Serum cobalamin and methylmalonic acid concentrations in juvenile dogs with parvoviral enteritis or other acute enteropathies

Abstract

Background: Low serum cobalamin concentrations have been associated with ileal malabsorption in dogs with chronic enteropathy. Increased serum methylmalonic acid (MMA) concentrations indicate cobalamin deficiency on a cellular level. Few studies have evaluated serum cobalamin concentrations or methylmalonic acid concentrations in juvenile dogs with parvoviral enteritis or nonparvoviral acute enteropathies. Objectives: Evaluate serum cobalamin and methylmalonic acid concentrations in juvenile dogs (6 weeks to 10 months old) with parvoviral enteritis or nonparvoviral acute enteropathy. Animals: Thirty-one juvenile dogs with parvoviral enteritis, 29 dogs with nonparvoviral acute diarrhea (NPVAD), and 40 healthy juvenile control dogs. Methods: Single-center, prospective, observational, cross-sectional study. Serum cobalamin and, when sufficient serum was available, MMA concentrations were measured. Results: Most serum cobalamin concentrations were within the adult reference interval. Serum cobalamin concentrations in healthy dogs (median, 848 ng/L; range, 293-1912 ng/L) were significantly higher than in dogs with parvoviral enteritis

Implications of hypocobalaminemia as a negative prognostic marker in juvenile dogs with parvovirus enteritis

“…Furthermore, MMA decreased from time point 1 to 2 independently from supplementation. In addition, we detected no significant correlation between CBL and MMA in the PG, results that align with previous literature and contradict the hypothesis of intracellular CBL deficiency ( 25 ). On the other hand, the negative correlation between CBL and MMA was confirmed in the HC.…”

“…Interestingly though, in this study, the median serum CBL concentration in the healthy group was low (379 pg./L) and no difference was found between CBL concentration in young and adult dogs ( 24 ), suggesting in contrast to our results, that the reference interval is the same. Another study showed that dogs with parvoviral enteritis or other non-parvoviral acute enteropathy-patients have lower CBL concentrations when compared to healthy dogs, despite most of them were still within the reference interval ( 25 ). In this study serum MMA concentrations did not differ between groups, and there was no evaluation of outcome performed ( 25 ).…”

“…Another study showed that dogs with parvoviral enteritis or other non-parvoviral acute enteropathy-patients have lower CBL concentrations when compared to healthy dogs, despite most of them were still within the reference interval ( 25 ). In this study serum MMA concentrations did not differ between groups, and there was no evaluation of outcome performed ( 25 ). However, our data indicates that low CBL concentration may be a negative predictor in young dogs with parvoviral enteritis, as outcome comparison among subgroups demonstrated higher CBL concentrations in survivors compared to non-survivors, while dogs with a CBL concentration under 300 pg./mL had 50% higher mortality risk.…”

“…On the other hand, the negative correlation between CBL and MMA was confirmed in the HC. A continuous gastrointestinal loss of CBL or transcobalamin II and other transport proteins has been proposed as a possible explanation for the lack of correlation between CBL and MMA in disease state ( 25 ). Dogs with parvoviral infection frequently receive antibiotics to treat or prevent possible bacterial translocation, secondary to intestinal epithelial loss, exacerbated by the virus causing leukopenia and neutropenia.…”

“…Hypocobalaminemia and CBL deficiency is a well described complication in chronic enteropathies in adult dogs, due to a combination of malabsorption and dysbiosis ( 8 , 22 , 23 ), but data for serum CBL status and metabolism in dogs with acute enteropathies with a special emphasis on young dogs under one year of age is lacking. More specifically, two previous studies have evaluated CBL status in dogs with parvovirosis, but to our knowledge CBL status has not yet been evaluated as a predictor of outcome ( 24 , 25 ). In accordance with human literature ( 26 ), suspected higher demands of CBL in young dogs with growth-related increased mitotic activity combined with CBL malabsorption due to parvoviral ileal enterocyte destruction and reduced dietary CBL intake, might predispose growing dogs with parvovirus enteritis to hypocobalaminemia ( 26 ).…”