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Hall GBF, Birkbeck R, Brainard BM, Camacho F, Davidow EB, LeVine DN, Mackin A, Moss T, Nash KJ, Stanzani G, Starybrat D, Stoye DQ, Tai C, Thomason J, Walker JM, Wardrop KJ, Wilson H, Wurlod VA, Humm K. A prospective multicenter observational study assessing incidence and risk factors for acute blood transfusion reactions in dogs. J Vet Intern Med 2024. [PMID: 39239720 DOI: 10.1111/jvim.17175] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/29/2023] [Accepted: 08/01/2024] [Indexed: 09/07/2024] Open
Abstract
BACKGROUND Reported incidence of blood transfusion reactions (TR) varies greatly. OBJECTIVE To prospectively evaluate the incidence of acute TRs in dogs receiving allogenic blood products, using consensus definitions, and to assess factors associated with TRs. ANIMALS Dogs (n = 858) administered allogenic blood products (n = 1542) between March and November 2022. METHODS Prospective, multicenter surveillance study occurring in referral hospitals in the United States, United Kingdom, and Australia recording TRs in dogs administered blood products as defined by the consensus guidelines published by The Association of Veterinary Hematology and Transfusion Medicine in 2021. RESULTS The incidence of acute TR was 8.9% (95% CI 7.0-11.1) for packed red blood cells (pRBCs) and 4.5% (95% CI 2.9-6.6) for plasma products. The most frequently reported TRs were febrile nonhemolytic TRs (FNHTR; 4%, 95% CI 2.8-5.5) when administering pRBCs and allergic TRs (3.2%, 95% CI 1.80-5.10) when administering plasma products. A higher dose of pRBC (adjusted odds ratio [aOR] 1.04 [95% CI 1.00-1.08]) was associated with a higher odds of TR. Administration of pRBCs stored for longer than 28 days was associated with higher odds of FNHTR (aOR 4.10 [95% CI 1.58-10.65]) and acute hemolytic TR (AHTR; OR 15.2 [95% CI 3.35-68.70]) when compared with pRBCs stored for 14 days or fewer. Leukoreduction of pRBC was not associated with lower odds of developing a TR (OR 1.47 [95% CI 0.89-2.42]). CONCLUSIONS AND CLINICAL IMPORTANCE Clinicians should be mindful of the age and dose of pRBC prescribed to dogs.
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Affiliation(s)
- Georgina B F Hall
- Clinical Science and Services, The Royal Veterinary College, London, UK
| | | | - Benjamin M Brainard
- Department of Small Animal Medicine and Surgery, College of Veterinary Medicine, University of Georgia, Athens, Georgia, USA
| | | | | | - Dana N LeVine
- Department of Clinical Sciences, Auburn University College of Veterinary Medicine, Auburn, Alabama, USA
| | - Andrew Mackin
- College of Veterinary Medicine, Mississippi State University, Starkville, Mississippi, USA
| | - Taylor Moss
- Department of Clinical Sciences, Auburn University College of Veterinary Medicine, Auburn, Alabama, USA
| | - Katherine J Nash
- School of Veterinary Science, University of Queensland, Gatton, Queensland, Australia
| | | | - Daria Starybrat
- The Royal (Dick) School of Veterinary Studies, University of Edinburgh, Edinburgh, UK
| | | | - Carolyn Tai
- Cummings School of Veterinary Medicine, Tufts University, North Grafton, Massachusetts, USA
| | - John Thomason
- College of Veterinary Medicine, Mississippi State University, Starkville, Mississippi, USA
| | - Julie M Walker
- Department of Medical Sciences, University of Wisconsin-Madison School of Veterinary Medicine, Madison, Wisconsin, USA
| | - K Jane Wardrop
- College of Veterinary Medicine, Washington State University, Pullman, Washington, USA
| | - Helen Wilson
- Langford Vets, University of Bristol, Bristol, UK
| | - Virginie A Wurlod
- Louisiana State University School of Veterinary Medicine, Baton Rouge, Louisiana, USA
| | - Karen Humm
- Clinical Science and Services, The Royal Veterinary College, London, UK
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Anderson KL, Birkenheuer A, Moore GE, Kendall A. A retrospective study of vector borne disease prevalence among anemic dogs in North Carolina. PLoS One 2023; 18:e0293901. [PMID: 37939135 PMCID: PMC10631695 DOI: 10.1371/journal.pone.0293901] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/16/2023] [Accepted: 10/20/2023] [Indexed: 11/10/2023] Open
Abstract
BACKGROUND Anemia is an important cause of morbidity and mortality in dogs. Further understanding of the prevalence of vector borne diseases (VBD) in anemic dogs is needed. OBJECTIVES The objective of this retrospective study was to describe the rate of exposure to or infection with VBD among anemic dogs presented to a teaching hospital in North Carolina and to further characterize the anemia in dogs with VBD exposure. ANIMALS A total of 597 anemic dogs that were concurrently tested for VBD were examined at a referral veterinary hospital between January 2012 and December 2018. METHODS Retrospective descriptive study. Demographic, clinicopathologic, and VBD testing data were obtained from medical records. RESULTS Of the 597 anemic dogs examined, 180 (30.15%; 95% CI: 26.49-34.01%) tested positive for one or more VBD. There was no difference in the severity of anemia or the proportion of dogs displaying a regenerative anemia between dogs testing positive and negative for VBD. CONCLUSIONS A large proportion of anemic dogs from this region test positive for exposure to or infection with VBD. Our study supported the use of PCR and serology run in parallel to maximize the chance of detecting exposure to or infection with VBD compared to either serology or PCR alone. At this time, it is unknown whether infection with VBD contributed to the development of anemia in these patients. However, given the prevalence of VBD exposure in anemic dogs, testing for VBD in anemic patients from this region of the United States is warranted.
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Affiliation(s)
- Katie L. Anderson
- Department of Veterinary Clinical Sciences, NC State University College of Veterinary Medicine, Raleigh, NC, United States of America
| | - Adam Birkenheuer
- Department of Veterinary Clinical Sciences, NC State University College of Veterinary Medicine, Raleigh, NC, United States of America
| | - George E. Moore
- Department of Veterinary Administration, Purdue University College of Veterinary Medicine, West Lafayette, IN, United States of America
| | - Allison Kendall
- Department of Veterinary Clinical Sciences, NC State University College of Veterinary Medicine, Raleigh, NC, United States of America
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Steblaj B, Galli J, Torgerson P, Kutter A. Evaluation of leukocyte depletion of packed red blood cell units and impact on clinically observed transfusion reactions. Front Vet Sci 2023; 10:1217575. [PMID: 37841457 PMCID: PMC10568135 DOI: 10.3389/fvets.2023.1217575] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/21/2023] [Accepted: 08/29/2023] [Indexed: 10/17/2023] Open
Abstract
Introduction The aim of this retrospective study was to determine whether there is an association between leukoreduction of packed red blood cell (pRBC) units and reduction of clinically observed transfusion reactions (TR), particularly febrile non-haemolytic transfusion reactions (FNHTR), and better outcomes in dogs. Secondary aims were to evaluate the effects of other factors suspected to influence transfusion reaction frequency or survival, including crossmatching, use of immunosuppressive drugs, and age and number of the blood products being administered. Materials and methods Medical data on dogs transfused with leukocyte-reduced (LR) and non-leukocyte-reduced (N-LR) pRBC units at the Animal Hospital Zürich, University of Zürich, Switzerland between January 1, 2007, and December 17, 2018 were searched. Before 2014, only N-LR blood were transfused. After 2014, both LR and N-LR blood were available. Results A total of 339 canine patients were transfused with 413 pRBC units; 30.5% (126/413) were LR units and 69.5% (287/413) were N-LR. Data collected from medical records was analyzed using univariate and multivariate logistic regression. In the present study, TR occurred in 19.8% of pRBC units (25/126) with LR and in 17.7% (51/287) of pRBC with N-LR; p > 0.05. FNHTR occurred in 6.3% of pRBC units (8/126) with LR and in 4.5% (13/287) of those with N-LR; p > 0.05. There was no correlation between the occurrence of TR and discharge from hospital (p > 0.05). Crossmatching, immunosuppressive therapy, and age of the blood product were not associated with the frequency of TR; p > 0.05 for all. The duration of survival days was not related to the number of transfusions dogs received. Discussion In the present study, the leukocyte-depletion of transfused pRBC units was not associated with fewer TR nor to fewer FNHTR compared to N-LR units. Discharge of dogs from hospital was not dependent on the occurrence of TR.
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Affiliation(s)
- Barbara Steblaj
- Section of Anaesthesiology, Department of Clinical Diagnostics and Services, Vetsuisse Faculty, University of Zürich, Zürich, Switzerland
| | - Jasmin Galli
- Institute of Veterinary Anatomy, Vetsuisse Faculty, University of Zürich, Zürich, Switzerland
| | - Paul Torgerson
- Section of Epidemiology, Vetsuisse Faculty, University of Zürich, Zürich, Switzerland
| | - Annette Kutter
- Section of Anaesthesiology, Department of Clinical Diagnostics and Services, Vetsuisse Faculty, University of Zürich, Zürich, Switzerland
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Elkin M, Amichay-Menashe N, Segev G, Kelmer E, Adlersberg D, Aroch I, Klainbart S. Retrospective study of canine blood xenotransfusion compared with type-matched feline blood allotransfusion to cats: indications, effectiveness, limitations and adverse effects. J Feline Med Surg 2023; 25:1098612X231183930. [PMID: 37466270 PMCID: PMC10812059 DOI: 10.1177/1098612x231183930] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 07/20/2023]
Abstract
OBJECTIVES Xenotransfusion is the transfusion of blood from one species to another. With varying availability of allogenic feline blood (AFB) and in emergency conditions, circumstances occur when canine blood is transfused to cats. This study aimed to characterise the indications, effectiveness, limitations, and acute and late transfusion-related adverse effects of canine blood xenotransfusion compared with matched AFB to anaemic cats, and their survival and longer-term outcome. METHODS This retrospective study (2013-2020) examined cats receiving canine blood xenotransfusions or AFB. RESULTS The study included 311 cats (xenotransfusion [X-group], n = 105; allotransfusion [A-group], n = 206). Xenotransfusion was more frequent among cats sustaining haemorrhage than in those with haemolysis (P <0.01) or hypoproliferative anaemia (P <0.001). Financial constraints were the most common reason to elect xenotransfusion (49%). The post-transfusion mean packed cell volume was higher (P <0.001) in the X-group (22%) compared with the A-group (18%), and also higher (P <0.001) at 48-96 h post-transfusion (23% vs 18%, respectively). Transfusion-related adverse effects (TRAEs) were more frequent (P = 0.001) in the X-group (37.1%) compared with the A-group (19.4%), as were delayed haemolytic transfusion reactions (85% vs 42.5%, respectively; P <0.001). Acute transfusion reactions (ATRs) were more frequent (P <0.001) in the A-group (60%) compared with the X-group (20%). TRAEs were unassociated with survival to discharge. The survival to discharge rate of the X-group (55%) was lower (P = 0.007) than in the A-group (73%), while post-discharge survival rates to 30 days of cats surviving to discharge were 90% and 88%, respectively (P = 0.85). CONCLUSIONS AND RELEVANCE Canine blood xenotransfusions to cats might save lives in emergency conditions when AFB is unavailable or blood typing is infeasible. The survival to discharge rate of the X-group was lower than that of the A-group. The longer-term survival rate of cats administered xenotransfusions and surviving to discharge from the hospital was good.
