How to Treat Anemia in Dogs

Anemia is a condition in which there is a deficiency of red blood cells, or hemoglobin, in circulation. This lack of red blood cells means an animal with anemia has less ability to carry oxygen in the blood. The signs of anemia in a dog can be subtle and come on slowly but mainly consist of a lack of energy and weariness. If you notice your dog drags behind you on walks or is more sleepy and tired than usual, your dog may be anemic. If you suspect your dog is anemic, then seeking prompt veterinary attention is crucial.

Method 1

Method 1 of 5:

Assessing Whether Your Dog is Anemic

1
Consider whether your dog might be anemic. Is your dog extremely tired and lethargic all of a sudden? Is it loosing weight for an unexplained reason? If you can't figure out the reason for these problem logically, consider that anemia might be the reason. ^{[1]XResearch source}
- Anemia can be caused by a wide variety of problems, from parasites to cancer drugs. Two of the most common causes of anemia in dogs are hemorrhage from a bleeding tumor and autoimmune disease, in which the body attacks it's own red blood cells.^{[2]XResearch source}
2
Check the color of your dog's gums. These should be a rosy pink color, just like our gums. It is preferable to look at gum color in a room with natural lighting, since artificial lighting can give the gums an artificial creamy or yellow tinge. Gently lift the lip and look at the gums, pale pink or white gums are a sign of anemia.
- Another place to look is inside the eyelid, which should be pink. The lining of an anemic dog's eyelid will be pale pink or white.
- If the gums look pale the dog should see a veterinarian.
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3
Take your dog to its veterinarian. The vet will examine the patient thoroughly, on the lookout for problems such as fleas, lice or other parasites, unusual organ enlargement, or masses within the abdomen which could indicate a tumor. The vet will then draw blood to run lab tests.
- The lab tests will look at the dog's biochemistry in order to see if the organs are working properly (troubleshooting for where to root cause lies) and haematology. The later is an examination of the red and white blood cells. This can tell the vet if the dog is indeed anemic, the severity of the problem, if the problem is recent or long-standing, and if the dog is making new red blood cells or not. All of these thing parameters help the veterinarian to understand where the problem lies, how serious it is, and what treatment is required.
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Method 2

Method 2 of 5:

Treating Anemia Caused by Autoimmune Disease

Autoimmune disease is when the body turns against its own tissues and the immune system attacks them as if the tissue were foreign invaders. This can happen to the red blood cells, resulting fewer red blood cells, and thus in anemia.^{[3]XResearch sourceHematologic disorder. Raskin. Clinical Medicine of the Dog and Cat. Publisher: Manson.}
2
Determine if your dog has anemia due to autoimmune disease. You vet will run a number of tests to investigate whether this is a possibility or not. These generally include looking at your dog's blood for a variety of indicators.
- The Coombs test involves looking for antigens that become glued to the cell membrane of a red blood cell. It is these antigens that the immune system becomes mobilized against. A lab test called the Coombs test is often run, but the results can be misleading or inconclusive because it can only detect large amounts of antigen on the cell membrane surface. It is possible to get a false negative result if the red blood cell is contaminated with antigen but with insufficient levels to trigger a positive result. ^{[4]XResearch sourceSerial monitoring of clinical hematological parameters in canine autoimmune haemolytic anemia. Day. JSAP 37 (11)}
- An alternative test involves the vet adding drops of saline to a microscope slide with some drops of the patient's blood on it. The slide is rocked to encourage the saline and blood to mix, and then examined under the microscope. If the red blood cells clump together despite being diluted, then this is called "auto-agglutination," and is a sign the cells are coated in sticky antigens, which is considered a 'positive' result.
- Another important clue is to look at the size and shape of the red blood cells (RBCs) under the microscope. RBCs that have been attacked by the immune system have an atypical appearance (smaller and without an area of central pallor) and are called spherocytes. If the vet sees spherocytes, then it is a reasonable assumption that the body is damaging it's own RBCs.^{[5]XResearch sourceSerial monitoring of clinical hematological parameters in canine autoimmune haemolytic anemia. Day. JSAP 37 (11)}
3
Treat anemia caused by autoimmune disease. If your veterinarian identifies this is the cause of the dog's problems then he or she will treat the dog with immunosuppressive drugs, principally corticosteroids. These drugs switch off the immune response, stop the attack, and allow the body to regenerate red blood cells.
- High dose (called 'immunosuppressive' doses) are necessary in order to switch off this harmful mechanism. These high doses may be given for 2 weeks to begin with. If repeat tests show the anemia is improving, then the dose will be gradually reduced, often over several months.^{[6]XResearch sourceSerial monitoring of clinical hematological parameters in canine autoimmune haemolytic anemia. Day. JSAP 37 (11)}
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Method 3

