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(6) Inadequate levels of B12 can disrupt this cycle and lead to the accumulation of homocysteine, which is toxic to neurons and poses an increased risk factor for cardiovascular disease, stroke, and cognitive decline

2019 AAHA Dental Care Guidelines for Dogs and Cats

Epub ahead of print

The British National Formulary (BNF) provides full clinical information on hydroxocobalamin

Neurological symptoms often develop gradually and may include: Paraesthesia : tingling or 'pins and needles' sensations, typically starting in the feet and hands Numbness : reduced sensation in the extremities, which may affect balance and coordination Burning pain : particularly in the feet, often worse at night Weakness : muscle weakness and difficulty walking Balance problems : unsteady gait and increased fall risk due to proprioceptive impairment Cognitive changes : memory problems, confusion, difficulty concentrating, and mood disturbances Haematological signs may accompany neurological symptoms and include fatigue, weakness, pallor, and shortness of breath due to megaloblastic anaemia