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Future trials should also measure important outcomes such as the clinical signs and symptoms of vitamin B 12 deficiency, health related-quality of life, socioeconomic effects, and report adverse events adequately, preferably in a primary care setting. Clinical practice guidelines British Columbia Medical Services Commission (MSC)

In fact in IBD has been reported an upregulation of the pore-forming claudin-2 and down-regulation of occludin, particularly claudin-5 and -8 in Crohn's disease and claudin-4 and -7 in UC (83, 86, 326)

Appropriate supplementation can be very helpful for dogs that are Vitamin B12 deficient, particularly when they also have chronic gastrointestinal disease, exocrine pancreatic insufficiency (EPI) and/or other absorption disorders

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