Will a Blood Transfusion to Treat Anemia in CKD help?

[FourJs]

We have a 10 year old, small mixed breed dog who has had CKD for a few years. About 12 weeks ago, he stopped eating for two days and when we took him to the vet, his kidney values we very elevated. Since then, we have done three rounds of IV fluids and daily subq fluids. He has been able to eat, drink, walk, and be comfortable and happy. Unfortunately, 5 days ago he took a turn for the worse. He had several episodes of vomiting in one day (very, very unusual for him) so I took him to the vet to see if his lab values had worsened. Five days ago lab values were: BUN 122, Creatinine 7.1, Phos 10.5, Albumin 2.1, Total Protein 4.7...honestly, no real change in these numbers as this is about where they have been for the last 12 weeks. The biggest difference has been with his hemoglobin and hematocrit. Twelve weeks ago, hemoglobin and hematocrit were on the low side of normal. Now hemoglobin is at 3.1 and hematocrit is at 9.6. He is getting weaker by the day, still able to walk some but his appetite is minimal, he has had several more times where he has vomited and overall seems somewhat uncomfortable. We have done three cerenia injections in 5 days and are now considering doing a blood transfusion tomorrow. I really haven't found any info on whether a blood transfusion is beneficial in a CKF dog so I am hoping that maybe someone out there can give me some input if they have had experience in this area. I really don't think he is going to be able to hang in there that much longer if the blood transfusion doesn't help. And if it is unlikely that it is going to help, I don't think I want to put him through spending another day getting poked and having to stay at the vet's office. Please, any help or suggestions would be much appreciated!

[FourJs]

In case another person comes across this post because they are having a similar situation, I have decided to post an update. Our dog, Jack, got a blood transfusion yesterday. Our vet was very clear from the beginning that he wasn't sure how much it would help and if it did help at all, it would be very short term. The blood transfusion raised his hematocrit from below 9% up to 12%. The plan was to do another transfusion today but over the course of the night, we decided it really didn't make a difference for our little guy and we didn't want to put him through another 6+ hours at the vet's office. After much thought and consideration, we made the hard decision to let him end his fight with this disease. He had fought like a champ these last 13 weeks. He did amazing considering what his kidney and red blood cell numbers were. We are so beyond incredibly sad to say goodbye but are so glad we had a another 3 months with him.

[tonyb286]

I am so sorry for your loss. Hard decisions sometimes have to be taken. Run free Jack. Xxx

[tonyb286]

Hi. It really depends on the type of anaemia, as to the best way of treating it. Severe anaemia demands a blood transfusion. However, this is quite a complex area ... while anaemia is very common in canine kidney disease, it takes a good vet to determine whether it's actually anaemia or the result of a tick-borne disease. I recommend having the reticulocyte count re-tested before any blood transfusion - or before the alternative treatment - a hormone treatment involving Erythropoietin  (which isn't normally advised until the HCT is 20 or below).

Once the (assumed) anaemia is treated, I would suggest starting your dog on Aranesp (darbepoetin alfa). Your vet needs to test erythropoietin levels to see if they're the cause of the low red blood cells, otherwise, the medication can be harmful. Anemia can also be caused by malnutrition if you are feeding too little protein.

Creating red blood cells requires iron, so iron supplementation is recommended while taking EPO or other medication designed to increase red blood cell production. Again, too much iron can be toxic, so follow your vet's dosage instructions.

Good luck.

Tony

[FourJs]

Thanks Tony for your advice. I had taken him in to get the transfusion before I saw this but he has been seen by two vets who both said the anemia is caused by his inability to produce erythropoietin. I have mixed emotions about the blood transfusion but he is so weak that I don't think he can survive too much longer without some type of intervention.