Anemia in Dogs | VCA Animal Hospital

What is anemia?

Anemia is a medical term referring to a reduced number of circulating red blood cells (RBC’s), hemoglobin (Hb or Hgb), or both. It is not a specific disease, but rather the result of some other disease process or condition.

Red blood cells are produced in the bone marrow and are released into the blood, where they circulate for approximately three months. As the RBCs age or become damaged, they are removed from the bloodstream and their components are recycled to form new red blood cells. The number of red blood cells may become reduced because of decreased production, lysis (cell destruction), or increased loss as seen with hemorrhage (bleeding).

Hemoglobin delivers oxygen to the cells and tissues of the body, and a dog that is anemic will suffer from symptoms related to a lack of oxygen.

What are the signs of anemia?

The most easily observed and common clinical sign of anemia is a loss of the normal pink color of the gums; they may appear pale pink to white when examined.

Anemic dogs also have little stamina or energy, so they seem listless or tire more easily. Additionally, weight loss, labored breathing, loss of appetite, a faster heart rate, or signs of blood loss (bloody nose, blood in the stool, urine, or vomit) may also be seen. Pale gums and lethargy indicate the need to perform blood tests.

How is anemia diagnosed?

There are several tests that are performed on the blood sample to diagnose anemia. The most common test is the packed cell volume (PCV) or hematocrit (HCT). These tests are often performed as part of a complete blood cell count (CBC). In a normal dog, 35% to 55% of the blood will be red blood cells. If the PCV is below 35%, the dog is generally considered anemic. Others tests to determine if a dog is anemic include the red blood cell count and the hemoglobin count.

What other tests are important when a dog is anemic?

When there is evidence of a low red blood cell count, it is important to know if the bone marrow is producing an increased number of new red blood cells in response to the lost red blood cells. When the body senses anemia, it releases immature (young) red blood cells from the bone marrow prematurely, and these immature red blood cells, called reticulocytes, can be stained for easier identification on the blood smear. The presence of increased numbers of reticulocytes indicates that the anemia is responsive. This means the body has identified anemia (responding) and is attempting to correct the deficit by releasing immature red blood cells. Most automated blood analyzers will detect the presence of reticulocytes to help your veterinarian quickly determine the body’s response to anemia.

A careful study of the blood smear is also important to look for blood parasites that might be causing red blood cell destruction and abnormal cells that could indicate leukemia (high white blood cell count). Additionally, a slide agglutination test can be done to help rule out the presence of autoimmune hemolytic anemia (see handout “Autoimmune Hemolytic Anemia in Dogs” for more information on this condition).

A bone marrow biopsy or aspirate is obtained if there is concern that the bone marrow is not responding appropriately to the anemic state (unresponsive or non-regenerative anemia). A sample of bone marrow is withdrawn and analyzed, providing valuable information about its condition, and occasionally revealing the cause of the anemia.

Biochemical profiles and urinalysis are other important tests for anemic dogs. These tests evaluate organ function and electrolyte levels providing important information about the overall health of the dog.

A fecal parasite exam is important to identify the presence of parasites in the intestinal tract that might be causing blood loss.

Imaging studies such as radiographs (X-rays) or ultrasound may be recommended to help determine the cause.

What causes anemia?

There are many diseases that can cause anemia. These are grouped into:

• diseases that cause blood loss
• diseases that cause hemolysis (red blood cell breakdown or destruction)
• diseases that decrease the production of red blood cells through bone marrow suppression

What diseases cause blood loss?

The main causes of blood loss in dogs include:

• trauma or injury to blood vessels or damage to internal organs, causing persistent bleeding
• heavy infestations of blood-sucking parasites, such as fleas, ticks, and hookworms
• tumors (benign or malignant) of the intestinal tract, kidneys, urinary bladder, and spleen that begin to bleed
• diseases that prevent proper blood clotting

What diseases cause hemolysis?

The main causes of hemolysis include:

• autoimmune disease, especially immune-mediated hemolytic anemia (IMHA or AIHA)
• blood parasites (e.g., Babesia)
• chemicals or toxins (e. g., zinc, rat poisons, onions, or garlic)
• cancer

What diseases prevent red blood cell production through bone marrow suppression?

The main causes of bone marrow suppression that result in decreased red blood cell production include:

• any severe, chronic (long-lasting) disease (such as chronic kidney or liver disease, Ehrlichia)
• very poor nutrition or nutritional imbalances
• autoimmune disease
• hypothyroidism
• chemicals or toxins (estrogen-based drugs, lead, some chemotherapy drugs, rarely some antibiotics such as chloramphenicol and trimethoprim-sulfadiazine)
• cancer

Do dogs get iron deficiency anemia?

