Scooter's Supplies for Chronic Renal Failure (CRF)

About Vitamin B Complex


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About Vitamin B Complex

Giving CRF cats vitamin B complex is easy and inexpensive and the supplemental vitamin B complex often increases both energy and appetite.  Some vets fail to recommend early supplementation of vitamin b complex for CRF, believing most cats are getting enough B vitamins from their food.  That's probably true for healthy cats, but B-vitamins are water-soluble and CRF cats are "polyuric" and make a lot of urine that dissolves and washes away the water soluble B-vitamins.  Talk to your vet about Vitamin B Complex as soon as your cat is diagnosed with CRF.  Vitamin B Complex supplementation may make a significant, visible difference in your cat's energy and appetite and has no real downside.  Please note that Vitamin B Complex, liquid or injectable, is non-prescriptive.  Some vets may write their clients prescriptions for injectable Vitamin B12 which is also inexpensive and of great benefit to CRF cats.

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Introduction

Types.  Vitamin b complex is available in pills, powders, liquids and injectables.  Only liquids and injectables are discussed on this page because I've yet to receive any reports of the successful use of pills and powders with cats.  Both liquids and injectables work and are easy to administer.  The real question is what works for you and your cat.  For example, our Scooter Cat is easy to pill.  Since he's already getting some pill meds in a daily gel cap, adding some high-potency liquid vitamin b complex to said gel cap was a natural.  Folks who are already comfortable using an insulin syringe may find it easy to use the injectable form of vitamin b complex and inject directly into their cat's water sack immediately after infusion.  Those who don't want to poke additional holes in their cats can add the injectable via the injection site on the IV admin set during each infusion or they can inject multiple doses directly into new IV bags of fluids so the vitamin b complex is administered with each subsequent infusion.  Some cats may allow owners to syringe the more palatable brands of liquid vitamin b complex onto their tongues or down their throats.  And some cats may consume those palatable brands of liquid vitamin b complex mixed with their food.  Again, talk to your vet about appropriate form and dosage.  And talk to yourself and your cat about what type of vitamin b complex and mode of administration you two can handle.

 

 

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Best Products?  Appropriate Dosage?  Liquid or Injectable?  Regular or High Potency?  Best brands?  Correct dosage?  These questions are not answered definitively on this page.  Folks have reported successfully using a variety of regular and high potency versions of B-complex at a variety of dosages.  The Liquids and Injectables sections of this page are based on those reports.  Please read those sections carefully, then talk to your vet about the right product and dosage.  It might be useful to bring along a print copy of this page for that discussion.

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About Vitamin B Complex Liquids
 

 

B complex liquids can be given in gel caps or syringed down a cat's throats and the more palatable kinds can be mixed with food or eyedroppered or oral syringed onto a cat's tongue.  Most of the Vitamin B complex products below are manufactured for human use and are packaged in human sized bottles.  These products are quite inexpensive for feline consumption.  For example, an 8 oz bottle of Twinlab Super-B Complex Regular costs $8-$15.  But since a cat-sized dosed is 0.5 mL per day (29.57 mL = 1 fl oz.), that bottle will last  about 474 days and the cost of vitamin b complex supplementation will be only 2-3 cents a day!  Pet-tinic and Liqui-Tinic are two animal-only brands of liquid b vitamins.  Both are much more expensive (on a per dose basis) than the human brands and deliver lower doses of the key b vitamin components.

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Brands.  Brands used by members of the Feline CRF Support Group include Twinlab Super-B Complex Regular, Sublingual B Total and GNC Liquid B-Complex.  Pet-tinic, Lixotinic and Liqui-Tinic and NutriVed B Complex Plus Iron are animal use only products that also supplement iron and copper, best for anemic or potentially anemic animals.
 

B-Complex Liquids Menu

 

 

 




Comparison Table. The table below compare three of the liquid vitamin b complex products that members of the Feline CRF Support Group are using --  Sublingual B Total, Twinlab Super-B Complex and GNC Liquid Vitamin B-Complex.  The Sublingual B Total and the GNC deliver 20 times more Vitamin B-12 than the Twinlab Super-B (at the daily dosage recommended by users) and the Sublingual B delivers twice the Folic Acid, but Twinlab Super-B delivers a more complete range of B vitamins than the other two.  Table 5 below presents a comparison of the three products.  

