Anaemia in dogs: Case study

Erythropoietin is overrated - over used on pets 

Currently, I'm treating a Dogue de Bordeaux who's just 9 months. He got progressively thin within 3 months with a declining Body Condition Score (BCS). Dewormed about 3 months back

1st visit (2 months ago):
- BCS was 4/9
- I thought he was malnourished
Suggested a diet for weight gain

Two weeks later:
- Lost appetite
- Pale gums
- BCS 3/9. The weight gain diet had not helped him. There was something beyond that
- Bloods revealed an immune mediated haemolytic anaemia. Treated for anaemia with repeat bloods in 5 DAYS

5 WEEKS later:
- Appetite gained
- Even Paler gums although meds continued
- BCS dropped further to almost 2/9
Tests revealed hook worm eggs and an iron deficiency anaemia

⏩ Bone marrow was responsive
⏩ Partially regenerative (mostly non regenerative)
⛔PCV 7% and extremely low rbc and Hb levels

Technically a blood transfusion was required which I did not hop onto. My intuition said, "let's wait". No Erythropoietin was given

✅ Dewormed safely. BCS "seemed to drop" to 1/9 - gut inflammation subsides, fluid retention resolves, true muscle/fat condition is now visible

✅ Started Iron supplementation with concurrent focused supplementation through the diet to facilitate iron absorption. It's just about one week since I started this therapy

✅The dogue de bordeaux's oral mucosae colour is slowly turning light pink. PCV increased but not yet normal. It's too early to judge BCS now itself

💡Usually, whenever HCT (Pcv) is low, and even at 15, no matter the reason for anaemia, Erythropoietin is used. Instead, figure out why the dog is anemic

Theoretically Erythropoietin should be used in non regenerative anaemia but why didn't I use Erythropoietin?

Erythropoietin strongly stimulates the marrow to produce more Rbc precursors but there's not enough iron to make Erythropoietin, the marrow's demand for iron skyrockets,. You will end up worsening functional iron deficiency and iron depletion

Consequences :
- makes anaemia worse
- bone marrow stress
- tissue hypoxia worsens
- potential for thrombosis or hypertension

There are so many reasons for a dog to be anemic

Erythropoietin in iron deficiency anaemia is unsafe and ineffective. Before giving Erythropoietin, clarify whether iron stores are adequate

This case also shows how focused nutrition is important to save a life

📷 A Google image of a Dogue de bordeaux

❤️

Dr. Romela Salgado 

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