Method 3 of 5:

Treating Anemia Caused by Blood Loss

A dog can lose blood because of injury (a traffic accident), parasites (fleas and lice), inflammation or ulcers in the bowel, or a bleeding tumor. In all of these examples the rate of blood loss is faster than the body's ability to make new red blood cells and so the number of blood cells in circulation falls. Once it goes below a certain level, the dog becomes anemic.
2
Stop bleeding from trauma. In the case of trauma, any bleeding areas need to be identified and stopped from bleeding. If your dog has been in an accident and is actively bleeding apply a pressure bandage (a firm bandage) or apply pressure to the wound with a clean cotton tea towel. You need to stop the bleeding while you seek veterinary help.
- The vet will clamp the bleeding vessel with artery forceps and then safely tie off the vessel.
3
Get your dog checked for a bleeding tumor. One of the most common causes of blood loss in a dog, apart from trauma, is a bleeding vascular tumor. Older dogs are prone to developing tumors on the spleen, which is an organ with a rich blood supply. These tumors are often delicate and crumbly, and a knock or bump can be sufficient to set the tumor bleeding. If the bleed is not sever the effect will be for blood to leak out of the circulation and pool in the belly. In more serious cases, the bleed can be severe enough to cause collapse, or even death, due to blood loss internally.^{[7]XResearch sourceFeline and Canine hemangiosarcoma. Chun. Comp Cont Ed. 21}
- Signs of blood loss from the gut include blood-stained vomit or feces, or very dark colored feces. If you are in doubt, collect a sample to show the vet.
- For a bleeding tumor, the vet needs to run diagnostic imaging such as ultrasound, CT or MRI scan, or radiography in order to identify the tumor and decide on the best treatment option.
- In cases of bleeding tumors the vet will attempt to stabilize the patient with intravenous fluids to maintain blood pressure, and if the bleed is severe enough then a blood transfusion may be required. Once the patient is strong enough to cope with an anesthetic then surgery to remove the spleen is the treatment of choice.^{[8]XResearch sourceFeline and Canine hemangiosarcoma. Chun. Comp Cont Ed. 21}
4
Look for signs of other internal problems. Other internal problems that cause bleeding such as a stomach ulcer or severe inflammation of the bowel. The vet will instigate treatment to protect the ulcer and let it heal or start treatment to reduce inflammation.
- If the dog is on medications, especially NSAID medications (Non-steroidal anti-inflammatories), such as meloxicam, then immediately stop the medication and inform your vet. This is because NSAIDs are associated with gut ulceration.
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Method 4

Method 4 of 5:

