Anemia – Where Did Those Red Blood Cells Go!

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Any animal that has red blood cells can present with anemia (a reduction in red blood cells), so of course that means most creatures on this planet!

But why does it happen and should you be worried and what do you do about it?

How is Anemia Defined?

Each species, be it bird, rabbit or snake, has a specific expected range of normal for the red blood cells (RBC). We look at the PCV (Packed Cell Volume) to determine the percentage of RBC present in the blood.

A Golden Eagle has a normal range of 35-47% while a Red Eared Slider can have anywhere from 25-35%. In order to know something is wrong, we have to know what the normal range is…but we can get an idea by looking at similar animals if we don’t have any numbers to work with. You can see that a turtle has an overall lower range than an eagle.

Anemia is simply having fewer than expected RBC or a lower PCV. It can be mild (30% in a rabbit) or severe (12% in a cockatiel) or anywhere in between depending on the cause and the duration of illness.
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What Causes Anemia?

There are 3 basic causes of anemia.

– Loss of RBC
– Lack of Production of RBC
– Destruction of RBC

Destruction!

In the exotics world we are lucky not to see a lot of destruction based causes of anemia. The big one to worry about is an autoimmune disorder such as IMHA (Immune Mediated Hemolitic Anemia). With IMHA the body sees RBCs as invaders and attempts to wipe them out. Actual diseases of the RBC such as blood parasites will cause the body to destroy the RBC in an attempt to destroy the parasite.

 Loss!

This occurs where there is bleeding either outside or inside the body. Trauma, resulting in bleeding, is a common cause. Other common causes include toxins such as lead (causing bleeding into the gut), ulcers or ulcerated tumors.

 Production Failure!

The most common cause of failure to produce red blood cells is call Anemia of Chronic Disease (ACD). ACD is usually due to a long standing inflammatory or infectious condition or neoplasia. The red blood cells have a shorter life span and aren’t being produced at the normal rate.

 

What Can We Do?

First and foremost, identify and treat the underlying problem. Is there an infection? Heavy metal toxicity? An open wound?

Second, support the anemia. Medications such as iron or vitamin K are useful in some situations. Transfusions can even be considered. We don’t use products such as epogen in exotics medicine…but that may change with time.

It’s always important to follow up and make sure that the anemia is responding to what is being done.
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Emergencies

True emergencies are stressful on everyone – the patient, the owner, the doctor, all the support staff. Some days hearing that an emergency is on its way is enough to make your head spin. How sick is it? Will it make it here? Can we save it?

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The best emergency is the non-emergency:

  • “No sir, that is not a tumor it is a normal growth associated with hormones in a female budgie. “
  • “Actually, your bird is loosing feathers because he is molting – that’s just how they get new ones.”

 Easy emergencies are also nice

  • Broken blood feathers that need to be treated but resolve easily
  • An injured toe that just needs a splint
  • Hay in the eye (remove it and the guinea pig starts to feel better immediately).

Too Late

Heavy Metal Toxicity
The hardest to deal with are the ones that arrived already passed on or struggle through our initial attempts to stabilize but just can’t stay with us. It’s heartbreaking to pass that kind of news on to an owner. Sometimes those creatures who entered our lives for only minutes can create a powerful bond that affects us with a profound sense of loss that lasts for days.

Happy Resolutions
The ones I remember the most are the heart stoppers we saved. Even years later I remember the dying parrotlet who began to revive almost immediately after receiving intravenous fluids. I don’t remember what came next aside from the fact that she got through that day and the next.

Just recently I saw a bird who was vomiting and had lost a lot of weight. She was hospitalized for supportive treatments until she could keep food down and became strong enough to tolerate testing. Xrays showed us large gas filled intestines that were at a complete standstill. Luckily this bird responded to the supportive care and we were able to keep her going until medicine for her infection could kick in. You wouldn’t believe how excited we all were the morning she passed a big dropping full of well-digested food!

Seeds vs. Pellets

The Diet
What to feed your feathered friend seems like a simple topic but the reality is that there are over 300 species of parrots (Psittaciformes) and over 5000 different Passeriformes (the family that canaries and finches belong to). Our diet recommendations change in response to improved understanding of what these guys need.

In The Wild
Many parrots eat seeds in the wild. They may also consume fruits, nuts, larvae, shoots, dead animals, barks, leaves and grubs. Nectivores/omnivores such as lories and lorikeets eat nectar and pollen in addition to fruits, larvae and seeds. But not all species eat all those foods. Hyacinth Macaws eat palm nuts which are about 50% fat – that would make a cockatiel quite obese!

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So At Home…
So why not feed your bird on an all seed diet – that’s what they’d eat in the wild, right? In part they would. There are 2 very significant differences between the wild and our homes.

The first is availability. In the wild, birds spend several hours each day looking for food. Different food items are available in differing amounts throughout the year. Birds have adapted to survive on these variations. At home, we give them a plentiful (usually too plentiful) supply of all sorts of seeds. Your bird is no dummy! He or she will sort through the offering to eat whatever they’d prefer. You might be feeding an all sunflower seed or all safflower seed diet without realizing it.

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The other important difference is that seeds in the wild are variable in protein and energy content. They are high in omega-3 fatty acids (these do not store well) and have moderate amounts of vitamins and minerals. Domesticated seeds (what you get from the stores) are high in energy from starches and omega-6 fatty acids. They are low in proteins, vitamins and minerals. They basically have candy-like nutrient levels.

Nutrient imbalances can affect any and every organ system in the body. Signs that you may see include changes in the feathers such as incomplete or frequent molts, retained feather shealths, abnormal coloration and irritability due to feather discomfort. Skin may be dry or flaky and itchy. Beaks and nails may split, be too long or have exaggerated curvature. There are other reasons your bird may show these signs, but if he or she eats an all seed diet they probably won’t resolve until the diet is improved.

To Sum Up
Getting your bird onto a pellet-based diet is the single most important change you can make to improve their long term health. We also recommend teaching them to eat dark leafy greans – take a look at our diet handout online here.

 ***Because your bird may have other health problems, we do not recommend working to convert the diet until after a veterinarian has examined your bird***

Chickens foraging