What Should I Do If My Cat Has Low Hematocrit Levels?

CatChannel veterinary expert Arnold Plotnick, DVM, talks about blood test results that could indicate anemia.

Q: How do I go about raising my cat’s hematocrit up from 21.3? He doesn’t have worms and checks out OK with everything else. I can’t figure out why his hematocrit and his hemoglobin level is so low this time at the vet. What can I do to make it better?

A: It’s impossible for me to advise you on this matter with the limited information you’ve given me, unfortunately. The hematocrit is a measure of the percentage of the blood that is comprised of red blood cells.  Cats typically have a hematocrit in the 29 to 48 range. Your cat’s hematocrit is low. In other words, your cat is anemic. He has too few red blood cells. 

In order to treat the cat’s anemia, you have to know the cause. The first thing your vet needs to do is determine whether the anemia is “regenerative” (the bone marrow is trying to replace the missing red blood cells) or  “non-regenerative” (the  bone marrow is unable to replace the missing cells). This is achieved by measuring the number of reticulocytes in the blood stream. Reticulocytes are immature red blood cells. If the anemia is regenerative, then the major causes are blood loss (the cat is bleeding, either internally or externally) or red blood cell destruction (the immune system is attacking the red blood cells and destroying  them).

Other tests can be performed to narrow down the cause of the anemia, such as measuring serum iron levels or doing a special test called a Coomb’s test. If the anemia is non-regenerative and the common causes of it (such as chronic renal failure) have been ruled out, it may be necessary to perform a bone marrow examination to further characterize the anemia.

A detailed description of how to figure out the cause of anemia in cats is beyond the scope of this column. The main point I’m making is that the best way to treat the anemia is to treat the underlying cause. Fortunately, a hematocrit of 21 is not dangerously low. Your cat does not need a blood transfusion with this degree of anemia. If your veterinarian cannot determine the cause of the anemia, you should take your cat to an internal medicine specialist for further evaluation.

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