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Affiliation(s)
- Maria Elkin
- Department of Small Animals Emergency and Critical Care, The Hebrew University Veterinary Teaching Hospital and Koret School of Veterinary Medicine, The Hebrew University of Jerusalem, Israel
| | - Noa Amichay-Menashe
- Department of Small Animals Emergency and Critical Care, The Hebrew University Veterinary Teaching Hospital and Koret School of Veterinary Medicine, The Hebrew University of Jerusalem, Israel
| | - Gilad Segev
- Department of Small Animal Internal Medicine, The Hebrew University Veterinary Teaching Hospital and Koret School of Veterinary Medicine, The Hebrew University of Jerusalem, Israel
| | - Efrat Kelmer
- Department of Small Animals Emergency and Critical Care, The Hebrew University Veterinary Teaching Hospital and Koret School of Veterinary Medicine, The Hebrew University of Jerusalem, Israel
| | - Dana Adlersberg
- Department of Small Animals Emergency and Critical Care, The Hebrew University Veterinary Teaching Hospital and Koret School of Veterinary Medicine, The Hebrew University of Jerusalem, Israel
| | - Itamar Aroch
- Department of Small Animal Internal Medicine, The Hebrew University Veterinary Teaching Hospital and Koret School of Veterinary Medicine, The Hebrew University of Jerusalem, Israel
| | - Sigal Klainbart
- Department of Small Animals Emergency and Critical Care, The Hebrew University Veterinary Teaching Hospital and Koret School of Veterinary Medicine, The Hebrew University of Jerusalem, Israel
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Tucker C, Winner A, Reeves R, Cooper ES, Hall K, Schildt J, Brown D, Guillaumin J. Resuscitation Patterns and Massive Transfusion for the Critical Bleeding Dog-A Multicentric Retrospective Study of 69 Cases (2007-2013). Front Vet Sci 2022; 8:788226. [PMID: 35071385 PMCID: PMC8766795 DOI: 10.3389/fvets.2021.788226] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/01/2021] [Accepted: 11/17/2021] [Indexed: 11/13/2022] Open
Abstract
Objective: To describe resuscitation patterns of critically bleeding dogs, including those receiving massive transfusion (MT). Design: Retrospective study from three universities (2007-2013). Animals: Critically bleeding dogs, defined as dogs who received ≥ 25 ml/kg of blood products for treatment of hemorrhagic shock caused by blood loss. Measurements and Main Results: Sixty-nine dogs were included. Sources of critical bleeding were trauma (26.1%), intra/perioperative surgical period (26.1%), miscellaneous (24.6%), and spontaneous hemoabdomen (23.1%). Median (range) age was 7 years (0.5-18). Median body weight was 20 kg (2.6-57). Median pre-transfusion hematocrit, total protein, systolic blood pressure, and lactate were 25% (10-63), 4.1 g/dl (2-7.1), 80 mm Hg (20-181), and 6.4 mmol/L (1.1-18.2), respectively. Median blood product volume administered was 44 ml/kg (25-137.4). Median plasma to red blood cell ratio was 0.8 (0-4), and median non-blood product resuscitation fluid to blood product ratio was 0.5 (0-3.6). MT was given to 47.8% of dogs. Survival rate was 40.6%. The estimated odds of survival were higher by a factor of 1.8 (95% CI: 1.174, 3.094) for a dog with 1 g/dl higher total protein above reference interval and were lower by a factor of 0.6 (95% CI: 0.340, 0.915) per 100% prolongation of partial thromboplastin time above the reference interval. No predictors of MT were identified. Conclusions: Critical bleeding in dogs was associated with a wide range of resuscitation patterns and carries a guarded to poor prognosis.
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Affiliation(s)
- Claire Tucker
- Department of Clinical Sciences, Colorado State University, Fort Collins, CO, United States.,TetraMed, Fort Collins, CO, United States
| | - Anna Winner
- Department of Clinical Sciences, Colorado State University, Fort Collins, CO, United States
| | - Ryan Reeves
- Department of Clinical Sciences, Colorado State University, Fort Collins, CO, United States
| | - Edward S Cooper
- Department of Clinical Sciences, The Ohio State University, Columbus, OH, United States
| | - Kelly Hall
- Department of Clinical Sciences, Colorado State University, Fort Collins, CO, United States.,TetraMed, Fort Collins, CO, United States
| | - Julie Schildt
- Department of Clinical Sciences, The University of Tennessee, Knoxville, Knoxville, TN, United States
| | - David Brown
- Department of Statistics, Colorado State University, Fort Collins, CO, United States
| | - Julien Guillaumin
- Department of Clinical Sciences, Colorado State University, Fort Collins, CO, United States.,TetraMed, Fort Collins, CO, United States
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6
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Frank MJ, Khattab MR, Wills RW, Archer TM, Mackin AJ, Suchodolski JS, Lidbury JA, Steiner JM, Sullivant AM, Thomason JM. Effects of leukoreduction on N-methylhistamine concentration in stored units of canine whole blood. Am J Vet Res 2021; 82:890-896. [PMID: 34669495 DOI: 10.2460/ajvr.82.11.890] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022]
Abstract
OBJECTIVE To determine the effects of leukoreduction on N-methylhistamine (NMH; a stable histamine metabolite) concentration in units of canine whole blood during storage and incubation at room temperature (approx 22 °C) to simulate temperature conditions during transfusion. ANIMALS 8 healthy adult Walker Hounds. PROCEDURES A standard unit of blood (450 mL) was obtained from each dog twice, with at least 28 days between donations. Blood units collected from 4 dogs during the first donation underwent leukoreduction, whereas the blood units collected from the other 4 dogs did not undergo leukoreduction, prior to storage at 4 °C. The alternate treatment was applied to blood units collected during the second donation. A sample from each unit was obtained for determination of plasma NMH concentration the day of donation (before and after leukoreduction when applicable) and before and after incubation at room temperature for 5 hours on days 14 and 28 of storage. RESULTS Units that underwent leukoreduction had substantially lower leukocyte and platelet counts than nonleukoreduced units. Plasma NMH concentration increased immediately after leukoreduction but did not change significantly during the subsequent 28 days of storage, nor did it differ between units that did and did not undergo leukoreduction. CONCLUSIONS AND CLINICAL RELEVANCE Leukoreduction and simulated transfusion temperature did not affect the histamine load in units of canine whole blood during the first 28 days of storage. Further research is necessary to determine whether histamine contributes to the development and severity of blood transfusion reactions in dogs.
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Affiliation(s)
- Mariah J Frank
- From the Atlantic Veterinary Internal Medicine and Oncology Hospital, Towson, MD 21286
| | - Mohammad R Khattab
- Gastrointestinal Laboratory, Department of Small Animal Clinical Sciences, College of Veterinary Medicine and Biomedical Sciences, Texas A&M University, College Station, TX 77843
| | - Robert W Wills
- Departments of Comparative Biomedical Sciences and Clinical Sciences, College of Veterinary Medicine, Mississippi State University, Mississippi State, MS 39762
| | - Todd M Archer
- Departments of Comparative Biomedical Sciences and Clinical Sciences, College of Veterinary Medicine, Mississippi State University, Mississippi State, MS 39762
| | - Andrew J Mackin
- Departments of Comparative Biomedical Sciences and Clinical Sciences, College of Veterinary Medicine, Mississippi State University, Mississippi State, MS 39762
| | - Jan S Suchodolski
- Gastrointestinal Laboratory, Department of Small Animal Clinical Sciences, College of Veterinary Medicine and Biomedical Sciences, Texas A&M University, College Station, TX 77843
| | - Jonathan A Lidbury
- Gastrointestinal Laboratory, Department of Small Animal Clinical Sciences, College of Veterinary Medicine and Biomedical Sciences, Texas A&M University, College Station, TX 77843
| | - Joerg M Steiner
- Gastrointestinal Laboratory, Department of Small Animal Clinical Sciences, College of Veterinary Medicine and Biomedical Sciences, Texas A&M University, College Station, TX 77843
| | - Alyssa M Sullivant
- Departments of Comparative Biomedical Sciences and Clinical Sciences, College of Veterinary Medicine, Mississippi State University, Mississippi State, MS 39762
| | - John M Thomason
- Departments of Comparative Biomedical Sciences and Clinical Sciences, College of Veterinary Medicine, Mississippi State University, Mississippi State, MS 39762
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Davidow EB, Blois SL, Goy-Thollot I, Harris L, Humm K, Musulin S, Nash KJ, Odunayo A, Sharp CR, Spada E, Thomason J, Walton J, Wardrop KJ. Association of Veterinary Hematology and Transfusion Medicine (AVHTM) Transfusion Reaction Small Animal Consensus Statement (TRACS). Part 1: Definitions and clinical signs. J Vet Emerg Crit Care (San Antonio) 2021; 31:141-166. [PMID: 33792171 DOI: 10.1111/vec.13044] [Citation(s) in RCA: 10] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/28/2020] [Accepted: 02/06/2021] [Indexed: 12/11/2022]
Abstract
OBJECTIVE To use a systematic, evidence-based consensus process to develop definitions for transfusion reactions in dogs and cats. DESIGN Evidence evaluation of the literature was carried out for identified transfusion reaction types in dogs and cats. Reaction definitions were generated based on synthesis of human and veterinary literature. Consensus on the definitions was achieved through Delphi-style surveys. Draft recommendations were made available through industry specialty listservs and comments were incorporated. RESULTS Definitions with imputability criteria were developed for 14 types of transfusion reactions. CONCLUSIONS The evidence review and consensus process resulted in definitions that can be used to facilitate future veterinary transfusion reaction research.
