiveness of seizure meds. But without B12, the rest of the body can’t function and can’t properly sustain and repair itself. B12 deficiency could actually be the cause of the seizures in the first place, but again, no one checks. It’s not “just a vitamin”, its essential for life – without it, all other functions in the body stop working. B12 deficiency can even cause aggressive tendencies in people, fits of rage, so perhaps pets known to be aggressive should be checked for deficiency – they could simply be more sensitive to decreased levels in the body.
So, if it is just regular thought and practice that a pet can’t be B12 deficient, THAT, in and of itself, is NAÏVE, and to some degree, an arrogant thought.
It would also be naïve for the FDA and AAFCO to continue using “minimum” standards, likely outdated figures, for certain things and not pay attention to maximum values and nutrients that can be completely out of balance in “food” that is “assumed” by pet owners to be a “complete” diet. Additionally, it is also naïve to think that not knowing the approximate nutrient amounts in the foods our pets consume is a good thing. Why shouldn’t we know the actual vitamin and mineral content? If the formulation of pet food, in particular kibble, is consistent, or “supposed to be”, and considered a “complete meal”, then companies can easily get the nutritional breakdown of that food and provide it to the consumer.
It can make one wonder if maybe that is the goal, to keep all of us, NAÏVE.
As Of December 2017
I have struggled to write this last part as I was hoping that maybe I would have a different ending to share by now. I started this article at the end of July of 2017, when everything hit me about what had been taking place all along with Shelby’s struggles. That epiphany led me to understand that I needed to share what I had learned – not for her benefit, or for her miracle healing, but for the benefit of others, so that this particular struggle never has to happen if people understand what could be at the heart of everything. I kind of knew, when I started writing, and even said to my husband, that if she left us the following day I would be ok with it as I understood why it all took place, just simply for me to write this.
By that July date she had already endured so much for over 2 years and the mental decline in and of itself was staggering. We are now nearing her 15th birthday, which is guesstimated to be in January. She was a rescue found wandering the streets of Suffolk County Long Island, fending for herself, likely by hunting, in the Fall of 2003. She was so skittish that she had to be humanely trapped to be saved by a wonderful rescue group called For Our Friends. It is now 3 years since her ear hematoma surgeries that I believe started the final decline.
I only discovered the true heart of her B12 deficiency essentially after 1.5 years of intense struggles, when the neurological symptoms were present. And even at that point, I never truly understood what it would take to overcome the issue despite my efforts to help her, so she likely never got enough to make her thrive, to fully heal. I then never realized that the deficiency had already done much more damage internally. Had I known or understood her digestive issues that were caused by the deficiency I could have taken additional actions back in March of 2017, but they were delayed until July when she reached another “end of the line” type moment. She even battled some small respiratory infections along with a few UTIs, one of which had her urinating blood in July. And although I started her not only on more intense supplementation along with providing enzymes and better digestible food, her body was likely too far degenerated at that time for a 14 year old to overcome.
It is now nearing the end of December of 2017, and she has backslid again. She is simply so much weaker that she has not been able to stand up for more than a moment without support from us. In July when we started the better diet and supplements she made a remarkable turnaround with strength and determination (the above video was taken about 3 weeks after her diet and supplement change). But her body just couldn’t seem to support the improvement. She was walking better and able to maneuver even getting down our deck ramp into the yard, as recently as October, but each burst of exercise just seemed to drain her further, 2 steps forward, and then 3 steps backward. She has even begun to hold her urine better, not as many accidents on the bed and she would try to get down onto the floor before she would allow herself to pee. She lost 20 pounds in 2 years and she is skin and bones in spite of eating every day. As weakness has grown I have even taken to stick blending wet food that I make and add in some additional supplements and have fed her with a turkey baster. She will occasionally eat solid food on good days, like pieces of chicken or beef and even had a few hard cookies the other day. But the good days have not been as frequent. The struggle for her and for myself and my husband has taken its toll in many ways.
As I finish writing this I am still trying “one more” Hail Mary Pass, because to me it always seems that there is just one chemical reaction I am missing to give her back her strength. At this moment, that is the addition of special iron supplementation. It is possible that even though the B12 has been working all along, due to digestive issues she has not been absorbing enough iron to replenish her rebuilding system and support any new cells, including increased red blood cells and support enough oxygenation for increased activity – hence her weakness after having “good days”. Iron and B12 do go hand in hand, but amounts in the diet and in simple vitamin supplements may not have been enough to support her, to “rebuild” her, especially with absorption issues. I could be fooling myself, but if I don’t try I can never know. I could just be prolonging the inevitable, as I know internally the prolonged effects of the deficiency have taken a toll. But, in only a week she has shown a glimmer of improvement, even some attempts to stand. Supplementation can take 2-3 weeks to see any significant signs of improvement, so we shall give it a chance.
