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Common symptoms include: Weight loss or failure to gain (especially in puppies) Chronic diarrhoea or soft stools Lethargy and general weakness Inappetence or fussy eating Intermittent vomiting Flatulence or digestive discomfort Poor coat condition or dull fur Neurological signs (e.g., tremors, confusion, ataxia) Low folate or folate imbalance on bloodwork In puppies or young dogs with genetic B12 absorption issues, growth may be stunted , and immune function may be compromised

11 of these 12 patients reported improvement in their symptoms after telephone follow up

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