Henry’s Fight: Severe Anemia, Babesia and Liver Stress
For several years, Henry has been one of the street dogs I regularly feed.
He has never been an easy dog to handle. Henry is very cautious around people and has clearly had bad experiences in the past. I have seen people treat him badly, and over time he learned that keeping his distance was safer. He was never truly aggressive toward me, but catching him or getting him into a car was almost impossible.
There were times when he had a lot of ticks, and whenever possible I treated him with parasite medication. At one point he also had an injured paw, possibly after being hit by a motorbike or hurt by someone. I wanted to take him to a vet then, but there was simply no safe way to catch him.
Then Henry disappeared.
I did not see him for more than two weeks, and I started wondering whether he was still alive.
When he finally appeared again, I immediately knew something was seriously wrong.
He slowly came toward me, stumbling as he walked. He had lost a lot of weight and looked extremely weak. This time there was no question about what to do. I got a transport cage and took him to the vet.
Normally Henry would have strongly resisted being put into a cage.
This time, he barely had the strength.
That was the beginning of what we now know is a very serious medical situation.
Henry’s Initial Examination
Despite his poor overall condition, some of Henry's basic vital signs were still stable when he arrived at the first clinic.
| Examination | Result | What it means |
|---|---|---|
| Temperature | 38.9°C | Within the normal temperature range for a dog |
| Heart | Normal on examination | No obvious abnormal heart sounds were reported |
| Respiration | Normal on examination | Breathing sounds were considered normal |
| Hydration | Dehydrated | Henry had lost more fluids than his body could compensate for |
| Gums | Very pale, slightly yellow | Pale gums are consistent with severe anemia. A yellow coloration can be associated with bilirubin accumulation, red blood cell destruction or liver and bile related problems |
The condition of his gums was particularly concerning because it matched what the blood tests would show shortly afterwards.
Severe Anemia
The first complete blood count showed that Henry was suffering from extremely severe anemia.
Anemia means that the body does not have enough functioning red blood cells and therefore cannot transport enough oxygen to the tissues.
Red blood cell results
| Test | Henry | Reference range | Explanation |
|---|---|---|---|
| RBC | 1.01 M/µL | 5.60–9.21 | Red blood cell count. Henry has only a fraction of the normal number of circulating red blood cells. |
| HCT | 6.6% | 36.6–61.1% | Hematocrit measures how much of the blood consists of red blood cells. 6.6% is critically low. |
| HGB | 3.2 g/dL | 12.4–22.0 | Hemoglobin carries oxygen inside red blood cells. Henry's level is profoundly reduced. |
| MCV | 65.0 fL | 57.6–75.2 | Average size of the red blood cells. This was within the laboratory's reference range. |
| RETIC | 164.7 K/µL | 10–110 | Reticulocytes are young red blood cells. The increased number suggests Henry's bone marrow is trying to replace lost or destroyed red blood cells. |
| Reticulocytes | 16.3% | — | The high proportion supports an active regenerative response by the body. |
The combination is important.
Henry does not simply have fewer red blood cells. His body appears to be actively trying to make replacements.
This type of response can occur when red blood cells are being lost or destroyed faster than the body can replace them.
The clinic warned me very clearly that, with blood values this low, Henry could collapse at any time.
Some calculated red cell indices, including MCH, MCHC and RDW, were also flagged by the analyzer. In a sample with anemia this extreme, some calculated values can become unreliable or distorted, so the clinically most important findings are the dramatically reduced RBC, hematocrit and hemoglobin together with the increased reticulocyte response.
Platelets and White Blood Cells
Henry's platelets were also reduced.
| Test | Henry | Reference range | Explanation |
|---|---|---|---|
| PLT | 127 K/µL | 148–674 | Platelets are involved in blood clotting. Henry's count is below normal. |
| MPV | 11.8 fL | 8.1–14.7 | Average platelet size. Within the laboratory range. |
| PDW | 14.9 fL | 6.4–21.2 | Describes variation in platelet size. Within the laboratory range. |
| PCT | 0.15% | 0.16–0.75 | The total proportion of blood volume made up of platelets was slightly low. |
His overall white blood cell count was not elevated.
| Test | Henry | Reference range |
|---|---|---|
| WBC | 8.14 K/µL | 5.05–18.60 |
| Neutrophils | 5.40 K/µL | 2.92–13.80 |
| Lymphocytes | 1.57 K/µL | 0.76–4.40 |
| Monocytes | 1.04 K/µL | 0.31–1.95 |
| Eosinophils | 0.12 K/µL | 0.06–1.23 |
| Basophils | 0.00 K/µL | 0.00–0.10 |
So although Henry is seriously ill, there was no major increase in his total white blood cell count at the time of this test.
The PCR Test Found Babesia gibsoni
Because Henry had a history of ticks and such severe anemia, the vets also tested his blood for several vector borne infections.
The PCR result finally provided an important piece of the puzzle.
Henry tested positive for Babesia gibsoni.
| Pathogen | Result |
|---|---|
| Babesia gibsoni | Positive |
| Anaplasma platys | Negative |
| Borrelia | Negative |
| Babesia canis | Negative |
| Ehrlichia species | Negative |
| Hemotropic Mycoplasmas | Negative |
The reported Ct value for Babesia gibsoni was 34.47, which the testing laboratory classifies as a relatively low pathogen load.
However, a low measured pathogen load does not mean the disease cannot have serious consequences.
Babesia is a microscopic blood parasite that infects red blood cells. The infection can contribute to destruction of those cells, producing hemolytic anemia.
In Henry's case, the veterinarians believe Babesia is an important contributor to his severe anemia.
