07/01/2025
Ravioli continued to have a poor appetite despite the anti-nausea and appetite stimulant medication. About a week and a half ago, I began to wonder if she may be battling a cobalamin (B12) deficiency, which can cause anorexia and lethargy. Cobalamin deficiency is not an uncommon side effect of gastrointestinal issues, and with the massive amount of antibiotics she was on (despite being on Fortiflora), I wondered if her intestinal biome wasn’t in great shape. Maybe she had some dysbiosis? Liver disease can also be a contributing factor, although her liver values are currently normal.
I reached out to her team at Tufts via email, led by the amazing Dr. Ossman, to get their thoughts. It took a couple days for her to get back to me, as she was finishing her ECC residency this month (Congrats Dr. Ossman!). She agreed it may be an issue and we discussed doing a GI panel to see where her values were.
In the interim, I began supplementing her with B12. It’s a water soluble vitamin, which means, their body will flush out any they don’t need. It’s a simple OTC tablet (also available as an injectable), given once a day. Within a couple days, we noticed a difference in her appetite. Within four days, there was a noticeable increase in her appetite and energy levels. We are now about a week and a half into giving B12 daily, and she has finished her bowl 6 out of the last 7 meals! She had not cleaned a bowl in months. Over the last 3 days, we began to wean her off her other medication and she continues to eat better on just the B12. While she still requires some convincing to eat some things, she has begun to beg again, which we think is a good sign.
So, we will still get a GI panel done at some point soon (there are other potential supplements she may need), we are happy she seems to be feeling better and showing interest in food again!
Go Smoli!
