How to treat and prevent iron deficiency anemia in cats

Iron deficiency anemia is a type of anemia in cats that most commonly occurs when chronic blood loss depletes the body’s supply of iron, which is needed to create healthy new red blood cells. It’s extremely rare for iron deficiency anemia in cats to be caused by a lack of iron in the diet. If you have a cat, read on to learn more about:

• What feline anemia is
• Symptoms of iron deficiency anemia in cats
• Medical treatment of iron deficiency anemia in cats
• How owners can help prevent nutritional deficiencies

In order to treat iron deficiency anemia, the underlying cause needs to be identified and addressed. Treatment usually targets chronic blood loss and may involve parasite control, treating urinary or gastrointestinal diseases, or surgery. While the underlying issue is being treated, supportive care for the anemia may be needed, such as blood transfusions or hospitalization. Iron deficiency anemia due to a poor diet is extremely rare in cats, especially those who are eating a nutritionally complete commercial diet.

Anemia in cats is not a disease in itself but a sign that something is wrong. It means there are fewer healthy red blood cells (RBCs) than normal, which can cause symptoms like tiredness and pale gums. Anemia is caused by an underlying problem that needs to be found and treated.

Most people think of anemia as simply "not having enough red blood cells," and that’s generally correct, but the medical definition is more specific. Anemia has many causes, many appearances, and is associated with many different kinds of diseases.

Anemia can result from:

• Fewer red blood cells in circulation
• Less hemoglobin (the oxygen-carrying protein inside red blood cells)
• A lower percentage of red blood cells in the bloodstream by volume

No matter the exact mechanism, anemia means the body isn’t getting as much oxygen as it should, which can lead to symptoms like fatigue, pale gums, or weakness.

When a cat is anemic, the body attempts to make up for the low oxygen-carrying capacity of the blood by making more RBCs as quickly as it can. Iron is an important component of hemoglobin, so it gets used up faster due to this increased effort. Over time, the cat may run low on iron, making it harder to produce healthy RBCs. As a result, the new cells are smaller than normal and can’t carry as much oxygen. This sets up a vicious cycle, with symptoms often growing worse.

Veterinarians use the term “iron deficiency anemia” to describe:

• Anemia due to chronic blood loss (the most common cause of this type of anemia)
• Anemia with RBCs that are smaller than normal/contain less hemoglobin

It’s extremely rare for iron deficiency anemia to be the result of an inadequate amount of iron in the diet. “Even though a cat with iron deficiency anemia may be given supplemental iron as part of their treatment, that doesn’t mean the problem was caused by a lack of iron in the diet to begin with,” explains Dr. Jo Myers, a veterinarian on the Vetster platform. “Since iron deficiency anemia is usually caused by chronic blood loss, the key to successful treatment is identifying the source of bleeding and fixing that.” Conditions that can lead to iron deficiency anemia in cats can include:

• Chronic gastrointestinal bleeding from ulcers, tumors, or inflammatory bowel disease
• Severe infestations of fleas, hookworms, ticks, and other blood-sucking parasites
• Chronic blood loss from urinary tract disease, such as infection, tumors, or bladder stones
• Iron deficiency from homemade or unbalanced diets lacking in iron (rare)

Health issues such as gastrointestinal conditions, urinary tract diseases, and blood-sucking parasites can cause slow, often undetected, blood loss over time. As blood is lost, the cat may become anemic, but if there’s still enough iron available to produce healthy new RBCs, it’s not yet an iron deficiency anemia. However, over time, as the iron supply is gradually used up, there’s not enough of it for the production of healthy RBCs, so the anemia becomes more severe; it’s at this point that the anemia is described as “iron deficiency anemia.” As a result of this deficiency, less and less oxygen is delivered to tissues around the body and symptoms usually become worse.

In many cases, iron deficiency anemia provides the first clue about what is causing a pet to be weak, tired, or less active. When a cat has a disease that causes slow, ongoing blood loss, such as lymphoma, the bleeding often goes unnoticed, so the underlying disease may not be detected when the anemia is first identified.

