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Clinicopathological findings and clinical presentation Blood cell count abnormalities, typically nonregenerative anemia with megaloblastosis, neutropenia, and hypersegmented neutrophils, can be early signs of derangements in cobalamin metabolism.72 With progression, disorders of phospholipid and amino acid metabolism have been documented in other species and might also occur in dogs.21, 73 In addition to blood cell dyscrasias and organic acidemias associated with neurological signs, especially dogs with hereditary cobalamin deficiency can show severe clinical signs such as failure to thrive, anorexia, lethargy, vomiting, and diarrhea