Flea Anemia

Every summer at least one of my patients dies from excessive fleas.

It is hard to imagine that something as tiny as a flea could be dangerous. We all know that fleas can make pets itch. Some of us are all too familiar with the spectacular skin inflammation in a flea-bite allergic pet but many people forget that fleas drink blood and that lots of fleas can drink lots of blood. The physical state of inadequate red blood cells is called ANEMIA and when it is severe enough, it is a life-threatening condition.



It is easy to under-estimate a pet’s infestation. Only animals allergic to flea bites will itch because of their fleas. This means that the animal who is not allergic to flea bites will not be scratching or losing hair, thus the owner may not realize that there is an active heavy infestation. If the pet is effective at licking and self-grooming, it may be hard to see the fleas, especially if the owner does not use a flea comb. Do not rely on your own ability to see the fleas; effect reliable flea control regardless of what you see or do not see.

Check for Flea Dirt

The black, pepper-like specks found in an infested pet’s coat are actually bits of blood that have been sucked up by the flea and excreted in neat little packages to feed the larval fleas that hatch in the environment. Even if live fleas are not seen, flea dirt means that live fleas are there.

Who are the Victims?

It takes a lot of fleas to produce enough blood loss to create a life-threatening situation for the host pet but it still happens commonly. The following situations are high-risk for flea anemia:

• Very young kittens being raised outdoors or by a mother cat who goes outdoors. Young kittens are small and do not have blood to spare. Furthermore, they are growing and trying to expand their blood volume; they are too young to effectively groom themselves and remove their own fleas. Flea anemia is probably the #1 cause of death in open-household kittens.

Elderly cats who go outdoors. The elderly cat is often debilitated from other metabolic problems. Grooming is less efficient, besides which an older cat is just not strong enough to withstand much blood loss.

Outdoor puppies. Their situation is similar to that of the kittens’. They are too small to effectively groom and are trying to grow in the face of on going blood loss.

Eventually, the weakness catches up with these animals and they will die unless they receive a blood transfusion.

Evaluation and Treatment

The good news is that these patients can still be treated even fairly late in the course of the disease. Often they will need blood transfusions or transfusion with blood substitutes. They also need to have the fleas removed and then returned to an environment where they will be protected from further infestation.

The first step is recognizing the problem. This is not difficult for a trained veterinary health care worker but it may not be easy for an uninformed pet owner. The affected animal will have pale gums (normal gums are shell-pink; anemic gums can be completely white). In advanced disease, the patient will be listless and even cold. A flea comb can be used to check for flea dirt. Cats sometimes eat small pebbles or cat litter when they are anemic.

• Be familiar with the normal color of your pet’s gums so that you can recognize a problem.

• Regular flea combing can help nip a big problem in the bud.

A test called a hematocrit or packed cell volume (PCV) is easily done in your vet’s office to assess the degree of anemia. The hematocrit or PCV reflects the percentage of red blood cells that should be in a sample of blood. In dogs the normal range is 38 to 57; for cats, 24 to 45. Blood transfusion becomes a consideration when values reach 20 or less.

Ridding the critically ill patient of fleas can be problematic. Often the patient is too sick to tolerate the stress of a bath and is too young or too small for flea control products. In this situation, your veterinarian will have to use his or her judgment on what is the safest route to removing the fleas. Recently, Capstar® has become available. This is a fast-acting flea-killing tablet with no known side effects for mammals. It is labeled for use in animals weighing 2 lbs or more and has been especially helpful in clearing severe flea infestations quickly, though without long-lasting effects. Visit the manufacturer’s website.

Returning Home

Of course after all the blood transfusions, heat support, and de-fleaing, the pet will ultimately go home, potentially to the same environment where the infestation occurred in the first place. Usually, topical flea control products will provide adequate future protection and the use of a vitamin and iron supplement will help the patient rebuild red blood cell reserves. The most important step in prevention is the owner's education.

There is no Reason for a Pet to Carry a Flea Burden in this Day and Age

There are still many people who unfortunately believe that fleas simply are part of pet ownership and that there is no way to avoid them. This may have been true at one time but, in reality, fleas have been optional for decades with flea control methods achieving higher levels of convenience and safety each year. The days of sprays, powders, and foggers are largely gone, supplanted by pills and spot-on preparations. No pet needs to have fleas in the 21st century; an owner has a pick of safe and effective products such as the ones shown below.

The general pet-owning population has certainly heard of fleas and is aware of most of the modern flea control products; yet still pets die from this easily preventable problem because people do not realize how serious it can be and cannot recognize when it has gotten to a serious point. Be pro-active and keep up your flea control all year round; if you wait for what you think of as warm weather, your pet may well already be infested. Do not assume a pet with fleas will scratch. Do not assume that if the humans are not being bitten then the flea burden must be light. Do not be one of those people whose beloved pet is lost to an easily preventable disease.


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