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26037 Cobalamin (B12) & Folate

Cobalamin (B12) & Folate
Test Code: VB12FOL
Synonyms/Keywords
​Vitamin B12, VB12, Folate
Test Components
​Cobalamin & Folate
Species
Canine, Feline
Test Category
Specimen Requirements
Specimen Type Preferred Container/Tube Acceptable Container/Tube Specimen Volume Specimen Minimum Volume
(allows for 1 repeat)
​Serum ​Red Top Tube (RTT) ​Serum Separator Tube (SST) ​500uL ​350 uL
​Hep Plasma ​Green Top Tube (GTT)
Collection Processing Instructions

​Samples should be collected from fasting animals: 12-18 hours for non-diabetic animals; 6 hours for diabetic animals.

Pancreatic function must be assessed before these results can be interpreted since they may be abnormal in animals with EPI (Exocrine Pancreatic Insufficiency)

Serum/Plasma should be separated from cells within one hour of collection and frozen as soon as possible unless transport to lab is <8 hours.

Acceptable Specimen Types
​Serum or Heparinized Plasma
Specimen Stability Information
Specimen Type Temperature Time
​Serum or Plasma ​Refrigerated ​8 hours
​Frozen (Preferred) ​60 days
Rejection Criteria
​EDTA Plasma
Room Temperature Samples
Interference
​Hemolysis and non-fasting status may interfere with results
Performing Laboratory Information
Performing Location Day(s) Test Performed Analytical Time Methodology/Instrumentation
​Marshfield ​Monday through Saturday ​2 hours ​Chemiluminescence/Immulite
Marshfield Center Laboratory Section
Test Information
​Reference intervals and interpretative comments from Gastrointestinal Laboratroy - College of Veterinary Medicine Texas A&M University, College Station, TX 77843-4474
Reference Intervals
Performing Location Canine Reference Intervals Feline Reference Intervals
​Marshfield ​Cobalamin: 251-908 ng/L ​Cobalamin: 290-1500 ng/L
​Folate: 7.7-24.4 ug/L ​Folate: 9.7-21.6 ug/L
Interpretation
Cobalamin: Canine
251-908 – Interpretation: Result within the reference interval
<251, “<150” – Interpretation: Consistent with distal small intestinal disease, EPI or small intestinal bacterial overgrowth.  Check canine TLI to rule out EPI.  Consider oral or parenteral cobalamin supplementation
251-470 – Interpretation: Result is at the low end of the reference interval.  Suggestive of distal small intestinal disease (i.e., ileum), EPI, or dysbiosis.  Check serum canine TLI concentration to rule out EPI. Oral or parenteral supplementation is indicated.
>908, “>1000” – Interpretation: There is no known clinical significance for serum cobalamin concentrations above the upper limit of the reference interval. 
Folate: Canine
7.7-24.4 – Interpretation: Result is within the reference interval
<7.7, “<1.0” – Interpretation: Decreased serum folate concentration.  Consistent with disease affecting proximal small intestine.  Consider  folate supplementation.
18.8-24.4 – Interpretation: Upper end of the reference interval.  May reflect small intestinal dysbiosis.  In patients with GI signs but without systemic complications (i.e., sever weight loss, hypoalbuminemia, or other) trial therapies with prebiotics (e.g., a diet containing fructooligosaccharieds (FOS)), probiotics, or antibiotics may be considered.  The Gastrointestinal Laboratory at Texas A & M university recommends Tylosin at 25 mg/kg q 12 hrs. PO for 6-8 weeks.
>24.4, “>50.0” – Interpretation: Consistent with small intestinal dysbiosis.  Small intestinal dybiosis often occurs secondary to chronic enteropathy or various other gastrointestinal disorders but can also be primary (idiopathic).
 
Cobalamin: Feline
290-1500 – Interpretation: Result is within the reference interval
<290, “<150” – Interpretation: Consistent with distal or diffuse small intestinal disease or EPI.  Check feline TLI to rule out EPI.  Oral or parenteral cobalamin supplementation is indicated.
290-693 – Interpretation: Result is at the low end of the reference interval.  Consider distal or diffuse small intestinal disease or EPI.  While this result is in the reference interval, many cats with results in this range are cobalamin-deficient on a cellular level and benefit from oral or parenteral cobalamin supplementation.
“>1500” – Interpretation: There is no know clinical significance for serum cobalamin concentration above the upper limit of the reference interval.
 
