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Anemia of Chronic Disease

By Steven L. Marks, BVSc, MS, MRCVS, DACVIM, North Carolina State College of Veterinary Medicine

Anemia of chronic disease can be characterized as mild to moderate, nonregenerative, normochromic, and normocytic. It is the most common form of anemia seen in animals. The anemia can be secondary to chronic inflammation or infection, neoplasia, liver disease, hyper- or hypoadrenocorticism, or hypothyroidism. The anemia is mediated by cytokines produced by inflammatory cells, which lead to decreases in iron availability, RBC survival, and the marrow’s ability to regenerate. Treatment should be directed at the underlying disease and often results in resolution of the anemia. The anemia may be reduced by treatment with recombinant human erythropoietin, but the risk of antibody formation to endogenous erythropoietin may outweigh benefit. Darbepoetin appears to have less impact to induce reactive antibodies.