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Table 5.  Comparison of Two B-Complex Liquids
Suggested Dosage Based on Experience of Group Members (1)

Product Pictures

  (2)


Product

Sublingual B Total

Twinlab Super B-Complex - Regular

Manufacturer

Vita 5 Nutrition.

Twin Laboratories Inc.

Manufacturer's Description

B-complex vitamins are factors in providing energy by converting carbohydrates to glucose.  The B-Complex vitamins are water-soluble and used by the body daily but not stored.

A pleasant tasting, high B-complex formula in liquid form for more efficient digestion, absorption, assimilation and utilization.

Suggested Cat Dose (3)

0.1 mL

0.5 mL

Folic Acid 

20 mcg

10 mcg

Vitamin B-1 (thiamine)

-

5

Vitamin B-2 (riboflavin) 

0.17 mg

5 mg

Vitamin B-3 (niacinamide/niacin)

2 mg

5 mg

Vitamin B-6 (pyridoxine) 

0.2 mg

5 mg

Vitamin B-12 (cobalamin)

100 mcg

5 mcg

Biotin

-

5 mcg

Pantothenic Acid

-

5 mg

Choline (bitartrate) 

-

5 mg

PABA (para-aminobenzoic acid)

-

1 mg

Inositol

-

5 mg

Base

Distilled Water, Sorbitol, Glycerine, Citric Acid, Fruit alor, Sodium Benzoate

 

Sizes

1 fl. oz eyedropper bottle, often comes in twin packs with 2 bottles

4 oz. and 8 oz. glass bottles, available in Regular or Herbal.  Regular is preferred for cats since some of the Herbal ingredients have not been tested on felines!
  1. Suggested dosages based on the experience of members of the Feline CRF Support Group.
  2. The picture shown is Twinlab Super B-Complex Regular Formula, preferred over the herbal formula because not all the herbal ingredients have been tested with cats.
  3. These are suggested minimum dosages for cats up to 10 lb.; dosages for bigger cats should be adjusted accordingly.  Coincidentally, all suggested dosages are precisely 1/10 of the recommended human dosage!

Sources - Liquid Vitamin B Complex

B-Complex Liquids Menu

Twinlab Super-B Complexin 4 and 8 oz. bottles should be widely available in health food stores and even some drug stores.  Get the "Regular" formula since some of the ingredients in the "Herbal" version have not been tested with cats!  If you can't find it locally:

Sublingual B Total comes in a 1 fl. oz. eyedropper bottle but is often marketed in "special value twin packs" with two 1 fl. oz. bottles.  It should be widely available in health food stores.  Be careful to buy the right product - Sublingual is the brand name of this product as well as the administration type (under the tongue for humans), and health food stores will have a variety of b complex sublingual products.  If you can't find it locally:


Pet-TinicŪ /Pet-Tabs Iron Plus Liquid is a very palatable liquid vitamin-mineral supplement for dogs and cats from Zoetis.  (Pet-Tabs Iron Plus liquid is identical to Pet-Tinic and also manufactured by Pfizer).  These products are often "private-labeled" through Vibrac distributors, e.g., Petco Pet-Tinic.  It's sold in 1 fl oz (30 mL) amber glass bottles with dropper in dispensing boxes and 4 fl oz (120 mL) amber glass bottles.  Recommended dose for cats is 1 mL (1 dropperful) per 10 lb of body weight twice a day. Ingredients include Corn Syrup, Water, Sucrose, Glycerin, Beef Liver Paste, Iron Proteinate, Sodium Citrate, Caramel Color, Citric Acid, Niacinamide, Potassium Sorbate, Cyanocobalamin, Thiamine Hydrochloride, Pyridoxine Hydrochloride, Riboflavin, Cupric Sulfate, Natural Anise Flavor, Sodium Hydroxide.  Pet-TinicŪ / Pet-Tabs Iron Plus is widely available at pet stores and veterinary clinics.  LixotinicŪ is Pet-tinic packaged in large sizes for large animals - it's exactly the same as Pet-TinicŪ. 