(As of mid January I have added greatly increased dosages of Biotin. The section above where I wrote about Biotin was actually added late to this article – I am still always researching information – seeing if I overlooked something that may have been a key component, or trying to find other related articles that can further connect dots since researchers tend to narrowly focus on things and articles do not always relate to other circumstances. Though still not walking, her energy has increased tremendously than just with the addition of iron, and she is now eating solid food on a regular basis again and in amounts she hasn’t in ages. Her eyes have a greater spark again. I may now understand why she backslid during Fall of 2017 when she had been getting better, but until I see further improvement I will wait to share the details – though Biotin is the link. No way to tell for certain yet if she indeed can overcome the damage and regain strength to walk, though she has stood independently for a few moments when lifted, and has attempted to walk a few times when fully supported.)
I am not looking forward to the next few days or weeks if it can be, as I know our time is likely dwindling quickly. I am just not one to give up very easily, I have a great deal of “Faith” on many levels. My husband has also referred to it as stubbornness. But just maybe, I will need to adjust this last section with more positive information, and that would be a good thing.
However, I finished the heart of this article before this tougher time had come. All along I seemed to know that when I finished the article it would bring everything to a close in some way shape or form. But then, if she had left sooner I don’t know if I would have had the push to finish the article at all. Even in the last few days & weeks I have learned a great deal more that was included in this article and could be beneficial to not just animals but people as well. As I stated at the very start, I believe this is just one of the reasons that God brought her and I together – and it will hopefully be her legacy. That other pets, and owners, will not have to suffer if B12 deficiency is thought of first for neurological issues instead of never at all. Maybe if we start looking at it more for animals and see positive results, then doctors will look at it more for humans as they should have all along, and certain diseases will never have to be dealt with at all. Now THAT would be the miracle from this.
UPDATE AS OF 4/26/18 11:00PM EST
I had been trying to formally update this article to provide some more details and a greater understanding I encountered within this last month, but since it is now gaining more views worldwide, I want to quickly post a few more facts.
As I stated above, Biotin made a significant difference in Shelby. So much so that she began eating better and getting stronger. In fact she had a healthier appetite than any time in the last year, which I thought great since she has lost over 20 pounds – more food, more nutrients, get better.
When she was improving back in early Fall I had decided to begin to change her pre-made raw food to a different brand that was raved about because of better probiotics and general ingredients. This food was pre-ground together and contained raw egg. As a result, I can only surmise, that the composition may have then allowed the Avidin enzyme to bind with any biotin in the mixture preventing its benefits. It “may” have also then bound with the extra Biotin in the B ComplexVET, preventing its benefits. If there was already a pre-existing GI issue with Biotin formation in the gut, Strike 3. The spiral then began to continue until she became weaker and no longer could consume whole food and I began blending a cooked mixture to feed to her. However, I added things to that mixture that then created its own set of circumstances – things like protein powder, loaded with amino acids, to help build muscles. I had then learned about adding Biotin which overcame the issue for a period of time and got her back to eating regular food, but this time I switched to a different raw food since she enjoyed it and seemed to do well with it. However I also added in some supplements that increased some of the amino acid load.
After a few weeks I noticed she was getting weaker again and it baffled me. I increased her dosage of Biotin and kept up with the B12 (most of which as Adenosyl/Hydroxy but also adding doses of Methyl) on a regular schedule throughout the day which helped, but only temporarily and still getting weaker. Increasing dosages were the only way to stabilize any progress, again baffling me to a point. But she had gotten so weak that when we took her to the vet at the very end of March to get her Rabies titer waiver the vet said “I think it’s time”. To which I had to agree, BUT, the NIGHT BEFORE I realized something critical and needed to see if it could make a difference.
