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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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Adamik KN, Yozova ID. Colloids Yes or No? - a "Gretchen Question" Answered. Front Vet Sci 2021; 8:624049. [PMID: 34277747 PMCID: PMC8282815 DOI: 10.3389/fvets.2021.624049] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/30/2020] [Accepted: 05/05/2021] [Indexed: 12/13/2022] Open
Abstract
Colloid solutions, both natural and synthetic, had been widely accepted as having superior volume expanding effects than crystalloids. Synthetic colloid solutions were previously considered at least as effective as natural colloids, as well as being cheaper and easily available. As a result, synthetic colloids (and HES in particular) were the preferred resuscitation fluid in many countries. In the past decade, several cascading events have called into question their efficacy and revealed their harmful effects. In 2013, the medicines authorities placed substantial restrictions on HES administration in people which has resulted in an overall decrease in their use. Whether natural colloids (such as albumin-containing solutions) should replace synthetic colloids remains inconclusive based on the current evidence. Albumin seems to be safer than synthetic colloids in people, but clear evidence of a positive effect on survival is still lacking. Furthermore, species-specific albumin is not widely available, while xenotransfusions with human serum albumin have known side effects. Veterinary data on the safety and efficacy of synthetic and natural colloids is limited to mostly retrospective evaluations or experimental studies with small numbers of patients (mainly dogs). Large, prospective, randomized, long-term outcome-oriented studies are lacking. This review focuses on advantages and disadvantages of synthetic and natural colloids in veterinary medicine. Adopting human guidelines is weighed against the particularities of our specific patient populations, including the risk-benefit ratio and lack of alternatives available in human medicine.
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Affiliation(s)
- Katja-Nicole Adamik
- Division of Small Animal Emergency and Critical Care, Department of Clinical Veterinary Science, Vetsuisse Faculty, University of Bern, Bern, Switzerland
| | - Ivayla D. Yozova
- School of Veterinary Science, Massey University, Palmerston North, New Zealand
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Jahr JS, Guinn NR, Lowery DR, Shore-Lesserson L, Shander A. Blood Substitutes and Oxygen Therapeutics: A Review. Anesth Analg 2021; 132:119-129. [PMID: 30925560 DOI: 10.1213/ane.0000000000003957] [Citation(s) in RCA: 31] [Impact Index Per Article: 10.3] [Reference Citation Analysis] [Abstract] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/05/2022]
Abstract
Despite the exhaustive search for an acceptable substitute to erythrocyte transfusion, neither chemical-based products such as perfluorocarbons nor hemoglobin-based oxygen carriers have succeeded in providing a reasonable alternative to allogeneic blood transfusion. However, there remain scenarios in which blood transfusion is not an option, due to patient's religious beliefs, inability to find adequately cross-matched erythrocytes, or in remote locations. In these situations, artificial oxygen carriers may provide a mortality benefit for patients with severe, life-threatening anemia. This article provides an up-to-date review of the history and development, clinical trials, new technology, and current standing of artificial oxygen carriers as an alternative to transfusion when blood is not an option.
