5 Natural Ways to Treat Canine Anemia
Anemia: Inadequate Red
Red blood cells are basically little microscopic bags of hemoglobin.
They have no DNA. They have no internal structures and thus no ability
to perform complicated metabolism. Despite their simplicity, their
function is crucial: they carry hemoglobin, the iron-containing complex
that allows for oxygen transport to the tissues, as well as carbon
transport to the lung for removal. Inadequate red blood cell quantity
inadequate hemoglobin, which means inadequate oxygen delivery. In the
patient this translates to lack of energy, poor appetite, pallor, and
an important reduction in life quality.
There are three important ways in which the kidney patient loses red
blood cells. The first way is bone marrow suppression. The second way
is bleeding. The third way is called hemodilution. Maintaining a stable
red blood cell quantity keeps the patient energetic and spirited and is
crucial to staying alive.
Bone Marrow Suppression
One of the functions of the kidney is to produce a hormone called
erythropoietin (pronounced “Urithro-po-eetin”). This hormone, often
simply referred to as “EPO,” represents the command to the bone marrow
to make more red blood cells. When the kidney is damaged, its ability
to produce erythropoietin is compromised. Red cells are still produced
but over time the red cell
sample in a PCV tube being read against a chart
Blood sample in a PCV tube being read against a chart
A simple measurement of red blood cell count is called the “packed
cell volume” or PCV. The packed cell volume is an expression of the
percentage of the blood’s volume that is taken up by red blood cells.
It can be measured using only a drop or two of blood and can be done
while you wait in any veterinary office. The sample is spun in a
machine called a centrifuge
to separate the red cells, white cells, and serum. The blood tube is
read against a chart to get the packed cell volume. Hematocrit or “HCT”
also measures the volume of blood present as red blood cells but uses a
measure of hemoglobin to determine it. Practically speaking, PCV and
measure the same thing.
43.3 - 59.3%
29.3 - 49.8%
In renal patients, weakness becomes evident in dogs and cats when the
packed cell volume drops below 20.
What can we do?
Thanks to genetic engineering, human erythropoietin is commercially
available in an injectable form. This means that the hormone that the
kidney has failed to make is replaced with injections. Injections are
given three times a week at first but when the patient is more stable
they can be backed off to twice or even once a week.
The injections can easily be given at home.
Treatment with erythropoietin injections is generally extremely
effective with normal red blood cell counts achieved usually within 4
An oral iron supplement must be given simultaneously so that the bone
marrow will have the building blocks necessary to make red blood cells.
Packed cell volume must be monitored weekly until the patient
stabilizes so the patient will need frequent veterinary visits at least
If this monitoring is skipped, it is easy for the red cell count to
become too high, thickening the blood and causing high blood pressure
(which in turn creates more kidney damage in addition to other
Cost of treatment is reasonable for small pets such as cats and smaller
dogs but could be prohibitive for even a medium-sized dog.
Because the product used is a human origin protein, it can induce a cat
or dog to generate antibodies against it. When the immune system is
stimulated in this way, it not only attacks the human erythropoietin
but also the patient’s own erythropoietin, creating a severe anemia. If
this happens, transfusions may be needed to manage the anemia. When the
stop, eventually the antibody production stops and the anemia resolves
somewhat but EPO cannot be used in this patient again and periodic
become the only means of managing anemia.
In a presentation by Dr. Sheri Ross at the 2006 meeting of the American
College of Veterinary Internal Medicine, she notes that in one study of
dogs and cats with naturally occurring kidney failure, two of three
dogs treated with erythropoietin for more than 90 days and 5 of 7 cats
treated for more than 180 days developed refractory anemia that was
attributed to anti-erythropoietin antibodies. A clinically significant
immunologic reaction to erythropoietin has been reported to occur in
20-70% of treated veterinary patients. A more commonly published
statistic is that antibody production is a problem in 30-40% of pets
using human erythropoietin but this complication poses a sobering
thought. It is important not to use this hormone at the first sign of
anemia but wait until it is really and truly needed.
Is Darbepoetin better than Erythropoietin?
Darbepoetin is a synthetic hormone meant as an improvement over the
natural hormone, erythropoietin. The synthetic version lasts longer and
is less antigenic (less likely to create any erythropoietin
antibodies). Cost is similar to erythropoietin and since most
veterinarians have experience with erythropoietin, this is what tends
to be prescribed. Furthermore, dosing for animals is still being worked
out though there are some guidelines
based on human conversions between darbepoetin and erythropoietin. It
that the changes made in the amino acid sequence have made darbepoetin
likely to generate anti-erythropoietin antibodies but in a patient that
already having a problem with antibodies, darbepoetin is close enough
EPO to be inactivated as well.
The calcium-phosphorus imbalance that goes with renal disease is
reviewed elsewhere but the bottom line is that the excess blood
results in renal insufficiency leads to demineralization of bone and
deposits in soft tissues. Mineralization is inflammatory and, when it
in the GI tract, it leads to bleeding, ulceration, and pain. The renal
patient cannot afford appetite loss, nausea or further blood loss so
treatment is needed while other efforts are made to control phosphorus
Beyond the phosphorus level, another problem is a hormone called
gastrin. Gastrin is a hormone involved in food digestion and is a
the stomach to release acid. Normally, when the need for gastrin has
passed, the kidney removes it from the circulation but in the kidney
patient gastrin is not efficiently removed. The prolonged presence of
gastrin also prolongs the stomach’s secretion of acid which can lead to
How Do we Know There Is Stomach/Intestinal Ulceration?
There are several clues on the lab work an in the patient’s physical
appearance that tell us that additional therapy is needed to control
this kind of blood loss.
