B12 shots forever??

My girl Shadow usually has a pretty strong stomach for a GSD, but recently,  she had really bad diarrhea, lots of blood in her stool, and vomiting out of nowhere for weeks.  She also started losing weight and went from 70 lbs a few months ago to 64 lbs a couple weeks ago and is slowly declining in spite of additional food, goat milk, yogurt, raw egg, etc. added to her food.   Her stool is normal now but we have not weighed her in a month to see if she's gaining weight. She's had multiple blood and fecal tests and ultrasound. Everything was clear. We ran another blood test and found this according to the vet: Shadow's B12 levels were low - this indicates true gastrointestinal disease.  Dr. Dowling recommends B12 injections to supplement - she would get an injection (under the skin, like a vaccine) weekly for 6 doses, then every 14 days for 6 doses, then monthly for life.  This can be scheduled as an appointment with a technician. She also recommends doing a strict diet trial with the z/d - assuming that she does well with no signs for several months, we would want to "test" her with one of her previous diets to see if signs come back. I asked for more clarification and the exact results and the vet said this (we have a consulting internist involved...Dr Dowling,  who was referenced) here: Let me clarify some of your questions with Dr. Dowling. Only her Cobalamin (B12) was abnormal – it was 250, and normal is 251-908. So VERY borderline low, however we tend to consider lower “normal” levels to be abnormal if everything else going on matches (symptoms and/or ultrasound findings).  When you schedule her first injection ask for a demonstration – then you can gauge if you think this might be something you can do at home. Since she gets it monthly long term, the bottle will likely expire before you can even get through half of it – that doesn’t mean it isn’t a cost savings though. The cost of a single injection is about $27, which is actually less than the cost of a technician appointment to give client owned injectable medications (doesn’t make sense to me – I’ll have to ask about this).  I would think that it would be better to get B12 naturally, but if she's not absorbing nutrients as well, maybe the initial shots would be a good idea, however, I would like to find a more natural way to manage this in the future. I know liver, fish, etc are high in B12, but wondering if anyone has experience with this and treated their dog successfully naturally and holistically vs all these vet visits and injections? Also wondering if raw food would help so she doesn't need injections. Thanks for your insights! We are at a loss. We've had many dogs with various issues, but this is a first.

Hello - It is my understanding that when Vitamin B12 is low, it can be difficult to fathom what's going on - whether the low Vit B12 caused a diarrhoea problem, or whether the Vit B12 was low because inflammation / problems in the gut prevented it from being absorped.  In the first scenario, stopping the Vet B12 could potentially cause a problem;  in the latter, once the guts have been functioning normally for some time, it might be that the patient can absorb Vit B12 naturally by themselves.   As a first opinion vet, I can imagine some degree of risk attached to stopping the Vit B12, especially when things are ticking along so nicely.   If you had two dogs the same, you could stop the injections for one dog and not the other and so carry out a scientific test;  in a clinical settimg however, you only have one of your dog so can only do what you think best.   Good questions for your vet include:  what experiments have been done that support out continuing to give Vit B12 injections at this point?  If they do not know, I would ask the / a specialist or pathologist.  I genuinely do not know what they will say.  Once you have as much information as you can get hold of between you, yourself and your vet will have a call to make.  Please would you let us know what you find / decide?