시아노코발라민 (비타민 B12)

비타민 / 영양 보충제

시아노코발라민(비타민 B12)은 정상적인 세포 기능에 필수적인 수용성 비타민입니다. - **주요 용도**: 비타민 B12 결핍증의 주사 치료. - **결핍의 주요 원인**: 외분비 췌장 기능 부전(EPI), 염증성 장질환(IBD) 및 기타 흡수 불량성 위장관 질환. - **종 특이성**: - **개와 고양이**: 위장관/췌장 질환에 속발하는 결핍증이 흔합니다. 자이언트 슈나우저 등의 품종은 유전적 흡수 장애(이머슬룬드-그라스베크 증후군)를 가질 수 있습니다. - **반추동물**: 반추위 미생물이 B12를 합성하기 위해 코발트를 필요로 하므로 식이성 코발트 결핍에 속발하는 경우가 많습니다. > **임상 요점**: 사람과 달리 개와 고양이는 TC1 결합 단백질이 없기 때문에 흡수 불량 상태에서 1~2개월 만에 B12 저장량이 빠르게 고갈될 수 있습니다(사람은 1~2년 소요).

작용 기전: Vitamin B12 acts as a crucial coenzyme for two major enzymatic pathways: 1. **Methylmalonyl-CoA mutase**: Converts methylmalonyl-CoA → succinyl-CoA. (Deficiency leads to methylmalonic acidemia/aciduria). 2. **Methionine synthase**: Catalyzes the remethylation of homocysteine → methionine, which is intimately linked with **folate** metabolism. - Required for normal cell growth, nucleoprotein and myelin synthesis, amino acid metabolism, and erythropoiesis. - **Note**: B12 deficiency can cause a functional folate deficiency. Unlike humans, macrocytic anemias do not appear to be a significant component of cobalamin deficiency in dogs or cats.

동물 종별 용량

Sheep

Treatment of vitamin B12 deficiency associated with cobalt deficiency (Lambs) · 100 micrograms (total dose) · injection · once weekly
Treatment of vitamin B12 deficiency associated with cobalt deficiency (Adult sheep) · 300 micrograms (total dose) · injection · once weekly
Treatment of vitamin B12 deficiency associated with cobalt deficiency · 0.2-0.4 mL of a 5000 micrograms/mL injection (1000-2000 micrograms) · IM or SC · weekly intervals if necessary

Cats

Cobalamin deficiency in cats with IBD · 250-500 micrograms (total dose per cat) · SC · once per week for 6 weeks, then every 1-2 months
Adjunctive treatment of idiopathic hepatic lipidosis · 250 micrograms (total dose) · SC · once per week · 6 weeks · Recheck serum B12 level in one to two weeks after cessation of treatment as some cats may need repeated administration.
Cobalamin deficiency associated with GI disease · 150-250 micrograms (total dose) · SC · once weekly for 6 weeks, then every 14 days for 6 weeks, then one dose 30 days later · Initial 16-week protocol · Based on body size. Recheck serum cobalamin concentration one month after last dose.
Cobalamin deficiency associated with exocrine pancreatic insufficiency · 100-250 micrograms (total dose) · SC · once weekly · Periodically assess cobalamin and folate levels.

Cattle

Treatment of vitamin B12 deficiency associated with cobalt deficiency · 0.2-0.4 mL of a 5000 micrograms/mL injection (1000-2000 micrograms) · IM or SC · weekly intervals if necessary

투여 경로

SCIMIVPO

금기

Hypersensitivity to cyanocobalamin or hydroxocobalamin
Known hypersensitivity to cobalt or cobalamin

이상반응

Pain at injection site (uncommon)
Anaphylaxis (rarely reported in humans)
Pain or stinging at the injection site
Mild allergic reactions (rare)

약물 상호작용

Antibiotics · Concurrent use can cause falsely low serum or red blood cell cobalamin values if a microbiologic method assay is used.
Omeprazole · May decrease oral absorption of Vitamin B12 by altering gastric pH · minor

모니터링

Serum cobalamin levels
Serum folate status (both before and after treatment)
Clinical signs associated with deficiency (weight loss, poor haircoat, vomiting, diarrhea)
CBC (baseline and ongoing if abnormal)
Serum cobalamin (Vitamin B12) levels
Serum folate levels
Clinical signs of gastrointestinal disease (weight gain, fecal consistency)

과용량

Cyanocobalamin is very safe. An inadvertent overdose given via SC or IM injection is unlikely to cause significant morbidity.

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