Horrendous inflammation in the mouth (odor, bloody or purulent drool,
sticky discharge on the lips and chin) includes ulceration. When
ulceration in the mouth is this bad, we can assume similar erosion is
occurring deeper in the tract.
A sign of GI bleeding is a BUN level that is more elevated than the
creatinine. Remember, the BUN partly depends on dietary protein.
Bleeding into the GI tract provides the intestine with blood to digest
and the BUN rises further. Some laboratories include a BUN:creatinine
ratio to highlight this phenomenon (a ratio >20 suggests intestinal
Uncontrolled phosphorus in and of itself suggests mineralization in the
What can we Do?
Medications for nausea and appetite stimulation can be used. The most
important treatment, of course, is going to be control of the
phosphorus level. Other treatments include the following:
When the mouth is purulent, there is probably secondary infection and
antibiotics can help clear it. Antiseptic mouthwashes may also be of
Reducing stomach acid helps reduce pain and bleeding when the GI lining
is ulcerated (at least in the stomach). Omeprazole is probably the
strongest antacid for veterinary use but famotidine tends to be
preferred because of its additional ability to antagonize parathyroid
hormone (which is a
uremic toxin and an elevator of blood phosphorus).
Sucralfate is an oral medication that forms a gentle webbing,
effectively a bandage, over the ulcers, protecting them from further
Pets presenting to the vet’s office in Stage IV or late Stage III
kidney failure are often dehydrated. A typical scenario is a pet that
had been drinking lots of water and eating fairly well suddenly stops
eating and is listless. Possibly it is even noticeable that the pet has
lost weight (though this is often erroneously attributed to age). The
owner waits a
day or two to see if the pet will start eating again and get better on
own and when that does not happen, the pet is brought to the vet. Once
diagnosis of kidney failure is made, fluid therapy will be recommended,
possibly fairly aggressively to drive the toxin levels down quickly.
the fluid therapy that is so helpful for driving toxin levels down,
will dilute the blood and drive the red blood cell count down.
This is not a big problem if the patient is not particularly anemic to
begin with but if the patient is already low on red blood cells or if
fluid therapy is very aggressive, by the end of hospitalization (or
even in the middle of it), the patient may be feeling the low red cell
What Can be Done?
One choice is to be less aggressive with the fluid therapy, though
this means a longer time to get to a livable toxin level. Another
is the use of erythropoietin as above, possibly in addition to a less
aggressive fluid administration rate. Using erythropoietin helps at
least increases the red blood cell production to balance the dilution
that comes with rehydration of the patient.
2007 - 2009 by the Veterinary Information Network, Inc. All rights
This work was originally published by Veterinary Information Network,
and is republished with VIN's permission.
5 Natural Ways To Treat Canine Anemia Article
By gene sower
Anemia can be caused by
excessive loss of red blood cells or by inadequate production.
Nutritional iron-deficiency anemia, common in people, is uncommon in
dogs with today's commercially balanced dog foods. Chronic iron
deficiency, as described by the 'Dog Owner's Home Veterinary Handbook,'
is a clear indication that an insidious loss of blood is taking place.
Blood loss is a condition that is commonly caused by wounds or
parasites such as worms and fleas. Symptoms of anemia in dogs include
white or pale gums, weakness, and a fast pulse. Sometimes this
condition indicates a more serious illness such as toxicity that
results from a drug exposure. However, the more simple and common cause
of anemia which is blood loss can be easily treated with a view toward
promoting the growth of new red blood cells.
You need to give your dog a special diet rich in iron, protein, and
vitamin B12. The following lists of foods and supplements are
especially helpful and provide the necessary nutrients that your dog
needs to treat anemia.
1. Beef liver which contains iron, protein, B complex, and B12.
2. Kelp powder which contains iodine and other trace minerals.
3. Green vegetables which contains iron and other minerals.
4. Nutritional yeast along with B12 which offers the same benefits as
5. Vitamin C, from 500 to 2,000 milligrams per day (depending on the
dog?s size) which helps with the absorption of iron from the intestinal
If the condition is caused by parasites, then you will need to nip the
problem in the bud and treat the parasite infestation first before
using any other forms of treatment.
Using a many commercially available flea treatments such as shampoos
and sprays can prove effective in killing fleas. But start by combing
or brushing your dog on a white sheet or blanket so you can see any
fleas fall off. And keep in mind that fleas can jump.
And don?t forget to wash your dog?s bedding and use a good flea powder
on carpets throughout the house, especially in the areas where the dog
sleeps and has it?s bed.
According to the Dog Owner's Home Veterinary Handbook', 'Signs (of
anemia) vary considerably, depending on the cause. Often they are
overshadowed by the signs of a chronic illness, of which anemia is but
one of the associated symptoms. In general, anemic dogs lack appetite,
lose weight, sleep a great deal and show generalized waekness. '
They go on to caution, 'With severe anemia, heart murmurs are common.
The pulse is rapid and so is the breathing rate. The dog may faint when
overexerting. Most of these signs also occur with heart disease, and
two conditions might be easily confused.'
vet can make the final diagnosis.
About the author
Gene Sower is the publisher of the DOG BYTES newsletter and owner of http://www.naturalpetsworld.com,
a site devoted to offering a huge selection of natural pet foods at
discount prices. from http://www.bloggingstuff.com
© BloggingStuff - All Rights Reserved -
back to top
The above information is simply
informational. It's intent is not to replace the advice of a
veterinarian nor to assist
you in making a diagnosis of your pet. Please consult with your own
veterinarian for confirmation of any diagnosis. Your pets life may
depend on it.