Symptoms of anemia usually reflect a lack of delivery of oxygen-rich red blood cells to tissues around the body. Signs include:

• Lethargy
• Pale or white gums
• Increased breathing rate

Lethargy, sleeping more than usual, and becoming less active than normal are often the first signs of feline anemia. Symptoms may be subtle and easy to overlook until the anemia is severe. Clinical signs can vary depending on how severe the anemia is and its underlying cause. Depending on what’s causing the anemia, additional symptoms may be present, such as:

• Weight loss
• Vomiting
• Diarrhea
• Bloody urine
• Visible worms in the stool
• Signs of fleas or ticks on the skin

Although symptoms of iron deficiency anemia are the same as in other types of anemia in cats, they are often more severe.

The diagnostic approach for a cat with signs of anemia usually starts with a physical exam and basic blood work. Regular blood tests, such as a complete blood cell count (CBC), can show if a cat is anemic and offer additional clues about how severe the anemia is, what type of anemia it is, and the potential underlying cause. However, additional diagnostic testing is usually necessary to fully characterize and understand the cause of the anemia. Tests may include:

• Diagnostic imaging, such as X-rays or ultrasound
• Additional blood tests
• Urinalysis
• Fecal exam
• Bone marrow biopsy

Sometimes, anemia is detected in an apparently healthy animal when they get routine blood work done, such as before a surgery or as part of a senior wellness exam.

A treatment plan for iron deficiency anemia is targeted at the underlying cause of the chronic bleeding. Treatment strategies may involve:

• Parasite control
• Chemotherapy for lymphoma
• Medications for GI ulcers
• Tumor removal
• Bladder stone removal

Supportive care may also be needed to address severe anemia while the underlying cause is being treated. This may include:

• Hospitalization for fluid therapy
• Blood transfusion
• Iron supplements to improve the health of new red blood cells

Although iron deficiency anemia is rarely caused by a lack of iron in the diet, providing good nutrition is still an important part of keeping cats healthy overall. Feeding a balanced, nutritionally complete diet helps ensure that cats have the nutrients they need to support red blood cell production and overall well-being. Poor diets can sometimes lead to iron or other nutrient deficiencies, which can complicate recovery if a cat becomes ill. Choosing the right food is one simple way owners can help protect their cats from potential health problems.

Iron deficiency and other nutritional deficiencies are rare in cats who eat a nutritionally complete diet. When choosing a diet, look for the Association of American Feed Control Officials (AAFCO) statement of nutritional adequacy on the label. This ensures the diet is nutritionally complete when given in a serving size appropriate for your cat’s body weight.

Poor diets that may have low iron content and lack other essential nutrients include:

• Homemade diets that are not formulated with the help of a veterinary nutritionist
• Foods without the AAFCO statement of nutritional adequacy
• Diets given at the incorrect portion size

If you have concerns about your cat’s diet, an online vet is a great resource to discuss the importance of nutrition and what to feed your cat based on your feline companion’s individual needs.

What are the symptoms of iron deficiency anemia in cats?

Signs of feline anemia include rapid breathing, lethargy, and pale mucous membranes. Since iron is necessary to make functional red blood cells, cats with iron deficiency anemia may have severe symptoms due to chronic blood loss and low iron content.

How can I prevent iron and other nutritional deficiencies in my cat?

Most iron deficiencies in cats are prevented by early identification and treatment of diseases that cause chronic blood loss. One easy method for doing this is to prevent blood-sucking parasites by keeping your cat on a regular parasite control plan as directed by a veterinarian. Nutritional deficiencies in general can be prevented by feeding a commercial diet with an AAFCO statement of nutritional adequacy on the label. In most cases, nutritional deficiencies in cats happen because of a health problem that affects how the body absorbs or uses nutrients, not because of issues with the diet itself. Managing underlying conditions, like inflammatory bowel disease, is an important part of preventing these deficiencies.

How is iron deficiency anemia in cats treated?

Treatment strategies for cats with iron deficiency anemia target the underlying cause of the anemia. Iron deficiency anemia is usually caused by chronic bleeding from conditions such as gastrointestinal disease, urinary tract disease, or bleeding tumors. Short-term management of anemia with supportive care may be needed until the underlying issue is resolved. Treatment methods may include parasite control, surgery, treatment for gastrointestinal diseases, blood transfusion, and others.

Disclaimer: This article, its content, and its related references do not constitute veterinary advice and should not be considered a substitute for veterinary care. If your pet is showing any symptoms that could indicate a medical emergency, please seek immediate emergency care.