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Affiliation(s)
| | - Shauna L Blois
- Department of Clinical Studies, Ontario Veterinary College, University of Guelph, Canada
| | | | | | - Karen Humm
- Department of Clinical Science and Services, The Royal Veterinary College, London, UK
| | - Sarah Musulin
- College of Veterinary Medicine, North Carolina State University, Raleigh, NC, USA
| | - Katherine J Nash
- VetMED Emergency and Specialty Veterinary Hospital, Phoenix, AZ, USA
| | - Adesola Odunayo
- Department of Small Animal Clinical Sciences, University of Tennessee, Knoxville, TN, USA
| | - Claire R Sharp
- School of Veterinary Medicine, Murdoch University, Perth, Australia
| | - Eva Spada
- Department of Veterinary Medicine, University of Milan, Lodi, Italy
| | - John Thomason
- Department of Clinical Sciences, Mississippi State University, Mississippi State, MS, USA
| | | | - K Jane Wardrop
- Veterinary Clinical Sciences, Washington State University, Pullman, WA, USA
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Sharma S, Boston SE, Kotlowski J, Boylan M. Preoperative autologous blood donation and transfusion in dogs undergoing elective surgical oncology procedures with high risk of hemorrhage. Vet Surg 2021; 50:607-614. [PMID: 33634898 DOI: 10.1111/vsu.13598] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/06/2020] [Revised: 12/23/2020] [Accepted: 12/29/2020] [Indexed: 11/30/2022]
Abstract
OBJECTIVE To describe preoperative autologous blood donation (PABD) and transfusion in dogs undergoing elective surgical oncology procedures with a high risk of intraoperative hemorrhage. STUDY DESIGN Prospective study. ANIMALS Twelve dogs. METHODS Dogs undergoing surgical oncology procedures associated with a high risk of hemorrhage were enrolled. Blood was collected a minimum of 6 days before surgery and separated into fresh frozen plasma (FFP) and packed red blood cells (pRBC). Dogs received FFP at the start of surgery and pRBC intraoperatively when hemorrhage ensued. The mean packed cell volume/total solids (PCV/TS) were calculated on the day of PABD preoperatively, immediately postoperatively, and 24 hours after transfusion. The dogs were monitored for transfusion-related adverse reactions, including hyperthermia, hypotension, tachycardia, bradycardia, pale mucous membranes, prolonged capillary refill time, or tachypnea/dyspnea. RESULTS Dogs enrolled in the study underwent mandibulectomy, maxillectomy, chest wall resection, and liver lobectomy. Ten of the 12 dogs that underwent PABD received autologous transfusion at first signs of hemorrhage intraoperatively. Iatrogenic anemia was noted in two dogs (PCV 30% and 31%). The mean PCV/TS levels on the day of blood collection, preoperatively, immediately postoperatively (after transfusion), and 24 hours posttransfusion were 45.1%/7.1 g/dL, 42.2%/6.73 g/dL, 33.2%/5.42 g/dL, and 36.5%/5.65 g/dL, respectively. No dog developed transfusion-related complications. CONCLUSION Preoperative autologous blood donation was well tolerated and led to uneventful autologous transfusion in 10 of 12 dogs. CLINICAL SIGNIFICANCE Preoperative autologous blood donation and autologous transfusion are feasible for dogs undergoing elective surgical procedures with a high risk of hemorrhage.
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Affiliation(s)
- Surabhi Sharma
- Surgical Oncology, VCA 404 Veterinary Emergency and Referral Hospital, Ontario, Canada
| | - Sarah E Boston
- Surgical Oncology, VCA 404 Veterinary Emergency and Referral Hospital, Ontario, Canada
| | - Jerzy Kotlowski
- Surgical Oncology, VCA 404 Veterinary Emergency and Referral Hospital, Ontario, Canada
| | - Matthew Boylan
- Surgical Oncology, VCA 404 Veterinary Emergency and Referral Hospital, Ontario, Canada
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Marshall H, Blois SL, Abrams-Ogg ACG, Bersenas AM, Ruotsalo K, Monteith G. Accuracy of point-of-care crossmatching methods and crossmatch incompatibility in critically ill dogs. J Vet Intern Med 2020; 35:245-251. [PMID: 33336866 PMCID: PMC7848312 DOI: 10.1111/jvim.15983] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/30/2020] [Revised: 11/19/2020] [Accepted: 11/20/2020] [Indexed: 02/02/2023] Open
Abstract
BACKGROUND The performance of commercial point-of-care crossmatch (CM) tests compared to laboratory tube agglutination CM is unknown. Additionally, there is limited information regarding CM incompatibility in ill dogs. OBJECTIVES To determine if point-of-care major CM methods are accurate in detecting compatible and incompatible tests when compared to laboratory CM methods, and to identify factors associated with CM incompatibility in dogs. ANIMALS Part 1 (prospective) included 63 client-owned dogs potentially requiring blood transfusion. Part 2 (retrospective) included all dogs from part 1, plus medical records of 141 dogs with major CM results. METHODS For part 1, major CM was performed using a tube agglutination assay (LAB-CM), a gel-based point-of-care test (GEL-CM), and an immunochromatographic point-of-care test (IC-CM). For part 2, medical record data were collected to determine rates of and risk factors for CM incompatibility. RESULTS Kappa agreement between the LAB-CM and GEL-CM methods could not be calculated due to a relative lack of incompatible results. Kappa agreement between the LAB-CM and IC-CM methods was 0.16 (95% confidence interval [CI] = 0-0.31, P = .007) indicating no agreement. The LAB-CM incompatibility in transfusion-naïve vs dogs that had a transfusion was 25% and 35%, (P = .3). CONCLUSIONS AND CLINICAL IMPORTANCE Compared to laboratory methods, point-of-care methods evaluated in our study lacked sensitivity for detecting incompatibilities. Dogs had similar rates of major CM incompatibility regardless of transfusion history. This suggests CM testing prior to transfusion be considered in all dogs however our study did not investigate clinical relevancy of incompatible LAB-CM.
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Affiliation(s)
- Hayden Marshall
- Department of Clinical Studies, University of Guelph, Guelph, Ontario, Canada
| | - Shauna L Blois
- Department of Clinical Studies, University of Guelph, Guelph, Ontario, Canada
| | | | - Alexa M Bersenas
- Department of Clinical Studies, University of Guelph, Guelph, Ontario, Canada
| | | | - Gabrielle Monteith
- Department of Clinical Studies, University of Guelph, Guelph, Ontario, Canada
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10
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Morris JL, Bloch CP, Brabson TL. The effect of time on packed cell volume following packed red blood cell transfusion in anemic dogs. J Vet Emerg Crit Care (San Antonio) 2020; 31:215-220. [PMID: 33118669 DOI: 10.1111/vec.13027] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/05/2018] [Revised: 04/05/2019] [Accepted: 05/28/2019] [Indexed: 11/30/2022]
Abstract
OBJECTIVE To compare the PCV at several timepoints following packed red blood cell (pRBC) administration to anemic dogs and to assess if underlying cause of anemia or regenerative status significantly affects these measurements. DESIGN Prospective, observational study from November 2016 to October 2017. SETTING A small animal emergency and specialty hospital. ANIMALS Forty-six anemic client-owned dogs that received a total of 50 pRBC transfusions for management of anemia. INTERVENTIONS Blood was collected, and a PCV was obtained prior to pRBC transfusion (T0), immediately after (T1), 30 minutes after (T2), 1 hour after (T3), 2 hours after (T4), and 4 hours after (T5) the transfusion. Underlying causes of anemia were classified as hemorrhage, hemolysis, and ineffective erythropoiesis. Dogs were also categorized in regard to regenerative status of anemia and the presence or absence of expected continued blood loss or destruction. MEASUREMENTS AND MAIN RESULTS The mean PCV at T0 was 0.15 L/L (15%). After administration of a pRBC transfusion, the mean PCV at T1 was 0.28 L/L (28%). For all other timepoints (T2, T3, T4, and T5), the mean PCV was 0.27 L/L (27%). The PCV did not change significantly over time post-transfusion (P = 0.184), and no pairwise combinations of times differed significantly (paired t-tests; P > 0.05 for all). When dogs were categorized via regeneration status and continued blood loss or hemolysis, results were consistent. CONCLUSIONS There was no significant change in PCV from the value obtained immediately after pRBC transfusion up to 4 hours post-transfusion in dogs with several different causes of anemia. These results suggest that obtaining a PCV immediately after administering a pRBC transfusion to an anemic dog may be just as reliable as obtaining a measurement 2 hours after the transfusion. This remains true for dogs with expected continued red blood cell loss or destruction.
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Affiliation(s)
| | - Christopher P Bloch
- Department of Biological Sciences, Bridgewater State University, Bridgewater, Massachusetts
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Martinez-Sogues L, Blois SL, Manzanilla EG, Abrams-Ogg AO, Cosentino P. Exploration of risk factors for non-survival and for transfusion-associated complications in cats receiving red cell transfusions: 450 cases (2009 to 2017). J Small Anim Pract 2020; 61:177-184. [PMID: 32115722 DOI: 10.1111/jsap.13108] [Citation(s) in RCA: 9] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/22/2019] [Revised: 11/20/2019] [Accepted: 12/15/2019] [Indexed: 12/20/2022]
Abstract
OBJECTIVES To describe red blood cell transfusion practices and short-term outcomes in anaemic cats. To determine clinical variables associated with non-survival and transfusion-related complications. MATERIAL AND METHODS In this retrospective study, blood bank records from the Ontario Veterinary College Health Science Centre (OVC-HSC) were reviewed to identify cats that received packed red blood cells or whole blood from 2009 to 2017. We extracted cause of anaemia, history of previous transfusion, pre- and post-transfusion packed cell volume, pre-transfusion compatibility testing, volume and dose of blood product, age of red blood cell unit, transfusion-associated complications and patient survival. RESULTS A total of 450 transfusion events were recorded in 267 cats. Blood loss was the most common indication for blood transfusion (44.9%), followed by ineffective erythropoiesis (37.5%) and red blood cell destruction (22.5%). Transfusion-associated complications occurred in 10.2% events and there was a 20.2% mortality after transfusion. Mean increase in packed cell volume 24-hours after transfusion was greater in cats undergoing major cross-match testing before transfusion (7.2%) versus those that did not (4.0%). Non-survival was associated with higher packed cell volume before transfusion, low patient body temperature before transfusion, anaemia due to blood loss and number of transfusions administered. Older age of transfused blood units was associated with non-survival and transfusion-related complications. CLINICAL IMPORTANCE This study was observational and so our analyses were exploratory, but suggest that major cross-match before transfusion tended to have greater transfusion efficacy and transfusion of older blood products might have detrimental effects on survival.