Iron deficiency anemia is a somewhat common disease in people, especially women. Iron deficiency can be common in dogs and is usually secondary to some form of chronic blood loss. It is occasionally seen in puppies that are being fed very poor diets or who have severe hookworm infections. If the underlying cause is addressed and iron is supplemented, the prognosis can be good.

How is anemia treated?

If your dog’s anemia is so severe that it is life-threatening, a blood transfusion will be needed. Before giving a transfusion, blood samples will be taken for diagnostic testing, or blood typing. The main purpose of a blood transfusion is to stabilize the dog while the underlying cause of the anemia is determined, and other treatments can begin to take effect.

Further, more specific treatment can be determined once the underlying disease causing the anemia has been diagnosed. Treatments may include corticosteroids (particularly for autoimmune hemolytic anemia), anthelmintics (de-worming medications such as pyrantel or fenbendazole), vitamin K1 in cases of some rodenticide toxicities, antibiotics such as doxycycline with some infectious causes, or surgery (in cases of a damaged organ such as the spleen or liver). Your veterinarian will outline a treatment plan specific to your dog’s needs based on diagnostic test results.

What is the prognosis for anemia?

The prognosis for dogs with anemia is based on the specific diagnosis, as well as the dog’s general condition at the time of diagnosis.

If the anemia is diagnosed early and the dog is in relatively good health, the prognosis is good. Dogs that have severe anemia, either caused by toxins, cancer, or autoimmune diseases, or as a result of severe trauma have a less favorable prognosis.

Hemoglobin and Hematocrit | Ulta Lab Tests

The Hemoglobin and Hematocrit test contains 1 test with 2 biomarkers.

Description: A Hemoglobin (Hgb) test is a blood test that measures the amount of hemoglobin your red blood cells contain.

The Hematocrit test is a blood test used to measure the percentage of red blood cells in your blood, usually for determining anemia.

Also Known As: HCT Test, Crit Test, Packed Cell Volume Test, PCV Test, Hb Test, Hgb Test

Collection Method: Blood Draw

Specimen Type: Whole Blood

Test Preparation: No preparation required

Average Processing Time: 1 to 2 days

When is a Hemoglobin and Hematocrit test ordered?

A full blood count usually includes a hematocrit measurement. It can also be ordered as part of a general health assessment, either by itself or in conjunction with a hemoglobin level. When a person develops signs and symptoms of a disorder that affects RBCs, such as anemia or polycythemia, these tests are frequently done.

When someone has signs and symptoms of severe dehydration, such as intense thirst, dry mouth or mucous membranes, and a lack of perspiration or urination, a hematocrit may be requested.

When someone has been identified with recurrent bleeding difficulties, anemia, or polycythemia, this test may be repeated numerous times or on a regular basis to check the success of treatment. It may also be ordered on a regular basis for persons receiving therapy for cancers that affect the bone marrow.

The hemoglobin test may be requested as part of a general health assessment or when a person exhibits signs and symptoms of a red blood cell disorder such as anemia or polycythemia.

When someone has been diagnosed with recurrent bleeding difficulties, chronic anemias, or polycythemia, this test may be done numerous times or on a regular basis to check the effectiveness of treatment. It’s also possible that it’ll be ordered on a regular basis for those having therapy for cancers that are known to harm the bone marrow.

What does a Hemoglobin and Hematocrit blood test check for?

A hematocrit is a test that determines the percentage of red blood cells in a person’s blood. RBCs, white blood cells, and platelets are suspended in plasma, a fluid component of blood. The hematocrit is a ratio that compares the volume of red blood cells to the volume of all of these components together, which is known as whole blood. A percentage or fraction is used to express the value. A hematocrit of 40%, for example, indicates that there are 40 milliliters of red blood cells per 100 milliliters of blood.

The hematocrit is a quick and easy approach to assess a person’s red blood cells and screen for disorders like anemia. It’s frequently done in conjunction with a hemoglobin level, and it’s also a part of a complete blood count, which is commonly used to assess a person’s overall health.

RBCs are made in the bone marrow and discharged into the bloodstream when they are fully mature or almost so. They normally constitute about 37 to 49 percent of the blood volume. Hemoglobin, a protein that binds to oxygen, is found in RBCs. RBCs’ main job is to transport oxygen from the lungs to the body’s tissues and organs. They also transfer a little amount of carbon dioxide from tissues and organs back to the lungs, where it is exhaled.

