Page 1386 - Small Animal Internal Medicine, 6th Edition

1358 PART XIII Hematology

but common in cats receiving incompatible blood products.
Delayed hemolytic reactions are more common and are
VetBooks.ir manifested primarily by an unexpected decline in the HCT
after transfusion over days in association with hemoglobine-
mia, hemoglobinuria, and hyperbilirubinemia. Circulatory
overload may be manifested by vomiting, dyspnea, or cough-
ing. The syndrome of transfusion-associated lung injury
(TRALI, a syndrome of peracute pulmonary disease associ-
ated with transfusion of blood components) was recently
documented in dogs, although the prevalence is low (3.7%)
(Thomovsky et al., 2014). Citrate intoxication occurs when
the infusion rate is too fast or the liver cannot metabolize the
citrate. Signs of citrate intoxication are related to hypocalce-
FIG 82.10 mia and include tremors and cardiac arrhythmias. If signs of
Pathogenetic classification of anemias.
a transfusion reaction are recognized, the transfusion must
be slowed or halted.

trochanteric fossa are anesthetized with 1% lidocaine. A bone Suggested Readings
marrow needle (18 gauge) or intraosseus catheter is placed Andrews GA, Penedo MCT. Red blood cell antigens and blood
into the marrow cavity parallel to the shaft of the femur. groups in the dog and cat. In: Weiss DJ, Wardrop KJ, eds. Schalm’s
Suction with a 10-mL syringe should yield marrow elements veterinary hematology. 6th ed. Ames, Iowa: Wiley-Blackwell;
(fat, spicules, and blood), confirming correct placement of 2010:711.
the needle. The blood is administered through a standard Birkenheuer AJ, et al. Efficacy of combined atovaquone and azithro-
blood administration set. mycin for therapy of chronic Babesia gibsoni (Asian genotype)
The recommended rate of administration is variable but infections in dogs. J Vet Intern Med. 2004;18:494.
should not exceed 22 mL/kg/day (up to 20 mL/kg/h can be Birkenheuer AJ, et al. Geographic distribution of babesiosis among
used in hypovolemic animals). Dogs and cats in heart failure dogs in the United States and association with dog bites: 150
may not tolerate a rate of more than 5 mL/kg/day. To prevent cases (2000-2003). J Am Vet Med Assoc. 2005;227:942.
bacterial contamination, blood should not be exposed to Birkenheuer AJ, et al. Serosurvey of anti-Babesia antibodies in stray
dogs and American pit bull terriers and American Staffordshire
room temperature during administration for longer than 4 terriers from North Carolina. J Am Anim Hosp Assoc. 2003;39:
to 6 hours; blood is considered to be contaminated if it has 551.
been at room temperature for more than 6 hours. If neces- Blais M-C, et al. Lack of evidence of pregnancy-induced alloanti-
sary, two smaller volumes of blood can be administered in bodies in dogs. J Vet Intern Med. 2009;23:462.
succession. Blood should never be administered with lac- Callan MB, et al. Canine red blood cell transfusion practice. J Am
tated Ringer’s solution because of the calcium chelation with Anim Hosp Assoc. 1996;32:303.
citrate and consequent clot formation that may occur. Castellanos I, et al. Clinical use of blood products in cats: a retro-
Normal saline solution (0.9% NaCl) should be used instead. spective study (1997-2000). J Vet Intern Med. 2004;18:529.
A simple rule of thumb to predict the increase in the recipi- Chikazawa S, Dunning MD. A review of anaemia of inflammatory
ent’s HCT is to remember that 2.2 mL/kg (or 1 mL/lb) of disease in dogs and cats. J Small Animal Practice. Blackwell Pub-
lishing Ltd. 2016;57(7):348–353.
transfused whole blood will raise the HCT by 1% if the donor Euler CC, et al. Survey of two new (Kai 1 and Kai 2) and other
has an HCT of approximately 40%. In cats, a unit of whole blood groups in dogs of North America. J Vet Intern Med. 15 ed.
blood or pRBCs increases the recipients HCT by approxi- 2016;30(5):1642–1647.
mately 5% (i.e., from 10% to 15%). Fiocchi EH, et al. The Use of Darbepoetin to Stimulate Eryth-
ropoiesis in the Treatment of Anemia of Chronic Kidney
COMPLICATIONS OF Disease in Dogs. J Vet Intern Med. Wiley/Blackwell (10.1111).
TRANSFUSION THERAPY 2017;31(2):476–485.
Transfusion-related complications can be divided into Furman E, et al. A retrospective study of 1,098 blood samples
those that are immunologically mediated and those that with anemia from adult cats: frequency, classification, and asso-
are of nonimmunologic origin. Immune-mediated reac- ciation with serum creatinine concentration. J Vet Intern Med.
2014;28(5):1391–1397.
tions include urticaria, hemolysis, and fever. Non–immune- Giger U, et al. Transfusion of type-A and type-B blood to cats. J Am
mediated complications include fever or hemolysis resulting Vet Med Assoc. 1991;198:411.
from the transfusion of improperly stored blood, circulatory Giger U. Hereditary erythrocyte enzyme abnormalities. In: Weiss
overload, citrate intoxication, disease transmission, and the DJ, Wardrop KJ, eds. Schalm’s veterinary hematology. 6th ed.
metabolic burden associated with the transfusion of aged Ames, Iowa: Wiley-Blackwell; 2010:179.
blood. Signs of immediate immune-mediated hemolysis Grahn RA, et al. Erythrocyte pyruvate kinase deficiency mutation
appear within minutes of the start of transfusion and include identified in multiple breeds of domestic cats. BMC Vet Res.
tremors, emesis, and fever; these are extremely rare in dogs 2012;8:207.