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Affiliation(s)
- L Martinez-Sogues
- Departament de Medicina i Cirurgia Animals, Facultat de Veterinària, Universitat Autònoma de Barcelona, Barcelona, Spain.,Hospital Clínic Veterinari (HCV), Universitat Autònoma de Barcelona, Barcelona, Spain
| | - S L Blois
- Department of Clinical Studies, Ontario Veterinary College, University of Guelph, Guelph, ON, Canada
| | - E G Manzanilla
- Teagasc Animal and Grassland Research and Innovation Centre, Mooreaprk, Cork, Ireland.,School of Veterinary Medicine, University College Dublin, Dublin, Ireland
| | - A O Abrams-Ogg
- Department of Clinical Studies, Ontario Veterinary College, University of Guelph, Guelph, ON, Canada
| | - P Cosentino
- Department of Clinical Studies, Ontario Veterinary College, University of Guelph, Guelph, ON, Canada
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12
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Foote ML, Brooks MB, Archer TM, Wills RW, Mackin AJ, Thomason JM. Coagulation factor activity in units of leukoreduced and nonleukoreduced canine fresh-frozen plasma. Am J Vet Res 2019; 80:846-851. [PMID: 31449444 DOI: 10.2460/ajvr.80.9.846] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022]
Abstract
OBJECTIVE To evaluate coagulation factors in units of leukoreduced (LR) and nonleukoreduced (non-LR) canine fresh-frozen plasma (cFFP). ANIMALS 8 healthy research dogs. PROCEDURES In a crossover study, dogs were randomly assigned to 1 of 2 groups from which blood was collected and either did or did not undergo leukoreduction. After a recovery period of ≥ 28 days, the dogs were switched between protocols. After each collection, blood samples were centrifuged, and cFFP was stored frozen for later comparative analysis of coagulation factors, antithrombin, and protein C activities (reported as comparative percentages of the corresponding activities determined in a canine pooled plasma standard); prothrombin and activated partial thromboplastin times; and fibrinogen concentration. RESULTS There were no significant differences detected between results for LR cFFP, compared with those for non-LR cFFP. CONCLUSIONS AND CLINICAL RELEVANCE Although there was variation among residual activities of coagulation factors in LR and non-LR cFFP, the variations and differences were considered unlikely to impact the efficacy of LR cFFP transfused for coagulation factor replacement in dogs. However, owing to the small sample size and high variability of results in the present study, additional research with a larger sample size is required for definitive conclusions on the effects of leukoreduction on coagulation factors in cFFP and to develop treatment guidelines for LR cFFP use in dogs with congenital and acquired coagulopathies.
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13
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Bosch Lozano L, Blois SL, Wood RD, Abrams-Ogg ACG, Bersenas AM, Bateman SW, Richardson DM. A pilot study evaluating the effects of prestorage leukoreduction on markers of inflammation in critically ill dogs receiving a blood transfusion. J Vet Emerg Crit Care (San Antonio) 2019; 29:385-390. [PMID: 31218809 DOI: 10.1111/vec.12857] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/09/2017] [Revised: 06/22/2017] [Accepted: 07/01/2017] [Indexed: 11/27/2022]
Abstract
OBJECTIVES To compare markers of inflammation after transfusion of leukoreduced (LR) packed RBCs (pRBCs) versus non-LR pRBCs in dogs with critical illness requiring blood transfusion, and to report survival to discharge and rates of transfusion reactions in these dogs. DESIGN Prospective randomized blinded clinical study June 2014-September 2015. SETTING University veterinary teaching hospital. ANIMALS Twenty-three client-owned critically ill dogs, consecutively enrolled. INTERVENTIONS Dogs requiring a single pRBC transfusion were randomized into the LR or non-LR pRBC group. Exclusion criteria included: requirement for multiple blood products, history of previous blood transfusion, and administration of anti-inflammatory or immunosuppressive medication prior to enrollment. MEASUREMENTS Blood samples were obtained immediately prior to transfusion, then 2 and 24 hours following transfusion. Parameters measured at each time point included: PCV, WBC count, segmented and band neutrophil counts, fibrinogen, and plasma lactate and C-reactive protein concentrations. Acute patient physiologic and laboratory evaluation fast score was calculated on admission. RESULTS Eleven dogs were included in the LR group and 12 in the non-LR group; scores of illness severity were not significantly different between groups. Total WBC count was significantly higher in the non-LR versus LR group 24 hours following pRBC transfusion, but this difference was not evident 2 hours following transfusion. No other inflammatory parameters at any time point were significantly different between LR versus non-LR pRBC transfused dogs. Survival rates to discharge for LR and non-LR groups were 8/11 and 9/12, respectively. Acute transfusion reactions were identified in 1/11 and 2/12 dogs in the LR and non-LR group, respectively. All transfused blood was stored ≤12 days. CONCLUSIONS Most markers of inflammation did not significantly increase following transfusion of LR versus non-LR pRBCs stored ≤12 days in ill dogs. Further prospective, randomized trials are needed in clinically ill dogs to determine the benefit of prestorage leukoreduction.
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Affiliation(s)
- Luis Bosch Lozano
- Department of Clinical Studies, Ontario Veterinary College, University of Guelph, Ontario, Canada
| | - Shauna L Blois
- Department of Pathobiology, Ontario Veterinary College, University of Guelph, Ontario, Canada
| | - R Darren Wood
- Department of Pathobiology, Ontario Veterinary College, University of Guelph, Ontario, Canada
| | - Anthony C G Abrams-Ogg
- Department of Clinical Studies, Ontario Veterinary College, University of Guelph, Ontario, Canada
| | - Alexa M Bersenas
- Department of Clinical Studies, Ontario Veterinary College, University of Guelph, Ontario, Canada
| | - Shane W Bateman
- Department of Clinical Studies, Ontario Veterinary College, University of Guelph, Ontario, Canada
| | - Danielle M Richardson
- Department of Clinical Studies, Ontario Veterinary College, University of Guelph, Ontario, Canada
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14
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Hughes J, Raszplewicz J. Phenylephrine use for blood sparing during splenectomy in a dog. VETERINARY RECORD CASE REPORTS 2018. [DOI: 10.1136/vetreccr-2018-000640] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022]
Abstract
A dog with immune-mediated haemolytic anaemia was presented for splenectomy. Phenylephrine administration immediately before the removal of the spleen induced splenic contraction and significantly elevated packed cell volume. This technique conserved red blood cells and may be beneficial in euvolaemic animals to reduce the likelihood of a transfusion being required in the event of surgical haemorrhage.
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15
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Bouzouraa T, Cadore JL, Chene J, Goy-Thollot I, Ponce F, Chalvet-Monfray K, Rannou B, Chabanne L. Implication, clinical and biological impact of vector-borne haemopathogens in anaemic dogs in France: a prospective study. J Small Anim Pract 2017; 58:510-518. [PMID: 28543264 DOI: 10.1111/jsap.12690] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/12/2016] [Revised: 03/29/2017] [Accepted: 03/29/2017] [Indexed: 11/30/2022]
Abstract
OBJECTIVES To prospectively describe the clinical and biological impact of vector-borne haemopathogens in anaemic dogs in France and occurrence of haemolysis. MATERIALS AND METHODS This prospective descriptive cohort study includes 134 client-owned dogs that were anaemic on admission at the Veterinary Teaching Hospital of VetAgro Sup, Lyon, France. They underwent comprehensive screening with PCR to detect a panel of vector-borne haemopathogens, SNAP Leishmania and SNAP 4Dx Plus (IDEXX). RESULTS Vector-borne haemopathogen-associated anaemia accounted for 17·2% (23/134) of anaemic cases. PCR for Babesia species, Mycoplasma species, Anaplasma platys or Ehrlichia canis and positive serology for Leishmania species, occurred in 11/23, 10/23, 2/23, 1/23 and 1/23 cases, respectively. Two dogs had positive PCR for both Babesia and Mycoplasma species. All dogs infected with Mycoplasma species alone had neoplastic disease. Vector-borne haemopathogens were the second most common cause of haemolysis (7/23, 30·4%). In the multivariable regression model, males were overrepresented ( OR : 2·82, P=0·03) and haemolysis ( OR : 3·31, P=0·01) was more frequent in dogs with vector-born haemopathogen-associated anaemia. CLINICAL SIGNIFICANCE Vector-borne haemopathogens are a common cause of anaemia in this geographical region.
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Affiliation(s)
- T Bouzouraa
- Department of Companion Animal, Internal Medicine Unit, Université de Lyon, VetAgro Sup - Campus Vétérinaire, 1 avenue Bourgelat, 69280, Marcy l'Etoile, France
| | - J L Cadore
- Department of Companion Animal, Internal Medicine Unit, Université de Lyon, VetAgro Sup - Campus Vétérinaire, 1 avenue Bourgelat, 69280, Marcy l'Etoile, France
| | - J Chene
- Laboratory of Parasitology, Université de Lyon, VetAgro Sup - Campus Vétérinaire, 1 avenue Bourgelat, 69280, Marcy l'Etoile, France
| | - I Goy-Thollot
- Intensive Care Unit (SIAMU), Université de Lyon, VetAgro Sup - Campus Vétérinaire, 1 avenue Bourgelat, 69280, Marcy l'Etoile, France
| | - F Ponce
- Oncology Unit, Université de Lyon, VetAgro Sup - Campus Vétérinaire, 1 avenue Bourgelat, 69280, Marcy l'Etoile, France
| | - K Chalvet-Monfray
- Department of Biostatistics, Université de Lyon, VetAgro Sup - Campus Vétérinaire, 1 avenue Bourgelat, 69280, Marcy l'Etoile, France.,Unité d'Épidémiologie Animale (EpiA, UR 0346), INRA Auvergne-Rhône-Alpes, Route de Theix, 63122, Saint Genès Champanelle, France
| | - B Rannou
- Laboratory of Clinical Pathology, Université de Lyon, VetAgro Sup - Campus Vétérinaire, 1 avenue Bourgelat, 69280, Marcy l'Etoile, France
| | - L Chabanne
- Unité d'Épidémiologie Animale (EpiA, UR 0346), INRA Auvergne-Rhône-Alpes, Route de Theix, 63122, Saint Genès Champanelle, France
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Langston C, Cook A, Eatroff A, Mitelberg E, Chalhoub S. Blood Transfusions in Dogs and Cats Receiving Hemodialysis: 230 Cases (June 1997-September 2012). J Vet Intern Med 2017; 31:402-409. [PMID: 28198040 PMCID: PMC5354009 DOI: 10.1111/jvim.14658] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/13/2016] [Revised: 10/06/2016] [Accepted: 12/20/2016] [Indexed: 12/01/2022] Open
Abstract
Background Multiple factors exist that contribute to anemia in dogs and cats receiving hemodialysis, can necessitate transfusion. Objectives To describe blood product usage in dogs and cats with acute and chronic kidney disease that were treated with intermittent hemodialysis to determine risk factors associated with the requirement for blood product transfusion. Animals 83 cats and 147 dogs undergoing renal replacement therapy at the Animal Medical Center for acute or chronic kidney disease. Methods Retrospective medical record review of all dogs and cats receiving renal replacement therapy for kidney disease, from June 1997 through September 2012. Results Blood products (whole blood, packed RBCs, or stromal‐free hemoglobin) were administered to 87% of cats and 32% of dogs. The number of dialysis treatments was associated with the requirement for transfusion in cats (adjusted OR 2.21, 95% CI 1.13, 4.32), but not in dogs (adjusted OR 0.98, 95% CI 0.95, 1.03). Administration of a blood product was associated with a higher likelihood of death in dogs (OR 3.198, 95% CI 1.352, 7.565; P = .0098), but not in cats (OR 1.527, 95% CI 0.5404, 4.317, P = .2). Conclusions and Clinical Importance Veterinary hospitals with a hemodialysis unit should have reliable and rapid access to safe blood products in order to meet the needs of dogs and cats receiving dialysis.