I had decided to research specific information on Methylmalonic Acidemia – the state of the body created by the toxic buildup. This led me to researching and gaining a cursory understanding of Organic Acid Metabolism. I found information regarding how Methylmalonic Acid (MMA), and its pre-cursor, Propionic Acid (PA) are actually “now” screened at birth in humans because there are gene abnormalities that can create problems with Organic Acid Metabolism in infancy – and there have been cases where adults have sudden onset of these same diseases (Methylmalonic and Propionic Acidemia – MMA/PA). Interestingly, not all US states test for all inborn gene mutations, and children born many decades ago would not have been identified as having issues with any of these relevant genes. The adult onset may then happen because diet or other circumstances triggered the issue, and doctors may not even be able to properly diagnose the condition unless all levels of deficiency are tested and then gene testing is performed – meaning some people may never be properly diagnosed with the condition. This could also signify how a parent can pass on a deficiency to a child at birth. This allows doctors to identify issues at birth and hone in on whether the issue lies with B12 function in the body or with Amino Acid function – both of which lead to the increase in these acids and require lifelong maintenance and/or diet alteration. I am not stating that dogs have this rare disease, though it is possible, just that their bodies have gotten into this state of disease due to deficiency. This is a link to one page describing the condition, though I will warn it is NOT an easy read. It does however provide a chart to show the information I discuss below. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4180313/
I received a further education on the effects of Biotin in digestion. Though there is a longer explanation, in order to cut to core of the issue I will try to explain it simply – and it is not easy, nor simple.
During digestion there are 4 essential amino acids (Valine, Methionine, Isoleucine and Threonine) that come from protein and ultimately need B12 to fully break down, along with Odd Chain Fatty Acids and Cholesterol – this process is actually referred to as the VOMIT process. In the GI tract, normal bacteria produce a certain amount of Propionic Acid during digestive functions. The breakdown (metabolism) of these amino acids and fats also produce PA. The buildup of Propionic Acid from those 3 processes then needs Biotin as a first level of neutralization/metabolism before turning into Methylmalonic Acid. As per information I provided in the earlier section of this article on Biotin, magnesium also plays a part in this metabolism. Methylmalonic Acid is then neutralized/metabolized by Adenosylcobalamin before entering the Citric Acid Cycle (also known as Krebs Cycle) in a body. If there is not enough Biotin to overcome the Propionic Acid, PA builds and then acts as a metabolic toxin in liver cells (likely those first signs of liver level elevation on blood tests). Without enough Adenosylcobalamin, Methylmalonic acid also builds and can start attacking nerves. It is actually hard to decipher in many instances what can be the direct cause of issues between MMA and PA, though knowing levels of Serum B12 and urine Methylmalonic Acid would be the best start to diagnosing the issue and detecting if Biotin could be a contributing cause. If Homocysteine is also checked it could rule out any Folate issues contributing to B12 inactivation. It may also indicate why different dogs can take a differing path of deterioration during the progression of “DM” symptoms. Their symptoms could be from pure B12 deficiency, pure Biotin deficiency (meaning Methylation may still happen in a body but Adenosyl can’t be activated to protect nerves and provide additional needed energy – these dogs may be overall stronger or still active because they can process carbohydrates for energy and possibly more cognitive if the brain isn’t yet involved, but lose nervous system mobility function before other symptoms occur), or a combination of both deteriorating the overall body more evenly – all depending on how far along and how well their overall system is still functioning.
Upon understanding this all, and then reading that the first course of action for a bodily state of MMA/PA Acidemia is dietary Protein Restriction, I had to try. (BTW – articles on MMA/PA do also mention that in extreme cases antibiotics could be used to suppress the gut bacteria from producing PA. For NEOSPORSIS dogs, this could signal why there is temporary improvement during treatment, but then functionality decreases upon stopping antibiotics – just a thought.) Another supplement stated to aid the process is Carnitine so I have added that in also. I immediately cut back on protein and fats and increased carbohydrates. The carbs I am currently using are rice, pasta and sweet potatoes, even bread. Not what I would have now generally thought of feeding, but carbohydrates were the only thing that would bypass the process in order to provide energy for the body. It then allows the body the chance to work on the Propionic Acid buildup and in turn the Methylmalonic Acid buildup without throwing more fuel on the fire. (You could probably think of it like trying to catch up on laundry. If you have 5 people in the house, especially a few kids who are constantly getting dirty and changing clothes, dirtying towels or other things, how do you catch up on regular laundry plus do the other things like bedding and towels, etc.? You either need to get another washer and dryer, or you need to create less laundry – right? The best way is if there was no immediate laundry to do, like when people are out of the house and not adding to the pile. Only then can you whittle down the pile and try to come on top of the problem instead of being buried under it. Adding another washer and dryer would then help to keep it manageable.)
