Anemia in dogs

This condition is caused by the loss or destruction of a large amount of red blood cells, which can happen in the case of internal or external bleeding caused by injury or a drug reaction, or a disease such as an immune-mediated disorder or cancer. Signs of anemia include tiredness, exercise intolerance (difficulty exercising), decreased appetite, and pale gums, though dogs with mild cases may not have any signs at all. A severe anemic may need a transfusion, and in all cases the underlying cause of the problem must be treated.

Summary

If your dog has anemia dont panic. Though severe anemia is life threatening and requires immediate veterinary attention, mild cases can be easier to reverse or manage.

Anemia develops when the number of red blood cells in the bloodstream is reduced. Since theyre responsible for the transport and delivery of oxygen throughout the body, a deficiency in red blood cells can be potentially catastrophic to the entire system.

There are many causes and types of anemia, ranging from simple blood loss or the destruction of red blood cells within the body as part of a specific disease process to the inability of the body to produce enough red blood cells. Treatment varies based on the underlying cause.

Signs and Identification

Because red blood cells carry oxygen, which is essential for all basic bodily functions, the most common signs of anemia are lethargy and exercise intolerance. Decreased appetite and pale mucous membranes (the gums, for example) are typical as well. Mild anemia may not be evident except through blood testing.

Identifying anemia definitively is done in the laboratory. Most veterinarians can perform a quick blood test called a packed cell volume (PCV) in the hospital. The PCV indicates the percentage of red blood cells in the bloodstream. If a dogs PCV is lower than the normal range, anemia is diagnosed.

Other blood tests can offer more detailed information regarding the anemia, such as whether the body is losing vs. destroying red blood cells and if its producing new red blood cells to replace them. Among these, the CBC (complete blood cell count) is the most common and critical. It evaluates the individual components of the blood, a fundamental first step in the evaluation of any anemia.

In dogs, the most common anemia-inciting processes include: Blood loss stemming from a severe injury that causes bleeding externally or internally Immune-mediated disease (a condition in which the bodys immune system attacks its own red blood cells) Bleeding into the gastrointestinal tract as a result of disease or severe inflammation Gastrointestinal bleeding as a reaction to certain medications, such as nonsteroidal anti-inflammatory drugs (NSAIDs) Infectious diseases, including certain diseases that are spread by ticks Blood loss from severe flea infestations (especially in very small dogs and puppies) Exposure to toxins such as lead or rat poison Cancer (may lead to bleeding into the gastrointestinal tract or bleeding from a tumor) Sometimes, anemia is caused by a lack of red blood cell production as a result of chronic diseases (such as certain types of cancer or kidney disease) or exposure to certain medications that may interfere with red blood cell production.

Diagnosis of these can be achieved with a battery of tests, including blood testing (such as a biochemistry panel), urinalysis, specific testing for tick-borne diseases, bacterial or viral infections and parasites, and imaging techniques like X-rays, ultrasound, and sometimes more sophisticated testing (such as CT scanning and the surgical biopsy of specific tissues).

Affected Breeds

All breeds of dogs can develop anemia, though some may suffer rare forms related to specific genetic diseases, such as hemophilia and other clotting disorders.

Treatment

In cases of anemia resulting from either acute or chronic loss or destruction of a large amount of red blood cells, a blood transfusion may be recommended (or required) for survival.

As previously mentioned, severe anemia results in a significantly reduced ability of the blood to deliver oxygen throughout the body and, most importantly, to vital organs such as the brain. Therefore, a blood transfusion is necessary to help deliver oxygen and nutrients to major organs and other parts of the body. Occasionally, multiple transfusions are required before the dogs body can produce enough red blood cells on its own.

Other treatments for anemia will ultimately need to be tailored to the underlying cause.

Prevention

Certain causes of anemia may be preventable. For example, to reduce the risk of infectious diseases and vehicular trauma, proper containment or supervision of dogs when outside is considered essential. Vaccination and parasite prevention are also recommended.

Anemia is a defined as a deficiency of red blood cells (erythrocytes) in the circulatory system. Adult dogs are anemic when the concentration of red cells in whole blood is less than 37 percent by volume. The

normal range is 39 to 60 percent. Red cells are produced by the bone marrow and have an average life span of 110 to 120 days. Old red cells are trapped by the spleen and removed from the circulation. The iron they contain is recycled to make new erythrocytes.

The purpose of red blood cells is to carry oxygen. Thus, the symptoms of anemia are caused by insufficient oxygen in the organs and muscles. Signs include lack of appetite, lethargy, and weakness. The mucous membranes of the gums and tongue become pale pink to white. In dogs with severe anemia, the pulse and respiratory rate are rapid, and the dog may collapse with exertion. A heart murmur may be heard. Recommended Related to Dogs

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Anemia can be caused by blood loss, hemolysis, or inadequate red blood cell production. Blood-Loss Anemia

In adult dogs the most common causes of blood loss are trauma, slow gastrointestinal bleeding associated with stomach and duodenal ulcers, parasites, and tumors in the gastrointestinal tract. Chronic blood loss also occurs through the urinary system. Hookworms and fleas are common causes of chronic blood loss in puppies.