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Affiliation(s)
- C Langston
- The Ohio State University College of Veterinary Medicine, Columbus, OH
| | - A Cook
- Veterinary Referral and Emergency Group, Brooklyn, NY
| | - A Eatroff
- ACCESS Specialty Animal Hospitals, Culver City, CA
| | - E Mitelberg
- Austin Veterinary Emergency and Specialty Center, Austin, TX
| | - S Chalhoub
- University of Calgary Faculty of Veterinary Medicine, Calgary, AB, Canada
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17
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Odunayo A, Garraway K, Rohrbach BW, Rainey A, Stokes J. Incidence of incompatible crossmatch results in dogs admitted to a veterinary teaching hospital with no history of prior red blood cell transfusion. J Am Vet Med Assoc 2017; 250:303-308. [DOI: 10.2460/javma.250.3.303] [Citation(s) in RCA: 15] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022]
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18
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Blake RR, Lee JH, Ross MK, Archer TM, Wills RW, Mackin AJ, Thomason JM. Evaluation of eicosanoid concentrations in stored units of canine packed red blood cells. J Am Vet Med Assoc 2017; 250:191-198. [PMID: 28058946 DOI: 10.2460/javma.250.2.191] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022]
Abstract
OBJECTIVE To evaluate eicosanoid concentrations in freshly prepared canine packed RBCs (PRBCs) and to assess changes in eicosanoid concentrations in PRBC units over time during storage and under transfusion conditions. DESIGN Prospective study. SAMPLE 25 plasma samples from 14 healthy Greyhounds. PROCEDURES Plasma samples were obtained during PRBC preparation (donation samples), and the PRBC units were then stored at 4°C until used for transfusion (≤ 21 days later; n = 17) or mock transfusion if expired (22 to 24 days later; 8). Immediately prior to use, 100 mL of saline (0.9% NaCl) solution was added to each unit and a pretransfusion sample was collected. A posttransfusion sample was collected after transfusion or mock transfusion. Concentrations of arachidonic acid, prostaglandin (PG) F2α, PGE2, PGD2, thromboxane B2, 6-keto-PGF1α, and leukotriene B4 were measured by liquid chromatography-mass spectrometry and analyzed statistically. RESULTS Median arachidonic acid concentration was significantly decreased in posttransfusion samples, compared with the concentration in donation samples. Median PGF2α, 6-keto-PGF1α, and leukotriene B4 concentrations were significantly increased in pretransfusion samples, compared with those in donation samples. Median PGF2α, thromboxane B2, and 6-keto-PGF1α concentrations were significantly increased in posttransfusion samples, compared with those in pretransfusion samples. Duration of PRBC storage had significant associations with pretransfusion and posttransfusion arachidonic acid and thromboxane B2 concentrations. CONCLUSIONS AND CLINICAL RELEVANCE Concentrations of several proinflammatory eicosanoids increased in PRBC units during storage, transfusion, or both. Accumulation of these products could potentially contribute to adverse transfusion reactions, and investigation of the potential association between eicosanoid concentrations in PRBCs and the incidence of transfusion reactions in dogs is warranted.
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19
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Miglio A, Stefanetti V, Antognoni MT, Cappelli K, Capomaccio S, Coletti M, Passamonti F. Stored Canine Whole Blood Units: What is the Real Risk of Bacterial Contamination? J Vet Intern Med 2016; 30:1830-1837. [PMID: 27734567 PMCID: PMC5115181 DOI: 10.1111/jvim.14593] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/03/2016] [Revised: 08/16/2016] [Accepted: 09/07/2016] [Indexed: 12/20/2022] Open
Abstract
Background Bacterial contamination of whole blood (WB) units can result in transfusion‐transmitted infection, but the extent of the risk has not been established and may be underestimated in veterinary medicine. Objectives To detect, quantify, and identify bacterial microorganisms in 49 canine WB units during their shelf life. Animals Forty‐nine healthy adult dogs. Methods Forty‐nine WB units were included in the study. Immediately after collection, 8 sterile samples from the tube segment line of each unit were aseptically collected and tested for bacterial contamination on days 0, 1, 7, 14, 21, 28, 35, and 42 of storage. A qPCR assay was performed on days 0, 21, and 35 to identify and quantify any bacterial DNA. Results On bacterial culture, 47/49 blood units were negative at all time points tested, 1 unit was positive for Enterococcus spp. on days 0 and 1, and 1 was positive for Escherichia coli on day 35. On qPCR assay, 26 of 49 blood units were positive on at least 1 time point and the bacterial loads of the sequences detected (Propionobacterium spp., Corynebacterium spp., Caulobacter spp., Pseudomonas spp., Enterococcus spp., Serratia spp., and Leucobacter spp.) were <80 genome equivalents (GE)/μL. Conclusions and Clinical Importance Most of the organisms detected were common bacteria, not usually implicated in septic transfusion reactions. The very low number of GE detected constitutes an acceptable risk of bacterial contamination, indicating that WB units have a good sanitary shelf life during commercial storage.
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Affiliation(s)
- A Miglio
- Department of Veterinary Medicine, University of Perugia, Perugia, Italy
| | - V Stefanetti
- Department of Veterinary Medicine, University of Perugia, Perugia, Italy
| | - M T Antognoni
- Department of Veterinary Medicine, University of Perugia, Perugia, Italy
| | - K Cappelli
- Department of Veterinary Medicine, University of Perugia, Perugia, Italy
| | - S Capomaccio
- Department of Veterinary Medicine, University of Perugia, Perugia, Italy
| | - M Coletti
- Department of Veterinary Medicine, University of Perugia, Perugia, Italy
| | - F Passamonti
- Department of Veterinary Medicine, University of Perugia, Perugia, Italy
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20
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Maglaras CH, Koenig A, Bedard DL, Brainard BM. Retrospective evaluation of the effect of red blood cell product age on occurrence of acute transfusion-related complications in dogs: 210 cases (2010-2012). J Vet Emerg Crit Care (San Antonio) 2016; 27:108-120. [PMID: 27669368 DOI: 10.1111/vec.12530] [Citation(s) in RCA: 25] [Impact Index Per Article: 3.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/09/2014] [Revised: 02/08/2015] [Accepted: 03/17/2015] [Indexed: 12/11/2022]
Abstract
OBJECTIVE To determine whether red blood cell (RBC) product age influences the occurrence of acute transfusion-related complications and mortality in dogs. The hypothesis was that acute transfusion-related complications and mortality would increase with age of product. DESIGN Retrospective study (2010-2012). SETTING University teaching hospital. ANIMALS Two hundred and ten clinical canine patients. INTERVENTIONS None. MEASUREMENTS AND MAIN RESULTS Medical records were reviewed for dogs receiving RBC-containing products. Patient signalment; reason for transfusion; product type, dose, age, and source; pretransfusion compatibility; rate, route, and method of administration; administration of multiple transfusions; underlying disease; occurrence of transfusion-related complications (eg, fever, hemolysis, gastrointestinal distress, cardiovascular, neurologic, and respiratory complications); various hematologic parameters; and survival were recorded. Data were analyzed for association between potential risk factors and occurrence of transfusion-related complications as well as between transfusion-related complications and survival. Of 333 transfusion events in 210 patients, 84 transfusion-related complications occurred. Fever was most common (41/333), followed by hemolysis (21/333). For every additional day of product age, the odds of hemolysis increased significantly (odds ratio, 1.11; 95% confidence interval, 1.06-1.16; P < 0.0001). Transfusion-related complications when considered as a whole were associated with higher dose of product, longer duration of administration per transfusion event, and immune-mediated disease, but not with source of product or general category of anemia. Administration rate was significantly slower in patients with febrile transfusion-related complications (P < 0.0001). Product age was not associated with increased mortality. CONCLUSIONS Age of stored RBC products is associated with increased risk of transfusion-related hemolysis, but not with fever. Prospective clinical studies evaluating the influence of storage duration on development of in vitro versus in vivo hemolysis are warranted.
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Affiliation(s)
- Christina H Maglaras
- Department of Small Animal Medicine and Surgery, College of Veterinary Medicine, University of Georgia, Athens, GA, 30602
| | - Amie Koenig
- Department of Small Animal Medicine and Surgery, College of Veterinary Medicine, University of Georgia, Athens, GA, 30602
| | - Deanna L Bedard
- Department of Small Animal Medicine and Surgery, College of Veterinary Medicine, University of Georgia, Athens, GA, 30602
| | - Benjamin M Brainard
- Department of Small Animal Medicine and Surgery, College of Veterinary Medicine, University of Georgia, Athens, GA, 30602
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Spada E, Proverbio D, Viñals Flórez LM, del Rosario Perlado Chamizo M, Serra y Gómez de la Serna B, Perego R, Baggiani L. Prevalence of naturally occurring antibodies against dog erythrocyte antigen 7 in a population of dog erythrocyte antigen 7–negative dogs from Spain and Italy. Am J Vet Res 2016; 77:877-81. [DOI: 10.2460/ajvr.77.8.877] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022]
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22
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Jagodich TA, Holowaychuk MK. Transfusion practice in dogs and cats: an Internet-based survey. J Vet Emerg Crit Care (San Antonio) 2016; 26:360-72. [DOI: 10.1111/vec.12451] [Citation(s) in RCA: 30] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/18/2014] [Revised: 07/29/2014] [Accepted: 08/09/2014] [Indexed: 11/30/2022]
Affiliation(s)
- Tiffany A. Jagodich
- Department of Clinical Studies, Ontario Veterinary College; University of Guelph; Guelph ON Canada
| | - Marie K. Holowaychuk
- Department of Clinical Studies, Ontario Veterinary College; University of Guelph; Guelph ON Canada
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23
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Lynch AM, Respess M, Boll AE, Bozych M, McMichael M, Fletcher DJ, De Laforcade AM, Rozanski EA. Hospital-acquired Anemia in Critically Ill Dogs and Cats: A Multi-Institutional Study. J Vet Intern Med 2016; 30:141-6. [PMID: 26578290 PMCID: PMC4913629 DOI: 10.1111/jvim.13650] [Citation(s) in RCA: 19] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/14/2014] [Revised: 08/17/2015] [Accepted: 09/21/2015] [Indexed: 12/15/2022] Open
Abstract
BACKGROUND Hospital-acquired anemia is commonly described in people but limited information currently is available regarding its prevalence in animals. HYPOTHESIS/OBJECTIVES Assess the prevalence of hospital-acquired anemia in hospitalized critically ill dogs and cats, and examine its relationship with phlebotomy practices, transfusion administration, and survival to discharge. ANIMALS Eight hundred and fifty-one client-owned animals (688 dogs and 163 cats). METHODS A multicenter, observational study was conducted in which packed cell volume (PCV) was recorded at the time of admission and on subsequent hospitalization days. Signalment, number of blood samples obtained, underlying disease, whether or not blood products were administered, duration of hospitalization, and survival to discharge were recorded. RESULTS Admission anemia prevalence was 32%, with overall prevalence during the hospitalization period of 56%. The last recorded PCV was significantly lower than the admission PCV for both dogs (admission PCV, 42% [range, 6-67%]; last recorded PCV, 34% [range, 4-64%], P < .0001) and cats (admission PCV, 31% [range, 6-55%]; last recorded PCV, 26% [range, 10-46%], P < .0001). Patients that developed anemia had significantly more blood samples obtained (nonanemic, 5 blood samples [range, 2-54]; anemic, 7 blood samples [range, 2-49], P < .0001). Hospitalized cats were significantly more likely to develop anemia compared to dogs (P < .0001), but anemic dogs were significantly less likely to survive to discharge (P = .0001). Surgical patients were at higher risk of developing hospital-acquired anemia compared to medical patients (OR, 0.63; 95% CI, 0.4-0.9; P = .01). CONCLUSIONS AND CLINICAL RELEVANCE Hospital-acquired anemia occurred frequently, especially in surgical patients. Additional studies focused on the direct effect of phlebotomy practices on the likelihood of anemia development in hospitalized animals are warranted.