This same thing would apply to how the body is trying to deal with deficiency and muscle wasting. Normal thought is to add in protein to attack the muscle wasting. The problem with that thought is that deficiency is allowing for a buildup of acids as it tries to break down the protein and fats. Even if there is enough Biotin to reduce PA to MMA, a deficiency in B12 is not allowing the body to do everything needed, plus process MMA. The body also needs B12 to repair tissue in the digestive tract to aid absorption, along with processing other toxins and performing methylation tasks, in addition to simply providing energy for cells and the body. The kidneys use B12 within its cells in a separate process to help filter out the MMA in the blood which is why an MMA urine test shows the state of the body at a cellular level. Remember, B12 is used by the body in 2 different forms (methylcobalamin and adenosylcobalamin) because different processes need the different chemical structures. So where does the body take the extra B12 it needs just to keep itself going? Muscle. And as a result, the body is likely adding an additional amino acid load as it breaks down its own cells – a continual degradation loop. So it can’t build muscle while trying to survive. So adding more protein in the diet thinking we can build muscle (cell division DNA process) during a state of deficiency is like trying to keep on top of the pile of laundry while having more people stay at the house and using the machines.
Until we restrict, or at least alter the food intake to reduce the offending amino acids and fats, we may not be able to come over the top of the deficiency and muscle wasting, in spite of even trying to supplement with B12. So low dose B12 supplementation would barely make a dent in the problem. This acid buildup is what deteriorates the body faster even though a dog may be eating all its food. Just like when an EPI dog eats but can’t gain weight. This would mean then that a pure raw diet could be detrimental to the recovery process for those pets that have already experienced extreme muscle wasting or are in the late stages of “DM”. Meats in general have a very high amino acid profile. Vegetables contain protein but have less of the offending amino acids, but are also missing certain other nutrients. The best approach would appear to be a natural whole food diet that uses meat and fat sparingly, or replaces it with whitefish (lower amino acid load) and includes carbohydrates and veggies for balance and other nutrients. Veterinarian Dr. Judy Morgan (www.drjudymorgan.com) recently published a new pet cookbook that provides such recipes and explanations of food energetics which may be of help to some pet parents.
Something to take note for those whose pets have experienced “pancreatitis attacks”. Symptoms of MMA/PA are known to include pancreatitis and liver issues. Does it start with a Biotin deficiency? Could it possibly happen with processed foods lacking the nutrient? even raw egg consumption not allowing continual Biotin creation by gut bacteria? Or general antibiotics or other meds killing off good bacteria? Or did it start by B12 deficiency causing an MMA buildup that could have prevented proper digestion to begin with? Perhaps that is more information for researchers to decipher.
There is another point that could be of interest for any pets who have had issues due to use of NSAIDS for pain and inflammation. Some of the most popular NSAIDS, including Rimadyl, (Advil for humans) are known as a Propionic Acid Class of drug. This means it utilizes and can add to issues with Propionic Acid metabolism. It affects the liver and kidneys because of this metabolism and likely due to any bodily deficiency in Biotin, Magnesium and B12.
What is interesting in all of this, is that it has taught me personally that the way to neutralize some acidity in the body is by adequately supplementing with Biotin and B12. This is important for me personally as I have been a chronic kidney stone producer for years (calcium and uric acid) and acid is not my friend. Since starting supplementation on myself it appears I have normalized my own PH level. For those who know that cancer is stated to thrive in an acidic state, this can be the underlying answer to why it is so prevalent – in both pets and humans. Especially since it has been shown that B12 deficiency is more prevalent in society than previously thought.
One month ago I started this new process on Shelby as best I can while still trying to get her to eat things she will willingly consume – again she has always been a picky eater. In that month she has once again made strides. The below picture was taken today –4/26/18. Two years after I took one of the above videos. She DID NOT walk to that position on her own – I pushed her so she could move her legs and feel like she was walking again. It was a good effort and seemed to bring a bit of joy to her. She can move the cart on a flat surface a little bit – mostly in circles, though she has jolted forward a few times – but she has been putting pressure on all of her legs and trying to fully stand and push, and that is the way to begin to rebuild. She actually gets restless when laying down and appears to want to go into the cart and try – this is a good sign. She is still weak, and still has not walked since the beginning of December, but I am still willing to try right alongside her. And to share anything else I learn as we go. I have glanced over a few more things during my research that I wanted to include in an update, but they will have to wait for a later update if they can add additional insight to this process.