RBCs have a 120-day lifespan, and the bone marrow must constantly manufacture new RBCs to replace those that have aged and degraded or have been lost due to hemorrhage. A variety of disorders can impact the bone marrow’s ability to produce new RBCs or the longevity of those already in circulation, as well as cause substantial bleeding.

The hematocrit measures both the number and volume of red blood cells. The hematocrit will drop when the size of the RBCs decreases, and vice versa. In general, the hematocrit will rise as the number of red blood cells increases, and it will fall to less than normal when the number of RBCs produced by the bone marrow decreases, the number of RBCs destroyed increases, or blood is lost due to hemorrhage. The overall amount of RBCs and hematocrit will diminish if the bone marrow is unable to manufacture new RBCs quickly enough, resulting in anemia.

Anemia is a condition in which the body is unable to provide adequate oxygen to tissues and organs, resulting in weariness and weakness. Too many RBCs are created in polycythemia, and the blood thickens, causing sluggish blood flow and other complications.

Hemoglobin is an iron-containing protein found in all red blood cells, which gives them their distinctive red color. RBCs use hemoglobin to bind to oxygen in the lungs and transport it to tissues and organs all over the body. It also aids in the movement of a little amount of carbon dioxide, which is a byproduct of cell metabolism, from tissues and organs to the lungs, where it is exhaled.

The hemoglobin test determines how much hemoglobin is present in a person’s blood sample. To swiftly assess an individual’s red blood cells, a hemoglobin level can be used alone or in conjunction with a hematocrit, a test that assesses the fraction of blood made up of RBCs. Red blood cells, which account for roughly 40% of the amount of blood, are created in the bone marrow and released into the bloodstream when they are mature, or nearly so. RBCs have a 120-day lifespan, and the bone marrow must constantly manufacture new RBCs to replace those that have aged and degraded or have been lost due to hemorrhage.

RBCs, and thus the level of hemoglobin in the blood, can be affected by a variety of diseases and situations. When the quantity of red blood cells grows, the hemoglobin level and hematocrit both rise. When the synthesis of RBCs by the bone marrow decreases, RBC destruction increases, or blood is lost owing to hemorrhage, the hemoglobin level and hematocrit fall below normal. Anemia is a disorder in which the body’s tissues and organs do not acquire enough oxygen, causing exhaustion and weakness. It is caused by a decline in RBC count, hemoglobin, and hematocrit. Polycythemia occurs when the body produces too many RBCs, causing the blood to thicken, resulting in sluggish blood flow and other complications.

Lab tests often ordered with a Hemoglobin and Hematocrit test:

• RBC Count
• Blood Smear
• Iron Total
• Iron and Total Iron Binding Capacity
• Ferritin
• Reticulocyte Count
• Vitamin B12
• Folate
• Complete Blood Count (CBC)
• G6PD
• Erythropoietin
• Hemoglobinopathy Evaluation

Conditions where a Hemoglobin and Hematocrit test is recommended:

• Anemia
• Sickle Cell Anemia
• Thalassemia
• Myeloproliferative Neoplasms
• Hemoglobin Abnormalities
• Bone Marrow Disorders

How does my health care provider use a Hemoglobin and Hematocrit test?

The hematocrit test is frequently used to diagnose anemia, usually in conjunction with a hemoglobin test or as part of a full blood count. The test can be used to detect, diagnose, or track a variety of illnesses and disorders that impact the amount of red blood cells in the blood. RBCs are red blood cells that circulate in the blood and transport oxygen throughout the body.

Some circumstances influence RBC formation in the bone marrow, resulting in an increase or decrease in the number of mature RBCs discharged into circulation. The longevity of RBCs in the circulation may be affected by other factors. The overall number of RBCs and hematocrit will diminish if there is increased destruction or loss of RBCs, and/or the bone marrow is unable to make new ones quickly enough, leading in anemia.

The hematocrit can tell if there’s a problem with RBCs, but it can’t tell what’s causing it. A blood smear, reticulocyte count, iron studies, vitamin B levels, and, in more severe cases, a bone marrow examination are some of the other tests that may be conducted at the same time or as follow-up to establish a reason.

Anemia is commonly detected with a hemoglobin test in conjunction with a hematocrit or as part of a complete blood count. The test can be used to detect, diagnose, or track a variety of illnesses and disorders that impact red blood cells and/or hemoglobin levels in the blood. All red blood cells include hemoglobin, an iron-containing protein that allows RBCs to bind to oxygen in the lungs and transport it to tissues and organs throughout the body.

