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What is Non-Regenerative Anemia?

Anemia is a decrease in the mass of red blood cells, the result of lack of production, loss of red blood cells, or destruction of red blood cells. There are two types of anemia: regenerative and non-regenerative. With regenerative anemia, alternatively, the bone marrow responds to the anemia by increasing production of red blood cells and releasing reticulocytes (immature red blood cells that don’t have a nucleus). Regenerative anemia can be caused by a hemorrhage or hemolysis (the rupture or destruction of blood cells). In non-regenerative anemia, the cause is usually a decrease in erythropoietin (a hormone controlled by the kidneys that influences red blood cell production as a response to low oxygen in tissues) or bone marrow abnormalities. The bone marrow does not effectively respond to the decrease levels of red blood cells. 

Non-regenerative anemia is a deficiency of the red blood cells where the bone marrow is not appropriately addressing the deficiency by increasing red blood cell production and releasing reticulocytes. Symptoms include lethargy, jaundice, fever, pale mucous membranes, and abnormal pulses.

Non-Regenerative Anemia Average Cost

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Average Cost

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Symptoms of Non-Regenerative Anemia in Dogs

Symptoms vary depending on the degree, duration, and cause of the anemia, but may include:

  • Tachycardia (fast heart rate)
  • Pale mucous membranes
  • Abnormal peripheral pulses
  • Hypotension (low blood pressure)
  • Lethargy
  • Weakness
  • Anorexia
  • Splenomegaly (enlarged spleen)
  • Abdominal distension
  • Heart murmur
  • Jaundice
  • Fever
  • Shock
  • Death

Types

Non-regenerative: Non-regenerative anemia is determined by the absence of reticulocytosis, indicating that erythropoiesis (red cell production) is not functioning properly. Non-regenerative anemia develops slowly and has many potential causes. 

Regenerative: Regenerative anemia is characterized by reticulocytosis, a condition where reticulocytes (immature red blood cells) are increased in circulation. This indicates that the body is responding appropriately to the anemia by releasing red blood cells (before they have matured) to compensate for the lower levels in the blood stream. These reticulocytes are polychromatophilic (they have an affinity to multiple acid, neutral and/or basic stains) on routine blood tests.

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Causes of Non-Regenerative Anemia in Dogs

  • Anemia of chronic disease/anemia of inflammation: This is the most common cause of non-regenerative anemia, typically shares similarities with iron deficiencies
  • Absolute iron deficiency: This cause of iron deficiency in dogs is typically caused by chronic blood loss such as in gastrointestinal disease, hookworms, neoplasia, and ulcerations (can cause hemorrhages which lead to iron deficiency)
  • Chronic renal failure: In cases of chronic renal failure, a decrease in erythropoietin may cause non-regenerative anemia
  • Neoplasia: Non-regenerative anemia can be a complication of cancer, though this is not the case for all cancers; anemia related to cancers is the result of bleeding or hemolysis caused by the neoplasia
  • Endocrinopathies: Endocrine diseases such as hypothyroidism, diabetes mellitus, and hypoadrenocorticism, can be associated with non-regenerative anemia
  • Liver disease: Non-regenerative anemia caused by liver disease occurs most regularly in cases of chronic liver disease
  • Infection of erythropoietic cells: Some viruses can cause infection in the erythropoietic cells, causing non-regenerative anemia
  • Disease or toxic injury to bone marrow: Any affliction to bone marrow can cause non-regenerative anemia because it inhibits the bone marrow’s ability to produce red blood cells
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Diagnosis of Non-Regenerative Anemia in Dogs

Your veterinarian will likely ask questions to establish a complete medical history. Some of these questions may focus on symptoms, exposure to certain toxins (such as rodenticides, heavy metals, or toxic plants), current drug treatments, vaccinations, history of travel, or previous illnesses. In addition, the following diagnostic tests may be used:

  • Physical exam
  • Complete blood count, particularly with focus on abnormalities and possible red blood cell parasites 
  • Urinalysis
  • Bone marrow evaluation

Analysis of red blood cells will focus on size and hemoglobin concentration. Complete analysis of the red blood cells will help to identify or rule out potential causes, including macrocytosis (increase in mean corpuscular volume) which suggests regenerative anemia, microcytosis (decrease in mean corpuscular volume) which indicates anemia from iron deficiency, lead poisoning established through abnormalities in hemoglobin concentration, and oxidative injury indicated by Heinz body formation.

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Treatment of Non-Regenerative Anemia in Dogs

Treatment depends on the underlying cause and severity of the regenerative anemia, as well as any underlying conditions that are causing or influencing the anemia, which may include cancer, liver disease, and renal failure. Treatment could include fluid therapy and, in many cases, blood transfusions. Treatment of the cause will need to be considered, and may need to be addressed before the anemia. Recovery will likely include periodic blood transfusions, though that depends on the cause of the non-regenerative anemia. Prognosis varies, ranging from good to poor.

