Anemia in Cats

Rags 2-9-09 (2 months before he died)
Rags 2-9-09 (2 months before he died)

What is anemia in cats? Anemia or anæmia/anaemia means without blood. An anemic cat is a cat that has a reduced number of red blood cells or hemoglobin or both. Anemia in cats is not a disease in itself, but rather, a result of another disease process occurring in the cat.

An owner may recognize anemia in older cats and in cats in general by the lack of pink in the cat’s gums or from the cat’s behavior, which is usually very tired and listless. Also, if you let your cat outdoors, you might notice an odd behavior of licking rainwater or melted snow. They crave minerals if they are anemic and try to acquire them from those sources.

If your cat has pale gingiva (gums) and lethargy, more than likely, your vet will want to do some bloodwork on your cat to have a look at the red blood cell count. The three tests that your vet can do to see if your cat is anemic are:

  • packed cell volume (PCV)
  • red blood cell count
  • the hemoglobin count

The most common test is the PCV test. In this test, your vet will place your cat’s blood in a centrifuge, separating the red blood cells from the plasma. 25%-45% of a cat’s normal blood will be red blood cells. If there is less than 25%, your cat is considered anemic.

There are other tests that your vet may want to perform once the red blood cell count test is done. They mainly involve the testing of bone marrow. The bone marrow creates and produces red blood cells. So, these tests help a vet determine if the bone marrow is doing what it should. Those include:

  • blood smear
  • reticulocyte count
  • bone marrow biopsy or aspirate
  • biochemical profile and urinalysis
  • fecal exam

Beyond bone marrow, your vet may want to do the following tests check organ functions and electrolyte levels, or parasite levels.

  • biochemical profile and urinalysis
  • fecal exam

Lastly, your vet may want to check your cat for the following diseases, as they are historically known to cause anemia in cats:

  • feline leukemia virus
  • feline immunodeficiency virus (FIV)

There are other reasons for anemia in cats, however. That is why so many tests are required—to determine which of these diseases might be causing the anemia. Your vet will probably have a better idea of what test to perform based on the age and condition of your cat.

  • Diseases that cause blood loss
    • Trauma or injury that severs blood vessels or internal organs
    • Parasites (fleas, hookworms, and ticks)
    • Tumors of the intestinal tract, kidneys, and urinary bladder
  • Diseases that prevent proper clotting of blood
  • Diseases that cause red blood cell breakdown (hemolysis)
    • Autoimmune disease
    • Blood parasites
    • Chemicals or toxins
    • The Feline Leukemia Virus
    • Neoplasia (cancer)
  • Diseases that decrease the production of red blood cells
    • Any severe, chronic disease
    • Autoimmune disease
    • Chemicals or toxins
    • The Feline Leukemia Virus
    • The Feline Immunodeficiency Virus
    • Neoplasia (cancer)
  • Very poor nutrition or nutritional imbalances

How to increase red blood cells in cats?

If you have a cat with anemia, there are some things that you can do to increase the red blood cell count for them. If it is a severe case, your cat will more than likely have a blood transfusion, which might be performed right after the results of the blood sample are in. This quick process is to ensure the cat is stabilized while more tests can be done to understand why this is happening.

Other options include:

  • Iron or Vitamin B Supplement for mild to moderate anemia (below 30% red blood cells)
  • Anabolic Steroids – if the anemia is not too severe
  • Erythropoietin or Epogen, Eprex or Procrit
  • Darpepoetin Alpha (Aranesp) – which The Feline CRF site says has a lower risk of a reaction than Epogen/Procrit and is the ESA of choice
  • Feline Erythropoietin
  • Blood Transfusions

More than likely, there is chronic kidney/renal failure in an older cat like Rags. Therefore, the kidneys no longer produce the needed erythropoietin, a hormone that stimulates the bone marrow to make red blood cells.

To learn more about anemia in older cats, especially cats with Chronic Renal Failure (CRF), please visit this very informative website, complete with references and links to formal studies on renal failure: TANYA’S FELINE CHRONIC RENAL FAILURE

This page is included on to educate owners about anemia in cats. It is not here to replace veterinary advice but rather to supplement it with explanations and options. Always consult a veterinarian before starting any regimen on your cat.

Do you have suggestions to improve the information on this page? If so, please send an email and let us know!

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Hi, I’m Jenny Dean, creator of Floppycats! Ever since my Aunt got the first Ragdoll cat in our family, I have loved the breed. Inspired by my childhood Ragdoll cat, Rags, I created Floppycats to connect, share and inspire other Ragdoll cat lovers around the world,

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  1. Tanya Overholt says:

    can a playful kitten still be anemic since they have fleas and there sibling passed away from being anemic due to case of having a bad flea issue?