Some people have asked me about specific supplements. I am NOT telling anyone what they should or should not do for their situation – I am simply informing you what I am doing or have done for my pup. At this point Shelby is 30 pounds and was just over 50 when symptoms started in 2015, and has now advanced easily to what could be considered late stages – which may simply be because I didn’t know things a year ago. Without her continuing decline I likely would not have found out the additional information I decided to share so that people can have more scientific information – it is not a guess – it is science. Without supplementation she would not have survived to this point. And, if I did not have the ability to be with her 24/7 I would likely not know what I do now, and I likely would have made that final decision long ago. I just did not know early in her progression what to do and how much to do – I had no guidance in the process. Every dog can be at a different level of decline and what they might respond to. Early stages might respond well to lower doses of any one particular thing, but if they don’t respond you may have to drastically increase doses before knowing if there can be any difference – it can also depend on weight of your pup. Shelby responded to just the B ComplexVET and Magnesium early on, but I had no idea that the increased doses of B12 and Biotin would have made a significant difference in those earlier stages – possibly reversing all her symptoms before further deterioration. She may have needed more magnesium overall but I was fearful of increasing dosages too high. Additionally, it may not happen overnight. Things have to take place at a cellular level before changes can start to be noticeable, especially if lower doses are used. Every time I added something I knew I had to wait at least a month, but as much as two or three before I might see significant changes. But then, some have told me they noticed changes in their still mobile pups after a few days to a week. Every dog is different. And yes, there still could be a totally different diagnosis for your dog. But sadly, if vets refuse to test, we can’t actually know for certain if this course of action can work for you without trying. (BTW – USA vets at least do have the ability to send blood to Texas A&M for MMA testing, most are either not knowledgeable of this process, or it is too much of a hassle for them) I have had multiple people tell me their vets flat out said it can’t be B12 because there was no evident anemia – including neurologists who “should” know better to at least fully test. Some just simply stated in “their opinion” it is not B12 deficiency. Those vets dismissed these owners and wouldn’t even prove them wrong by running a test, maybe even because they feared they could be right.
Dr. David Carr, an actual doctor (who knows how to read blood tests) who was only finally diagnosed with B12 deficiency when he was near death, after chief neurologists (who also know how to read blood tests) never even tested him, had a very poignant line in the video below: “I’m sure it would have gone down that I died from a neurological condition……. Ignorance”
The main supplements I use for Shelby are:
Adenosyl/Hydroxy (liquid and pill form) – Shelby gets this multiple times during the day to keep it in her system. For the liquid I squirt and entire syringe in her mouth under her tongue to get better absorption.
(for owners of female dogs – when treating with Adenosyl/Hydroxy, or any form of Adenosylcobalamin – you may experience a small side effect. Within a few days of starting on this particular supplement Shelby began with a yellowish vaginal discharge. This did freak me at first. I stopped the supplement and the side effect stopped so i knew it had to do directly with this form as no other form created this issue. When I started it back up the discharge happened again but I decided to see what would happen. After a few days it lessened and then stopped. Adenosyl has been noted in some articles to have an affect on the mucous membranes. Perhaps that is one link to the “fatty” layer that protects the myelin sheath. But understanding this fact allowed me to realize that it was indeed having an affect on the body and it may have been repairing and shedding cells. It can be a little gross, but do not be alarmed – its a good thing.)
B5000 liquid – this is Methylcobalamin. I will give a dose in the morning and often one at night. (I squirt a full syringe directly under her tongue for better absorption)
If you have the opportunity to get B12 shots through your vet – do so – preferably as Hydroxocobalamin or as Methylcobalamin. (and if the vet will give you a script to continue shots at home – EVEN BETTER.) Hydroxocobalamin is a version the body would get through food and can be converted into either Methylcobalamin or Adenosylcobalamin, it is also found to stay in the body longer before being excreted which can help replenish storage faster. It also can bind to the cyanide molecules taken in through years of synthetic cyanocobalamin in processed foods as well as other toxins in the body (like heavy metals and chemicals ingested in food) as Hydroxo needs to go through the “Methylation Process” in the body – the very thing that makes the majority of other chemical reactions in the body work. Methylcobalamin is readily available for cells to use. This is both good and bad in some ways since it means it bypasses the initial methylation process – that critical chemical reaction with Folate and B6, though as the body cycles through chemical reactions it is still utilized in future reactions. Though this technically shouldn’t be a problem, in dogs there is a possibility that there can be a problem with Methylation, as happens with the MTHFR gene mutation. No way to know this for certain without gene testing. Methylcobalamin may not be absorbed and utilized as well as taking Hydroxo or sublingual Adenosyl. In some humans, because of the gene mutation, methylcobalamin treatment did not actually improve overall symptoms nor raise Serum B12 levels. Hydroxocobalamin as an injection is more expensive than Cyano, but in this case the benefits of what you can get for what you are paying could be life changing. This version is used most often in human severe B12 deficiency cases and cases of heavy metal poisoning and for smokers. Adenosyl is not given as an injection and only comes in liquid or sublingual lozenge form or in pills.
