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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

Need pet health advice? Ask a vet

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Ask a Vet

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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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Serious severity

Has Symptoms

Weakness
Loss Of Balance
Shortness Of Breath

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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1611 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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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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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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Stella

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Labrador Retriever mix

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11 Years

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Serious severity

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Has Symptoms

Lethargy
Enlarged Spleen
Sudden Blindness
Non Regenerative Anemia
Red Iris

I have an 11 year old Lab Mix. I took her to my vet because she was lethargic, having trouble going down our porch steps and defecating sometimes without warning that she had to go out. The vet did an ultrasound because she felt a mass in her stomach and remarked that something was wrong with her eyes. The mass turned out to be her spleen which is incredibly enlarged. Her blood tests came back as non-regenerative anemic with her monocytes showing as just over the normal range. They did an x-ray of her chest and abdomen with which came back as unremarkable. She was also having trouble seeing. By the time we got home, she was almost completely blind. They sent her home with Doxycycline, Gabapentin, Dermamaxx and Pepcid to see if anything improved. She seems to feel better, but cannot see a thing. She does not indicate that she needs to go out to go to the bathroom, and I can see that her eyes look like they are bulging and the iris is a little red. The vet seems baffled as to what's causing all of the problems and referred us to an ophthalmologist to see if they can determine anything further. What is your opinion for the cause(s) and treatment?

March 8, 2018

Stella's Owner

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Dr. Michele K. DVM

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1611 Recommendations

Thank you for your email. I think a referral to an ophthalmologist is a great idea. Many diseases show signs through the eyes, and a specialist is highly trained to determine those changes and what might be causing them. Hopefully, they will be able to help figure out what is happening with Stella and get her treatment. I hope that she does well.

March 8, 2018

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Jax

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Border collie mix

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8 Years

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Critical severity

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Has Symptoms

Anemia

My dog has a form of non-regenerative anemia, and my vet believes it is due to the bone marrow not producing red blood cells. He's had 2 transfusions in the last 2 weeks, and those coupled with medicine and diagnostic costs have left me very near the top of what I can afford. If I am unable to do another transfusion if/when he needs it in the next couple weeks, what am I looking at in terms of options? If his PCV were to drop below 10, what are the repercussions (lowest it has been is 12)? Basically, if he doesn't get a transfusion what complications would arise, and what would he die from at that point? I don't want him to suffer, and would likely put him down if it gets that bad. I just haven't been able to find an article that cuts straight to the point of what the cause of death would be if anemia were to go untreated. He's an extremely calm and complacent dog, and it is hard to tell if he's experiencing discomfort or pain because he's so extremely chill and unreactive when he's perfectly healthy.

Dec. 13, 2017

Jax's Owner

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3320 Recommendations

When there is an insufficient number of red blood cells in systemic circulation the oxygen carrying capacity of blood decreases which causes a dog’s respiratory rate to increase in an attempt to get more oxygen in the body; unfortunately it gets to a point where a dog will be oxygen starved as the blood cannot carry sufficient levels of oxygen to meet the demands of the cells in the body. A reduction of red blood cells may be due to an increase in destruction (infections, parasites, autoimmune disease, cancer) or a decrease in production (kidney disease, bone marrow disorders); if cost is becoming an issue, you may try reaching out to charity clinics and nonprofits. Regards Dr Callum Turner DVM

Dec. 13, 2017

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Jesse

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Shepherd/Husky

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7 Years

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Serious severity

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My dog was fine one day and the next he wasn't. Listless, weak, pale membranes. dark urine. He appeared to go downhill quickly. Took him to the vet, Hct, Hgb, and RBC low and within two days even lower. He could barely walk. Admitted to hosp. Transfused and became even worse. Had a bone marrow biopsy, didn't appear as abnormal as I expected but def. non-regenerative anemia, actually PRCA, no other cells affected. He was too weak and his body never had a chance to respond to steroid therapy. I lost him. I will never get over this loss and I seek answers everyday regarding my "shusky" How common ins this and why. Can the multi-valent vaccines cause the condition? How come some dogs survive. Why did my pup go downhill so quickly? Does it sound like an IM anemia. I'm always looking for news and new treatments for this dreaded condition. Thank you.