  2. Davistiano says:

    All you guys’ comments make me cry, but glad that there are so many cat lovers in this world!!
    My lovely cat “Jelly” has recently (few days ago) diagnosed with CKD with Anaemia, he is only 3 years old!! He is currently in hospital having IV fluid since Wednesday evening. When I got him 2 years ago, he never showed great interest in food but he did finish an appropriate portion everytime. Whenever I am in my kitchen preparing food, he will sit (like a dog) tight at the kitchen door looking at me seems like waiting: I am here ready for the food!

    He is an indoor car, but he is quite active in the house; he at night time will run through the house from one end to the other end full speed and sometimes at the end jump through the sofa at the end and all the objectives onto his cat tree. He loves sitting on my and my wife’s lap and if we stroke his chin, he will flip over and ask for more……everyday when we come home, when our car get onto the driveway, he will start meowing inside the house and stand right at the door waiting for us.

    To me (and I guess all the cats to their owner), he is a very special boy. He is always discipline and playful. I still cannot believe he is diagnosed with such illness. He had his annual check in Sept 2014 and he was fine! Even when I had my wedding in Oct, he was also part of it with his little bowtie……and now he is only weighing 2.6kg, not showing interest to food and drink a lot of water. The morning when I take him to the vet, he was lying on my cuision with his eye saying: I am dying….. He was in fever of 40.5C, the vet immediately admitted him after running a blood test showing serious toxin – but we never let him get close to any toxic stuff, no flowers, no insecticide nothing….

    Since he is on IV fluid, he started eating more but still drink a lot of water – his HCT count is dropping from first test of 16% to 9% today, RBC is 2 only……vet said will give him a chance on IV fluid until Monday, then depends on his situation we may be forced to do the hardest decision ever……… I can’t imagine how we will ever get through this if that happens on Monday…….

  3. Dementia Boy says:

    Dear Kona’s Momma,

    I’m sure you’ve read everything you can on FIP at this point. Although Pedersen has retired, UC Davis continues his crusade against FIP. They’re actively recruiting breeders to send in DNA samples, but some breeders seem reticent. Here’s a link; perhaps you could call UC Davis for some additional assistance. If you live in Northern California or Northern Nevada, that would be fantastic.

    I take it your breeder didn’t do HCM DNA testing on the parents? Please take a look at floppycats “bad breeders” and “good breeders.” There’s also a link there to some of Dr. Pedersen’s work. (He was my Jolie’s primary care vet for three years; she has, among a million other problems, a strange mutation of the corona virus, but it’s not FIP.)

    For textbook symptoms of and factors contributing to dry FIP, (org?) has an excellent article. Unfortunately, your sweet Kona fits the profile all too well. I’m not a vet, and it may well be something else. But I don’t think so.

    Your breeder has a lot of explaining to do. Obviously you’re going to keep Kona but she owes you a refund.

  4. Dementia Boy says:


    Sorry to be meeting like this =(

    Could you please post Kona’s bloodwork?

    Has the vet run a corona antibody titer?

    Thanks for any additional info, especially any info from the breeeder. I take it he’s been tested for FeLV/FIV?

    1. The corona antibody titer is a pointless test.. It will only tell the vet if the cat has been exposed to the corona virus, not if it has mutated into FIP. It can have a high count and not have mutated, and it can have a near negative result and it did mutate..

  5. Kona's Momma says:

    My 10 month old Ragdoll boy has been diagnosed with either FIP or cancer. When I brought him home from the breeder he had diarrhea and he sneezed a lot. I took him to the vet and they did virtually every test to see why he had the diarrhea. Everything was negative, although we did put him on dewormers and antibiotics just in case. His sneezing we thought was the different environment. He got over both symptoms in a few weeks and seemed normal. He was neutered and continued to thrive. Just about a week ago I noticed he was sleeping more but a few days ago I also noticed his third eyelid showing (a lot at time) so I brought him in as an emergency. Since he looked fine except for this, they prescribed lysine. The next day I noticed it looked worse so I brought him back in to have blood tests run. He is severely anemic and high protein levels are very high. The next day we took X-rays which show that he has an enlarged heart, kidneys and lymph nodes. The radiologist is suggesting FIP or cancer. I notified the breeder and she said she kept one of his litter (a female) and she is beautiful so she wonders what happened. OMG really… about insensitive and beyond stupid. I just had to vent…but if anyone has any suggestion, please reply. I am devastated….I have had 4 cats…one who lived to 16 and died last May. My beautiful boy Kona does not deserve this.

