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This limitation of standard lab testing approaches stems from how reference ranges are calculated

But for dogs whove stopped responding well to traditional pain management, it may offer a path to better quality of life

2 The British Society for Haematology recommends intramuscular vitamin B 12 for severe deficiency and malabsorption syndromes, whereas oral replacement may be considered for patients with asymptomatic, mild disease with no absorption or compliance concerns

Other common symptoms of B12 deficiency include: Lethargy or a total lack of energy Extreme fatigue Palpitations Pale skin Feeling faint Breathlessness Weight loss and loss of appetite Your doctor may prescribe B12 injections in extreme cases that take effect right away