Red blood cells make up the majority of the cells found in circulation. Red cell function is measured in several ways. First, packed-cell volume is the percentage of whole blood that is made up of cells, with a normal value of 35 – 55%. Less than 30% is considered anemia, and less than 20% is life threatening. Absolute red cell count is an estimated number of cells per volume of whole blood. Normal canine and feline blood contains more than five million cells in every microliter (1/1,000,000th of 1 liter). Other tests that determine red blood cell health, but not quantity, include MCV – mean corpuscular volume (size of the cell) and MCHC – mean corpuscular hemoglobin concentration (amount of hemoglobin bound to the cell).

When anemia is discovered, it is categorized as either regenerative or non-regenerative. The bone marrow should respond to anemia by producing more red blood cells; therefore, an increase in the number of immature cells called reticulocytes should be seen on lab results. If there are more than sixty thousand reticulocytes per microliter, the anemia would be considered regenerative. Otherwise, the anemia is called non-regenerative, and a reason for bone marrow suppression should be pursued. Non-regenerative anemia is usually more difficult to treat and is progressive if it is not reversed.

Treatment for acute blood loss may include a blood transfusion. Whole blood or packed red cells are given intravenously to correct the anemia, giving the body time to regenerate its own cells. Corticosteroid is given before a transfusion to avoid rejection of the foreign cells and prevent anaphylaxis (allergic reaction). Blood typing is usually not performed unless multiple transfusions are expected to be necessary, as antibodies to the cells may destroy subsequent transfusions.

A synthetic hormone called Epogen (erythropoietin) can be used to stimulate the bone marrow to produce red blood cells. Erythropoietin is produced by the kidneys; therefore in chronic renal failure, Epogen is supplemented to correct anemia. Antibodies form in response to the Epogen injections however, making repeated injections less and less effective as the renal failure progresses.

In IMHA (immune-mediated hemolytic anemia), the body destroys its own red blood cells for some reason. The treatment for IMHA is immunosuppressive drugs like prednisone and azathioprine (Imuran). These medications stop the immune system from attacking the red blood cells.
Maintenance dosing of steroid is almost always necessary to prevent recurrence of the anemia.

The prognosis for a pet diagnosed as anemic depends on the degree of anemia, whether or not the bone marrow is capable and actively producing new cells, and the underlying disease process that caused the blood loss to begin with. In general, regenerative anemias are more easily treated than non-regenerative forms. The prognosis of the causative disease process will directly determine the outcome.

Acute Renal Failure (ARF)
Acute Renal Failure means that the kidneys are damaged suddenly. This is usually caused by poisoning or a lack of blood flow. Poisons that can cause ARF are ethylene glycol (antifreeze); heavy metals such as zinc and lead; and large doses of certain antibiotics, acetaminophen, and chemotherapy drugs. Inadequate blood flow can be caused by shock, hemorrhage, low blood pressure, or dehydration. Infectious illnesses like Leptospirosis can also cause ARF.

Signs of acute renal failure are not very specific. Loss of appetite, vomiting and diarrhea or dehydration may be seen. Some pets with ARF urinate excessively while others stop urinating altogether. Information on the pets recent experiences is crucial in diagnosis of ARF. Once the veterinarian suspects kidney disease, blood and urine tests are used to determine the cause and the severity of the condition.

Animals with ARF are treated with IV fluids. Additional medications are used to correct electrolyte and pH imbalances and to reduce symptoms. Specific treatment for the original cause of the kidney damage is given if the cause is known. Healing can occur in tissues that are merely damaged, and viable parts of the kidneys will work harder to compensate. Unfortunately, the portions of the kidneys that have been destroyed will not recover.

Pet owners can do several things to reduce the chance of ARF. Keep antifreeze away from pets, and clean up spills immediately. Follow medication dosage instructions, and never give people medicine to pets without first consulting your veterinarian. Make sure that pets, especially older ones, always have access to fresh water.

Chronic Renal Failure (CRF)
Chronic Renal Failure is seen most often in pets over eight years of age, particularly cats. CRF occurs when the functional structures of the kidneys wear out. The damage happens gradually, so months or years may pass before symptoms appear. As much as 75% of the kidney tissue may be destroyed by that time.

Like ARF, symptoms of CRF can be vague. Early signs include loss of appetite, weight loss, vomiting, diarrhea, constipation, and sores in the mouth. As the illness progresses, animals drink more water, urinate more, and may have urinary accidents in the house. Eventually, toxin buildup and electrolyte imbalances can damage the nervous system and the eyes, causing seizures, coma and blindness. Many animals with CRF become anemic, because the kidneys are also responsible for stimulating production of new blood cells. The veterinarian will perform blood and urine tests to confirm a diagnosis of CRF and to assess the severity of symptoms.