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Affiliation(s)
- Jonathan S Jahr
- From the David Geffen School of Medicine at University of California Los Angeles, Ronald Reagan UCLA Medical Center, Los Angeles, California
| | - Nicole R Guinn
- Department of Anesthesiology, Center for Blood Conservation Duke University Medical Center, Durham, North Carolina
| | - David R Lowery
- US Military, San Antonio, Texas.,Department of Anesthesiology, Uniformed Services University of the Health Sciences, San Antonio Military Medical Center, San Antonio, Texas
| | | | - Aryeh Shander
- Department of Anesthesiology, Critical Care and Hyperbaric Medicine, Englewood Hospital and Medical Center, Englewood, New Jersey.,TeamHealth Research Institute, Englewood Hospital and Medical Center, Englewood, New Jersey
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Abstract
OBJECTIVES The objectives of this study were to describe the clinical use and outcome of autologous transfusions in cats with intracavitary haemorrhage. METHODS A retrospective descriptive study was performed. Computerised medical records of a single referral centre were searched for cats receiving an autotransfusion. Medical records were evaluated for underlying disease process, autotransfusion technique, autotransfusion volume, time period over which the autotransfusion was given, packed cell volume (PCV) pre- and post-autotransfusion, percentage rise in PCV, use of other blood products and any complications of the procedure. Survival to discharge and survival at 2 months was documented. RESULTS Between July 2012 and March 2018 a total of 12 autotransfusions were performed in eight cats. All patients were diagnosed with haemoperitoneum. Four of the eight cats were diagnosed with abdominal neoplasia, three had postoperative haemorrhage and one had a traumatic haemoperitoneum. Three cats received more than one autotransfusion. Blood was collected using a 23 G butterfly catheter and 20 ml syringe in 7/12 collections, a 23 G needle and 20 ml syringe in 2/12 collections and directly into syringes from the open abdomen at the time of surgery in 3/12 collections. A median volume of 50 ml (range 25-80 ml) was collected and administered, meaning a median volume of 16.5 ml/kg (range 9-26 ml/kg) was administered. The autologous transfusions were given over a median of 3 h (0.25-6 h). Five cats were given another blood product alongside the autotransfusion. Median percentage PCV increase was 5% (range 1-7%). Anticoagulant was used in 5/12 autotransfusions. No clinically relevant adverse effects were reported. Six of the eight cats survived to discharge. Two month survival was 60% (3/5). CONCLUSIONS AND RELEVANCE Autologous transfusion appears to be a safe and effective technique for stabilising cats with haemoperitoneum. This technique allows rapid and cheap provision of blood and avoids the need for an allogenic blood donor.
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Affiliation(s)
- Laura P Cole
- Department of Clinical Science and Services, The Royal Veterinary College, Hatfield, UK
| | - Karen Humm
- Department of Clinical Science and Services, The Royal Veterinary College, Hatfield, UK
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Meng F, Kassa T, Jana S, Wood F, Zhang X, Jia Y, D’Agnillo F, Alayash AI. Comprehensive Biochemical and Biophysical Characterization of Hemoglobin-Based Oxygen Carrier Therapeutics: All HBOCs Are Not Created Equally. Bioconjug Chem 2018; 29:1560-1575. [DOI: 10.1021/acs.bioconjchem.8b00093] [Citation(s) in RCA: 39] [Impact Index Per Article: 6.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/11/2022]
Affiliation(s)
- Fantao Meng
- Laboratory of Biochemistry and Vascular Biology, Division of Blood Components and Devices, Center for Biologics Evaluation and Research, Food and Drug Administration, Silver Spring, Maryland 20993, United States
| | - Tigist Kassa
- Laboratory of Biochemistry and Vascular Biology, Division of Blood Components and Devices, Center for Biologics Evaluation and Research, Food and Drug Administration, Silver Spring, Maryland 20993, United States
| | - Sirsendu Jana
- Laboratory of Biochemistry and Vascular Biology, Division of Blood Components and Devices, Center for Biologics Evaluation and Research, Food and Drug Administration, Silver Spring, Maryland 20993, United States
| | - Francine Wood
- Laboratory of Biochemistry and Vascular Biology, Division of Blood Components and Devices, Center for Biologics Evaluation and Research, Food and Drug Administration, Silver Spring, Maryland 20993, United States
| | - Xiaoyuan Zhang
- Laboratory of Biochemistry and Vascular Biology, Division of Blood Components and Devices, Center for Biologics Evaluation and Research, Food and Drug Administration, Silver Spring, Maryland 20993, United States
| | - Yiping Jia