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Affiliation(s)
- A M Lynch
- Cummings School of Veterinary Medicine at Tufts University, North Grafton, MA
- College of Veterinary Medicine, University of Florida, Gainesville, FL
| | | | - A E Boll
- Cornell University College of Veterinary Medicine, Ithaca, NY
| | - M Bozych
- College of Veterinary Medicine at the University of Illinois, Urbana, IL
| | - M McMichael
- College of Veterinary Medicine at the University of Illinois, Urbana, IL
| | - D J Fletcher
- Cornell University College of Veterinary Medicine, Ithaca, NY
| | - A M De Laforcade
- Cummings School of Veterinary Medicine at Tufts University, North Grafton, MA
| | - E A Rozanski
- Cummings School of Veterinary Medicine at Tufts University, North Grafton, MA
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Lynch AM, O'Toole TE, Hamilton J. Transfusion practices for treatment of dogs undergoing splenectomy for splenic masses: 542 cases (2001–2012). J Am Vet Med Assoc 2015; 247:636-42. [DOI: 10.2460/javma.247.6.636] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022]
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25
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Lynch AM, O'Toole TE, Respess M. Transfusion practices for treatment of dogs hospitalized following trauma: 125 cases (2008–2013). J Am Vet Med Assoc 2015; 247:643-9. [DOI: 10.2460/javma.247.6.643] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022]
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26
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Haley AL, Mann FA, Middleton J, Nelson CA. Perioperative red blood cell transfusion requirement for various surgical procedures in dogs: 207 cases (2004-2013). J Am Vet Med Assoc 2015; 247:85-91. [PMID: 26086233 DOI: 10.2460/javma.247.1.85] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022]
Abstract
OBJECTIVE To compare perioperative RBC transfusion among dogs undergoing liver lobectomy, splenectomy, partial gastrectomy, rhinotomy, thyroidectomy, perineal herniorrhaphy, and intrathoracic surgery. DESIGN Retrospective case series. ANIMALS 207 client-owned dogs that underwent various surgeries. PROCEDURES Medical records were reviewed for dogs that had undergone liver lobectomy, splenectomy, partial gastrectomy, rhinotomy, neoplastic thyroidectomy, perineal herniorrhaphy, or intrathoracic surgery. Transfusion requirement (packed RBC, whole blood, and bovine hemoglobin-based oxygen carrier) and survival rate at 2 weeks after surgery were compared among dogs undergoing the various surgeries. RESULTS Patients undergoing splenectomy and liver lobectomy were significantly more likely to receive RBC transfusion when each was compared with patients undergoing all other procedures. A significant association was found between body weight and perioperative RBC transfusion, with greater odds of transfusion as body weight increased. Dogs receiving perioperative RBC transfusions were significantly less likely to survive to 2 weeks after surgery. CONCLUSIONS AND CLINICAL RELEVANCE Results indicated that dogs undergoing splenectomy and liver lobectomy may require RBC transfusion perioperatively. Veterinarians who perform these procedures should plan accordingly and have packed RBCs or whole blood donors readily available.
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Bruce JA, Kriese-Anderson L, Bruce AM, Pittman JR. Effect of premedication and other factors on the occurrence of acute transfusion reactions in dogs. J Vet Emerg Crit Care (San Antonio) 2015; 25:620-30. [PMID: 26109490 DOI: 10.1111/vec.12327] [Citation(s) in RCA: 30] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/28/2013] [Accepted: 04/24/2015] [Indexed: 11/28/2022]
Abstract
OBJECTIVE To evaluate the effect of premedication on transfusion reactions (TRs) within 24 hours after blood product transfusions in dogs. DESIGN Retrospective study between 2008 and 2011. SETTING Private veterinary referral hospital. ANIMALS Nine hundred and thirty-five transfusion events in 558 dogs. INTERVENTIONS None. MEASUREMENTS AND MAIN RESULTS Medical records of dogs receiving blood product transfusions were reviewed. Information collected included signalment, weight, transfusion product type, reason for transfusion, first or subsequent transfusion, whether an acute reaction occurred, type of reaction, whether the reaction was treated, premedication prior to the transfusion and the premedication used, other medications the animal was given, whether the animal had an immune-mediated process, and whether the transfusion was administered in the perioperative period. A total of 144 (15%) acute TRs were documented in 136 dogs. The most common TRs were fever alone (77/144 [53%]) and vomiting alone (26/144 [18%]). Six dogs died due to the TR (4%). TR was not associated with age (P = 0.257), sex (P = 0.754), weight (P = 0.829), or premedication (P = 0.312). The type of blood product transfused (P < 0.001) was significantly associated with TRs, with packed RBCs most likely associated with a TR, and plasma least likely. Immune disease (P = 0.015) was significantly associated with occurrence of a TR. Significantly fewer reactions were documented following transfusions given in the perioperative period (P = 0.023). CONCLUSIONS While most TRs were mild, there were some serious reactions observed including hemolysis, dyspnea, and 6 deaths. Immune-mediated disease was associated with development of a TR, while transfusion during the perioperative period was associated with lower likelihood of reaction. Packed RBC transfusions were associated with development of acute TRs. Overall occurrence of TR was not significantly altered with premedication; however, when evaluated alone, antihistamines decreased the incidence of acute allergic reactions.
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Affiliation(s)
| | | | - Ashley M Bruce
- Department of Animal Science, Auburn University, Auburn, AL, 36849
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Holowaychuk MK, Musulin SE. The effect of blood usage protocol on the age of packed red blood cell transfusions administered at 2 veterinary teaching hospitals. J Vet Emerg Crit Care (San Antonio) 2015; 25:679-83. [DOI: 10.1111/vec.12339] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/09/2013] [Accepted: 11/27/2013] [Indexed: 11/27/2022]
Affiliation(s)
- Marie K. Holowaychuk
- Department of Clinical Studies, Ontario Veterinary College; University of Guelph; Guelph Ontario Canada
| | - Sarah E. Musulin
- Department of Clinical Sciences, College of Veterinary Medicine; North Carolina State University; Raleigh North Carolina
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Beer KS, Silverstein DC. Controversies in the use of fresh frozen plasma in critically ill small animal patients. J Vet Emerg Crit Care (San Antonio) 2015; 25:101-6. [PMID: 25603692 DOI: 10.1111/vec.12280] [Citation(s) in RCA: 22] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/30/2014] [Accepted: 09/15/2014] [Indexed: 11/28/2022]
Abstract
OBJECTIVE To review the literature supporting or discouraging the use of fresh frozen plasma (FFP) transfusion in critically ill patients. DATA SOURCES Human and animal publications were searched using PubMed without time limits and the following keywords were used: "fresh frozen plasma," "coagulopathy," "hypocoagulable state," "hypercoagulable states," and "critical illness." HUMAN DATA SYNTHESIS The commonly used tests of coagulation (eg, prothrombin time, activated partial thromboplastin time, international normalized ratio) are poorly predictive of clinical bleeding. FFP use in critically ill patients is unlikely to result in improved outcomes and may be associated with increased risks. VETERINARY DATA SYNTHESIS There is insufficient evidence to make definitive conclusions regarding the use of FFP in critically ill animals, but clinical studies are underway that may provide further data that clarify the optimal use of FFP in animals. CONCLUSIONS The use of FFP in critically ill patients remains controversial. In the absence of clinical bleeding or a risk for clinical bleeding associated with a planned procedure, treatment use of FFP is not recommended in human patients. There are insufficient data in critically ill animals to enable formulation of recommendations. Further research is warranted in dogs and cats to establish evidence-based guidelines.
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Affiliation(s)
- Kari Santoro Beer
- Department of Clinical Studies, University of Pennsylvania, Philadelphia, PA
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Hann L, Brown DC, King LG, Callan MB. Effect of duration of packed red blood cell storage on morbidity and mortality in dogs after transfusion: 3,095 cases (2001-2010). J Vet Intern Med 2014; 28:1830-7. [PMID: 25311875 PMCID: PMC4895626 DOI: 10.1111/jvim.12430] [Citation(s) in RCA: 38] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/10/2014] [Revised: 06/25/2014] [Accepted: 07/09/2014] [Indexed: 11/28/2022] Open
Abstract
Background Accumulating evidence suggests that transfusion of packed red blood cells (PRBCs) stored for >14 days is associated with increased rates of sepsis, multiple organ dysfunction, and mortality in human patients. Objective To determine if duration of PRBC storage has an effect on morbidity and mortality in dogs after transfusion. Animals Dogs admitted to the Matthew J Ryan Veterinary Hospital of the University of Pennsylvania. Methods A retrospective case review of dogs identified through blood bank logbooks that received PRBC transfusions (minimum, 5 mL/kg) between 2001 and 2010. Dogs were categorized according to major cause of anemia (eg, hemorrhage, hemolysis, ineffective erythropoiesis) for analysis. Results A total of 3,095 dogs received 5,412 PRBC units. Longer duration of PRBC storage was associated with development of new or progressive coagulation failure (P = .001) and thromboembolic disease (P = .005). There was no association between duration of PRBC storage and survival for all dogs overall. However, a logistic regression model indicated that for dogs with hemolysis, 90% of which had immune‐mediated hemolytic anemia, longer duration of PRBC storage was a negative risk factor for survival. For every 7 day increase in storage, there was a 0.79 lesser odds of 30 day survival (95% CI, 0.64–0.97; P = .024). Conclusions and Clinical Importance Duration of PRBC storage does not appear to be a major contributing factor to mortality in the overall canine population. However, longer duration of PRBC storage may negatively impact outcome in dogs with immune‐mediated hemolytic anemia, thus warranting further investigation with prospective studies.