A hemoglobin test can be used for a variety of purposes, including:

• Anemia and polycythemia are diagnosed, diagnosed, and measured.
• Assess the patient’s reaction to anemia or polycythemia treatment.
• If the anemia is severe, you can help make decisions about blood transfusions or other therapies.

Some factors influence RBC production in the bone marrow, resulting in an increase or decrease in the quantity of mature RBCs discharged into the bloodstream. The longevity of RBCs in the circulation can be influenced by a variety of factors. The overall amount of RBCs and hemoglobin will diminish if there is greater destruction of RBCs or loss of RBCs through bleeding, and/or the bone marrow is unable to make new ones quickly enough, leading in anemia.

This test can tell you if you have an issue with red blood cell production or longevity, but it can’t tell you what’s causing it. A blood smear, reticulocyte count, iron studies, vitamin B12 and folate levels, and, in more severe cases, a bone marrow examination are some of the other tests that may be conducted at the same time or as follow-up to establish a reason.

What do my Hematocrit and Hemoglobin test results mean?

Red blood cells make up between 37 percent to 49 percent of the total amount of blood.

Because a hematocrit is frequently performed as part of a complete blood count, other components including RBC count, hemoglobin, reticulocyte count, and/or red blood cell indices are taken into account. Other considerations include age, gender, and race. In general, the hematocrit reflects the RBC count and hemoglobin readings.

Anemia is diagnosed by a low hematocrit, low RBC count, and low hemoglobin.

Because hemoglobin levels are frequently measured as part of a complete blood count, the results of other components are taken into account. Hemoglobin levels must be interpreted in conjunction with other indicators such as RBC count, hematocrit, reticulocyte count, and/or red blood cell indices when they rise or fall. Other characteristics to consider are age, gender, and race. Hemoglobin reflects the RBC count and hematocrit results in general.

Anemia is defined as a low hemoglobin level combined with a low RBC count and a low hematocrit. Among the causes are:

• Excessive blood loss-as a result of severe trauma or continuous bleeding from the digestive tract, bladder, or uterus.
• Iron, folate, or B12 deficiency are examples of nutritional inadequacies.
• Toxins, radiation, chemotherapy, infection, and medicines can all cause damage to the bone marrow.
• Aplastic anemia, myelodysplastic syndrome, or tumors of the bone marrow, such as leukemia, lymphoma, multiple myeloma, or other cancers of the bone marrow
• Renal failure—severe and chronic kidney illnesses cause the kidneys to produce less erythropoietin, a hormone that drives RBC synthesis in the bone marrow.
• Inflammatory diseases or disorders that last a long time
• Hemoglobin production is reduced.
• Excessive destruction of red blood cells, such as hemolytic anemia caused by autoimmunity or faults in the red blood cell itself, such as hemoglobinopathy, RBC membrane abnormalities, or RBC enzyme.

Polycythemia is defined as a high hemoglobin level combined with a high RBC count and hematocrit. Among the causes are:

• Lung disease-when a person’s body is unable to breathe in and absorb enough oxygen. As a result, the body produces more red blood cells to compensate.
• Congenital heart disease—in some cases, an improper connection between the two sides of the heart occurs, resulting in lower blood oxygen levels. The body responds by creating extra red blood cells in an attempt to compensate.
• Excess erythropoietin-producing kidney tumors
• Hemoglobin levels in heavy smokers are higher than in nonsmokers.
• Genetic factors
• Having to live at a high altitude
• Dehydration causes hemoglobin to rise unnaturally when the volume of fluid in the blood declines.
• Polycythemia vera-a rare condition in which the body creates too many RBCs.

We advise having your results reviewed by a licensed medical healthcare professional for proper interpretation of your results.

What does low hemoglobin mean and what to do about it

Likbez

Health

May 25, 2021

Lifehacker figured out why a blood test can worsen.

If the KLA showed low hemoglobin, you should go to the therapist: anemia can cause fatigue, bouts of weakness, dizziness, shortness of breath, heart palpitations and other troubles. The doctor will order tests for ferritin, serum iron, or vitamins C and B-12. Sometimes an ultrasound of the internal organs is required. What to do after the examination will depend on the causes of the problem. They are conditionally divided into three groups.

1. You are producing few red blood cells

Red blood cells carry hemoglobin. If they are formed less than normal, then the amount of hemoglobin decreases. This happens due to various pathologies.

Iron deficiency

Without iron ions, neither high-quality red blood cells nor hemoglobin can be produced. This type of anemia can occur if the absorption process in the intestine is impaired, there is little iron in the diet, or its concentration has decreased after blood loss.