- Laboratory of Biochemistry and Vascular Biology, Division of Blood Components and Devices, Center for Biologics Evaluation and Research, Food and Drug Administration, Silver Spring, Maryland 20993, United States
| | - Felice D’Agnillo
- Laboratory of Biochemistry and Vascular Biology, Division of Blood Components and Devices, Center for Biologics Evaluation and Research, Food and Drug Administration, Silver Spring, Maryland 20993, United States
| | - Abdu I. Alayash
- Laboratory of Biochemistry and Vascular Biology, Division of Blood Components and Devices, Center for Biologics Evaluation and Research, Food and Drug Administration, Silver Spring, Maryland 20993, United States
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Doolin KS, Chan DL, Adamantos S, Humm K. Retrospective evaluation of unexpected events during collection of blood donations performed with and without sedation in cats (2010-2013). J Vet Emerg Crit Care (San Antonio) 2017; 27:555-560. [PMID: 28795784 DOI: 10.1111/vec.12643] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/03/2015] [Revised: 02/09/2016] [Accepted: 04/11/2016] [Indexed: 11/28/2022]
Abstract
OBJECTIVES Describe unexpected events (UEs) that occurred during blood donation in cats with and without sedation. DESIGN Retrospective observational study (2010-2013). SETTING University teaching hospital. ANIMALS Client-owned healthy cats enrolled in a blood donation program. INTERVENTIONS None. MEASUREMENTS AND MAIN RESULTS Blood collection for transfusion was performed 115 times from 32 cats. Seventy donation events were in unsedated cats and 45 in sedated cats. For each collection, the anticipated blood volume to be collected, actual blood volume collected, sedation protocol, and any UE in the peridonation period were recorded. There were 6 categories of UEs: movement during donation, donor anxiety, inadequate collected blood volume, jugular vessel related UEs, additional sedation requirement, and cardiorespiratory distress. Fisher's exact test was used to compare the frequency of UEs between sedated and unsedated cats. UEs were recorded in 54 of 115 collections. In the donor population, movement was reported as an UE in 0 cats that donated under sedation and 24/70 (34.3%) cats that donated without sedation (P < 0.001). Donor anxiety occurred in 2/45 (4.4%) cats that donated under sedation and 14/70 (20.0%) cats that donated unsedated (P = 0.014). Unsedated donation did not increase the likelihood of inadequate donation volume, jugular vessel related UEs, or cardiorespiratory distress. Eight of 45 (17.8%) sedated donations required additional sedation. CONCLUSIONS Movement during donation and signs of donor anxiety were more frequent in unsedated cats. These were considered minor issues, expected in unsedated cats being gently restrained. Blood collection from unsedated feline donors is a viable alternative to sedated donation.
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Affiliation(s)
- Kerry S Doolin
- Section of Emergency and Critical Care, Department of Clinical Science and Services, The Royal Veterinary College, University of London, UK
| | - Daniel L Chan
- Section of Emergency and Critical Care, Department of Clinical Science and Services, The Royal Veterinary College, University of London, UK
| | - Sophie Adamantos
- Langford Veterinary Services, University of Bristol, Langford, Bristol, UK
| | - Karen Humm
- Section of Emergency and Critical Care, Department of Clinical Science and Services, The Royal Veterinary College, University of London, UK
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Monticelli P, Stathopoulou TR, Lee K, Adami C. Life-threatening perianaesthetic complications in five cats undergoing biliary tract surgery: case series and literature review. J Feline Med Surg 2017; 19:717-722. [PMID: 27099297 PMCID: PMC11128805 DOI: 10.1177/1098612x16646152] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/27/2024]
Abstract
Case series summary The aim of this case series was to describe the intra- and early postanaesthetic complications occurring in five cats undergoing major surgeries involving the gallbladder and the biliary tree. The five cases of this series were admitted to the Queen Mother Hospital for Animals between June and December 2015, and were all overseen by the same senior anaesthesist. Pre-existing pancreatitis was a common finding. Observed life-threatening events were persistent, unresponsive hypotension in the absence of major blood loss, which occurred mainly during surgical manipulation of the biliary tract, and postoperative renal failure. Relevance and novel information Biliary surgery carries the potential for life-threatening complications in cats. The pathogenesis of such morbidities is likely to be multifactorial. The perianaesthetic use of haemoglobin-based oxygen-carrying solution may be considered as an alternative treatment option when hypotension is unresponsive to fluids and traditional positive inotropes and vasopressors.
