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The secondary outcomes will be the serum vitamin B12 concentration (pg/ml), adverse events (description, moment of onset and resolution, intensity, cause, steps taken), adherence to treatment (measured at each patient visit via the number of vials used for patients in the oral arm, and the number of injections given in the intramuscular arm), quality of life (measured using the EuroQoL-5D questionnaire), and patient satisfaction and preferences

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Your cat may show one or more of the following symptoms : Anorexia Lethargy/Weakness Dehydration Weight loss Vomiting much more rare in cats than in dogs, and may be intermittent so not realized as being clearly linked to other possible symptoms Abdominal pain which may only be shown by your cat trying to find cool places to lie to soothe its tummy (bathroom basin, tile floor.) or sitting/lying in a hunched up way to avoid pressure on its tummy Diarrhea Fever Jaundice if the liver has become affected, usually only seen in severe cases Light coloured stools if the liver has become affected One further symptom/sign in diabetic cats is BGs that are difficult to control