Pet-TinicŪ delivers smaller quantities of the b vitamins than the other products on this page but it does supplement both iron and copper.  Accordingly, Pet-TinicŪ is only recommended for anemic CRF cats who can benefit from the iron/copper supplementation.  (Please note that the pill form of Pet-Tabs Iron Plus is a different product with different ingredients).  If you can't find Pet-TinicŪ / Pet Tabs Iron Plus locally:


  NutriVed B Complex Plus Iron Liquid;  Each teaspoonful (5 mL) contains:Liver fraction 250 mg Minerals: Copper (from copper sulfate) 250 mcg Iron (from iron peptonized) 25 mg Vitamins: Vitamin B1 (thiamine) 7.5 mcg Vitamin B2 (riboflavin) 1.5 mg Vitamin B6 (pyridoxine) 1.5 mg Vitamin B12 (cyanocobalamin) 2.5 mcg Choline 7.5 mg Folic acid 10.0 mcg Inositol 20.0 mg Niacin 20.0 mg Pantothenic acid 7.5 mg Indications: For supplementation of the diet to aid in the prophylaxis and treatment of iron, copper, amino acid, and vitamin B-complex deficiencies in young or orphaned dogs and cats and convalescent or debilitated dogs and cats.  [Editor's note -- best for anemic animals.]

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About Vitamin B Complex Injectables

 

 

For cats already getting regular infusions, Vitamin B Complex injectable may be delivered subcutaneously via three techniques:

  • Injection into new IV fluids bags.
  • Injection into the injection port on IV admin sets during infusion.
  • Injection into the cat's "water sack" immediately after infusion.

Discuss the best mode of administration, appropriate product and dosage with your vet.  The information following may assist you in preparing for that discussion.

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B-Complex Injectables Menu


 Best Injectable Technique? Whatever works for you and your cat is best, but there are some valid considerations.

 

 

 

As noted above, whatever works for you and your cat is fine.  Do talk to your vet about the best form of administration and the proper dosage prior to starting b-complex supplementation.

Fortified v. Regular Vitamin B Injectable v. Pet-tinic

Vitamin B complex injectable is an over the counter medication for animal use and is available in two versions, regular and a more potent "fortified" version.  See the chart below for a comparison of the active ingredients of the two.

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Fortified Vitamin B Complex Injectable v. Regular Injectable v. Pet-tinic (1)
Active Ingredients - each recommended dose (2) contains


Ingredient

Fortified
(AgriLabs)
.5 mL

Regular
(VEDCO)
.5 mL

Pet-tinic
1.0 mL (4)

Thiamine HCl  (Vitamin B1) 

50 mg 

6.25 mg

0.42 mg

Riboflavin (as 5' phosphate sodium) (Vitamin B2)

2.5 mg 

1.0 mg

0.20 mg

Niacinamide  (Vitamin B3)

50 mg 

6.25 mg

2 mg

d-panthenol  (Vitamin B5)

5 mg 

2.5 mg

- 

Pyridoxine HCl  (Vitamin B6)

5 mg 

2.5 mg

0.25 mg

Cyanocobalamin (cryst.)  (Vitamin B12)

50 mcg 

2.5 mcg

0.42 mcg 

Benzyl alcohol (preservative) 

1.5% 

1.5%

-

Water (2)

q.s.

q.s

-
  1. This table compares AgriLabs Fortified and VEDCO regular injectables and Pet-tinic solution (for oral administration only).  All are labeled for dog and cat use.  The suggested dose of the injectables ranges from .5 mL to 2 mL.
  2. 0.5 mL is a common daily dosage of injectable for a 10 lb. cat.  1.0 mL is the recommended daily dose of Pet-tinic for the a 10 lb. cat. 
  3. Fortified delivers 8 times more B1 than regular, 2.5 times as much B2, ..., 20 times as much B12, etc.  While all the B-vitamins are important for a CRF animal, B12 is the first among equals.  B12 helps appetite and energy and is often administered as a separate injection.  As noted by a vet below, some anemic animals sometimes cannot absorb enough B12 orally.
  4. Some have suggested that the orally-administered liquid Pet-tinic as a vitamin b complex supplement.


Both the regular and fortified brands that I've found for sale on the Internet are listed in the table below.  Clicking on any name in the table will bring up the labeling information for that product.  Note that only ArgriLabs Fortified and the VEDCO regular specifically say they are intended for "dog and cat" use.  But the active ingredients in all these products are the same, the only difference being some have an citric acid "buffer" and some do not. All may be suitable for cats - please discuss with your vets.