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Affiliation(s)
| | | | - Karla Lee
- Royal Veterinary College, University of London, Hatfield, UK
| | - Chiara Adami
- Royal Veterinary College, University of London, Hatfield, UK
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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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Oron L, Bruchim Y, Klainbart S, Kelmer E. Ultrasound-guided intracardiac xenotransfusion of canine packed red blood cells and epinephrine to the left ventricle of a severely anemic cat during cardiopulmonary resuscitation. J Vet Emerg Crit Care (San Antonio) 2017; 27:218-223. [PMID: 28072500 DOI: 10.1111/vec.12565] [Citation(s) in RCA: 15] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/30/2014] [Revised: 03/20/2015] [Accepted: 04/18/2015] [Indexed: 11/30/2022]
Abstract
OBJECTIVE To describe the use of an ultrasound-guided intracardiac xenotransfusion of canine packed red blood cells (pRBC) to the left ventricle of a severely anemic cat during cardiopulmonary resuscitation (CPR). CASE SUMMARY An 8-year-old previously healthy neutered female cat was presented with severe weakness after she had disappeared for 1 month. On presentation, the cat was in hypovolemic shock, laterally recumbent, and severely anemic with massive flea infestation. Within minutes of admission, the cat became agonal and suffered cardiopulmonary arrest. CPR was immediately initiated; however, attempts to gain IV access during CPR were unsuccessful. As the cat's blood type was yet unknown, 10 mL of canine pRBC was transfused directly into the left ventricular chamber using ultrasound guidance, as well as 0.02 mg/kg of epinephrine using a similar technique. The cat regained cardiac activity and once the jugular vein was cannulated it received 20 additional mL of canine pRBC intravenously. The packed cell volume and total plasma protein following the intracardiac transfusion were 0.09 L/L [9%] and 30 g/L [3.0 g/dL], respectively. Subsequent blood typing revealed the cat had type B blood. The cat was discharged 3 days post-CPR and was alive and doing well 3 months following discharge. NEW OR UNIQUE INFORMATION PROVIDED This is the first reported case of ultrasound-guided intracardiac canine-to-feline xenotransfusion during CPR.
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Affiliation(s)
- Liron Oron
- Department of Small Animal Emergency and Critical Care, Hebrew University Veterinary Teaching Hospital, Koret School of Veterinary Medicine, The Hebrew University of Jerusalem, Rehovot, 761001, Israel
| | - Yaron Bruchim
- Department of Small Animal Emergency and Critical Care, Hebrew University Veterinary Teaching Hospital, Koret School of Veterinary Medicine, The Hebrew University of Jerusalem, Rehovot, 761001, Israel
| | - Sigal Klainbart
- Department of Small Animal Emergency and Critical Care, Hebrew University Veterinary Teaching Hospital, Koret School of Veterinary Medicine, The Hebrew University of Jerusalem, Rehovot, 761001, Israel
| | - Efrat Kelmer
- Department of Small Animal Emergency and Critical Care, Hebrew University Veterinary Teaching Hospital, Koret School of Veterinary Medicine, The Hebrew University of Jerusalem, Rehovot, 761001, Israel
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Black V, Adamantos S, Barfield D, Tasker S. Feline non-regenerative immune-mediated anaemia: features and outcome in 15 cases. J Feline Med Surg 2016; 18:597-602. [PMID: 26116621 PMCID: PMC10816389 DOI: 10.1177/1098612x15588800] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/27/2024]
Abstract