Liver and Blood Chemistry
Because Henry's blood serum appeared unusually yellow and his gums had a slight yellow coloration, the vets recommended a more comprehensive blood chemistry panel.
The results showed several significant abnormalities.
| Test | Henry | Reference range | What it tells us |
|---|---|---|---|
| Albumin | 1.7 g/dL | 2.5–4.4 | Albumin is an important blood protein made mainly by the liver. Henry's level is low. |
| ALP | 156 U/L | 20–150 | An enzyme associated with the liver and biliary system. Mildly elevated. |
| ALT | 396 U/L | 10–118 | An enzyme released when liver cells are damaged or stressed. Henry's value is markedly elevated. |
| Total Bilirubin | 1.5 mg/dL | 0.1–0.6 | Bilirubin comes from the breakdown of red blood cells and is processed through the liver and bile system. Henry's level is elevated. |
| Amylase | 1372 U/L | 200–1200 | Mildly increased. The clinic considered this less significant than the other abnormalities. |
| Total Protein | 10.3 g/dL | 5.4–8.2 | Elevated. |
| Globulin | 8.6 g/dL | 2.3–5.2 | Strongly elevated. Globulins can increase during chronic inflammation, infection or immune stimulation. |
| Sodium | 133 mmol/L | 138–160 | Mildly low. |
| Potassium | 4.2 mmol/L | 3.7–5.8 | Normal. |
| BUN | 17 mg/dL | 7–25 | Within the laboratory reference range. |
| Creatinine | 0.8 mg/dL | 0.3–1.4 | Within the laboratory reference range. |
| Phosphorus | 4.5 mg/dL | 2.9–6.6 | Normal. |
| Glucose | 94 mg/dL | 60–110 | Normal. |
| Calcium | 8.6 mg/dL | Approx. 8.6–11.8 | At the lower end of the laboratory range. |
The most striking abnormalities here involve Henry's liver related markers, bilirubin and blood proteins.
ALT is considerably elevated, suggesting that liver cells are under significant stress or have been injured.
Bilirubin is also elevated. Bilirubin is produced when hemoglobin from old or damaged red blood cells is broken down. Normally, the liver processes it and sends it into the bile system.
In Henry's situation there may be more than one process happening at the same time.
His Babesia infection can contribute to destruction of red blood cells, increasing bilirubin production. At the same time, the liver itself appears to be under considerable stress.
The vets therefore believe his liver abnormalities may be connected to the Babesia infection, his overall condition, his age, or a combination of these factors.
Importantly, Henry's BUN and creatinine were within the laboratory reference ranges, so this particular chemistry panel did not show the same obvious evidence of kidney dysfunction that it showed for his liver.
His Eyes Are Also Affected
The vets also examined Henry's eyes.
A fluorescein stain showed that both eyes have corneal ulcers.
This test uses a special dye that attaches to damaged areas of the cornea, making ulcers easier to see.
Henry also underwent a Schirmer Tear Test, which measures tear production.
Both eyes produced less than 10 mm of tears per minute.
That is abnormally low and indicates insufficient tear production, commonly called dry eye.
The clinic noted that his age may contribute to the problem, although reduced tear production can have several possible causes.
For Henry, this means the eyes require treatment and monitoring in addition to everything happening internally.
Why Henry Cannot Receive the Babesia Treatment Immediately
Finding Babesia gives us something concrete to treat.
But Henry is currently too unstable for the vets to proceed directly with the full treatment plan.
His red blood cell values are dangerously low, and the immediate priority is therefore to stabilize him first.
The clinic is currently giving him:
- Erythropoietin – this medication stimulates the body to produce more red blood cells.
- Ornipural – this is being used as supportive treatment for his liver.
The current plan is to administer these supportive injections every two days.
After three rounds, another blood test is scheduled for October 5, 2026.
The vets will then evaluate whether his red blood cell levels and overall condition have improved enough to proceed with specific Babesia treatment.
If Henry becomes sufficiently stable, the planned Babesia treatment is imidocarb, given as two injections approximately two weeks apart.
Because Henry tested specifically positive for Babesia gibsoni, the treatment strategy may need to be adjusted depending on his response and the clinic's assessment. For now, stabilizing his circulation and organ function comes first.
Latest Update
At the moment, Henry remains under veterinary care.
The most recent update from the clinic is cautiously stable.
He is still very selective with food. He currently accepts boiled chicken liver and wet food but refuses his regular food and dry food.
He passed normal stool overnight and urinated normally in the morning.
For now, the plan has not changed.
The clinic will continue supportive treatment for his blood and liver and repeat his blood tests on October 5.
That test will be extremely important because it should show whether Henry is beginning to respond to treatment and whether his body is strong enough to move on to the next stage.
What Happens Next
Right now, Henry is not out of danger.
With a hematocrit of only 6.6% and hemoglobin of 3.2 g/dL, his anemia is extremely severe. The veterinarians have warned that his condition could deteriorate or that he could collapse.
But we also finally know much more about what is happening inside his body.
We know that he has Babesia.
We know that his body is trying to regenerate red blood cells.
We know that his liver is under significant stress.
And we know that despite everything he has been through, he is still here.
For years Henry survived on the street while keeping people at a distance. I could feed him and help him where possible, but there was always a limit to how close he would allow anyone to get.
When he walked toward me that day after disappearing for more than two weeks, he was weak enough that those barriers were suddenly gone.
I wish it had happened under different circumstances.
But at least this time we were able to get him somewhere safe.
For now, Henry is exactly where he needs to be.
We will know more after his next blood test on October 5.
Help dogs like this one
Every case on this blog was paid for by people reading it.