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Anemia Caused by Renal Disease in Animals


Steven L. Marks

, BVSc, MS, MRCVS, DACVIM (SAIM), North Carolina State College of Veterinary Medicine;

Allison Kendall

, DVM, MS, DACVIM, North Carolina State University

Last full review/revision Sep 2019 | Content last modified Oct 2020

Chronic renal disease Renal Dysfunction in Small Animals Failure of the filtration function of the kidneys leads to the development of azotemia (an excess of nitrogenous compounds in the blood), which may be classified as prerenal, renal, postrenal... read more Renal Dysfunction in Small Animals is a common cause of nonregenerative anemia in animals. Erythropoietin is normally produced by the peritubular endothelial cells in the renal cortex. Animals with renal disease produce less erythropoietin, leading to anemia. Darbepoetin is hyperglycosylated compared with recombinant human erythropoietin and anecdotally is associated with a reduced risk of red cell aplasia. The recommended starting dose is 1 mcg/kg SC once weekly in cats and 0.45 mcg/kg SC once weekly in dogs. PCV is monitored weekly until the desired improvement is reached (this will vary with the initial degree of anemia), after which the dose interval is increased. Animals receiving darbepoetin or recombinant human erythropoietin require supplemental iron to support RBC production. (Also see Hematinics Hematinics Anemia can be treated pharmacologically by providing components needed for RBC production, including hemoglobin synthesis, and by stimulating bone marrow formation of RBCs. Vitamin B12 is essential... read more .)

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Circulatory System
A 10-year-old, male-castrated golden retriever has a 1-month history of mild lethargy and decreased appetite. On physical examination, he has pale mucous membranes and weak femoral pulses. His complete blood count (CBC) shows a decreased packed cell volume (PCV), decreased mean corpuscular volume (MCV), and decreased mean corpuscular hemoglobin concentration (MCHC). His biochemistry panel shows a mildly increased blood urea nitrogen (BUN) level and mildly increased serum alkaline phosphatase (ALP) level. Which of the following is the most likely cause of this dog’s anemia? 
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