OBJECTIVES Pure red cell aplasia (PRCA) and non-regenerative immune-mediated haemolytic anaemia (NRIMHA) are uncommon causes of non-regenerative anaemia affecting the bone marrow in the cat. This retrospective study aimed to describe the clinical features, treatment and outcome (remission and survival) of cats with these disorders. METHODS Cases of PRCA and NRIMHA presenting between 2009 and 2013 were retrieved. Clinical features including signalment, history, clinical signs and diagnostic investigations were recorded, as well as treatment(s) used and outcome (remission and survival). Outcome was compared for PRCA and NRIMHA. RESULTS Fifteen cats met inclusion criteria: seven with PRCA and eight with NRIMHA. The majority (12/15) were younger than 3 years of age. Volume overload was common (8/11). Treatment with whole blood transfusions with or without Oxyglobin was necessary in most cats (14/15) and resulted in congestive heart failure in one cat. Most cats (11/15) achieved remission 12-42 days after starting immunosuppressive treatment. Treatment protocols associated with remission were glucocorticoids alone (remission in 6/7 cats), glucocorticoids and chlorambucil (remission in 3/6 treated cats), glucocorticoids and ciclosporin (one cat only) and ciclosporin alone (one cat only). Relapse was observed in 3/11 cats, and 8/11 cats were still receiving treatment at the time of follow-up. Outcome (remission and survival) did not differ between PRCA and NRIMHA. CONCLUSIONS AND RELEVANCE PRCA and NRIMHA are uncommon causes of anaemia in predominantly young cats. The prognosis is reasonable, with a mortality rate of 27%, and it can take at least 6 weeks before remission is observed. Following clinical remission, gradual withdrawal of immunosuppressive treatments should be attempted, with close monitoring for relapse; some cats may require long-term treatment. This study is the first to report the use of chlorambucil as an adjunctive immunosuppressant in these cases. Outcome did not differ for PRCA and NRIMHA.
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Affiliation(s)
- Victoria Black
- The Feline Centre, Langford Veterinary Services, University of Bristol, Langford, UK
| | - Sophie Adamantos
- The Feline Centre, Langford Veterinary Services, University of Bristol, Langford, UK
| | - Dominic Barfield
- Department of Clinical Science and Services, The Royal Veterinary College, Hawkshead Lane, North Mymms, UK
| | - Séverine Tasker
- The Feline Centre, Langford Veterinary Services, University of Bristol, Langford, UK
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Kisielewicz C, Self IA. Canine and feline blood transfusions: controversies and recent advances in administration practices. Vet Anaesth Analg 2014; 41:233-42. [PMID: 24576208 DOI: 10.1111/vaa.12135] [Citation(s) in RCA: 56] [Impact Index Per Article: 5.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/23/2013] [Accepted: 11/15/2013] [Indexed: 11/28/2022]
Abstract
OBJECTIVES To discuss and review blood transfusion practices in dogs and cats including collection and storage of blood and administration of products. To report new developments, controversial practices, less conventional blood product administration techniques and where applicable, describe the relevance to anaesthetists and anaesthesia. DATABASES USED PubMed and Google Scholar using dog, cat, blood transfusion, packed red blood cells and whole blood as keywords. CONCLUSIONS Blood transfusions improve oxygen carrying capacity and the clinical signs of anaemia. However there are numerous potential risks and complications possible with transfusions, which may outweigh their benefits. Storage of blood products has improved considerably over time but whilst extended storage times may improve their availability, a phenomenon known as the storage lesion has been identified which affects erythrocyte viability and survival. Leukoreduction involves removing leukocytes and platelets thereby preventing their release of cytokines and bioactive compounds which also contribute to storage lesions and certain transfusion reactions. Newer transfusion techniques are being explored such as cell salvage in surgical patients and subsequent autologous transfusion. Xenotransfusions, using blood and blood products between different species, provide an alternative to conventional blood products.