CRF is a progressive, irreversible disease. Treatment is aimed at slowing the rate of damage and minimizing symptoms. Diets for pets with CRF usually contain restricted amounts of high quality protein and are low in minerals. Many pets require supplemental fluids given periodically under the skin or intravenously. Medications are given to manage nausea, correct electrolyte and pH imbalances, control high blood pressure, and stimulate blood cell production.

The newest treatments available for pets with CRF are hemodialysis and kidney transplantation. These procedures are very costly and are only available at certain veterinary teaching hospitals and specialty practices. Hemodialysis is used as a temporary, emergency method for cleansing the blood. Transplantation can extend a pets life for two or more years. Kidney transplants are complex surgeries with a success rate of about 80% in cats. Pets that receive transplants must remain on anti-rejection medicine for life. Regardless of the type of treatment, the goal is to maintain the pets quality of life. When this is no longer possible, euthanasia may be considered.

Chronic Renal Failure is not preventable. Although some have suggested that low protein diets might have a protective benefit for animals with healthy kidneys, scientific research does not support this belief

Acute Renal Failure (ARF)
Acute Renal Failure means that the kidneys are damaged suddenly. This is usually caused by poisoning or a lack of blood flow. Poisons that can cause ARF are ethylene glycol (antifreeze); heavy metals such as zinc and lead; and large doses of certain antibiotics, acetaminophen, and chemotherapy drugs. Inadequate blood flow can be caused by shock, hemorrhage, low blood pressure, or dehydration. Infectious illnesses like Leptospirosis can also cause ARF.

Signs of acute renal failure are not very specific. Loss of appetite, vomiting and diarrhea or dehydration may be seen. Some pets with ARF urinate excessively while others stop urinating altogether. Information on the pets recent experiences is crucial in diagnosis of ARF. Once the veterinarian suspects kidney disease, blood and urine tests are used to determine the cause and the severity of the condition.

Animals with ARF are treated with IV fluids. Additional medications are used to correct electrolyte and pH imbalances and to reduce symptoms. Specific treatment for the original cause of the kidney damage is given if the cause is known. Healing can occur in tissues that are merely damaged, and viable parts of the kidneys will work harder to compensate. Unfortunately, the portions of the kidneys that have been destroyed will not recover.

Pet owners can do several things to reduce the chance of ARF. Keep antifreeze away from pets, and clean up spills immediately. Follow medication dosage instructions, and never give people medicine to pets without first consulting your veterinarian. Make sure that pets, especially older ones, always have access to fresh water.

Chronic Renal Failure (CRF)
Chronic Renal Failure is seen most often in pets over eight years of age, particularly cats. CRF occurs when the functional structures of the kidneys wear out. The damage happens gradually, so months or years may pass before symptoms appear. As much as 75% of the kidney tissue may be destroyed by that time.

Like ARF, symptoms of CRF can be vague. Early signs include loss of appetite, weight loss, vomiting, diarrhea, constipation, and sores in the mouth. As the illness progresses, animals drink more water, urinate more, and may have urinary accidents in the house. Eventually, toxin buildup and electrolyte imbalances can damage the nervous system and the eyes, causing seizures, coma and blindness. Many animals with CRF become anemic, because the kidneys are also responsible for stimulating production of new blood cells. The veterinarian will perform blood and urine tests to confirm a diagnosis of CRF and to assess the severity of symptoms.

CRF is a progressive, irreversible disease. Treatment is aimed at slowing the rate of damage and minimizing symptoms. Diets for pets with CRF usually contain restricted amounts of high quality protein and are low in minerals. Many pets require supplemental fluids given periodically under the skin or intravenously. Medications are given to manage nausea, correct electrolyte and pH imbalances, control high blood pressure, and stimulate blood cell production.

The newest treatments available for pets with CRF are hemodialysis and kidney transplantation. These procedures are very costly and are only available at certain veterinary teaching hospitals and specialty practices. Hemodialysis is used as a temporary, emergency method for cleansing the blood. Transplantation can extend a pets life for two or more years. Kidney transplants are complex surgeries with a success rate of about 80% in cats. Pets that receive transplants must remain on anti-rejection medicine for life. Regardless of the type of treatment, the goal is to maintain the pets quality of life. When this is no longer possible, euthanasia may be considered.

Chronic Renal Failure is not preventable. Although some have suggested that low protein diets might have a protective benefit for animals with healthy kidneys, scientific research does not support this belief