Anemia - Part 1

Pet Tales
by Barry B. Burtis D.V.M.

Geritol is a multi-vitamin mineral supplement for human use. From the very beginning of the mass media era, Geritol has been promoted as a cure for iron deficiency anemia or "tired blood". Influenced by television commercials, I grew up thinking anemia should not be much of a problem for animals. Surely if they developed "tired blood", it would be simple to prescribe some Animal-Geritol to make them better.

Unfortunately, it did not take me long as a veterinarian to realize that anemia can be a very complex problem and sometimes very challenging to deal with. Anemia, like a fever, is not specific disease. There are a host of different kinds of anemia that can be caused by a variety of disorders. Reduced to its most simple definition, anemia is a reduction below normal in the number of erythrocytes (red blood cells), the quantity of hemoglobin or the volume of packed red blood cells per 100 ml. of blood which occurs when the equilibrium between blood loss and blood production is disturbed.

Why is this a problem? Well, oxygen is carried to the cells in the body that require it, bound in the hemoglobin pigment found in the red blood cells. If oxygen isn't getting there, then amongst other things, an affected animal will certainly feel weak and appear tired.

Tyson is a six year old neutered male domestic short-hair cat. Old habits die hard and Tyson, though a house pet, still enjoys getting outside for some time every day. He was presented to the animal hospital because his owners had noticed him exhibiting a poor appetite, depressed and weak. On examination, Tyson was found to have a fever and some of his mucus membranes had a slight yellow colour.

Lady was an eight year old spayed female, blond, cocker spaniel. She was taken to visit her veterinarian because she had suddenly collapsed when she came in from the yard. She had seemed a bit off her food and her owners thought she had been a bit lethargic and breathing differently for a few days. She had vomited twice and had some diarrhea in the previous 24 hours. In addition, on examination, it was found that Lady had pale mucus membranes, a heart murmur and a slightly elevated above normal body temperature.

At least, the diagnosis of anemia is usually not difficult. Essentially any of a red blood cell count (RBC), checking a hemoglobin (Hb) level or determining a packed cell volume (PCV) on the patient provides the necessary information. Most commonly in clinical situations, a PCV is done first. It requires only a few drops of blood to perform, it takes only a few minutes to get results and is quite inexpensive. When a blood sample from Tyson and Lady was collected, put in a tiny glass tube and centrifuged, each patient was found to have a significantly below normal PCV. Therefore, each patient had a severe anemia. Now, that was very important starting information but the next big questions were what had caused their anemia and what could be done to help them.

To answer these questions, more tests would be necessary. But, these other tests cannot be done quite so quickly as a PCV. While awaiting the results of a more complete diagnostic workup, most patients found to be anemic on initial presentation will require some immediate supportive care. That was certainly the case with both Lady and Tyson.

There are various treatments that may immediately need to be considered for an anemic patient. Geritol is not enough. Therapy will depend on the degree of the anemia and how serious are the symptoms in the patient. Some patients can be treated as out-patients; the more seriously ill will require hospitalization. Rest and elimination of stress will be important for any patient. Good nursing care is essential. Intravenous fluids may be necessary to maintain sufficient blood volume and correct dehydration. Medications to control a fever and other complications of an anemia may need to be considered. Intravenous administration of glucose-containing fluids may be recommended for moribund animals. Blood transfusions or oxygen therapy are necessary for some. More specific antibiotic or other drug therapy will usually not be started until a more specific diagnosis can be made.

In my next column I will discuss anemia further and continue the story of Tyson and Lady.