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Tierarztl Prax Ausg K Kleintiere Heimtiere 2018; 46(05): 309-314
DOI: 10.15654/TPK-180458
Übersichtsartikel – Review Article
Georg Thieme Verlag KG Stuttgart · New York

Cobalaminmangel bei Hund und Katze

Cobalamin deficiency in dogs and cats
Franziska Hanisch
1   Tierarztpraxis Dr. Deicke, Halberstadt
,
Linda Toresson
2   Department of Equine and Small Animal Medicine, Faculty of Veterinary Medicine, Helsinki University, Finland
3   Evidensia Specialist Animal Hospital, Helsingborg, Sweden
,
Thomas Spillmann
2   Department of Equine and Small Animal Medicine, Faculty of Veterinary Medicine, Helsinki University, Finland
› Institutsangaben
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Publikationsverlauf

Eingegangen: 08. April 2018

Akzeptiert nach Revision: 21. Mai 2018

Publikationsdatum:
12. Dezember 2018 (online)

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Zusammenfassung

Cobalamin ist ein Vitamin der B-Gruppe und als Kofaktor an Stoffwechselabläufen wie der Nukleinsäuresynthese, der Aminosäuresynthese und dem Zitratzyklus beteiligt. Da Säugetiere Cobalamin nicht selbst synthetisieren können, sind sie auf die Zufuhr über die Nahrung angewiesen. Die Resorption des Vitamins setzt bei Hund und Katze ein funktionales exokrines Pankreas voraus. Sie erstreckt sich über Magen und Duodenum bis hin zum Ileum und stellt einen äußerst komplexen Prozess dar. Somit kann eine Fülle gastrointestinaler Erkrankungen wie z. B. chronische Enteropathien, intestinales Lymphom oder exokrine Pankreasinsuffizienz zur Hypocobalaminämie führen. Ferner wurde bei einigen Hunderassen (Riesenschnauzer, Border Collie, Australian Shepherd und Beagle) ein primärer, hereditärer Cobalaminmangel (Imerslund-Gräsbeck-Syndrom) nachgewiesen. Zu den klinischen Sympto men einer Hypocobalaminämie zählen Inappetenz, Erbrechen, Diarrhö, Wachstumsstörungen und neuronale Defizite. Als labordiagnostische Veränderungen wurden nichtregenerative Anämie, Leukopenie, Hypoglykämie und Hyperammonämie beschrieben. Bei Verdacht auf einen Cobalaminmangel wird die Vitaminkonzentration bei Hund und Katze üblicherweise mittels Immunoassay im Blut gemessen. Da jedoch Blut- und Zellgehalt des Vitamins differieren können, ist die isolierte Cobalaminmessung in ihrer Aussagekraft limitiert. Die Therapie hängt in erster Linie von der Primärerkrankung ab und hat zum Ziel, die Ursache der Hypocobalaminämie zu beseitigen. Oftmals zeigt sich ein Behandlungserfolg der gastrointestinalen Erkrankung allerdings erst dann, wenn zusätzlich parenteral oder oral Cobalamin verabreicht wird. Bei Patienten mit Imerslund-Gräsbeck-Syndrom ist die regelmäßige und lebenslange Substitution essenziell.

Summary

Cobalamin is a member of the B-group of vitamins and a cofactor for metabolic processes like nucleic acid synthesis, amino acid synthesis, and the citric acid cycle. Mammals are unable to synthesize cobalamin and therefore rely on adequate food intake. Cobalamin absorption is a complex process in the stomach, duodenum, and ileum, requiring a functional exocrine pancreas. Thus, a great number of gastrointestinal diseases like chronic enteropathies, intestinal lymphoma, or exocrine pancreatic insufficiency can lead to hypocobalaminemia. Furthermore, some dog breeds (Giant Schnauzer, Border Collie, Australian Sheperd Dog, and Beagle) can have a primary, hereditary cobalamin deficiency (Imerslund-Gräsbeck syndrome). Clinical signs of cobalamin deficiency comprise anorexia, vomiting, diarrhoea, failure to thrive, and neuropathies. Laboratory findings like non-regenerative anemia, leukopenia, hypoglycemia, and hyperammonaemia have also been described. When hypocobalaminemia is suspected usually in dogs and cats, the cobalamin concentration is usually measured by immunoassay. Because the concentrations of cobalamin in blood and cells can differ the sole measurement of the vitamin concentration is of limited informative value. Treatment depends on the underlying disease aiming at eliminating the cause of hypocobalaminemia. However, successful therapy of gastrointestinal diseases often requires an additional oral or parenteral cobalamin supplementation. In patients with Imerslund-Gräsbeck syndrome, a regular and lifelong cobalamin supplementation is essential.

Schlüsselwörter

Vitamin B12 - Hypocobalaminämie - Imerslund-Gräsbeck-Syndrom - Methylmalonsäure - Homozystein

Keywords

Vitamin B12 - hypocobalaminemia - Imerslund-Gräsbeck syndrome - methyl malonic acid - homocysteine
 

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