Abstract：
OBJECTIVE: Determine comparative tolerance of daily oral and weekly parenteral cobalamin supplementation, in hypocobalaminaemic dogs with chronic enteropathy. Determine whether oral is as effective as parenteral supplementation at achieving eucobalaminaemia, in hypocobalaminaemic dogs with protein-losing enteropathy, severe hypocobalaminaemia or high canine inflammatory bowel disease activity index at inclusion.
METHODS: Thirty-seven client-owned dogs with hypocobalaminaemia and clinical signs of chronic enteropathy were prospectively enrolled in three UK referral centres. Dogs were randomly allocated to daily oral for 12 weeks or weekly parenteral cobalamin supplementation for 6 weeks and one additional dose 4 weeks later. Serum cobalamin, body condition score, canine inflammatory bowel disease activity index and bodyweight were assessed at inclusion, weeks 7 and 13. Serum methylmalonic acid concentration was evaluated at inclusion and at week 13. Owners completed treatment adherence, palatability, tolerance and satisfaction questionnaires at week 13.
RESULTS: Nineteen dogs completed the study. All dogs orally supplemented achieved normal or increased cobalaminaemia at weeks 7 and 13. There was no statistical difference in cobalamin concentration at week 13 in dogs treated with oral or parenteral supplementation, regardless of presence of protein-losing enteropathy, severity of hypocobalaminaemia or canine inflammatory bowel disease activity index at inclusion. Serum methylmalonic acid concentration was not significantly different between oral and parenteral groups, neither were treatment adherence, satisfaction, and tolerance scores at week 13.
CONCLUSIONS: Oral is as effective and as well-tolerated as parenteral cobalamin supplementation in hypocobalaminaemic dogs with chronic enteropathy and severe clinical or biochemical phenotypes, and should be considered as a suitable treatment option regardless of disease severity.
METHODS: Thirty-seven client-owned dogs with hypocobalaminaemia and clinical signs of chronic enteropathy were prospectively enrolled in three UK referral centres. Dogs were randomly allocated to daily oral for 12 weeks or weekly parenteral cobalamin supplementation for 6 weeks and one additional dose 4 weeks later. Serum cobalamin, body condition score, canine inflammatory bowel disease activity index and bodyweight were assessed at inclusion, weeks 7 and 13. Serum methylmalonic acid concentration was evaluated at inclusion and at week 13. Owners completed treatment adherence, palatability, tolerance and satisfaction questionnaires at week 13.
RESULTS: Nineteen dogs completed the study. All dogs orally supplemented achieved normal or increased cobalaminaemia at weeks 7 and 13. There was no statistical difference in cobalamin concentration at week 13 in dogs treated with oral or parenteral supplementation, regardless of presence of protein-losing enteropathy, severity of hypocobalaminaemia or canine inflammatory bowel disease activity index at inclusion. Serum methylmalonic acid concentration was not significantly different between oral and parenteral groups, neither were treatment adherence, satisfaction, and tolerance scores at week 13.
CONCLUSIONS: Oral is as effective and as well-tolerated as parenteral cobalamin supplementation in hypocobalaminaemic dogs with chronic enteropathy and severe clinical or biochemical phenotypes, and should be considered as a suitable treatment option regardless of disease severity.
摘要：
目的：确定每日口服和每周肠胃外补充钴胺的比较耐受性，在患有慢性肠病的低钴胺血症犬中。确定口服是否与肠胃外补充剂一样有效，在患有蛋白质丢失性肠病的低钴胺血症犬中，纳入时严重的低钴胺血症或高犬科动物炎症性肠病活动指数。
方法：在英国三个转诊中心前瞻性招募了37只患有低钴胺血症和慢性肠病临床体征的患者饲养犬。狗被随机分配到12周的每日口服或6周的每周肠胃外钴胺补充和4周后的一次额外剂量。血清钴胺，身体状况评分,纳入时评估犬炎性肠病活动指数和体重，第7周和第13周。在包含时和在第13周评估血清甲基丙二酸浓度。业主完成治疗依从性，适口性,第13周的容忍度和满意度问卷。
结果:19只狗完成了研究。所有口服补充的狗在第7周和第13周达到正常或增加的钴胺血症。口服或肠胃外补充剂治疗的狗在第13周的钴胺浓度没有统计学差异，无论是否存在蛋白质丢失性肠病，纳入时的低钴胺血症或犬炎症性肠病活动指数的严重程度。血清甲基丙二酸浓度在口服组和肠胃外组间无显著差异，治疗依从性也不是，满意,和第13周的耐受性评分。
结论：在患有慢性肠病和严重临床或生化表型的低钴胺血症犬中，口服与肠胃外补充钴胺一样有效且耐受性良好。无论疾病严重程度如何，都应被视为合适的治疗选择。
方法：在英国三个转诊中心前瞻性招募了37只患有低钴胺血症和慢性肠病临床体征的患者饲养犬。狗被随机分配到12周的每日口服或6周的每周肠胃外钴胺补充和4周后的一次额外剂量。血清钴胺，身体状况评分,纳入时评估犬炎性肠病活动指数和体重，第7周和第13周。在包含时和在第13周评估血清甲基丙二酸浓度。业主完成治疗依从性，适口性,第13周的容忍度和满意度问卷。
结果:19只狗完成了研究。所有口服补充的狗在第7周和第13周达到正常或增加的钴胺血症。口服或肠胃外补充剂治疗的狗在第13周的钴胺浓度没有统计学差异，无论是否存在蛋白质丢失性肠病，纳入时的低钴胺血症或犬炎症性肠病活动指数的严重程度。血清甲基丙二酸浓度在口服组和肠胃外组间无显著差异，治疗依从性也不是，满意,和第13周的耐受性评分。
结论：在患有慢性肠病和严重临床或生化表型的低钴胺血症犬中，口服与肠胃外补充钴胺一样有效且耐受性良好。无论疾病严重程度如何，都应被视为合适的治疗选择。