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Affiliation(s)
- L Hann
- Department of Clinical Studies-Philadelphia, School of Veterinary Medicine, University of Pennsylvania, Philadelphia, PA
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Holowaychuk MK, Leader JL, Monteith G. Risk factors for transfusion-associated complications and nonsurvival in dogs receiving packed red blood cell transfusions: 211 cases (2008-2011). J Am Vet Med Assoc 2014; 244:431-7. [PMID: 24479457 DOI: 10.2460/javma.244.4.431] [Citation(s) in RCA: 41] [Impact Index Per Article: 4.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022]
Abstract
OBJECTIVE To determine whether the number, volume, or age of transfused packed RBC units; volume of other blood products; or pretransfusion PCV was a risk factor for transfusion-associated complications or nonsurvival in dogs. DESIGN Retrospective case series. ANIMALS 211 client-owned dogs receiving stored packed RBC transfusions. PROCEDURES Information collected or calculated from the medical record of each dog included the total number, volume, and dose of packed RBC units; mean age of packed RBC units; number of packed RBC units > 14 days old; age of oldest packed RBC unit; volume and dose of other blood products used; pretransfusion PCV; acute patient physiologic and laboratory evaluation score; transfusion-associated complications; and outcome. RESULTS The dose (mL/kg) of other blood products transfused was a risk factor for transfusion-associated complications (OR, 1.03; 95% confidence interval [CI], 1.01 to 1.05). The pretransfusion PCV (OR, 1.13; 95% CI, 1.06 to 1.21) and dose of packed RBCs administered (OR, 1.04; 95% CI, 1.02 to 1.07) were risk factors for nonsurvival. Age of transfused packed RBC units was not identified as a risk factor for transfusion-associated complications or nonsurvival, but the study was statistically underpowered to detect this finding. CONCLUSIONS AND CLINICAL RELEVANCE Administration of larger doses of other non-packed RBC blood products was a risk factor for transfusion-associated complications, and a higher pretransfusion PCV and larger dose of packed RBCs administered were risk factors for nonsurvival. Prospective randomized studies are needed to determine whether conservative transfusion strategies will reduce transfusion-associated complications and improve outcome in dogs.
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Affiliation(s)
- Marie K Holowaychuk
- Department of Clinical Studies, Ontario Veterinary College, University of Guelph, Guelph, ON N1G 2W1, Canada
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Kisielewicz C, Self I, Bell R. Assessment of clinical and laboratory variables as a guide to packed red blood cell transfusion of euvolemic anemic dogs. J Vet Intern Med 2014; 28:576-82. [PMID: 24417587 PMCID: PMC4857975 DOI: 10.1111/jvim.12280] [Citation(s) in RCA: 9] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/21/2013] [Revised: 10/06/2013] [Accepted: 11/18/2013] [Indexed: 12/02/2022] Open
Abstract
Background There are no standardized guidelines for determining the likelihood that euvolemic anemic dogs will benefit from transfusion of packed red blood cells (pRBC). Objectives To report clinical and laboratory variables of dogs receiving pRBC transfusion, which could guide transfusion of other anemic dogs. Animals Twenty‐four client‐owned anemic dogs receiving pRBC transfusion. Methods Prospective study; 30 transfusions assessed. Clinical findings (mucosal color, pulse quality, heart rate, respiratory rate, mentation/exercise tolerance) before and after transfusion were evaluated by the anemic dog clinical assessment score (ADCAS). Hemoglobin concentration, hematocrit, venous oxygen content (CvO2), and lactate concentration were measured from blood samples taken before and after transfusion. These results were not used for case management. Results All ADCAS variables decreased significantly with transfusion (P < .001); the total score was ≥5/12 before transfusion, and ≤3/12 in all cases that were deemed to no longer require transfusion. Hematocrit and CvO2 were <17% and <5 mL/dL, respectively, in 83% of cases before transfusion and hemoglobin concentration was <5.8 g/dL in 80%. Hemoglobin concentration, hematocrit, and CvO2 increased significantly with transfusion (P < .001); lactate concentration decreased significantly (P = .006). Conclusions and Clinical Importance Clinical and laboratory variables improved significantly after transfusion of pRBC. By identifying how transfusion affected these variables, it was possible to recognize clinical (ADCAS) and laboratory (hemoglobin, CvO2, lactate) variables, which could be useful in guiding the decision to transfuse dogs with similar presentations.
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Affiliation(s)
- C Kisielewicz
- Queen Mother Hospital for Animals, Royal Veterinary College, Hatfield, Hertfordshire, UK
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Kavanagh C, Shaw S, Webster CRL. Coagulation in hepatobiliary disease. J Vet Emerg Crit Care (San Antonio) 2012; 21:589-604. [PMID: 22316251 DOI: 10.1111/j.1476-4431.2011.00691.x] [Citation(s) in RCA: 33] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/18/2022]
Abstract
OBJECTIVE To review the pathogenesis and clinical consequences of coagulation abnormalities accompanying hepatobiliary disorders and to highlight the need for further studies to characterize these derangements and their treatment options in small animal patients. DATA SOURCES Veterinary and human medical literature: original research articles, scientific reviews, consensus statements, and recent texts. SUMMARY The liver plays an important role in the production and clearance of many components of coagulation. A wide range of hemostatic derangements can occur in patients with hepatobiliary disease including alterations in platelet number and function, coagulation factor levels, anticoagulants, vascular endothelial function, and fibrinolysis. As these hemostatic alterations include both pro- and anticoagulation pathways, the net result is often a rebalanced hemostatic system that can be easily disrupted by concurrent conditions resulting in either clinical bleeding or thrombosis. Conventional coagulation tests are inadequate at identifying the spectrum of coagulation alterations occurring in patients with hepatobiliary disease, but their evaluation is necessary to assess bleeding risk and provide prognostic information. A paucity of information exists regarding the treatment of the coagulation derangements in small animals with hepatobiliary disease. Extrapolation from human studies provides some information about potential treatment options, but further studies are warranted in this area to elucidate the best management for coagulation abnormalities in dogs and cats with hepatobiliary disease. CONCLUSION Hepatobiliary disease can have profound effects on coagulation function leading to hypercoagulable or hypocoagulable states. Overall coagulation status with hepatobiliary disease depends on both the type and severity of disease and the presence of associated complications.
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Affiliation(s)
- Carrie Kavanagh
- Department of Clinical Sciences, Cummings School of Veterinary Medicine, Tufts University, North Grafton, MA 01536, USA
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Chervier C, Cadoré JL, Rodriguez-Piñeiro MI, Deputte BL, Chabanne L. Causes of anaemia other than acute blood loss and their clinical significance in dogs. J Small Anim Pract 2012; 53:223-7. [DOI: 10.1111/j.1748-5827.2011.01191.x] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/17/2022]
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36
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Godinho-Cunha LF, Ferreira RMRF, Silvestre-Ferreira AC. Whole blood transfusion in small animals: indications and effects. AN ACAD BRAS CIENC 2011; 83:611-7. [PMID: 21670882 DOI: 10.1590/s0001-37652011000200020] [Citation(s) in RCA: 12] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/27/2009] [Accepted: 09/30/2010] [Indexed: 11/22/2022] Open
Abstract
Transfusion therapy is a major resource that can improve the patient's capability to overcome the underlying disease. However, the effects of whole blood infusion, and how they affect the patient's outcome, are not yet clear. For this study, a protocol was developed in order to monitor a group of 15 animals (9 dogs, 6 cats) that received a total of 19 transfusions; 3 animals received more than one transfusion each. The most common indications for blood transfusion included acute blood loss (47%), coagulopathy (33%) and other anaemias (20%). The mean pre-transfusion packed cell volume (PCV) of animals with acute blood loss (18%) was higher than in the group of coagulopathy (15%) or other anaemias (15%). The survival rates at 6 days after transfusion were greater in the coagulopathy (80.0%) and other anaemias (66.7%) than in the group of acute blood loss (42.9%). After transfusion, pulse rate ( p <0.01) and platelet count ( p <0.05) decreased significantly, and there was a significant increase in body temperature of the animals that suffered from hypothermia before the transfusion ( p <0.05). Overall survival was predictable based upon posttransfusion body temperature, observed PCV change, the difference between the obtained and the calculated PCV, and administered transfusion volume ( p <0.05).
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Affiliation(s)
- Luís F Godinho-Cunha
- Departamento de Ciências Veterinárias, Hospital Veterinário, Universidade de Trás-os-Montes e Alto Douro Quinta de Prados, Vila Real, Portugal
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Prittie JE. Controversies related to red blood cell transfusion in critically ill patients. J Vet Emerg Crit Care (San Antonio) 2010; 20:167-76. [PMID: 20487245 DOI: 10.1111/j.1476-4431.2010.00521.x] [Citation(s) in RCA: 39] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
Abstract
OBJECTIVE To review the evolution of and controversies associated with allogenic blood transfusion in critically ill patients. DATA SOURCES Veterinary and human literature review. HUMAN DATA SYNTHESIS RBC transfusion practices for ICU patients have come under scrutiny in the last 2 decades. Human trials have demonstrated relative tolerance to severe, euvolemic anemia and a significant outcome advantage following implementation of more restricted transfusion therapy. Investigators question the ability of RBCs stored longer than 2 weeks to improve tissue oxygenation, and theorize that both age and proinflammatory or immunomodulating effects of transfused cells may limit efficacy and contribute to increased patient morbidity and mortality. Also controversial is the ability of pre- and post-storage leukoreduction of RBCs to mitigate adverse transfusion-related events. VETERINARY DATA SYNTHESIS While there are several studies evaluating the transfusion trigger, the RBC storage lesion and transfusion-related immunomodulation in experimental animal models, there is little research pertaining to clinical veterinary patients. CONCLUSIONS RBC transfusion is unequivocally indicated for treatment of anemic hypoxia. However, critical hemoglobin or Hct below which all critically ill patients require transfusion has not been established and there are inherent risks associated with allogenic blood transfusion. Clinical trials designed to evaluate the effects of RBC age and leukoreduction on veterinary patient outcome are warranted. Implementation of evidence-based transfusion guidelines and consideration of alternatives to allogenic blood transfusion are advisable.
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Affiliation(s)
- Jennifer E Prittie
- Department of Emergency and Critical Care, Animal Medical Center, New York, NY 10065, USA.
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Garon CL, Cohn LA, Scott MA. Erythrocyte survival time in Greyhounds as assessed by use of in vivo biotinylation. Am J Vet Res 2010; 71:1033-8. [PMID: 20807142 DOI: 10.2460/ajvr.71.9.1033] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022]
Abstract
OBJECTIVE To determine erythrocyte survival time in Greyhounds. ANIMALS 6 Greyhounds used as blood donors and 3 privately owned non-Greyhound dogs. PROCEDURES In vivo biotinylation of erythrocytes was performed by infusion of biotin-N-hydroxysuccinimide into each dog via a jugular vein catheter. Blood samples were collected 12 hours later and then at weekly intervals and were used to determine the percentage of biotin-labeled erythrocytes at each time point. Erythrocytes were washed, incubated with avidin-fluorescein isothiocyanate, and washed again before the percentage of biotinylated erythrocytes was measured by use of flow cytometry. Survival curves for the percentage of biotinylated erythrocytes were generated, and erythrocyte survival time was defined as the x-intercept of a least squares best-fit line for the linear portion of each curve. RESULTS The R2 for survival curves ranged from 0.93 to 0.99 during the first 10 weeks after infusion of erythrocytes. Erythrocyte survival time for the 3 non-Greyhound dogs was 94, 98, and 116 days, respectively, which was consistent with previously reported values. Erythrocyte survival time for the 6 Greyhounds ranged from 83 to 110 days (mean, 93 days; median, 88 days). As determined by use of in vivo biotinylation, erythrocyte survival times in Greyhounds were similar to those determined for non-Greyhound dogs and did not differ significantly from erythrocyte survival times reported previously for non-Greyhound dogs. CONCLUSIONS AND CLINICAL RELEVANCE Erythrocyte survival time was similar in Greyhounds and non-Greyhound dogs. Greyhounds can be used as erythrocyte donors without concerns about inherently shorter erythrocyte survival time.
