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.

(Photocredit: Modified from
Public Domain image via Wikimedia Commons)

PETS WILL NOT ITCH FROM THEIR FLEAS
UNLESS THEY ARE ALLERGIC TO FLEA BITES.

NO SCRATCHING DOES NOT MEAN NO FLEAS!

(original graphic by marvistavet.com)

CHECK FOR FLEA DIRT

The black, pepper-like specks found in the 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, the presence of 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 very small and do not have blood to spare. Further, 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 that go outdoors. The elderly cat is often debilitated from other metabolic problems. Grooming is less efficient plus the older cat is just not strong enough to withstand much blood loss. 

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

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 will also need to have their fleas removed and will ultimately need to be returned to an environment where they will be protected from further flea infestation.

(original graphic by marvistavet.com)

Normal pink color of the gums.
(original graphic by marvistavet.com)

The first step is recognizing the problem. This is not difficult for a trained veterinary health care worker but 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. Pets sometimes eat small pebbles, dirt, or cat litter when they are anemic in an effort to obtain more iron.

• 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.
• Use flea control products all year round so you don't get caught with a surprise heavy flea burden in the spring.
  
  
  

A test called a HEMATOCRIT (HCT) 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 present in a sample of blood. In dogs the normal range is 38 to 57 and in cats the normal range is 24 to 45. Blood transfusion becomes a consideration when values reach 20 or less.

The packed cell volume is measured by placing a
blood sample in a small glass tube called a
"capillary tube." The serum and red blood cells
are separated within the tube and a special chart
is used to measure the percentage
of red blood cells present.
(original graphic by marvistavet.com)

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. It is worth mentioning nitenpyram (brand names Capstar^®, PetArmor FastCaps^®, and Capguard^®) at this point as this simple product has greatly enhanced our ability to clear fleas from a patient quickly and safely. Nitenpyram is available as 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 begins killing fleas within 20 minutes of oral administration. While it does not have long-acting flea protection, its ability to rapidly remove a lethal flea burden has made it especially popular for use patients with dangerous flea infestations. To visit the Capstar website, click here.

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 his or her red blood cell reserves. If the infestation is severe, consider treating the home environment separately before the patient returns to it. Your veterinarian can help you select safe and effective home treatments. The most important prevention is the owner's education.