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B12 in Brief

  • 82% of all EPI dogs have insufficient B12 levels that if not corrected will inhibit the dog from optimally healing. Lack of weight gain, lethargy, lack of appetite, continued loose stools, etc., all suggest possible insufficient B12. Recent preferred B12 regimen was with generic B12 injections not multivitamin or complex B12 injections. B12 dosing protocol is set forth by Texas A&M Gastro Lab  In general, average-dose over-the-counter B12 pills tend not to work well. However, high-dose B12 pills that have the intrinsic factor included tend to work very well at increasing the B12 levels in most EPI dogs.  Although the intrinsic factor is needed to transport “digested” B12 into the blood stream, technically the intrinsic factor delivery system should not typically be damaged by EPI, and supposedly (according to old research) intrinsic factor should be species specific- -HOWEVER- -it has been observed in many EPI dogs (via individual B12 blood tests) that when a B12 pill includes the intrinsic factor, even if not species specific (i.e. porcine intrinsic factor), the success rate is extremely high.  Recent research suggests that B12 pills at very high doses without intrinsic factor may work, however we have also observed failures with oral B12 without intrinsic factor. Since we cannot identify which dogs do much better with the intrinsic factor (even if not species specific) and which don’t, Epi4Dogs position when giving oral B12, is that we suggest giving high-dose B12 pills with intrinsic factor included, until further research gives us a better understanding of the B12 and intrinsic process in the EPI dog.


  • In the USA, Wonderlabs Pet Factor B12  or  Wonderlabs  Trinfac B  are products widely used (with great success supported by before and after Cobalamin blood tests)  in many EPI pets with low B12.   If you are in the UK, you can purchase B12 with Intrinsic Factor from Chemeyes, LLC. If upon initial EPI diagnosis, your dog has insufficient B12 levels… also talk to your vet about also possibly treating for SID/SIBO (small intestinal dysbiosis / small intestinal bacterial overgrowth) as this too can contribute to depleting B12 stores in the body.


  • When the body’s own bugs produce spontaneous Folate (B9)…. then a high Folate value indicates possible SID/SIBO. To date there are no known other unintended health consequences from high Folate levels due to an outside source of Folate (such as pills).


  • When the body’s Folate level is high from an outside source (when taking pills) that does not cause nor encourage SID/SIBO.


  • When the vet draws blood for a Cobalamin B12 blood test, you will receive a Cobalamin reading (B12) and a Folate reading (B9). When the Folate level is high, that is an indication that SID may be present. However, when the Folate reading is in the normal range, SID is often still present. Currently, Folate test results are no longer depended upon to diagnose SID.To properly diagnose SID and whether antibiotics are needed, assess the situation by the underlying disease (EPI) and if there are any on-going SID signs, then talk to your vet about treating for SID (small intestinal dysbiosis).


  • In “some” cases sublingual tabs help- -but check ingredients for dangerous artificial sweeteners. Avoid Xylitol, and ask your vet if it is safe and do not use if it contains Mannitol or Sorbital. Also with sublingual tabs, there have been multiple reports of these pills working for a while and then they are no longer effective.


  • B12 levels in EPI dogs need to be in the normal upper-mid range level… normal or low-normal is not sufficient!


  • Dogs with insufficient B12 levels and a chronic condition, like EPI, should be supplemented for life with B12. If not a chronic condition, then insufficient B12 supplementation does not need to be on-going.


  • If possible, ask for a Cobalamin (B12) blood test to be done at the same time as a TLI blood test is done to save money. A dog must be fasted for 12-15 hours. Texas A&M Gastro Lab is the premier laboratory to test B12 levels.