What to do

Take iron tablets as prescribed by your doctor. In severe cases, the drug can be administered intravenously or even a blood transfusion.

Hypovitaminosis

When a person does not get enough vitamin C, B12 or folic acid, hemoglobin levels may also decrease. All due to the fact that these substances are involved in the division of red blood cells.

What to do

The doctor will prescribe vitamin complexes and a diet. Food should include many foods rich in ascorbic and folic acid, as well as B12.

Kidney diseases

In these organs, the hormone erythropoietin is synthesized, which normally stimulates the division of red blood cells. If chronic kidney disease develops, then their ability to produce hormones decreases, hemoglobin in the blood falls.

What to do

The artificial hormone erythropoietin helps to restore the normal concentration of red blood cells and hemoglobin. Sometimes iron tablets are additionally prescribed.

Cirrhosis

Protein synthesis is impaired in cirrhosis. Including those that are used to build hemoglobin. Also, due to liver disease, the absorption of nutrients in the intestines can worsen. All this gradually leads to the development of anemia.

What to do

Cirrhosis is incurable, so doctors usually prescribe drugs to support the liver. In severe cases, an organ transplant is needed.

Hypothyroidism

In this disease, the thyroid gland produces less hormones. Therefore, the work of many internal organs is disrupted and anemia can develop.

What to do

You can normalize the level of hemoglobin if you get rid of hypothyroidism. To do this, endocrinologists prescribe thyroid hormone in tablets.

Chronic inflammatory bowel disease

These pathologies include Crohn’s disease and ulcerative colitis. Because of them, the absorption of many nutrients worsens, including vitamins and iron, which are necessary for the division of red blood cells and the synthesis of hemoglobin.

What to do

The therapist will prescribe anti-inflammatory drugs, antibiotics and vitamins, as well as adjust the diet. In severe cases, surgery will be required.

Blood cancer

Due to leukemia, myeloma and other oncohematological diseases, bone marrow cell division is disrupted. Therefore, there are fewer red blood cells and hemoglobin.

What to do

In order to increase the level of hemoglobin, it is necessary to achieve remission, in which the symptoms of blood cancer partially or completely disappear. The oncohematologist will select an individual treatment. It could be radiation or chemotherapy. For some, targeted and immunotherapy is suitable: the growth of cancer cells is stopped by affecting certain body molecules. Sometimes a bone marrow transplant is done.

Other oncological diseases

Due to cancer of any organ, metabolism in the body changes, and certain substances begin to be lacking. This means that the level of red blood cells decreases, they can no longer tolerate hemoglobin. Therefore, weakness, pallor and other symptoms of anemia appear.

What to do

Treatment will depend on the stage and severity of the disease. You may need surgery, radiation, or chemotherapy.

Rheumatoid arthritis

This is an autoimmune disease in which the body produces antibodies and begins to destroy its own tissues. This often damages the kidneys. If this happens, they stop producing the hormone erythropoietin, which is supposed to stimulate red blood cell division.

What to do

Rheumatoid arthritis is incurable. But a doctor – a therapist or a rheumatologist – can prescribe drugs that will reduce the inflammatory process in the body, which means they normalize the functioning of the kidneys.

Lead poisoning

This metal can be found in paint, old plumbing pipes, and sometimes in cans or cosmetics. If lead enters the body, it accumulates in the bones and internal organs, damaging the kidneys.

What to do

The doctor will prescribe a drug that removes the metal from the body.

How drugs work

Some HIV and cancer drugs can lower hemoglobin.

What to do

Usually, when treating cancer or HIV, the blood test is constantly repeated to monitor the person’s condition. If the doctor notices anemia, he may change the drug or prescribe additional drugs to increase hemoglobin.

2. Your red blood cells are rapidly destroyed

In some pathological conditions, blood cells die faster than new ones appear.

Enlarged spleen

Normally, this organ must destroy old and damaged cells. But if the spleen is enlarged, it can also destroy good red blood cells. This condition is called splenomegaly. Symptoms are anemia, feeling tired and frequent bleeding.

What to do

After the examination, the doctor may recommend that the spleen be removed.

Porphyria

This is a hereditary disease. In humans, the synthesis of hemoglobin is disrupted due to a lack of special enzymes. The toxic substance porphyrin accumulates in the blood, due to which red blood cells can be destroyed. Anemia occurs and the following symptoms appear:

• pain in the abdomen, chest, legs;
• red or brown urine;
• constipation or diarrhoea;
• convulsions;
• urination disorder;
• increased blood pressure;
• mental disorders, hallucinations;
• blisters, redness and itching of the skin;
• burning pain when exposed to sunlight.