Gross cellular B12 deficiency CANNOT be resolved with one shot a week or a month. This could be where some previous DM study attempts at using B12 have failed to make any difference in DM dogs, since it was not known how serious a cellular deficiency was at the heart of the problem. I have read anecdotal reports that stated they realized many DM dogs appeared to have low B12 levels but that supplementation did not make a significant difference. Could what I explained above be the reason why? Including Biotin and Magnesium. That is why taking additional supplements, or daily shots, is the way to overcome the severe disease state of B12 deficiency. If muscle wasting has already started, DAILY supplementation must be done to stand any chance at halting progression and rebuilding storage, along with making certain of Biotin availability with Magnesium Support and even proper Calcium amounts to aid intestinal absorption and chemical reactions. The 3 forms of B12 may also have to be used to support all chemical reactions.
(side note – Adenosylcobalamin is also known as Dibencozide. some companies make a sublingual – under the tongue lozenge type pill – of this format. in the past i used these also as i could slip it under her tongue when she was sleeping and it would dissolve. AGAIN – they CANNOT use the sweetener Xylitol – be VERY CAREFUL. The same thing can be applied to methylcobalamin sublingual pills. Some companies even combine all 3 forms in one supplement. Another company making a liquid combo of Methyl/Adenosyl is Global Healing – called Vegansafe B12 – you can squirt a syringe full under the tongue)
Biotin – these are 8mg pills. She has gotten these at least twice a day. During her weakest point I have given her at least 3 times a day and have even done 2 at a time when she was in metabolic overload crisis. Again it can get urinated out and I wanted to make certain if she was having absorption problems that she had enough in her system to overcome acid buildup. I had done lower dose pills initially, using that at night with higher in the morning, but I wasn’t seeing the kind of reaction until I was using these regularly and in higher doses when she was having more issues.
B ComplexVET – basically according to dosing – but can give increased amounts. B Complex is safe in general and can be your first course of treatment especially if your pup is just starting to show signs of issues. But if symptoms return you will need to use higher dosing of B12 and Biotin (and B2) at the very least along with Magnesium.
(8/2019 A quality complete B Complex such as this is critical when supplementing. B2 – also known as Riboflavin – plays a critical role in B12 cycling in the body. If not enough B2 is available B12 supplementation, in particular as just Methylcobalamin, could fail to make significant difference. It could progress muscle wasting during DM progression. A B Complex contains larger doses than found in just a general multi and should not be ignored in treatment. Article will be updated by September 2019 with further information)
Canine Geriatric Basics – according to dosing or less if diet should be adequate. This is a very good multi-vitamin that contains bio-active forms of many nutrients.
I will also use Magnesium Glycinate in low doses. I have used various brand names including Pure Encapsulations. Magnesium Chloride has been stated to have better absorption in many cases. I personally did not use it, but I have read some articles on its use in animals.
RX Amino B-Plex – this is liquid B Complex. It does not contain Folate, nor Biotin. It does contain low doses of Amino Acids, but also contains Iron and Potassium. I will actually give her around five squirts once or twice a day – not around the same time as food or other supplementation. Liquid absorbs better, plus with the iron it might help to boost her during more strained times. She does try to “exercise” so if she has had an extra strenuous day trying to move in the cart I want to make certain she keeps up with any increase in activity. It makes a difference for her on some days. There is also evidence from people who suffer with B12 issues that during storage deficit rebuilding (high dose supplementation), Potassium has been known to drop in the body. It is therefore important to make certain the diet contains an adequate amount. Supplementing in this form may be easier. It is possible that this element has also helped her.
I use BioCase pills at this point to aid digestion. I actually use one pill of BioCase Plus that contains Intrinsic Factor and Probiotics plus a nominal dose of Methylcobalamin, and 2 pills of regular BioCase for each meal. It is the trial and error balance that has seemed to work best for her. Because she is particular with food, mix-in enzymes have not worked well recently, but general digestive enzymes may work well for others depending on condition of the GI tract. If you give wet food to your dog, and they will eat anything without issue, using powdered BioCase and allowing it to begin predigesting the food prior to serving would be the best way to ensure better digestion and absorption. I did use this method before she declined in the fall from Biotin insufficiency.
Carnitine is stated to help with MMA/PA – it aids fatty acid metabolism. I decided based upon her “brain” issues to do so as Acetyl-l-carnitine which is one form stated to have a better neurological/brain affect.
I do need to bring attention to fermented Goat Milk that has been one of the latest super supplements. I was also giving that to her before her latest weakness bout. It turns out that goat milk actually has one of the highest amino acid amounts – a negative in this issue. It could have been another thing adding to the acid buildup leading to her last bout of weakness. I stopped using it when I realized this issue.
