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Production of red blood cells (RBCs) takes place in the bone marrow. For development and maturation of red blood cells to take place, bone marrow requires an adequate supply of a hormone called erythropoietin (EPO), a glycoprotein hormone that controls the production of red blood cells. Erythropoietin is produced by the kidneys. In chronic kidney disease (CKD), the kidney cannot produce an adequate amount of erythropoietin, resulting in bone marrow failure. Lack of RBC production will ultimately lead to anemia in cats that are suffering from chronic kidney failure. Middle-aged to older cats are most commonly affected by chronic kidney failure, but the condition may also occur in young cats.

Symptoms and Types

As anemia in this case is principally related to chronic kidney disease, the symptoms are mixed, and relate to both CKD and anemia. Following are a few of the symptoms related to anemia in the presence of CKD:

• Weight loss
• Fatigue
• Lethargy
• Depression
• Weakness
• Apathy (state of indifference)
• Cold intolerance
• Changes in behavior
• Tachypnea (rapid breathing)
• Tachycardia (rapid heartbeat)
• Syncope (fainting)
• Seizures

Causes

Following are some of the causes behind chronic kidney failure and anemia:

Chronic kidney disease can occur as:

• Inherited
• Congenital (pups born with the problem)
• Acquired form (in later life)
• Iron deficiency
• Infection
• Cancer
• Blood loss through alimentary tract (the entire canal from the mouth to the anus)
• Disease that causes disruption of RBCs

Diagnosis

You will need to give a thorough history of your pet's health, including a background history of symptoms. After taking a complete history, your veterinarian will conduct a complete physical examination on your cat. Laboratory tests will include a complete blood profile, a chemical blood profile, a complete blood count, and a urinalysis. The results of these tests will provide valuable information for the diagnosis of the cause of the kidney failure and the extent of anemia related to it. Your veterinarian will be particularly interested in knowing the level of erythropoietin in the blood. Specific tests may be used to diagnose the underlying cause of the chronic kidney disease and resulting anemia. An examination of the bone marrow examination may be conducted to evaluate the structure and functions of bone marrow. X-ray and ultrasound imaging will show any abnormal structure of the kidneys that is typical in chronic kidney disease. Ultrasound may reveal smaller than normal or irregular-shaped kidneys, both characteristic of chronic kidney disease.