Many people may have heard of the word anemia, but are not sure what it means. Anemia means a low number of red blood cells, or a low amount of circulating red blood cells. While anemia as an umbrella term refers to a low number of red blood cells due to a variety of reasons (loss, destruction, decreased production), hemolytic anemia is a specific type of condition. Hemolytic anemia is a type of anemia in which a cat’s immune system destroys its own red blood cells. In this article, we will explain what exactly hemolytic anemia is, its causes, and how to diagnose and treat this disease.
What is hemolytic anemia?
Hemolytic anemia is a specific type of anemia caused by the destruction of red blood cells in cats. This happens because the cat’s own immune system seeks out and destroys red blood cells. This may seem like a strange concept, but it can occur in any cat of any age.
The normal life cycle of red blood cells involves production in the bone marrow and subsequent release into the bloodstream. After red blood cells have served their purpose, the body naturally breaks them down and discards them. Different parts of the red blood cell circulate through the spleen, liver, and bone marrow, where they are recycled or destroyed. In particular, the liver recycles the iron portion of red blood cells called bilirubin. These body systems function to continually break down old red blood cells and use/recycle or dispose of their components, while pumping new red blood cells out of the bone marrow to keep the body’s circulatory system in balance.
When your immune system is triggered by something (more on that below), red blood cells are “marked” to be destroyed. This may not sound like a big deal, but if the body is unable to maintain an adequate rate of red blood cell production to compensate for the amount being destroyed, this can become a serious problem. Both the liver and spleen are overwhelmed with the number of red blood cells and red blood cell “parts” to process, causing problems for each organ. Additionally, all red blood cells are marked and/or coated with antibodies. These antibodies can stick to red blood cells and cause potentially fatal blood clots. Antibodies also trigger other systems in the body to further destroy them. Overall, it’s a vicious cycle.
What are the signs of hemolytic anemia in cats?
Hemolytic anemia, and anemia in general, may be difficult to notice until your cat’s condition is severe. Many of the cats we know and love are extremely callous and lazy. Therefore, it can be difficult to notice lethargy and weakness, one of the most common abnormal signs of anemia.
Red blood cells are responsible for circulating oxygen throughout the body, so a low red blood cell count means all the body’s organs are starved for oxygen. Over time, your cat will feel and act much weaker than normal. They may sleep more often or be reluctant to wake up. Additionally, if the anemia becomes severe, your cat’s breathing rate may begin to increase as the cat’s body struggles to circulate fewer red blood cells. Unfortunately, if your cat already has a sedentary lifestyle or tends to hide frequently, you may not notice these signs at first.
Your cat may also have a decreased appetite and may experience nausea and vomiting. In cases of anemia, abnormalities in the gastrointestinal tract are often noticed. Your cat’s gums, tongue, and conjunctiva (lining the eyes and eyelids) may be pale to white in color. However, over time, these tissues can actually turn yellow, a condition called jaundice.
Depending on the cause of anemia and the degree of progression, changes in the color of urine and stool may be observed. Urine can vary in color from orange to what is commonly referred to as port wine color. The stool may also be orange in color. Over time, your cat may have difficulty walking, trip or fall, and may become unresponsive if the condition worsens.
What causes hemolytic anemia in cats?
Often, the cause of hemolytic anemia cannot be found. This is called idiopathic. However, your veterinarian may want to perform other tests to rule out other causes. Some cats, especially if they are outdoors only or indoors/outdoors, are susceptible to various tick-borne diseases, blood parasites, and even viruses such as FeLV (feline leukemia virus) and FIV (feline transmissible virus). More likely. ). All of these can cause hemolytic anemia.
Hemolytic anemia can also be caused by other diseases, such as cancer. Cancer does not have to be directly related to the spleen or liver; it can occur anywhere in the body. It is thought that cancer and potentially the presence of some markers may be triggers that cause the destruction of red blood cells. While some of these tests to diagnose anemia can be performed in-house, many require specialized tests sent to a lab to be completed for confirmation.
