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Knowing whether the anaemia is regenerative or not will help in narrowing down the likely underlying cause of the anaemia. Regenerative anaemias are usually caused by either an increased breakdown of the RBCs (termed haemolysis) or by blood loss (eg, from bleeding excessively). Non-regenerative anaemias are usually caused by an underlying problem in the bone marrow preventing or interfering with the normal production of RBCs. Specific causes include: Blood loss anaemia: Serum ferritin concentration, a measure of the body's iron stores, is currently the most efficient and cost-effective test for diagnosing iron deficiency [ 11-13]. Because serum ferritin decreases during the first stage of iron depletion, it can identify low iron status before the onset of IDA [ 7, 9, 14]. A serum ferritin concentration lower than 30 mcg/L suggests iron deficiency, and a value lower than 10 mcg/L suggests IDA [ 15]. However, serum ferritin is subject to influence by inflammation (due, for example, to infectious disease), which elevates serum ferritin concentrations [ 16].
As the iron requirement of adult cats hasn't been studied, there is no defined minimum requirement, and the recommended amount is the same as the one of kittens. Increased fragility of RBCs, such as with a disease known as pyruvate kinase deficiency, seen particularly in Abyssinian and Somali cats
The federal government's 2020–2025 Dietary Guidelines for Americans notes that "Because foods provide an array of nutrients and other components that have benefits for health, nutritional needs should be met primarily through foods. ... In some cases, fortified foods and dietary supplements are useful when it is not possible otherwise to meet needs for one or more nutrients (e.g., during specific life stages such as pregnancy)." A variety of treatments may be used depending on the specific underlying cause of the anaemia, and these may include antibiotics for some infectious causes (such as Mycopalsma haemofelis), immunosuppressive drugs (such as corticosteroids) if there is immune-mediated destruction of RBCs, iron supplementation for iron deficiency anaemia etc. Since excessive amounts can lead to toxicity as already noted, talk to your veterinarian before you begin supplementation. The best iron for cats supplements Treatment of anaemia will be both symptomatic and supportive for the affected cat, and specific (targeted at the underlying disease itself).
If the cause of your cat’s iron deficiency anemia is an improper diet, a solution as simple as dietary changes can be enough to resolve the issue. Foods with high iron content include meat products (such as liver, heart, and muscle), as well as brewer’s yeast, wheat germ, egg yolks, and oysters. Blood Loss: Conditions that result in blood loss, such as trauma, surgery, or severe flea infestations, might lead to iron-deficiency anemia. Short MW, Domagalski JE. Iron deficiency anemia: evaluation and management. Am Fam Physician. 2013 Jan 15;87(2):98-104. [ PubMed abstract] If your vet confirms their diagnosis, the course of treatment will relate to the underlying condition causing the problem. They may recommend blood transfusions, along with measures to increase the levels of iron in the cat’s body, which a vet may administer via intravenous methods.
Diagnostic testing
Iron is absorbed through the cat’s small intestine. It can be found in sources like lean meats, legumes, liver, fish and whole grains. Most well-balanced, high quality cat foods have your cat’s daily requirements of this mineral at a ratio of 36.4 mg of iron per pound of food eaten. However, since red blood cells only live for 110 days, they will need to be replaced on a constant basis. If your cat isn’t eating well, especially after surgery or other trauma, or has other underlying health issues, its iron levels and red blood cells may be affected. What Can Cause Iron Loss? Presence of reticulocytes (immature RBCs) – using special stains these cells can be distinguished from normal (mature) RBCs, and by determining their number it is possible to gauge how regenerative the anaemia is. In 2002, the WHO characterized IDA as one of the 10 leading risk factors for disease around the world [ 42]. Although iron deficiency is the most common cause of anemia, deficiencies of other micronutrients (such as folate and vitamin B12) and other factors (such as chronic infection and inflammation) can cause different forms of anemia or contribute to their severity. Mycoplasma haemofelis infection (feline infectious anaemia, formerly known as Haemobartonella felis infection), or other similar organisms Paleness or pallor– A common sign of anaemia in cats is paleness of the mucous membranes (these are the membranes – or ‘skin’– lining the mouth and around the eyes etc). However, this is not an entirely reliable sign as pale membranes can also be seen for other reasons.
Common symptoms include pale or white gums, rapid breathing, lethargy, weakness, reduced appetite, and an increased heart rate. Cats may also display signs of pica, where they eat non-food items, due to cravings related to mineral deficiencies. The FNB has established ULs for iron from food and supplements based on the amounts of iron that are associated with gastrointestinal effects following supplemental intakes of iron salts (see Table 3). The ULs apply to healthy infants, children, and adults. Physicians sometimes prescribe intakes higher than the UL, such as when people with IDA need higher doses to replenish their iron stores [ 5]. Table 3: Tolerable Upper Intake Levels (ULs) for Iron [ 5] AgeTable 1 lists the current iron RDAs for nonvegetarians. The RDAs for vegetarians are 1.8 times higher than for people who eat meat. This is because heme iron from meat is more bioavailable than nonheme iron from plant-based foods, and meat, poultry, and seafood increase the absorption of nonheme iron [ 5]. Developing iron deficiency is more common in kittens than adult cats due to the low levels of iron in milk. However, this problem generally works out as the kitten gets older and is moved to a meat-based diet. What Can Iron Deficiency Lead to A veterinarian can diagnose iron-deficiency anemia through blood tests, specifically a complete blood count (CBC). This test will show the number and appearance of red blood cells and may reveal a decreased number or pale appearance, indicating anemia. However, before reaching toxic levels of iron, a diet high in iron can have negative consequences such as reducing the absorption of zinc and copper. [2][3] Hemoglobin and hematocrit tests are the most commonly used measures to screen patients for iron deficiency, even though they are neither sensitive nor specific [ 5, 7, 17]. Often, hemoglobin concentrations are combined with serum ferritin measurements to identify IDA [ 7]. Hemoglobin concentrations lower than 11 g/dL in children under 10 years of age, or lower than 12 g/dL in individuals age 10 years or older, suggest IDA [ 8]. Normal hematocrit values are approximately 41% to 50% in males and 36% to 44% in females [ 18]. Recommended Intakes
National Research Council. 2006. Nutrient Requirements of Dogs and Cats. Washington, DC: The National Academies Press. Untreated, anaemia can be a debilitating disease, and if severe can be life-threatening. Unfortunately, cats are particularly prone to the development of anaemia. This is partly because their RBCs have a shorter lifespan (around 70 days) than many other animals (around 110-120 days in dogs and humans) – this means they have a higher turnover of RBCs and anaemia can, therefore, develop quite rapidly if anything interferes with this. Also, cats suffer from a number of different diseases and infections that can cause anaemia. Types of anaemia Frequently used forms of iron in supplements include ferrous and ferric iron salts, such as ferrous sulfate, ferrous gluconate, ferric citrate, and ferric sulfate [ 3, 27]. Because of its higher solubility, ferrous iron in dietary supplements is more bioavailable than ferric iron [ 3]. High doses of supplemental iron (45 mg/day or more) may cause gastrointestinal side effects, such as nausea and constipation [ 5]. Other forms of supplemental iron, such as heme iron polypeptides, carbonyl iron, iron amino-acid chelates, and polysaccharide-iron complexes, might have fewer gastrointestinal side effects than ferrous or ferric salts [ 27].DeLoughery TG. Iron deficiency anemia. Med Clin North Am. 2017 Mar;101(2):319-32. doi: 10.1016/j.mcna.2016.09.004. [ PubMed abstract]
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