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Affiliation(s)
- Catherine L Garon
- Department of Veterinary Medicine and Surgery, College of Veterinary Medicine, University of Missouri, Columbia, MO 65211, USA
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McMichael M, Smith S, Galligan A, Swanson K, Fan T. Effect of Leukoreduction on Transfusion-Induced Inflammation in Dogs. J Vet Intern Med 2010; 24:1131-7. [DOI: 10.1111/j.1939-1676.2010.0561.x] [Citation(s) in RCA: 71] [Impact Index Per Article: 5.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022] Open
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Snow SJ, Ari Jutkowitz L, Brown AJ. Retrospective Study: Trends in plasma transfusion at a veterinary teaching hospital: 308 patients (1996-1998 and 2006-2008). J Vet Emerg Crit Care (San Antonio) 2010; 20:441-5. [DOI: 10.1111/j.1476-4431.2010.00557.x] [Citation(s) in RCA: 43] [Impact Index Per Article: 3.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
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Blais MC, Rozanski EA, Hale AS, Shaw SP, Cotter SM. Lack of Evidence of Pregnancy-Induced Alloantibodies in Dogs. J Vet Intern Med 2009; 23:462-5. [DOI: 10.1111/j.1939-1676.2009.0286.x] [Citation(s) in RCA: 26] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022] Open
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Miller A, Morley P, Rao S, Avery A, Lana S, Olver C. Anemia Is Associated with Decreased Survival Time in Dogs with Lymphoma. J Vet Intern Med 2009. [DOI: 10.1111/j.1939-1676.2008.0210.x] [Citation(s) in RCA: 43] [Impact Index Per Article: 2.9] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022] Open
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Waldrop JE, Rozanski EA, Freeman LM, Rush JE. Packed red blood cell transfusions in dogs with gastrointestinal hemorrhage: 55 cases (1999-2001). J Am Anim Hosp Assoc 2007; 39:523-7. [PMID: 14736715 DOI: 10.5326/0390523] [Citation(s) in RCA: 16] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/11/2022]
Abstract
Fifty-five dogs received packed red blood cell (PRBC) transfusions for gastrointestinal (GI) hemorrhage during a 26-month period (1999 to 2001), accounting for 11.7% of the PRBC transfusions in that time. Thirty-nine (61%) dogs had an intestinal pathology (primary or secondary) as the cause of GI hemorrhage, including intestinal masses, gastroenteritis, hepatic disease, and renal disease. Nonsteroidal and steroidal anti-inflammatory drug use was found frequently in dogs with GI hemorrhage. Sixteen (39%) dogs were identified as having immune-mediated thrombocytopenia (IMT) and associated GI hemorrhage. Dogs with IMT received more transfusions of PRBC than nonIMT dogs (P<0.03) and received a significantly larger total volume of PRBC (P<0.01) during hospitalization.
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Affiliation(s)
- Jennifer E Waldrop
- Department of Clinical Sciences, School of Veterinary Medicine, Tufts University, North Grafton, Massachusetts 01536, USA
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Hurcombe SD, Mudge MC, Hinchcliff KW. Clinical and clinicopathologic variables in adult horses receiving blood transfusions: 31 cases (1999–2005). J Am Vet Med Assoc 2007; 231:267-74. [PMID: 17630896 DOI: 10.2460/javma.231.2.267] [Citation(s) in RCA: 48] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022]
Abstract
OBJECTIVE To determine clinical and clinicopathologic abnormalities in horses administered a blood transfusion and evaluate effects of blood transfusion on these variables. DESIGN Retrospective case series. ANIMALS 31 adult horses that received > or = 1 blood transfusion. Procedures-Medical records of horses receiving a blood transfusion were reviewed to obtain clinical findings, laboratory test results before and after transfusion, adjunctive treatments, transfusion type and volume, response to transfusion, results of donor-recipient compatibility testing, adverse reactions, and outcome. RESULTS 31 horses received 44 transfusions for hemorrhagic anemia (HG; n = 18 horses), hemolytic anemia (HL; 8), or anemia attributable to erythropoietic failure (EF; 5). Tachycardia and tachypnea were detected in 31 of 31 (100%) and 22 of 31 (71%) horses, respectively, before transfusion. The PCV and hemoglobin concentration were less than the reference range in 11 of 18 horses with HG, 8 of 8 horses with HL, and 5 of 5 horses with EF. Hyperlactatemia was detected in 16 of 17 recorded values before transfusion. Heart rate, respiratory rate, and PCV improved after transfusion, with differences among the types of anemia. Seventeen (54%) horses were discharged, 9 (29%) were euthanized, and 5 (16%) died of natural causes. Adverse reactions were evident during 7 of 44 (16%) transfusions, varying from urticarial reactions to anaphylactic shock. CONCLUSIONS AND CLINICAL RELEVANCE Abnormalities in clinical and clinicopathologic variables differed depending on the type of anemia. Colic, cold extremities, signs of depression, lethargy, tachycardia, tachypnea, low PCV, low hemoglobin concentration, and hyperlactatemia were commonly detected before transfusion and resolved after transfusion.
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Affiliation(s)
- Samuel D Hurcombe
- Department of Veterinary Clinical Sciences, College of Veterinary Medicine, The Ohio State University, Columbus, OH 43210, USA
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Blais MC, Berman L, Oakley DA, Giger U. Canine Dal blood type: A red cell antigen lacking in some Dalmatians. J Vet Intern Med 2007; 21:281-6. [PMID: 17427389 PMCID: PMC3132505 DOI: 10.1892/0891-6640(2007)21[281:cdbtar]2.0.co;2] [Citation(s) in RCA: 18] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022] Open
Abstract
BACKGROUND Based upon alloantibodies produced after sensitizing dogs with transfused blood, more than a dozen blood group systems have been recognized thus far, and some have been classified as dog erythrocyte antigens (DEA). HYPOTHESIS A new canine red cell antigen was suspected, based on the development of specific alloantibodies in a Dalmatian previously sensitized by blood transfusions. ANIMALS Twenty-six Dalmatians (including 1 Dalmatian in need of blood compatibility studies); 55 canine blood donors. METHODS Serologic tests, including blood typing, crossmatching, and direct Coombs' test were performed by standard tube techniques and a novel gel column technology adapted from human blood banking. RESULTS By day 40 after transfusion of an anemic Dalmatian, all major crossmatch tests to 55 non-Dalmatian dogs were incompatible. The 2 initial donors, who were compatible before transfusion, were also now incompatible, suggesting the development of an alloantibody to a common red cell antigen. No siblings were available, but 4 of 25 unrelated Dalmatians were crossmatch compatible, suggesting that they were missing the same red cell antigen. The patient was blood typed DEA 1.1, 3, 4, and 5 positive, but DEA 7 negative. Further blood typing and crossmatching results did not support an association to any of these known blood types. The alloantibodies produced were determined to be of the immunoglobulin G class. CONCLUSIONS AND CLINICAL IMPORTANCE Based upon the identification of an acquired alloantibody in a Dalmatian, a presumably new common blood type named Dal was identified. Dalmatians lacking the Dal antigen are likely at risk of delayed and acute hemolytic transfusion reactions.
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Affiliation(s)
- Marie-Claude Blais
- Section of Medical Genetics and Penn Animal Blood Bank, School of Veterinary Medicine, University of Pennsylvania, 3900 Spruce Street, Philadelphia, PA 19104-6010, USA
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Blais MC, Berman L, Oakley DA, Giger U. Canine Dal Blood Type: A Red Cell Antigen Lacking in Some Dalmatians. J Vet Intern Med 2007. [DOI: 10.1111/j.1939-1676.2007.tb02961.x] [Citation(s) in RCA: 62] [Impact Index Per Article: 3.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022] Open
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A retrospective study of blood transfusion in dogs from a veterinary hospital in Bangkok, Thailand. ACTA ACUST UNITED AC 2006. [DOI: 10.1007/s00580-006-0631-5] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/24/2022]
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Blood Transfusion and Blood Substitutes. FLUID, ELECTROLYTE, AND ACID-BASE DISORDERS IN SMALL ANIMAL PRACTICE 2006. [PMCID: PMC7149518 DOI: 10.1016/b0-72-163949-6/50027-8] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Indexed: 10/02/2023]
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Couto CG, Iazbik M. Effects of Blood Donation on Arterial Blood Pressure in Retired Racing Greyhounds. J Vet Intern Med 2005. [DOI: 10.1111/j.1939-1676.2005.tb02775.x] [Citation(s) in RCA: 10] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022] Open
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Abstract
OBJECTIVE To determine the number of and reasons for RBC transfusions, incidence of acute transfusion reactions, prevalence of blood types, volume of blood administered, change in PCV, and clinical outcome in cats. DESIGN Retrospective study. ANIMALS 126 cats that received RBC transfusions. PROCEDURE Medical records of cats that received whole blood or packed RBC transfusions were reviewed for signalment, blood type, pre- and post-transfusion PCV, volume of blood product administered, clinical diagnosis and cause of anemia, clinical signs of acute transfusion reactions, and clinical outcome. RESULTS Mean volume of whole blood administered i.v. was 172 mL/kg (7.8 mL/lb) versus 9.3 mL/kg (4.2 mL/lb) for packed RBCs. Ninety-four percent of cats had blood type A. Mean increase in PCV among all cats was 6%. Fifty-two percent of cats had anemia attributed to blood loss, 10% had anemia attributed to hemolysis, and 38% had anemia attributed to erythropoietic failure. Acute transfusion reactions occurred in 11 cats. Sixty percent of cats survived until discharge. CONCLUSIONS AND CLINICAL RELEVANCE RBC transfusions resulted in an increase in PCV in cats with all causes of anemia in this study. The rate of death was greater than in cats that did not receive transfusions, but seriousness of the underlying disease in the 2 groups may not be comparable. Death rate of cats that received transfusions was not attributable to a high rate of transfusion reactions. Results confirm that pretransfusion blood typing or crossmatching is required to minimize the risk of adverse reactions.
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Affiliation(s)
- Debra A Klaser
- Bobst Hospital and the Jaqua Transfusion Medicine Service, The Animal Medical Center, 510 E 62nd St, New York, NY 10021, USA
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