What to do

Treatment depends on symptoms. Most likely, you will have to follow a diet all your life, do not smoke, give up alcohol, protect your skin from the sun. Also, the doctor may prescribe hormones and drugs that will help reduce the synthesis of dangerous porphyrin in the body.

Hemolysis

In this condition, erythrocytes are intensively destroyed. Hemolysis develops due to infections, autoimmune diseases, or exposure to toxins. A person suddenly or gradually develops anemia. In some cases, it is so severe that it leads to death.

What to do

It all depends on the person’s condition and the cause of hemolysis. Sometimes iron or folic acid supplements are sufficient for treatment. Some patients need an immune suppressant, while others need a blood transfusion.

Thalassemia

This is a rare hereditary blood disorder that develops a DNA mutation. It leads to the appearance of an abnormal structure of hemoglobin, due to which red blood cells are destroyed. With this disease, the spleen enlarges, iron accumulates in the body, heart problems and bone deformities occur.

What to do

Usually the disease is diagnosed in childhood, so the hematologist prescribes treatment early. This can be a blood transfusion, taking special drugs to remove excess iron, or even a bone marrow transplant.

Sickle cell anemia

This is the name of a hereditary disease in which red blood cells are shaped like a sickle or crescent. Therefore, they get stuck in the vessels, quickly destroyed, and anemia occurs in a person. This disease is accompanied by severe muscle pain, swelling, frequent infections, and an increased risk of stroke.

What to do

Treatment is usually started in childhood, as symptoms appear early. A hematologist prescribes drugs that help slow down the destruction of red blood cells and reduce the symptoms of anemia. Sometimes a blood transfusion or stem cell transplant is needed.

3. You have lost blood

If a person loses a lot of blood due to various injuries, operations, hemoglobin does not always have time to recover. Therefore, anemia occurs. But most of the time it comes from three reasons.

Bleeding in the digestive tract

With an ulcer or cancer of the stomach, intestinal polyps, the body loses some blood. It cannot be seen in the feces, but anemia develops at the same time. With hemorrhoids, bleeding can also occur, which leads to a decrease in hemoglobin.

What to do

Medications may be prescribed to treat an ulcer. If they don’t help, you’ll have to have surgery. Intestinal polyps are removed surgically, and there are non-surgical methods to combat hemorrhoids.

Heavy menstruation

Hemoglobin levels can also decrease due to intense blood loss. This is usually to blame:

• hormonal imbalance;
• ovarian dysfunction;
• uterine fibroids;
• endometrial polyps;
• endometriosis;
• cancer of the uterus or cervix;
• intrauterine device.

What to do

Perhaps the doctor will prescribe drugs to improve blood clotting, hormones. In some cases, surgery will be necessary.

Frequent blood donation

If a person has become a donor, tests within 2 weeks after the procedure may indicate anemia. Then the level of hemoglobin and erythrocytes will be restored. You can donate blood again no earlier than after 56 days. But for some people, the body does not have time to recover during this time. For example, due to malnutrition or heavy periods.

What to do

If the anemia persists, your doctor will prescribe iron supplements to improve your blood count.

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• Why do we need hemoglobin and what is its norm
• How to decipher a general blood test: the norm of indicators
• Why the level of leukocytes in the blood is low and what to do about it
• Why platelets are needed and how many should be normal

Anemia in cancer: the relationship of oncology and anemia, anemia in cancer treatment and symptoms

Anemia is a pathological condition characterized by a decrease in red blood cells and / or hemoglobin concentration per unit volume of blood. Anemia is not an independent disease, it is a symptom that is characteristic of a wide variety of diseases, including malignant tumors.

According to statistics, anemia in cancer is detected in every third patient, and during chemotherapy – in more than 90% of cases. The danger of this condition in oncology lies in the fact that, along with a decrease in the level of hemoglobin and red blood cells, the oxygen capacity of the blood also decreases. This factor adversely affects the course of the cancer process, reduces the effectiveness of treatment and worsens the further prognosis.

