The Use of Darbepoetin to Stimulate Erythropoiesis in Anemia of Chronic Kidney Disease in Cats: 25 Cases

Background: Anemia is present in 30-65% in cats with chronic kidney disease (CKD) and few long-term treatment options exist. Darbepoetin is effective in treating anemia of kidney disease in humans and may be used in cats. Hypothesis/Objective: To evaluate the use of darbepoetin, a recombinant analog of human erythropoietin, to stimulate erythropoiesis, and to effectively treat anemia of kidney disease in cats. Animals: Twenty-five of 66 cats that received >= 2 doses of darbepoetin at the Animal Medical Center between January 2005 and December 2009 were included in this study. Methods: Cats were included in the study if they received darbepoetin and follow-up data were available for at least 56 days and had CKD as a primary clinical diagnosis. Cats were excluded if they were treated with darbepoetin but did not have kidney disease. Response to treatment was defined as reaching or exceeding a target packed red blood cell volume or hematocrit of 25%. Results: Fourteen of 25 cats responded. Thirteen of those 14 cats received a dosage of 1 mu g/kg/wk or higher. Presumptive adverse effects included vomiting, hypertension, seizures, and fever. Conclusions and Clinical Relevance: Darbepoetin is effective for treatment of anemia of kidney disease in cats. Pure red cell aplasia appears to be less common with darbepoetin than with epoetin usage.