B-Complex Injectables Menu

Brands of Vitamin B Complex - Fortified and Regular

 

Fortified

Regular

AgriLabs Fortified Vitamin B Complex

Vitamin B Complex

Phoenix Pharmaceutical Vitamin B Complex

Phoenix Pharmaceutical Vitamin B Complex Fortified

Sparhawk-Vet Labs Vitamin B Complex High Potency

Sparhawk-Vet Labs Vitamin B Complex

VITA-JECŪ Vitamin B Complex  Fortified 

VEDCO Vitamin B Complex

 

VITA-JECŪ Vitamin B-Complex

AgriLabs Vitamin B Complex

Vitamin B Complex injectables come in 100 cc, 250 cc and 500 cc bottles (1 cc =  1 mL).  Vitamin B Complex injectable is an over-the-counter medication, although some vendors do erroneously insist on a prescription.
 

 

REMINDERS / WARNINGS.

  • Vitamin B complex injectable administered via infusion may sting.  That's one of the reasons that some inject into the inline port during infusion and many more inject into the water sack immediately following infusion. 
  • There are a number of variants of vitamin b complex injectables that may include substances potentially harmful for your cat such as vitamin c.  Please be careful in purchasing the right vitamin b complex injectable for your cat.

 

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Vendors - Mail Order/Internet


 

 

B-Complex Injectables Menu

You'll also need ...

If you're using injectables, you'll need disposable syringes and needles to inject the vitamin b complex.

Insulin syringes are fine for injecting into the IV admin set injection site and/or the water sack on the cat.  Insulin syringes are available in .25, .3, .5 and 1 mL sizes and are generally sold in boxes of 100.  They're over-the-counter in almost all states.  Residents of CT, IL, MA, NJ, NY and RI need a prescription from their vets.  A box costs anywhere from $8 - $23.  Local pharmacies should have them in stock.  If not, many of the mail order vendors listed on the CRF Supplies web page sell insulin syringes.  It's best to buy the smallest volume syringe that will accommodate your current and future needs.  For example, if your dosage is .25 mL, a .25 mL insulin syringe would be best.  But if that dosage might increase to .5 mL in the future, then a .5 mL insulin syringe would best serve your once and future needs.

Disposable syringes with needlesin 3 mL, 5 mL and 10 mL are widely available in boxes of 100, again OTC in most states.  You'll need these to inject large volumes of supplements directly into the fluids bags.  Residents of CT, IL, MA, NJ, NY and RI need a prescription from their vets.  Again, many of the "fluids vendors" listed on the CRF Supplies web page sell disposable syringes with needles.  Prices range from $15-$25 for a box of 100.  Buy the smallest volume syringes that will serve your needs now and in the future..

 

 

Vet Comments

Kathy James, Veterinary Nephrologist, DVM, PHD, Educational Director the Veterinary Information Network (VIN) and Consulting Nephrologist to the Feline CRF Support Group:

It seems to me like all these methods could work fine, each having its pros and cons.  Oral would seem to be ideal for most patients under the general theory that "if the gut works, use it."  But there might be selected patients with gastrointestinal disease that might respond better to injectables.  Injecting SQ b-vits hurts, but if folks are finding that the cats don't object to injecting it into their fluid pockets, I don't see any problems with it.  The caveat would be that I've not done it, so I guess there's always the chance of long-term irritation issues.

Betsy Sigmon, DVM, 2001 President of the North American Veterinary Conference (NAVC):

Many of these kitties become anemic but cannot absorb oral B12 . In those cases I use injectable B12 (0.15 cc sub-cut) if blood tests indicate cobalamin deficiency.
 


David's Advice

  1. I personally prefer the high-potency vitamin b complex products that supplement a lot of vitamin B12.  B12 is the ingredient that can do the most for your cat's energy and appetite.
  2. Since many CRF cats don't eat well, mixing vitamin b complex with canned food is a little risky - you never know if your cat is getting a full dose of his b complex supplement. Some have had success mixing supplements with small amounts of baby food and handfeeding the baby food to their cats.  If that works for you, great.  My personal preference is using administration techniques that insure that the cat is receiving a full dose, e.g. using an eyedropper or an oral syringe with a liquid, putting liquid or capsule contents in a gel cap for oral administration, administering injectable b complex during infusion or following infusion, etc.
  3. As noted above by Dr. Sigmon, some CRF cats cannot absorb B12 administered orally.  If B-Complex supplementation doesn't improve your cat's energy and appectite, ask your vet about testing for a cobalamin deficiency.  If there is such a deficiency, you can administer B12 by subcutaneous injection.  B12 injectable is prescriptive.