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Anemia: overview
Introduction
- Cause: anemia is defined as a deficiency of erythrocytes either in number or volume or both, hemoglobin concentration and hematocrit. Causes include hemorrhage, hemolysis and reduced production of erythrocytes.
- Signs: depend on chronicity. Pallor, weakness, lethargy, exercise intolerance, collapse. Signs related to underlying chronic disease process.
- Diagnosis: hematological examination, including blood smear examination.
- Treatment: depends on the cause of anemia.
- Prognosis: depends on the cause of anemia.
Presenting signs
- Pallor.
- Weakness.
- Lethargy.
- Weight loss.
- Non-specific signs of chronic disease.
- Evidence of trauma.
Acute presentation
- Lethargy.
- Collapse.
- Signs of hemorrhage or trauma.
- Tachycardia, tachypnea, hypothermia Hypothermia.
- Pale or white mucous membranes.
Age predisposition
- Older age if anemia is due to chronic disease.
Gender predisposition
- Uterine adenocarcinoma Uterine adenocarcinoma and endometrial aneurysm are common in middle aged, unneutered does.
Cost considerations
- Moderate to high cost if chronic underlying disease process needing extensive investigations.
- High cost if blood transfusion Blood: transfusion/intensive care required.
Special risks
- Anemia increases the risk of anesthesia.
Pathogenesis
Etiology
- The lifespan of rabbit erythrocytes is approximately 57 days.
- Anemia of chronic disease (non-regenerative anemia) is very common in pet rabbits, eg associated with chronic otitis Otitis media/interna, dental disease Teeth: dental disease - overview, abscesses Abscess, renal disease Kidney: disease, pododermatitis Ulcerative pododermatitis (Bumble foot).
- Hemorrhage: internal or external parasites, trauma, hemorrhage associated with uterine adenocarcinoma Uterine adenocarcinoma or aneurysm.
- Sequestration of red cells, eg liver lobe torsion Liver: lobe torsion.
- Hemolysis: destruction of red cells, eg toxic plant ingestion such as potato leaves and stems Poisonous plants Poisoning: overview.
- Failure of production of erythrocytes: bone marrow suppression or neoplasia, renal disease leading to reduced production of erythropoietin.
Predisposing factors
General
- The most common causes reported in a recent study are:
- Inflammatory or neoplastic cause (29%) due to severe dental disease Teeth: dental disease - overview, encephalitozoon Encephalitozoonosis, neoplasia (eg lymphoma Lymphosarcoma: overview and thymoma Thymus: neoplasia).
- Hemorrhage (24%) due to trauma (fractures Limb fracture), metropathies (uterine adenocarcinoma Uterine adenocarcinoma), and lower urinary tract disease Urine: hematuria Urinary incontinence Cystitis Urolithiasis.
- Renal disease (7%) Kidney: disease.
- No obvious cause (25%).
Specific
- Chronic disease potentially due to:
- Pasteurellosis Pasteurellosis.
- Dental disease Teeth: dental disease - overview.
- Pneumonia Pneumonia.
- Pododermatitis Ulcerative pododermatitis (Bumble foot).
- Pyometra Pyometra.
- Blood loss due to:
- Gastric ulceration Stomach: gastric ulceration.
- Internal or external parasitism Dermatology: parasitic disease - overview.
- Surgical procedure, eg enucleation may be associated with severe hemorrhage from periorbital sinus Enucleation: transpalpebral Enucleation: transconjunctival.
- Aneurysm.
- Hemolysis:
- Exposure to toxins, eg potato plant leaves and stems Poisonous plants Poisoning: overview.
- Onions, garlic and chive ingestion.
Pathophysiology
- Anemia can be induced be several mechanisms.
- Hemorrhage: internal or external blood loss.
- Hemolysis: destruction of red cells.
- Failure of production of red cells: bone marrow disorders, neoplasia.
- Anemia of chronic disease: reduced red cell lifespan and increased consumption.
Timecourse
- Rapid onset anemia:
- Blood loss.
- Hemolysis.
- Slow onset anemia:
- Bone marrow suppression.
- Parasitism.
- Anemia of chronic disease.
Severity of anemia
- Mild anemia has been found to be the most common (70%).
- Moderate (19%).
- Severe (11%) due to enteral coccidiosis, trauma, aneurysm, liver lobe torsion, and uterine neoplasia.
Diagnosis
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Treatment
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Prevention
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Outcomes
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Further Reading
Publications
Refereed Papers
- Recent references from PubMed and VetMedResource.
- Dettweiler A, Klopfleisch R, Muller K (2017) Anemia in pet rabbits: causes, severity, and reticulocyte response. Vet Rec 181 (24), 656 PubMed.
- Jeklova E, Leva L, Knotigova P & Faldyna M (2009) Age-related changes in selected haematology parameters in rabbits. Res Vet Sci 86 (3), 525–528 PubMed.
- Marshall K L (2008) Rabbit haematology. Vet Clin North Am Exotic Anim Pract 11 (3), 551-567 PubMed.
- Melillo A (2007) Rabbit clinical pathology. J Exotic Pet Med 16 (3), 135-145 PubMed.
Other sources of information
- Quesenberry K E, Orcutt C J, Mans C & Carpenter J W (2021) Ferrets, Rabbits and Rodents Clinical Medicine and Surgery. 4th edn. Elsevier, USA.
- Campbell T (2015) Peripheral Blood of Mammals. In: Exotic Animal Hematology and Cytology. 4th edn. Wiley Blackwell, USA. pp 3-36.
- Varga M (2014) Clinical Pathology. In: Textbook of Rabbit Medicine. 2nd edn. Butterworth Heinemann, UK. pp 111-136.
- Wesche P (2014) Clinical Pathology. In: BSAVA Manual of Rabbit Medicine Eds: Meredith A & Lord B. BSAVA, UK. pp 124-137.