Treating Anemia Caused by Parasites

1
Assess whether your dog has a parasitic infection. A heavy infestation with fleas or lice, can cause anemia as these parasites suck blood. Another significant cause of blood loss is the lungworm parasite, Angiostrongylus vasorum. The mechanism by which infection causes bleeding is not known, but it can be severe and life-threatening. For all parasitic infections the treatment is to kill the parasites, thus removing the blood-sucking drain and allowing the dog to regenerate the missing red blood cells.
- 1. Another consideration is are blood-borne parasite such as Babesia or Haemobartonella which can damage red blood cells and lead to their destruction. It is critical to seek veterinary help for these conditions which require specific medications such a primaquine or quinine and clindamycin for Babesia, and tetracycline antibiotics for Haemobartonella.
2
Put your dog on preventative medication. There are many excellent and effective flea control medications available. Be sure to use something that is licensed for use in the dog and proven to be effective, such as fipronil (Frontline, Effipro,) or selamectin (Stronghold UK, Revolution US), although other effective products are also available.
- Lungworm is common in the UK and dogs pick up infection by contact with infected feces, or slugs and snails. Prevention is better than cure and this means using a monthly preventative treatment. If the dog tests positive for lungworm, then those same preventative treatments are used to kill the worms, but in addition the dog may need antibiotics to prevent pneumonia, and steroids to prevent inflammation and a possible allergic reaction to the dying worms.^{[9]XResearch source}
3
Follow your vet's recommendations for further treatment. In cases of severe blood loss a blood transfusion may be necessary. Dog blood banks exist which can often ship blood at short notice. Ideally the vet will blood type the dog using a simple in house test, and can then put in a call to the blood bank to request the appropriate sample.
- This is most useful when surgery is planned, such as to remove a previously bleeding spleen, but the delay of even a few hours while a sample is shipped, can be too long for an severely hemorrhaging patient.
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Method 5

Method 5 of 5:

Treating Anemia Caused by Kidney Disease

If you have ruled out all the common causes of anemia in dogs, don't give up and stop looking. A less common cause of anemia in the dog is kidney disease, which is less prevalent in the dog than other species, such as the cat. For dogs that do have kidney disease, the anemia comes about because the kidney produces a hormone called erythropoietin, which stimulates the bone marrow to produce new red blood cells. However, in dogs sick with kidney failure, as the active renal tissue is replaced with scar tissue the amount of cells available to produce erythropoietin falls.
One treatment is to give the dog iron supplements and B vitamins. Many dogs with kidney failure have poor appetites and so may be deficient in vital building blocks for hemoglobin (the molecule that carries oxygen) in red blood cells. However, the benefits of these supplements are limited because of the scale of the problem.
3
Treat the underlying cause of the anemia. This means you need to address the lack of erythropoietin. In theory, injecting the dog regularly with synthetic erythropoietin should encourage the production of new red blood cells, but sadly, this seemingly simple solution is fraught with problems. For a start, the synthetic erythropoietin can be difficult to obtain and is very expensive. On top of this there is a high incidence of allergic reaction to the artificial erythropoietin, which in turn can activate rejection of the body's own erythropoietin, thereby making the problem worse rather than better.
- When making a decision about how best to act in the dog's interests, this involves careful consideration and detailed discussion with your veterinarian. With this treatment in particular, you need to weigh the potential risks and benefits for your individual dog.
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Expert Q&A

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Question
Can your dog die from anemia?
Melissa Nelson, DVM, PhD
Veterinarian
Dr. Nelson is a Veterinarian who specializes in Companion and Large Animal Medicine in Minnesota, where she has over 18 years of experience as a veterinarian in a rural clinic. She received her Doctor of Veterinary Medicine from the University of Minnesota in 1998.
Melissa Nelson, DVM, PhD
Veterinarian
Expert Answer
Yes, at some point the dog's blood will not be able to carry oxygen to its body.
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Question
Can a dog die by having a flea?
Melissa Nelson, DVM, PhD
Veterinarian
Dr. Nelson is a Veterinarian who specializes in Companion and Large Animal Medicine in Minnesota, where she has over 18 years of experience as a veterinarian in a rural clinic. She received her Doctor of Veterinary Medicine from the University of Minnesota in 1998.
Melissa Nelson, DVM, PhD
Veterinarian
Expert Answer
Not a single flea, but a whole swarm of fleas can kill a dog. Puppies are especially vulnerable.
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Question
What should a dog's gums look like?
Melissa Nelson, DVM, PhD
Veterinarian
Dr. Nelson is a Veterinarian who specializes in Companion and Large Animal Medicine in Minnesota, where she has over 18 years of experience as a veterinarian in a rural clinic. She received her Doctor of Veterinary Medicine from the University of Minnesota in 1998.
Melissa Nelson, DVM, PhD
Veterinarian
Expert Answer
They should generally be a pink to dark pink color. Pale gums can be a sign of anemia.
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