Folate: Feline
9.7-21.6 – Interpretation: Result is within the reference interval
<9.7, “<1.0” – Interpretation: Decrease serum folate concentration.  Consistent with proximal or diffuse small intestinal disease.  Consider folate supplementation
>21.6, “>50.0” – Interpretation: Consistent with small intestinal dysbiosis.  Small intestinal dybiosis often occurs secondary to chronic enteropathy or various other gastrointestinal disorders but can also be primary (idiopathic).
Synonyms/Keywords
​Vitamin B12, VB12, Folate
Test Components
​Cobalamin & Folate
Species
Canine, Feline
Test Category
Specimen Requirements
Specimen Type Preferred Container/Tube Acceptable Container/Tube Specimen Volume Specimen Minimum Volume
(allows for 1 repeat)
​Serum ​Red Top Tube (RTT) ​Serum Separator Tube (SST) ​500uL ​350 uL
​Hep Plasma ​Green Top Tube (GTT)
Collection Processing Instructions

​Samples should be collected from fasting animals: 12-18 hours for non-diabetic animals; 6 hours for diabetic animals.

Pancreatic function must be assessed before these results can be interpreted since they may be abnormal in animals with EPI (Exocrine Pancreatic Insufficiency)

Serum/Plasma should be separated from cells within one hour of collection and frozen as soon as possible unless transport to lab is <8 hours.

Acceptable Specimen Types
​Serum or Heparinized Plasma
Specimen Stability Information
Specimen Type Temperature Time
​Serum or Plasma ​Refrigerated ​8 hours
​Frozen (Preferred) ​60 days
Rejection Criteria
​EDTA Plasma
Room Temperature Samples
Interference
​Hemolysis and non-fasting status may interfere with results
Test Information
​Reference intervals and interpretative comments from Gastrointestinal Laboratroy - College of Veterinary Medicine Texas A&M University, College Station, TX 77843-4474
Reference Intervals
Performing Location Canine Reference Intervals Feline Reference Intervals
​Marshfield ​Cobalamin: 251-908 ng/L ​Cobalamin: 290-1500 ng/L
​Folate: 7.7-24.4 ug/L ​Folate: 9.7-21.6 ug/L
Interpretation
Cobalamin: Canine
251-908 – Interpretation: Result within the reference interval
<251, “<150” – Interpretation: Consistent with distal small intestinal disease, EPI or small intestinal bacterial overgrowth.  Check canine TLI to rule out EPI.  Consider oral or parenteral cobalamin supplementation
251-470 – Interpretation: Result is at the low end of the reference interval.  Suggestive of distal small intestinal disease (i.e., ileum), EPI, or dysbiosis.  Check serum canine TLI concentration to rule out EPI. Oral or parenteral supplementation is indicated.
>908, “>1000” – Interpretation: There is no known clinical significance for serum cobalamin concentrations above the upper limit of the reference interval. 
Folate: Canine
7.7-24.4 – Interpretation: Result is within the reference interval
<7.7, “<1.0” – Interpretation: Decreased serum folate concentration.  Consistent with disease affecting proximal small intestine.  Consider  folate supplementation.
18.8-24.4 – Interpretation: Upper end of the reference interval.  May reflect small intestinal dysbiosis.  In patients with GI signs but without systemic complications (i.e., sever weight loss, hypoalbuminemia, or other) trial therapies with prebiotics (e.g., a diet containing fructooligosaccharieds (FOS)), probiotics, or antibiotics may be considered.  The Gastrointestinal Laboratory at Texas A & M university recommends Tylosin at 25 mg/kg q 12 hrs. PO for 6-8 weeks.
>24.4, “>50.0” – Interpretation: Consistent with small intestinal dysbiosis.  Small intestinal dybiosis often occurs secondary to chronic enteropathy or various other gastrointestinal disorders but can also be primary (idiopathic).
 
Cobalamin: Feline
290-1500 – Interpretation: Result is within the reference interval
<290, “<150” – Interpretation: Consistent with distal or diffuse small intestinal disease or EPI.  Check feline TLI to rule out EPI.  Oral or parenteral cobalamin supplementation is indicated.
290-693 – Interpretation: Result is at the low end of the reference interval.  Consider distal or diffuse small intestinal disease or EPI.  While this result is in the reference interval, many cats with results in this range are cobalamin-deficient on a cellular level and benefit from oral or parenteral cobalamin supplementation.
“>1500” – Interpretation: There is no know clinical significance for serum cobalamin concentration above the upper limit of the reference interval.
 
Folate: Feline
9.7-21.6 – Interpretation: Result is within the reference interval
<9.7, “<1.0” – Interpretation: Decrease serum folate concentration.  Consistent with proximal or diffuse small intestinal disease.  Consider folate supplementation
>21.6, “>50.0” – Interpretation: Consistent with small intestinal dysbiosis.  Small intestinal dybiosis often occurs secondary to chronic enteropathy or various other gastrointestinal disorders but can also be primary (idiopathic).
Performing Laboratory Information
Performing Location Day(s) Test Performed Analytical Time Methodology/Instrumentation
​Marshfield ​Monday through Saturday ​2 hours ​Chemiluminescence/Immulite
Laboratory Section
For most current information refer to the Marshfield Laboratory online reference manual.