Here are Oz's lab values from the specialty lab: RBC: 4.74 (L); HGB: 11.1 (L); HCT: 32.4 (L); recticulocyte: 52; % reticulocyte: 1.1; BUN: 15; Creat: 0.8. So kidney values are in the normal range. This lab considers a reticulocyte count < 110 as indication of inadequate bone marrow response. His other results are just slightly below the reference range, although when the vet ran them they were lower (RBC: 2.84; HCT: 20.3; HGB: 11.0 and reticulocytes: 46.7). His food is Wellness kibble. He was just groomed and no signs of ticks - doesn't mean he hasn't gotten bit in the past, even though he gets monthly tick and flea applications. Would you think the most likely culprit is his IBD?
Actually, I am not concerned about tick infestation blood loss (which would have been obvious) but rather tick borne infectious diseases like ehrlichiosis and babesia which could be from a long-ago single tick bite that was never noticed. Non-regenerative anemia is different from anemia that would show up from blood loss, etc. This is a problem caused by inadequate red blood cell production rather than loss of red blood cells from bleeding, tick infestation, etc. Different still is immune-mediated hemolytic anemia where the body attacks and destroys its own red blood cells. It is a sign of a good vet clinic that they followed up with a reticulocyte count without being asked.
Originally Posted by RodRussell
This link is about IMHA, but there is a good description of non-regenerative anemia versus responsive anemias:
"Anemia due to poor red blood cell production by the bone marrow is called a non-responsive anemia. Such anemias are caused by chronic inflammatory diseases (like inflamed skin, infected teeth, or other long standing irritations), kidney failure, cancers of various types, or certain drugs (especially agents of chemotherapy).
Normally when red blood cells are lost, the drop in blood oxygen that results causes hormonal changes leading to increased production of red blood cells by the bone marrow. These are called responsive anemias because the bone marrow is responding. Bleeding and immune mediated red blood cell destruction are both responsive anemias.
There are several ways to determine if the anemia is responsive or not from the blood panel results. Most blood panels run by reference laboratories include a portion called a complete blood count, or CBC, which reviews red blood cell count, size, shape, and maturity as well as white blood cell types and ratios. A patient with a responsive anemia will have an active bone marrow. Red blood cells will be released early leading to a variety of sizes and redness of red blood cells circulating in the blood (less mature red blood cells are larger and paler than mature cells). Further, red blood cell precursors called reticulocytes are released. (These may be thought of as red blood cells so immature they canít truly be called red blood cells yet.) If the bone marrow stimulus is especially strong, red blood cells may be released still containing cell nuclei."
Non-regenerative anemia is one of the symptoms of a couple of tick-borne diseases.
Originally Posted by Love my Cavaliers
You didn't give normal values for either lab, so I'll assume Antech Lab normals. Those second CBC numbers are not scary-dangerous. The HCT that the vet ran (20.3) and the RBC at 2.84 ARE scary-dangerous; you would have seen symptoms at those values. (My girl who died of IMHA had an acute drop to an HCT of 15, and she collapsed and was taken to ER.) Was that an inhouse profile? FWIW, I alway use an outside lab like Antech. I never get inhouse labs unless the dog is hospitalized at an emergency 24 hour clinic. Get copies of all lab work and keep them at home in a folder so you have a historical reference. It is good that this was found on routine blood chemistry at a more early stage.
I have never heard of non-regenerative anemia caused by IBD, but that certainly does not mean that this is not the cause. I'll try to do a little research. I think it is highly unlikely that this is related to diet or lack of supplements or medications, and it also appears that there is no kidney disease. I would definitely talk with internist about tick titers. And, again, I would use Protatek and I would talk on the phone with Dr. Holland who is a real expert on TBD. Tick titer results are not "black and white," so I'd want an expert to interpret and to recommend specific tests - even more of an expert than an internist. (I went down this road with two old Cavalier rescues who were Lyme positive.)
Here is an interesting link:
I'll post again if I find anything more about IBD causing this.
I just noticed on the lab report that it says "Slide Reviewed Microscopically. No Parasites Seen." So that would seem to rule out both Erlichia and Babesia. Am I correct in that assumption?. . . Am I correct in that assumption?..
No - sorry, that is not a correct assumption. You need tick titers to rule out infectious diseases caused by a tick bite.
Oz has been to see the internist and his latest labs indicate that his anemia has resolved itself. His internist said that the bone marrow needs at least a week after an insult to begin regenerating blood cells and interestingly, about a week before all this started (when Oz had his teeth cleaned) he had a bout of extreme lethargy on a Saturday night and I took him to the local Blue Pearl Emergency Center. They diagnosed it as a flare-up of his IBD, gave him sub-q fluids, some Pepcid and sent him home. Never took bloodwork. I bet if they had, they would have found the beginning of the anemia then. So despite my opinion of Blue Pearl, he has recovered and we are just dealing with his IBD now. Still don't know why he had that bout of lethargy and went into the anemia though. Hopefully it won't happen again. I will ask that question when we see his internist in three weeks. Thank you for all your help with this.
Glad to hear this. You must be so pleased.