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As absorption is reduced, body stores become low and a deficiency occurs Underlying diseases most commonly include: IBD (inflammatory bowel disease) Intestinal cancer (especially small cell lymphoma) Liver disease Pancreatitis and other pancreatic diseases Symptoms of low B12 levels Typically found in middle-aged or older cats that present with: Weight loss Diarrhea Vomiting Anorexia Thickened intestines In humans, B12 deficiency may also be associated with dementia, cardiovascular disease, and a certain type of anemia, although these are not specifically recognized problems in cats

Cachexia Sarcopeni 11 , 698709 (2020)

Risks versus benefits should always be assessed

If its incredibly severe, you can have B12 injected

Y., & Lee, M.-S