This condition is very similar to sickle cell anemia in humans. Normally, red blood cells (RBCs) in dogs are of biconcave discoid shape, but in metabolic anemia, this shape is lost and they become abnormally elongated and blunt, with finger-like projections called spicules coming out of the surface of the RBCs. These abnormalities render RBCs non-functional, and left untreated, can lead to anemia in affected dogs. Metabolic anemia is normally due to an underlying disease of the kidney, liver, or spleen due to which the shape of red blood cells (RBCs) is changed. There are no specific symptoms related to metabolic anemia in dogs. However, the symptoms related to disease of kidney, liver, or spleen responsible for metabolic anemia may be present.