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Affiliation(s)
- Caroline Kisielewicz
- Queen Mother Hospital for Animals, Royal Veterinary College, Hatfield, Hertfordshire, UK
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12
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Korman RM, Hetzel N, Knowles TG, Harvey AM, Tasker S. A retrospective study of 180 anaemic cats: features, aetiologies and survival data. J Feline Med Surg 2013; 15:81-90. [PMID: 22989560 PMCID: PMC10816667 DOI: 10.1177/1098612x12461008] [Citation(s) in RCA: 25] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Abstract
The study comprised 180 anaemic cats. Descriptive and survival data were obtained. Cats were classified by aetiology of anaemia development and degenerative, anomalous, metabolic, miscellaneous, neoplastic, infectious, inflammatory, immune-mediated, toxic, traumatic or vascular disease (DAMNITV) classification and anaemia severity. Sixty-four (35.6%) cats had mild [packed cell volume (PCV)/haematocrit (HCT) 20-24.9%], 58 (32.2%) moderate (14-19.9%), 23 (12.8%) severe (11-13.9%) and 35 (19.4%) very severe (<10.9%) anaemia. By aetiology of anaemia development, bone marrow (BM) abnormalities were more common (95, 52.8%) than haemorrhage (37, 20.6%) or haemolysis (19, 10.6%). By DAMNITV classification, infectious diseases were more common (39, 21.7%) than neoplasia (36, 20%), metabolic (21, 11.7%), trauma (15, 8.3%), miscellaneous (14, 7.8%), inflammatory (11, 6.1%), immune-mediated (11, 6.1%), anomalous (8, 4.4%), toxic (2, 1.1%) or vascular disease (1, 0.6%). BM abnormalities were significantly associated with more severe anaemia (P = 0.003). Most cats (112, 62.2%) survived to discharge whereas 55 (30.6%) were euthanased and 13 (7.2%) died. Survival to discharge was not associated with anaemia severity but was associated significantly with aetiology of anaemia development (P = 0.046), as cats with haemolysis were more likely to survive to discharge than cats with BM abnormalities. Survival to discharge was also associated significantly with DAMNITV classification (P = 0.010), with cats with neoplasia being less likely, and cats with immune-mediated disease more likely, to survive to discharge. Cox regression analysis found that survival was not associated with anaemia severity, but was associated with DAMNITV classification (P = 0.011) and age (P = 0.082), with cats with immune-mediated disease and younger cats more likely to survive.
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Affiliation(s)
- Rachel M Korman
- The Feline Centre, Langford Veterinary Services, School of Veterinary Sciences, University of Bristol, UK.
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14
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Chalhoub S, Langston C, Eatroff A. Anemia of renal disease: what it is, what to do and what's new. J Feline Med Surg 2011; 13:629-40. [PMID: 21872790 PMCID: PMC10832667 DOI: 10.1016/j.jfms.2011.07.016] [Citation(s) in RCA: 31] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
Abstract
PATIENT GROUP It is estimated that 15-30% of geriatric cats will develop chronic kidney disease (CKD), and that 30-65% of these cats will develop anemia as their renal disease worsens. Anemia of renal disease is multifactorial in its pathogenesis, but the main cause is reduced production of erythropoietin, a renal hormone that controls the bone marrow's production of red blood cells, as kidney disease progresses. PRACTICAL RELEVANCE It is important to recognize the presence of anemia of renal disease so that adequate treatment may be instituted to improve quality of life and metabolic function. Erythrocyte-stimulating agents (ESAs), such as epoetin alfa, epoetin beta and darbepoetin alfa, have been developed to counteract the effects of decreased erythropoietin production by the kidneys. These treatments, which are the focus of this review, have 83% similarity in amino acid sequence to the feline hormone. On average, the target packed cell volume (>25%) is reached within 3-4 weeks of ESA therapy. CLINICAL CHALLENGES The use of ESAs has been associated with a number of complications, such as iron deficiency, hypertension, arthralgia, fever, seizures, polycythemia and pure red cell aplasia (PRCA). Darbepoetin has a prolonged half-life compared with epoetin and thus can be given only once a week, instead of three times a week. The incidence of PRCA appears to be decreased with darbepoetin use when compared with epoetin use in cats. EVIDENCE BASE There is limited published evidence to date to underpin the use of ESAs in cats. This review draws on the relevant publications that currently exist, and the authors' personal experience of using these therapies for over 5 years.
