You do everything right and yet your dog still has an upset stomach.
Doggie diarrhea — not a pleasant topic on so many levels. However, if your dog suffers from regular stomach upsets, it will be a subject close to your heart, so read on.
In that peculiar way that sometimes occurs where the stars align, this happened to a problem patient of mine.
A Rough-Coat Collie’s Story
Roy the rough-coat collie was having a decidedly rough time with persistent diarrhea. Indeed, his person had invested in blood tests and followed advice to date, and yet Roy was still sloppy in the stools department — and his person was getting impatient.
It wasn’t that we didn’t know what was wrong with Roy; he had inflammatory bowel disease. His treatment involved:
- A hypoallergenic diet: This drastically reduces the risk of food intolerance or allergy as a trigger for the lining of the bowel to become inflamed.
- Pre- and probiotics: The nature of Roy’s diarrhea meant he had lost most of the bacteria helpful to digestion, and these needed replacing.
- Antibiotics: Where the normal gut flora and fauna had been lost, other bacteria had invaded and flourished. The trouble was that these bacteria don’t help digestion and had to be gotten rid of so that healthy gut bacteria could flourish.
- Steroids: The severity of Roy’s inflammation meant that he passed blood. This severe soreness needed settling down with anti-inflammatories, of which steroids were the first choice.
With Roy still in the doldrums despite the diagnostics and treatment, it looked like we’d have to add in an even stronger anti-inflammatory medication. But Roy’s human was unhappy and didn’t like the idea.
What to do?
Cobalamin for Bowel Health
It has long been recognized that cobalamin is essential for good bowel health. Indeed, decades ago, for a dog with an upset stomach, vets often gave a shot of cobalamin to speed recovery. However, in the push for evidence-based medicine (EBM), this practice was stopped as “old school,” as it was anecdotal at best rather than based on hard evidence.
In a spirit of what goes around comes around, I decided to resurrect this seemingly dinosaur practice. I gave Roy a shot of cobalamin and asked to see him back the following week.
But only 3 days later, Roy’s human called me, ecstatic on the end of the line. After weeks of horrid poop, that very morning Roy had passed a minor miracle of a perfectly formed poop. Whoop-whoop!
Reassessing our plans, we elected to give Roy 6 weekly cobalamin injections and then review his therapy after that.
Why Cobalamin Matters
The news gets better and better because cobalamin is actually a vitamin — Vitamin B12, to be precise. This is a water-soluble vitamin and has several important roles in the body, including:
- DNA synthesis
- Fatty acid metabolism
- Cell metabolism
- Making new red blood cells
Symptoms that a dog with low cobalamin might show include:
- Poor appetite
- Failure to thrive
- Dull, starry coat
As you can see, this humble vitamin is actually very important.
What Low Blood Levels Mean
When blood levels of cobalamin are low, then gut health dips and the dog is less able to absorb the goodness from food. When the bowel wall is healthy, it can process Vitamin B12 and absorb it.
Happily, there are lots of B12-rich foods out there, but in an ironic twist, it turns out that an unhealthy gut is least able to absorb the cobalamin. Worse than that, cobalamin only lasts half as long when the dog is deficient — talk about adding insult to injury.
In dogs, only 1% of the cobalamin in food is absorbed across the bowel wall by diffusion. Instead, to get cobalamin from the gut lumen into the blood depends on a special transport system in the last part of the small intestine.
At this location are special molecules that bind to cobalamin in the gut lumen and help transport it across the gut wall. Unfortunately, this mechanism breaks down, like a car with an empty fuel tank, when blood cobalamin levels fall, meaning the body is less efficient at the very thing it needs to do. This means that feeding a cobalamin-rich diet, while commendable, is unlikely to help very much.
Giving cobalamin systemically, in the form of weekly injections for 6 weeks can tip the scales and get things going again. Once the blood levels are raised, then the gut transport system for cobalamin starts working and everything starts to swing again.
The injections can sting, and occasionally patients develop a sterile abscess at the injection site, but these issues aside, there are no major side effects. However, it’s a fair bet the dog would prefer not to visit the vet every week for over a month.
Thankfully, there’s good news on the horizon: For the first time, there’s a nutraceutical tablet available that contains cobalamin in a form the gut can process and absorb when blood levels are low. You can give the supplement (Cobalaplex, made by Protexin) to the dog once a day at home and avoid the dreaded vet trips and needle.
Roy’s Tail Is Still Wagging
The great news is that Roy is still doing so well that we’re weaning down the dose of his steroids. He’s maintained a solid poop on the hypoallergenic diet alone, now that the allergens have gone, and his bowel health is top-notch.
Of course, if your dog has diarrhea, then see the vet. But it is heartening to know that a simple vitamin may be what’s needed. So if your dog has a tummy upset or even long-term diarrhea, spare a thought for the B vitamins — they could help turn the corner.
This pet health content was written by a veterinarian, Dr. Pippa Elliott, BVMS, MRCVS. It was last reviewed March 30, 2018.