    1. Am glad you could come here and vent. I’m so very very sorry that both of you have to go through this horrible thing in the first place. Agree with Dementia Boy that it sounds like FIP unfortunately. I had a little Himalayan girl a long time ago who died from FIP and it was so heart breaking. Please take comfort in knowing that you are giving him a priceless gift – your unconditional love. He is so blessed to have you to care for and love him like you do. Shame on that breeder for being so heartless. She should have offered to pay the vet bills and refund your money regardless which way Kona’s health turns out. It would have been appropriate for her to offer you the girl kitty she bragged about. However, I know that you probably wouldn’t trust her again to have a kitty from that cattery ever again and don’t blame you at all.
      Please know that you and Kona will be in my thoughts and prayers for peace, comfort and strength to get through this rough time. ♥♥♥

  6. Dementia Boy says:

    For cats deficient in B and D vitamins, you might want to try Murr pouched food from Iceland. It’s basically all organ meat, including–nummers!!–lamb lungs. In my opinion, it’s too high in purines and D vitamins for cats who *don’t* have vitamin deficiencies, unless you mix it in with raw or just feed it as an occasional treat.

    I’ve found only one place on line that sells it and it’s not cheap. However, if you live near a store called The Grocery Outlet–I don’t know if these are nationwide or just in northern California and northern Nevada, you might check there. I bought some pouches–I won’t tell you how many because you might think I’m a crazy cat lady–for 2/$1.00 with an Oct. 2015 expiration date. The labeling was crooked, so I got four for the price of one (or 160 for the price of 40).

  7. Dementia Boy says:

    There are as many different types of anemia as there are underlying causes. Non-regenerative, I think, is the saddest kind because neither knowledge nor money can save your beloved kitty. Epogen only prolongs the time between transfusions.

  8. Our ragdoll Blue got really lethargic when we first brought her home at 3 months and wouldn’t eat, lost a lot of weight and just slept all the time. She was really close to dying. Vet said she was anemic and tested her for everything under the moon. The tests all came back negative. He put her on an antibiotoc and anti diarrhea medicine and though they helped it didn’t fix the issue. We finally realized she had a malabsorption issue and was unable to retain some of the nutrients from her food. Like protein. So we had her put on a very high protein cat food (iams). It saved her life. When we tried another food she got sick again so we switched back and she was fine within a few hours. It was scary but so glad the fix was so easy.

  9. My 5 year old male cat is acting normal, eating, sleeping, playing, etc.
    BUT I JUST NOTICED his nose and gums ARE WHITE!!!!??? We have an apt tonight at 7:30 I am freaking out…. What ELSE could this be but ANEMIA????

  10. Jeanette, I salute you for rescuing a kitten who wouldn’t have had a chance otherwise. The fact that Rusty’s reached 14 years is a testament to how much love and care he’s been given. I’m sure he knows how much he is loved.

    I am so sorry you now have to deal with his passing, my heart is sore for you. At the end of the day, we love them until they can be here with us no longer. Know that you’ve done something very special for your boy. 🙂

    I’ve long been worried about the effect shots have in cats. I do a lot of reading and there seems to be so little guidance for vets on avoiding over vaccination, and giving rabies shots to purely indoor breeds. My local council would have them microchipped and rabies vacc’d, but luckily my vet is a smart man and works on a case by case basis. I always recommend TALKING to the vet about any fears you have, allowing them to give you their perspective, but make it clear that you are the one making the decisions on the cat(s) that you know very well.


  11. After reading through the comments on anemic cats, I want to share my story with you. I adopted our beautiful cat Rusty when he was just a kitten about 6 months old. He was ‘anemic’ and his then owners were about to have him put down. I took him to the vet and his red blood cell count was 5. The vet did not think he would make it but said his only chance was an emergency blood transfusion. It was just before Christmas and my boyfriend and I rushed him to Helen Woodward Hospital where he underwent his first blood transfusion with cows blood (in an emergency there is no time to match a cats blood). He was in the hospital for a few days, having another blood transfusion 24hours later when they matched his blood type. He was diagnosed with a rare red blood cell aplasia where his immune system was treating his red blood cells as enemy cells and killing them off as fast as his body was producing them. It cost a lot of money but we had the best Christmas that year… we didn’t buy presents but spent everything on our cat. It not only helped save Rusty’s life but brought us closer together and gave us a better perspective on life and material things. He was only given a small chance of making it, but 6 blood transfusions later and a year on immune suppressant pills he was a very happy cat. When we weened him off the pills, there was a chance it would happen again, but it didn’t. Our Rusty is now 14 years old and has had a great life, but unfortunately is now in decline. He has cancer, congestive heart failure and hyperthyroidism. He had a bad reaction to the methimazole drug used to treat hyperthyroidism and his red blood cell count has been dropping because of the meds. We have taken him off the drug and the vet gave him an iron injection and we are hoping this will help. He has been given less than 3 months to live and we are nearing the end of the second month. Heartbreaking as he has been the best cat I ever had, but he is hanging in there and not ready to give up the fight yet. That’s one thing for sure, cats let you know when they are ready to leave this world. Hope this information can help someone else. They think his rare red blood cell aplasia was brought on by his injections he had as a kitten… For rabies, leukemia etc.