Treatment: Treatment must be directed toward the cause of the anemia. Gastrointestinal bleeding can be detected by checking the stools for microscopic traces of blood. Urinalysis will pick up traces of blood

in the urine that may not be visible to the naked eye. Other tests can also be used to determine the cause of the occult (microscopic) bleeding. Hemolytic Anemias

Hemolysis is an acceleration in the normal process of red blood cell breakdown. Red blood cells break down to form bile and hemoglobin. With severe hemolysis, these breakdown products accumulate in the body. Accordingly, in a dog experiencing an acute hemolytic crisis you would expect to see jaundice and hemoglobinuria (passing dark-brown urine that contains hemoglobin). In addition, the dog appears weak and pale and has a rapid pulse. The spleen, liver, and lymph nodes may be enlarged.

Causes of hemolysis include immune-mediated hemolytic anemia, congenital hemolytic anemia, infectious diseases (such as canine babesiosis and leptospirosis), drug reactions to medications such as acetaminophen, and poisonous snake bites. A number of bacteria produce toxins that destroy red blood cells, so hemolysis can also occur with severe infections. Immune-Mediated Hemolytic Anemia

This is the most common cause of hemolysis in adult dogs. Red blood cell destruction is caused by autoantibodies that attack antigens present on the surface of the cells, or by antigens from medications or organisms attached to the red blood cell walls. The weakened cells are trapped in the spleen and destroyed mmune-Mediated Hemolytic Anemia continued...

Poodles, Old English Sheepdogs, Irish Setters, and Cocker Spaniels are predisposed to immune-mediated hemolytic anemia, but all breeds are susceptible. Affected dogs are usually between 2 and 8 years of age; females outnumber males four to one.

Most cases of immune-mediated hemolytic anemia are idiopathic. That is, the reason why the autoantibodies developed in that particular dog is unknown. In some cases there is a history of recent drug therapy. An immune-mediated hemolytic anemia also occurs with systemic lupus erythematosus.

The diagnosis is made by microscopic examination of blood smears, looking for specific changes in the appearance of the erythrocytes and other blood elements; and by serologic blood tests.

Treatment: Treatment of idiopathic immune-mediated hemolytic anemia is directed toward preventing further red cell destruction by blocking the antigen-antibody reaction using corticosteroids and immunosuppressants. Severe anemia is corrected with blood transfusions. Splenectomy (removal of the spleen) may be beneficial, but only when tests prove that the spleen is contributing to the hemolytic process.

The response to treatment depends on the rate of hemolysis and whether an underlying cause can be found and corrected. The outlook is guarded; even with appropriate medical treatment, the mortality rate is close to 40 percent. Congenital Hemolytic Anemia

Several inherited abnormalities in the structure of red blood cells can result in their premature destruction. Phosphofructokinase deficiency is an autosomal recessive trait that occurs in English Springer Spaniels and Cocker Spaniels. A deficiency of this enzyme results in changes in the pH of red blood cells, causing the cells to periodically fragment and produce bouts of hemoglobinuria. There is no effective treatment.

Pyruvate kinase deficiency is another red blood cell enzyme deficiency caused by an autosomal recessive gene. This disease is recognized in several breeds, including Basenjis, Beagles, and West Highland White Terriers. Puppies usually develop the hemolytic anemia at 2 to 12 months of age. Death by age 3 is the usual outcome. Methemoglobinemia in Dogs

The purpose of hemoglobin in the blood is to carry oxygen from the lungs to other parts of the body. Methemoglobin is the result of iron oxygenation, and while it is a form of hemoglobin, it does not carry oxygen. Under normal conditions, methemoglobin is converted back to hemoglobin, and a balance is maintained. But when there is too much methemoglobin in the blood, inadequate oxygenation of bodily tissues ensues. A visible sign of methemoglobinemia is when the blood becomes brownish in color, instead of the normal oxygen rich red color. Methemoglobinemia can be the result of a genetic disorder, or it can be caused by later exposure to certain chemical agents.

Symptoms

Depression Weakness Rapid breathing Discoloration of skin and mucous membranes Jaundice Vomiting Hypothermia Swelling of face or jaw

Causes

Genetic disorder Acetaminophen ingestion Ibuprofen ingestion Topical anesthetics such as benzocaine Skunk musk

Diagnosis

Your veterinarian will want to know whether your dog has ingested acetaminophen or ibuprofen, or whether you have applied a topical medication. Blood tests may also be done at a laboratory to examine the levels of methemoglobins. If the methemoglobinemia is chronic, it is likely that the blood test will reveal a high volume of red blood cells. On the other hand, if the anemia is severe, or the cause is exposure to drugs such as acetaminophen, ibuprofen, or a topical medication, the veterinarian will look for evidence of organ injury.

A spot test may be performed where a drop of the dogs blood will be placed on an absorbent white paper and a drop of normal blood will be placed next to it. If the animal is suffering from methemoglobinemia, its blood will be noticeably browner than the bright red of the normal blood spot. Treatment

Mild to moderate no treatment necessary If drug-induced, discontinuation of the drug Acetaminophen or ibuprofen overdose vomiting induced immediately Inherited animals have normal life expectancy and do not require treatment Severely anemic blood transfusions Electrolyte imbalances resulting from vomiting, diarrhea, kidney injury, or impending shock may be treated with IVs In cases of severe anemia, methylene blue may be administered intravenously to reduce the methemoglobin count

Living and Management

Exercise extreme care when using acetaminophen and ibuprofen medications. If your pet has ingested them by accident, induce vomiting and take it to the veterinarian immediately. If you are giving your pet ibuprofen for pain, be alert for symptoms of anemia. Color should return to the skin and mucous membranes once the amount of methemoglobin in the blood has returned to a level that is not critical, and blood on the spot test appears bright red. If methylene blue treatment has been given, the proportion of red cells in the blood should be monitored closely.