Diagnosing hemolytic anemia in cats
Diagnosis of hemolytic anemia must be made by a veterinarian. You may suspect your cat is anemic because the gums are pale, jaundiced, or weak, but an accurate diagnosis must be made with several different types of blood tests. there is. First, your veterinarian will likely perform a complete CBC (complete blood count) and chemistry tests. These tests will check your cat’s red blood cell count, platelet count, white blood cell count, and kidney/liver values. If your cat is anemic, your veterinarian will likely examine a blood sample under a microscope. They are looking to see if the red blood cell count is actually decreasing and not just a mechanical error. They’re also looking for something called a spherocyte, a type of red blood cell shape that may be present during destruction.
If your veterinarian confirms anemia, he or she will likely perform a test to check for “self-aggregation.” Remember what we said above that during this process, all the red blood cells become coated with antibodies and the red blood cells stick together? This test confirms that the red blood cells are clumped together. This should not occur in a healthy cat, and the presence of autoaggregation in the face of anemia is evidence of hemolytic anemia.
How do I care for a cat with hemolytic anemia?
First, I would like to emphasize how important it is to follow all diagnostic and treatment options as directed by your veterinarian. Cats with anemia are often very unstable, especially if it is severe at the time of diagnosis. Your cat will need active care for the first few days, then extensive care and monitoring for weeks and possibly the rest of his life. Starting your cat on one medication is often not enough, and it is essential to monitor your cat’s blood levels with regular retests.
Depending on your cat’s severity at the time of diagnosis, a blood transfusion may be recommended. These are often only completed in specialty or university clinics. Cat blood types are very specific, and many regular veterinary clinics do not carry both blood types or even blood type testing kits to ensure you are given the correct type of blood. Additionally, blood transfusions are not without risks, and your cat will require around-the-clock care while receiving a blood transfusion. However, keep in mind that your cat’s body is still destroying red blood cells, even if they are transfused. Therefore, in addition to receiving blood transfusions, cats also need to be started on medications to slow or stop this destruction. Without these, transfused blood would be immediately destroyed by the body.
The drugs needed are called immunosuppressants. There are many different types on the market today, and the exact medication your veterinarian will prescribe will depend on the type of cat. Steroids are the most common, cheapest, and easiest to administer. However, there are other options that may be more effective for your cat, and it can also be given in combination with steroids.
If your cat is also diagnosed with an infectious component, such as a blood parasite or tick-borne disease, your cat will also require a long course of antibiotics.
It is never recommended to give cats commercial iron supplements or red meat to increase their iron levels. Many commercial products can be toxic to cats, and simply trying to increase iron will not increase the number of circulating red blood cells. Hemolytic anemia should always be managed by a veterinarian.
Frequently asked questions (FAQ)
What happens if my cat goes into remission?
Many cats improve with aggressive treatment and remain stable until a veterinarian determines they are in remission. However, there is always a chance of recurrence, so regular blood tests and tests are recommended for patients with hemolytic anemia or anemia in general.
Will my cat die from hemolytic anemia?
Unfortunately, this is not uncommon. As I mentioned earlier, many cats aren’t even diagnosed until they’re seriously ill, and at that point, the effectiveness of medications can wear off faster than the body’s ability to destroy cells. Additionally, many cats do not take their medications, making administration and proper treatment difficult, if not impossible.
conclusion
Hemolytic anemia is a specific type of anemia that occurs due to the destruction of the body’s own red blood cells. In cats, this can occur at any age and in any breed. Some cats can develop hemolytic anemia due to certain infections, but often no cause can be found (called idiopathic). Diagnosing hemolytic anemia is not difficult, but requires several different types of blood tests. Other tests are often done to rule out infections or cancers that may be causing the illness. Because cats are not diagnosed until they are seriously ill, you may not notice any obvious abnormalities in your cat at first. Once diagnosed, your veterinarian may give your cat a blood transfusion, or at least begin aggressive immunosuppressive medications. Hemolytic anemia is a serious disease that must be treated quickly and aggressively. Many cats will go into remission, but fatalities are not uncommon.
Featured image credit: Prystai, Shutterstock