    1. WOW Jeanette – that’s incredible! Cow’s blood! Who knew!?

      I am sorry to hear he is on the decline. As a human that has taken Methimazole, I am sorry to hear about the side effects.

      Bless you for saving your little man and giving a good life – and more importantly finding out what’s important in life! A lesson I have learned recently too =).

      Kisses to Rusty!!

  12. Our three yr old boy came down with anemia in May. Tests done. Steroids given. Looks like it is gone but themn… It comes back! Three times. He is on b12 and steroids again now. We will just have to keep trying to get him well. Any suggestions on food or what else we can do?

  13. I just lost my 14 year old companion, Maia to anemia.She started losing weight few months ago. Then I noticed her licking the screen door every chance she got. Not knowing that she was lacking iron, we blocked her from the screens.

    Reading this post and the responses comforted me more than anything else today. Knowing that even if caught early, she may not have recovered without expensive and repetitive treatment was comforting to read. By the time we got her to the vet last night her red blood cell count was 9%. The vet said she could get transfusions, but individual cats react differently. We would have been giving her then anywhere from every other day to every other month just to help her survive a few more months and that with weakness and discomfort breathing.

    We think her anemia may have been bone marrow cancer related. It was awful to go through. We opted for putting her to sleep. I held her. She purred even after her heart had stopped. It was at once the most terrible and the most beautiful moment in my life. I hope this helps others feel the comfort I have knowing I am not alone in my grief. Maia is a special cat, her purr always brought me joy.

  14. luis alvarez says:

    Hi Jenny

    our cat Mishu has Anemia and some other problems she is 17years old and was fine she has been on other meds for different things for some time but now she is no eating and was incapacitated and had to have an enema not long ago.

    is there any thing you can recommend for her (we do have injection B12) but what else can we do


    Luis Alvarez

    1. Hi Luis,

      Sorry to hear about Mishu, it is not a fun process.

      I assume you’ve eliminated all dry food – have you tried all sorts of wet food?

      When Rags was on his way out, I fed him baby food. He ate that for a few months. What has your vet said?


  15. I know my kitten died of anemia. He was only around six months old, but like everyone else, it came out of nowhere. He already had a hard start in life. As we found him in the backyard, and my aunt gave him to me. I bottle fed him, cleaned him so he could go to the bathroom, I essentially raised his as my baby. He survived despite some really terrifying setbacks twice. I was so glad to have him, and then out of nowhere this April he started getting very lethargic and weak. He didn’t want to play, eat or even move. We were planning to take him in to our family vet on the following Monday but I think it was Saturday I knew something was really wrong. So we took him to the emergency vet and they ran blood tests and concluded that his blood levels were dangerously low. They said the only way we could save him was a blood transfusion, and even that was only a chance. We didn’t have the money for it and he was already getting so weak he couldn’t hold his bladder or sit up so we decided to have him put down. It was probably the hardest decision of my life. I cried so much and I still do. It’s so hard to raise something as your child only to watch it die. His name was Sid. He was a little Manx kitten. I wish I knew what caused anemia because now I am terrified of getting another cat as I don’t want to go through this again.

  16. Sylva Smith says:

    I’ve found the stained baby food meats to work wonders! My cats love the gerber meats – especially the ham, for some reason. works really good to hide medicines too.

  17. Al in SoCal says:

    Looking for some advice. My cat is 17 going on 18 years old. She was diagnosed with severe anemia. They wanted to do more tests before a blood transfusion. She’s REALLY thin – like emaciated. My question is should we do some of the therapies here like beef liver, supplements, etc? My vet wants to do lots and lots of tests – and my cat HATES the vet – it traumatizes her …

    Kind of stuck and hoping there is some time left for my cat.

  18. leslie ng says:

    My cat mimi also having the same severe anaemic epsodes over 12 months. She bounced back the first two episodes and at one time PCV was 40% normal. She just had another severe anaemia but this time had two transfusion did nothing in two weeks, her last transfusion last week so far she is responding but dont know how long this gonna last… Vets have all the test including FLV all negative.. Same as everyone else just put down as auto immune??????
    I give her daily erythopoitein injection daily at the moment, dont know if make any difference…:(

  19. I have a kitty that has had two bouts with anemia at this point, and I’m holding my breath as we come to the anniversary of it in the spring to see if it happens again (it happened early spring both times)

    signs that she was anemic was eating dirt and licking cement. she wasn’t overly pale, she didn’t have fleas, she didn’t stumble or act odd, just had a weird love affair with the cement in the basement and the dirt in my potted plant. and a little weight loss.

    We have no obvious reason for it. pred and doxy cleared her up both times and she bounced back right away and stayed healthy for a year.. *knock wood*

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