I also DO NOT give her any fat supplements. No special fish oils or even coconut oil. I wish I went with my gut years ago when I thought she was not responding well to the oils. Hindsight is 20/20 as they say. That is what eventually made me research a connection between Fatty Acids and B12 and why I cited the article I listed earlier. Unless she gets back to some form of “normal” I will not risk adding them in at this point.
Though I made a notation earlier in the article of green lipped mussels, they too have a large amino acid load – again a negative in this situation. I had also been feeding her cooked whole mussel before her latest weakness issue. That too has also been stopped at this point.
You should also consider using a quality Probiotic. The gut bacteria are what would naturally produce amounts of Biotin and B12 along with many other beneficial elements for the body to function properly. Every time you kill off the bacteria with antibiotics and drugs you compromise the body’s natural ability to heal itself. I used MaryRuth Organics DOG Probiotics. (they make a cat and human formula too) They are a tasteless liquid and I can tell you they are VERY effective. If you start with too high a dose your pup will likely get diarrhea at first. As I said – VERY effective. However, they do not contain a huge varied strain of different bacteria and therefore may not work for every dog. Of course there are many other companies that make probiotics, many in a powdered form, and have been used successfully by many owners.
4-28-18 Yesterday I unexpectedly had to say goodbye to another heart-light – Shelby’s partner in crime – Trinity. I NEVER expected her to go before Shelby. Trin had Cushings but ultimately succumbed to sudden gastrointestinal bleeding and kidney failure. The bleeding may have come from something she consumed while in the yard as we had found her “finishing” something a few days earlier and there was a possibility someone could have tossed something into the yard, or even a hawk could have left remains, likely from a bird, that she consumed. Just a few days before her death I realized that I might be able to overcome some of her issues with the same approach to MMA/PA I discussed above because things were affecting her liver, pancreas and kidneys and she was eating a raw diet full of protein and some good fats, and carbs were considered bad for a Cushings dog. As I stated earlier, dogs don’t have to have “DM” to be having symptoms of deficiency taking over their body – you would hardly ever know Trinity had anything major wrong with her by the way she acted – though she did develop Calcinosis Cutis which I then understood could break out from Fish Oil supplementation that we used for her “dry skin”. (And now I discover this one particular research paper that discusses the direct link between increased levels of Cortisol and decreased levels of B12 – this essentially explains the Cushings link to B12. Trin had been on “allergy” meds a few years before her Cushings diagnosis, for constant red lumps between her toes that the vet said was a general allergy. These meds likely depressed her immune system further leading to a larger B12 deficiency that preceded the Cushings diagnosis. She was also on Fish Oil supplementation as per suggestion from the vet. In turn, overproduction of Cortisol then drains B12 even quicker in trying to neutralize the toxic affects of overproduction – no veterinary articles discuss this known fact or suggest supplementation to correct deficiency. I was never told Cushings could develop from immune suppressing drugs like allergy meds or the more powerful immune suppressants like Prednisone – causing medically induced Cushings. Medicine induced Cushings can be called Exogenous and Iatrogenic Hyperadrenocorticism. I was told it was likely a tumor on the Pituitary and not that the pituitary can be affected by previous drugs. Perhaps my vet was not familiar with this fact. In fact, hormonal disruption is also a side affect of B12 deficiency so it even could have added to the situation, actually causing the fatty acid issues that caused the skin conditions for which she needed allergy meds that eventually caused hormonal issues causing the Cushings.) We had her just over 6 years, but she spent 1.5 years in a shelter eating the bare minimum and then coming to us eating the wrong food long before I realized a better way. I was giving her some regular B12 and had added in Biotin which helped her coat start to grow back in after having thinning affects from Cushings – but never dosing with the intensity of Shelby’s routine. And for a longer time Trin had eaten dry food mixed with cooked food, but she also consumed a dry currently under lawsuit for extremely high lead levels – likely leading to her kidney damage – further draining her B12 storage because the B12 was needed to filter the heavy metal toxicity. I am beating myself up for not paying closer attention to her sooner as I struggled with Shelby, but then, she “seemed” healthier, until it was too late to do anything about it. Another lesson I can simply pass on to others as I wipe away tears and go through my “if only I had”… Hug your babies – all of them!!
