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CASE REPORT article

Front. Vet. Sci.
Sec. Veterinary Emergency and Critical Care Medicine
Volume 12 - 2025 | doi: 10.3389/fvets.2025.1500464

Suspected propofol associated Heinz body anemia in 5 mechanically ventilated dogs; a historical case series

Provisionally accepted
Emily M Ireland Emily M Ireland 1*Claire Rebecca Sharp Claire Rebecca Sharp 2Ellie M Leister Ellie M Leister 3Susan Boyd Susan Boyd 4
  • 1 Brisbane Veterinary Emergency and Critical Care Service, Albany Creek, Australia
  • 2 School of Veterinary Medicine, Murdoch University, Murdoch, Australia
  • 3 Pet Intensive Care Unit, Underwood, Australia
  • 4 Vetnostics Pathology, Murarrie, Australia

The final, formatted version of the article will be published soon.

    Objective: The aim of this report is to raise awareness of the risk of oxidant induced erythrocyte injury, including Heinz body (HB) anemia, in critically ill dogs by describing the condition in five dogs receiving propofol constant rate infusions.Case summary: This case series describes five dogs with suspect propofol induced HB anemia undergoing mechanical ventilation (MV) for lower motor neuron disease. Four cases of tick paralysis (Ixodes holocyclus) and one case of suspected eastern brown snake (Pseudonaja textilis) envenomation were maintained on propofol constant rate infusions as a component of total intravenous anesthesia. All dogs became anemic, and complete blood count and blood smear interpretation by a specialist clinical pathologist confirmed the presence of oxidative red blood cell injury (eccentrocytosis and HBs). Duration of MV ranged from 76-131 hours, with HBs identified within 47-96 hours of commencing propofol. All five dogs survived to discharge, with one dog requiring a blood transfusion.New or unique information provided: While propofol induced HB anemia is a recognised phenomenon in cats, to the authors knowledge, this is the first case series detailing multiple occurrences in dogs. Veterinarians should be aware of the risk of propofol induced oxidative erythrocyte injury in dogs receiving prolonged infusions of propofol, and consider risk mitigation by using propofol as part of multiagent intravenous anaesthesia, keeping dose rates as low as practical, and daily monitoring of blood smears, and red blood cell indices.

    Keywords: oxidant1, erythrocyte2, eccentrocytosis3, propofol4, tick paralysis5, snake envenomation6, total intravenous anesthesia7, Transfusion8

    Received: 23 Sep 2024; Accepted: 02 Jan 2025.

    Copyright: © 2025 Ireland, Sharp, Leister and Boyd. This is an open-access article distributed under the terms of the Creative Commons Attribution License (CC BY). The use, distribution or reproduction in other forums is permitted, provided the original author(s) or licensor are credited and that the original publication in this journal is cited, in accordance with accepted academic practice. No use, distribution or reproduction is permitted which does not comply with these terms.

    * Correspondence: Emily M Ireland, Brisbane Veterinary Emergency and Critical Care Service, Albany Creek, Australia

    Disclaimer: All claims expressed in this article are solely those of the authors and do not necessarily represent those of their affiliated organizations, or those of the publisher, the editors and the reviewers. Any product that may be evaluated in this article or claim that may be made by its manufacturer is not guaranteed or endorsed by the publisher.