Main causes of anemia in cancer patients

A decrease in the level of erythrocytes and hemoglobin may develop due to a decrease in their formation, accelerated destruction, or as a result of loss. Each of these causes is facilitated by its own factors, which we will consider in more detail:

• Insufficient production of blood cells and hemoglobin can develop with bone marrow damage, lack of iron in the body or some vitamins (folic acid, vitamin B12). These conditions can be directly related to cancer. For example, iron loss can develop as a result of constant vomiting, lack of appetite and impaired absorption in the intestine, which is affected by the tumor process. Some types of drugs that are prescribed for malignant tumors inhibit the growth of not only cancer cells, but also blood cells that are actively dividing. Also, anemia can develop with direct damage to the bone marrow by a tumor process.
• Accelerated destruction of red blood cells is observed when exposed to various drugs and with abnormal activity of the immune system. The destruction of red blood cells directly in the vessels is called intravascular hemolysis. This process proceeds normally after the completion of the erythrocyte life cycle, which is 120 days. However, under the influence of various factors (taking antibiotics, cytostatics, the addition of a secondary infection, etc.), this period is significantly reduced, which leads to the development of anemia.
• Blood loss in cancer patients can be either acute or chronic. The first option occurs during surgical treatment of cancer, as well as the development of internal bleeding, which is a frequent complication of the underlying disease. The development of anemia in chronic blood loss is noted in cases where there is a hidden source of minor bleeding. For example, in colorectal cancer, blood may be excreted in the feces without the patient noticing.

Establishing the exact cause of anemia is critical to the choice of treatment. In addition, the doctor takes into account the severity, type of anemia, the general condition of the patient, and other parameters. You can get this information at the diagnostic stage.

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How to detect anemia

Examination traditionally begins with a patient interview and anamnesis. The doctor must remember that not always anemia develops due to the underlying disease. Low hemoglobin in oncology may be due to hereditary or any other causes that are not associated with the tumor process. It is also necessary to establish the type of previous antitumor treatment, the duration and number of courses, the name of the drugs that were used. At the next stage, the doctor conducts a general examination. Anemia can be manifested by pallor of the skin, weakness, loss of appetite, dizziness and other symptoms. Very often, these manifestations are observed in various types of cancer that occur without anemia, so it is impossible to make a diagnosis based only on the patient’s complaints.

Objective information can only be obtained through laboratory tests. Anemia in oncology is diagnosed by the following tests:

• The number of reticulocytes.
• Serum iron level.
• Transferrin and ferritin protein levels.
• Vitamin B12 and folic acid levels.

Special attention is paid to the general blood test. It determines the level of hemoglobin, the number of red blood cells and hematocrit (the ratio of formed elements to the liquid component of blood). Also, the average volume of an erythrocyte, the average content of hemoglobin in an erythrocyte and the average content of hemoglobin in the entire erythrocyte mass are determined.

If necessary, other laboratory tests or special methods may be included in the comprehensive examination program for anemia.

How anemia is classified

Depending on the value of the color index, severity and mechanism of development, anemia is divided into several categories. The color index of blood reflects the degree of saturation of red blood cells with hemoglobin. Its value normally ranges from 0.85 to 1.05 units. A decrease in the indicator is noted in hypochromic anemia, and an increase in hyperchromic anemia. If the color index is normal, but the hemoglobin level is still low, then they speak of normochromic anemia.

In terms of severity, anemia is divided into three groups, depending on the concentration of hemoglobin:

1. In mild anemia, the hemoglobin level does not fall below 90 g/l.
2. With an average degree of anemia, the indicator ranges from 90-70 g / l.
3. Severe anemia is characterized by a drop in hemoglobin below 70 g/L.

Classification of anemia according to the mechanism of development is the most extensive. Among the common forms are noted:

• Iron deficiency anemia. It develops as a result of malabsorption, increased loss or insufficient intake of iron into the body.
• Hemolytic anemia. It is characterized by the destruction of erythrocytes in the vascular bed or beyond. The most common causes are specific enzyme deficiencies, autoimmune diseases, and drug exposure.
• Posthemorrhagic anemia. This condition is characteristic of acute or chronic blood loss
• Aplastic anemia. It is characterized by a decrease in the level of erythrocyte precursor cells in the bone marrow. Usually, there is a decrease in other formed elements – platelets and leukocytes.
• B12 deficiency anemia. With a lack of vitamin B12, the process of formation of red blood cells is disrupted, their life expectancy decreases. A vitamin deficiency can be associated both with a violation of its absorption in the intestines, and with insufficient intake into the body.

In most cases, the exact type of anemia can be determined after several laboratory tests, but sometimes more complex diagnostic methods, such as genetic testing, must be used. Understanding the mechanism of anemia development and obtaining the most complete information about changes in blood counts are an important component of effective treatment of this symptom.