Sadness Is More Powerful Than Any Supplement – I must now write what I had hoped I wouldn’t have to yet….. on 5/21/18 Shelby joined Trin at the Bridge. Literally the day after Trin left us, Shelby began to eat less and less. They had a special bond, in particular over this past year. Trin used to clean her face and paws after she ate and perhaps that is why the thought of eating wasn’t as appealing anymore. I still tried to “tweak” things, but it was obvious that this time was very different. I even think I saw her crying a few times, tears coming from her eyes, and to be fair, my husband and I were crying often too. She still wanted to go into her cart every day, multiple times a day, in spite of getting weaker without me being able to get any significant food into her. But without the interaction she had with Trin, without sharing water out of the same bowl or getting a lick on the face or pushed out of the way, it wasn’t the same. I had feared it might be the case once Trin was gone, but I thought maybe we could get her past it, but we were all grieving. I myself found it hard to eat for days after Trin’s passing. I think too, with finding out the additional information about MMA/PA and a few other things I have or will add in this article, that I “learned” everything I needed to, and it was OK, it was time. We completed our mission together, and now the rest is for me to carry on – her “legacy” – to help others, pets and people. This was perhaps the last piece of the puzzle and now I need to share the full picture with everyone I can.
In the end, intense B12 and Biotin supplementation, along with additional magnesium, definitely helped Shelby – along with supporting her with the RX Amino B Plex to add in some Potassium and Iron as the body was getting stronger. She had regained control of her urine and her poop was better. Her initial symptoms actually went away and she was primarily left with weakness that overtook her when Biotin was compromised. If I had given her higher doses earlier in her progression it could have reversed everything. If I hadn’t changed her food to something that prevented Biotin absorption I never would have understood the whole process with fatty acid metabolism, the critical components of B12 and Biotin, and how it drains energy from the body along with destroying nerves and cells and can lead to muscle wasting – along with the overload of certain amino acids that can make issues worse. I can’t make you believe this, I can only tell you so that you can try it for yourself and see if it helps your dog. B12 and Biotin are completely safe in high doses. B12 is better as a shot, Biotin is also available as a shot, but a vet has to believe/understand in why they would supplement and that is not an easy sell to them since most would not immediately understand the chemical reactions involved if they have not researched the information. So if your only choice is supplementing by yourself then you can use the information I provided above. I didn’t write this for fame or fortune – I wrote this for one reason – that others might be able to heal their pups and not experience the same scenario I and MANY others have experienced. Deficiency better explains what is happening, triggering the body into decline, than to think it is some gene predetermining a disease in all different breeds. Especially since Abnormal Fatty Acid Metabolism is known to affect over 500 different genes in the body and destroy nerves and cells. But the ONLY way to know if it is indeed the problem is to test for Methylmalonic Acid levels since Serum B12 could be considered “normal”. (Serum B12 under 500 is deficient, under 300 is SEVERE deficiency, over 900 is inactive B12 due to deficient cofactors.)
You Don’t Know What You Don’t Know, Until You Find Out Something You Didn’t Know. Only Then Can You Ask Better Questions, Get Better Answers, And Solve More Complex Problems. And Hopefully, Find The Right Solution For You.
This is the video that contains a great deal of information regarding B12 deficiency and the way it is misdiagnosed in humans. Please understand that the SAME EXACT THING can be stated about our companion animals. If you have a dog diagnosed with DM, think of their symptoms and the progression as you watch some of the people describe their symptom progression. In particular, the pediatrician, Dr. David Carr, who was diagnosed, a DOCTOR who DID NOT KNOW HE HIMSELF HAD B12 deficiency, nor did the specialists he went to, and how he explains how his symptoms started – his story begins in full around the 17 minute mark of the video. One of his comments after being diagnosed with B12 deficiency is extremely poignant…. “I’m sure it would have gone down that I died from a neurological condition……. Ignorance”
The nurse, Sally Pacholok, who wrote the book “Could it be B12? An Epidemic of Misdiagnosis”, featured and shown in the above video, was the subject of a short movie done about how she came to write the book. In and of itself, the movie provides some additional insight into recognizing symptoms that can be related to B12 deficiency. Again remember, the same exact thing can be related to animals.
Norman Clinical Laboratory – www.B12.com – Human Standard Urine Testing (UPDATE – They have done this test for animals/dogs. As of this moment they have not verified results with animal laboratory testing methods, but they do agree that the method is standardized and should reflect a somewhat accurate result for dogs)
One small reason I had a passion to write this is due to the passing of a friend a few years back. She died from what was diagnosed as ALS. The one thing I remember about her struggle with the symptom progression was that she kept stating “It all started after dental surgery”. I do not know the details of her diagnosis or testing or treatments. I can only wonder if maybe she was never tested for B12 deficiency made worse by Nitrous Oxide during the dental surgery. She LOVED dogs and would often ask me about Shelby and her hunting exploits or her habit of getting skunked on a regular basis. Rest in Peace Marcia.
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Blessings To You!