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Even meat-eaters can experience deficiency due to poor absorption, which often relies on a stomach-produced protein called intrinsic factor

Here is what to watch for: Gradual or persistent weight loss despite maintaining a reasonable appetite Chronic or recurring diarrhoea that does not fully resolve with standard treatment Reduced appetite or inconsistent interest in food Lethargy and reduced energy that does not match the dogs age or activity level A dull, dry, or poorly conditioned coat that does not reflect the diet being offered Slow recovery from illness or repeated episodes of digestive upset In more advanced cases, neurological signs such as weakness, unsteady gait, or reduced responsiveness In many long-term rescue cases, vitamin B12 deficiency has been present for months before the dog receives proper assessment

Most patients have several contributing factors at once

Ma XH, Liu JHZ, Liu CY, Sun WY, Duan WJ, Wang G, et al