Oct. 18, 2017

Jesse's Owner

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Pure red cell aplasia (PRCA) is an idiopathic condition meaning we don’t fully know why it happens but it is suspected to be immune mediated and only red blood cells (erythrocytes) are affected; some cases respond to immunosuppressive therapy but since the true cause is unknown it is difficult to treat. I understand your distress at the loss of your Shusky, but I am unable to shed any further light on this condition for you. Regards Dr Callum Turner DVM www.msdvetmanual.com/circulatory-system/anemia/primary-bone-marrow-diseases

Oct. 18, 2017

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Goldie

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Golden Retriever

dog-age-icon

9 Years

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Critical severity

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Critical severity

Has Symptoms

Uninterested In Food, Lethargy, Nra

My dog has been admitted to an emergency vet for non regenerative anemia. She became uninterested in good about a week and a half ago... took her to our local vet who saw her, ran her CBC which came back around 19%. He sent us home with some iron supplements, doxycycline, and Prilosec. Iron supplements were before we knew she had the NRA. Doxycycline was to treat any possible infection she may be experiencing and the Prilosec to help Incase she was experiencing any sort of gastrointestinal blood loss. Over the weekend I noticed a slight decline. We brought her back in and reran her CBC - finding they had dropped to 15%. The vet referred us to an internal med. specialist. She was given a chest X-ray and sonogram and everything came back clear. She was tested for Lyme or tick borne illness ... again, clear. They performed a blood transfusion which got her count back up to about 21% and are planning on doing a bone marrow test to see if they can determine the cause. This girl is my life— and I don’t want to give up on her too soon....but financial responsibility is a real thing. My question is — is there REAL hope that she could recover from this? I know there are ‘treatment options’ and it would depend on what the bone marrow test comes back with... but I need to be able to gauge when to say— enough. And I’m not sure if I’m getting that yet. Also— I need to know because I will always wonder and I will never forgive myself. Would grapes cause this? A while back— I kind of lost a lot of faith in the medical community and started following naturopathic professionals. I received many conflicting stories about whether grapes were safe or not for dogs. Indecently— she loves them. I haven’t given her any significant amount in about 3-4 months — if I’m eating them- I’ll maybe give her 2-3 individual grapes (shes 90lbs) and tell her no more. Do you think they caused this??? I will never be able to face myself.

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Monty

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Scottish Terrier

dog-age-icon

14 Years

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Serious severity

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

Serious severity

Has Symptoms

Walking Tenderly
Lethargy
Lethargic,

Just had my vet ring with dogs blood test, she said he has significant non-regenerative anemia she recommends an external referral to an internal medicine specialist, she seemed very vague and when asked about costs said it could run to thousands. He’s a scotty dog and is 14 in January he has a heart murmur but this hasn’t effected him so far he’s been a bit lethargic and slow this last month or so but put it down to his age but took him to vets for a check up.

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Tucker

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Brittany (Spaniel)

dog-age-icon

7 Years

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Serious severity

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Serious severity

Has Symptoms

Weight Loss, Nausea, Limping

I have a 7 year old Brittany who was recently diagnosed with non-regenerative anemia; in July his blood panel was fine, August his blood panel came back out of whack. Was also experiencing a lot of nausea, some vomiting, loss of appetite and lethargy. Based on blood panel and the Dx of non-regenerative anemia, we performed advanced ultrasound; this revealed a jejunal mass which was surgically removed 3 days ago and we are waiting for biopsy results. Also of note: Tucker collapsed (looked drunk, couldn't stand/walk) 4 months ago; after a heart ultrasound, the emergency vet doc said it could've been a one-off. Now wonder if the collapse was somehow related to the current findings of NRA and his jejunal mass...Our boy also has had lameness for a few years now with no logical reason for it, but has gotten worse over the last 6 months. Always hopping, raising his hind legs (many years of x-rays and physical exam reveal nothing torn or broken of his back legs). After the mass was surgically removed, we could see that he felt much livelier and perky. ls losing weight even though I am feeding him more than usual, though but not at a rapid pace, just feels bonier in the spine/hips. Some questions: Is non-regenerative anemia reversible? What types of cancer do you see the best results with the use of chemotherapy? (quality of life as well as extended life) Thank you, from a mom who loves her boy!

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Nugget

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Labrador Retriever

dog-age-icon

10 Years

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Moderate severity

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0 found helpful

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Moderate severity

Has Symptoms

Low Rbc

Our lab that we rescued which we think is about 10 years old was diagnosed with non regenerative anemia. The vet did tests and X-rays but are unable to decipher why this is occurring. 2 weeks after the first test his blood count went from 28 to 23. The X-rays didn’t show anything. What are the possibilities from here? Can dogs get supplements like humans? Why isn’t our vet acting on it by maybe giving him steroids to suppress the body from attacking? We are unsure if we should get go to another vet for a second opinion. Seems like a very difficult situation when the vet has no idea why the anemia is happening. Our dog eats, voids, acts normal as well so no other weird indications.

Non-Regenerative Anemia Average Cost

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

Average Cost

$5,500

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