Methods for treating anemia

There are three ways to eliminate anemia in cancer patients: red blood cell transfusion, administration of erythropoietin, administration of iron supplements. In some cases, the treatment of anemia in oncology may combine a combination of these methods.

RBC transfusion for anemia

RBC transfusion is the most effective method by which you can quickly replenish the deficiency of red blood cells, restore hemoglobin and hematocrit levels. However, without eliminating the cause of anemia, this method will only give a temporary effect. Therefore, red blood cell transfusion is not an alternative to other methods and is used only when indicated. One of them is a decrease in hemoglobin levels below 90 g/l. Transfusion is performed when the patient develops characteristic signs of anemia, among which are noted:

• Dizziness.
• Loss of consciousness.
• Tachycardia.
• Fatigue.
• Chest pain.
• Shortness of breath.

This method of treating anemia can also be used in patients who have received chemotherapy or radiation therapy and who have a rapid decrease in hemoglobin or red blood cells.

The use of erythropoiesis stimulants

Erythropoiesis stimulants in anemia increase the concentration of hemoglobin and erythrocytes by increasing their formation in the bone marrow. When combined with blood transfusions, this method shows very good results, but it also has a number of disadvantages regarding complications. In particular, the use of erythropoiesis stimulants for the treatment of anemia increases the risk of developing thrombotic complications, which is already high in cancer patients. According to data obtained in the course of several scientific studies, this risk increases by 1.4-1.7 times.

Recently, the question of the effect of erythropoiesis stimulators on the survival of cancer patients has been discussed. In particular, experts have found that the use of drugs of this group in the treatment of anemia in patients with a widespread tumor process of the head and neck, cervix, breast and other diagnoses reduces life expectancy by 10-17%. In this regard, experts suggest adhering to the following rules:

1. If the hemoglobin level is less than 100 g / l and the patient is being treated with chemotherapy drugs, then erythropoiesis stimulants can be prescribed to correct anemia and prevent further decline in indicators.
2. If the hemoglobin level drops to 100 g/l and below, but chemotherapy is not carried out, then the use of erythropoiesis stimulants is not recommended due to an increased risk of complications and a decrease in life expectancy.
3. In all other cases, the use of erythropoiesis stimulants for the treatment of anemia in cancer patients should be used with caution.

Also, throughout the entire treatment period, it is important to monitor the dynamics of laboratory parameters and, with an increase in hemoglobin levels, gradually reduce the dosage of erythropoiesis stimulants.

Iron preparations in the treatment of anemia

Iron preparations are used to treat iron deficiency anemia, which occurs in 30-60% of cancer patients. At the same time, a decrease in the level of iron in oncology can be associated both with the tumor process itself or with the treatment, and with other factors. For example, when prescribing erythropoiesis stimulants, the existing supply of iron in the body becomes insufficient to cover the need that arises as a result of the active synthesis of hemoglobin in the bone marrow.

Both intravenous and oral medications can be used to treat anemia. The second option is more convenient for the patient, since the tablets are easier to take, but at the same time, this form acts more slowly and often leads to complications from the gastrointestinal tract. Intravenous administration allows you to achieve a quick effect, which is important during chemotherapy.

Thus, for the treatment of anemia, modern oncology can offer various methods that affect the mechanisms of development of this symptom. The exact therapy plan is selected individually for each patient, taking into account laboratory blood counts, the characteristics of the treatment of the underlying disease, and other parameters.

Treatment of anemia with traditional methods

Some patients, for various reasons, refuse to take the drugs described above and turn to traditional medicine. Of course, some plants or products can have a stimulating effect on the hematopoietic system. However, given the main diagnosis and the severity of anemia, this action is extremely insufficient to restore the hemoglobin level and the oxygen function of the blood. As a result, the effectiveness of anticancer treatment decreases, the prognosis worsens, and the risk of an unfavorable outcome increases significantly. It is impossible to eliminate severe anemia at home using folk methods. This should be done by doctors of the appropriate profile, who have modern medicines at their disposal.

Frequently asked questions from patients

Is megaloblastic anemia a cancer?

Despite the intimidating name, megaloblastic anemia is not a cancer. It develops due to other reasons: a lack of vitamin B12, a violation of its utilization and a lack of folic acid. Treatment of this condition should be aimed at eliminating the underlying cause. Sometimes some drugs that are used in oncology (hydroxyurea, immunosuppressants) lead to megaloblastic anemia.

What causes anemia in stomach cancer?

The main cause of anemia in this type of cancer is the bleeding that accompanies the cancer. At the same time, classical iron deficiency anemia develops: the body loses more hemoglobin and iron than it can restore.