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EMG/NCS and muscle enzymes are normal

Further, long-term use of acid-reducing drugs and the anti-diabetes drug metformin and repeated exposure to nitrous oxide have been implicated in vitamin B 12 deficiency (see Drug interactions)

Diagnosis typically involves blood tests including full blood count (showing macrocytosis), anti-intrinsic factor antibodies (which are specific for pernicious anaemia), and sometimes anti-parietal cell antibodies

Veterinarians may prescribe budesonide alone or in combination with other therapies such as immunosuppressants or antibiotics, depending on the severity of your cat's condition and how they respond to initial treatment