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Affiliation(s)
- Serge Chalhoub
- (Small Animal Internal Medicine) Charleston Veterinary Referral Center, 3484 Shelby Ray Court, Charleston, SC 29414, USA
| | | | - Adam Eatroff
- Nephrology/Hemodialysis Unit, Internal Medicine Department, The Animal Medical Center, 510 East 62nd Street, New York, NY 10065, USA
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Wehausen CE, Kirby R, Rudloff E. Evaluation of the effects of bovine hemoglobin glutamer-200 on systolic arterial blood pressure in hypotensive cats: 44 cases (1997–2008). J Am Vet Med Assoc 2011; 238:909-14. [DOI: 10.2460/javma.238.7.909] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022]
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Barfield D, Adamantos S. Assessment of feline blood for transfusion. Vet Rec 2011; 168:350-1. [DOI: 10.1136/vr.d2036] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/03/2022]
Affiliation(s)
- D. Barfield
- Department of Veterinary Clinical Science; Royal Veterinary College; Hawkshead Lane, North Mymms Hatfield Hertfordshire AL9 7TA
| | - S. Adamantos
- Department of Veterinary Clinical Science; Royal Veterinary College; Hawkshead Lane, North Mymms Hatfield Hertfordshire AL9 7TA
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Abstract
PRACTICAL RELEVANCE blood transfusions are a potentially life-saving procedure that are within the reach of most small animal practitioners. Only minimal equipment is required. PATIENT GROUP any cat with clinical signs attributable to a reduced red blood cell mass that is affecting oxygen transport (as a result of reduced packed cell volume or acute blood loss) is a potential candidate for a transfusion. CLINICAL CHALLENGES although the principles of transfusion medicine are not complicated, there can be fatal consequences if certain steps are omitted. DIAGNOSTICS blood typing kits and blood filters are readily available from veterinary wholesalers, laboratories and blood banking services. EVIDENCE BASE over the past three decades, a substantial body of clinical research and reports has built up covering feline blood types and transfusion medicine. This article draws on that research to provide clinical guidance aimed at all veterinarians in feline or small animal practice who either currently practise transfusion medicine or plan to do so.
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Wondratschek C, Weingart C, Kohn B. Primary Immune-Mediated Thrombocytopenia in Cats. J Am Anim Hosp Assoc 2010; 46:12-9. [DOI: 10.5326/0460012] [Citation(s) in RCA: 16] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/11/2022]
Abstract
Feline primary immune-mediated thrombocytopenia (pIMT) is a rare condition, and only a few cases have been described in veterinary literature. Five cats with severe thrombocytopenia most likely due to pIMT are described. A flow cytometry platelet-bound antibody test was positive in all cats; underlying diseases or triggering factors causing thrombocytopenia were not detected. Three cats were transfused with blood type-compatible fresh whole blood; one cat received Oxyglobin as well. All cats were treated with prednisolone; one cat received chlorambucil in addition. Four cats responded to treatment and were discharged from the hospital. One cat was euthanized due to dyspnea. Primary immune-mediated thrombocytopenia is rarely diagnosed in cats, but it is important as a differential diagnosis in cats presented with surface bleeding.
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Affiliation(s)
- Christina Wondratschek
- Clinic for Small Animals, Faculty of Veterinary Medicine, Free University of Berlin, Oertzenweg 19b, Berlin, 14163, Germany
- From the
| | - Christiane Weingart
- Clinic for Small Animals, Faculty of Veterinary Medicine, Free University of Berlin, Oertzenweg 19b, Berlin, 14163, Germany
- From the
| | - Barbara Kohn
- Clinic for Small Animals, Faculty of Veterinary Medicine, Free University of Berlin, Oertzenweg 19b, Berlin, 14163, Germany
- From the
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