  • Fluid therapy
  • Blood transfusions, in severe cases
  • Removal of any drugs or irritants that could be causing the anemia, especially in instances where the drug is toxic to the bone marrow
  • Most genetic diseases have no real treatment
  • Treatment of the underlying causes of the anemia, including liver disease, chronic renal failure, and endocrine diseases
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Recovery of Non-Regenerative Anemia in Dogs

Recovery and management will depend largely on the underlying condition. If the anemia cannot be completely treated, your veterinarian will likely require multiple follow up visits for blood transfusions or supplemental therapy to help with the anemia. Depending on the cause, treatment, as well as post-treatment recovery, will vary—cause and follow up treatment will influence prognosis.

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Non-Regenerative Anemia Average Cost

From 367 quotes ranging from $1,500 - $10,000

Average Cost

$5,500

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Non-Regenerative Anemia Questions and Advice from Veterinary Professionals

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Cookie

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Beagle

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11 Years

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Serious severity

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0 found helpful

pill-rating-filledpill-rating-filledpill-rating-filledpill-rating-filledpill-rating-filled

Serious severity

Has Symptoms

Shortness Of Breath
Weakness
Loss Of Balance

I have an 11 year old beagle named Cookie who just got diagnosed with nonregenerative anemia. We left her with a dog sitter for a week and when we came back she almost passed out when she saw us. It was like she lost control of her body, she fell over and couldn't get back up for a few minutes. She has Addison's disease so we assumed that the stress of not seeing us for a week made her pass out, but then it happened a few more times and we took her to the vet. They also said her bone marrow is decreasing. Looking back now, I think the problems started before we even left. Her breathing was a lot heavier than normal for at least a few months before. They told us that if her PCV gets lower (it's at 17 now) we'll have to do a blood transfusion. We're a little unsure about how to handle everything. Of course they told us that one transfusion might not be enough, but just one is expensive and we've already spent a lot getting to this point. I don't know how far we can keep going. Sometimes she doesn't have an appetite but if we bring out her favorite foods she's always down. And usually she'll eat at some of the day, so she isn't going long times without food. Are transfusions really the only option? What is the process afterwards, how is the transfusion going to help? Is this inevitably going to keep happening?

July 28, 2018

Cookie's Owner

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Dr. Michele K. DVM

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0 Recommendations

I wish that I could answer your questions, but without knowing the reason for the anemia, I don't know what other options there are or how she will respond. There are many causes for anemia, and typically the blood transfusion is to help keep levels up while we treat the actual cause. Since your veterinarian will know more about why Cookie is anemic and what to expect longer term, it is very reasonable to ask those questions of them and get more information. I hope that she does well.

July 28, 2018

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Leo

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pit bull terrier

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4 Years

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Critical severity

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5 found helpful

pill-rating-filledpill-rating-filledpill-rating-filledpill-rating-filledpill-rating-filled

Critical severity

Has Symptoms

Bruising
Still Less Active
Seemed To Be Improving

I took my dog to ER because I found a bruise on his leg and his abdomen incision scar was getting darker(he had recently been treated for severe sepsis and discharged from hospital 12 days prior, with anemia tested and resolving 9 days prior). He had completed his antibiotics 4 days prior. They found he did not have platelets and a low red blood cell count. He was admitted and administered steroids to prevent immune system from attacking red blood cells/platelets and required blood transfusions daily. Five days later they performed the Recticulocyte test, and results given the next day said he had nonregenerative anemia. Would you have tested his blood for infection/sepsis upon arrival or at some time to determine if that could be reason why he wasn't creating platelets given his history (or even not given his history but in general)? If sepsis was found, what would be the treatment, likelihood of survival?

March 12, 2018

Leo's Owner


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Dr. Michele K. DVM

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5 Recommendations

Thank you for your email. I'm not sure that I'm clear on your question. Sepsis can cause aberations in body function, and may have caused the immune mediated disease that he seems to be recovering from. There is no particular test for sepsis, it is more based on a number of signs and tests. It seems that Leo is improving, and it would be best to continue his therapy per your veterinarian's advice.

March 12, 2018

Thank you. Leo died the day of the results. They found fluid in his abdomen that they said was septic. His abdomen had started looking swollen days before but was thought due to enlarged liver. It seems the antibiotics had kept infection at bay, and they think must not have completely gone in the first place. I guess I am just trying to understand it all. Since he was improving but all of a sudden had the bruises appear and a drastic decline. Is there any way keeping him on antibiotics longer could've rid him of sepsis? Maybe we should've had his anemia, etc tested again after the antibiotics? And if it had worsened could re-upping on antibiotics been an option to eliminate the infection? Hoping this post can help others in the future. Just want to add, when you're worried about your pet but your regular vet assures you all is good, follow your intuition and go straight to emergency or another vet for 2nd opinion immediately. Leo could be alive if I had. And get pet health/accident insurance-so you won't have to worry about emergency costs and expensive treatment.

March 13, 2018

Leo's Owner

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Non-Regenerative Anemia Average Cost

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Average Cost

$5,500

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