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LeVine DN, Goggs R, Kohn B, Mackin AJ, Kidd L, Garden OA, Brooks MB, Eldermire ERB, Abrams-Ogg A, Appleman EH, Archer TM, Bianco D, Blois SL, Brainard BM, Callan MB, Fellman CL, Haines JM, Hale AS, Huang AA, Lucy JM, O'Marra SK, Rozanski EA, Thomason JM, Walton JE, Wilson HE. ACVIM consensus statement on the treatment of immune thrombocytopenia in dogs and cats. J Vet Intern Med 2024. [PMID: 38779941 DOI: 10.1111/jvim.17079] [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: 03/29/2024] [Accepted: 04/04/2024] [Indexed: 05/25/2024] Open
Abstract
Management of immune thrombocytopenia (ITP) in dogs and cats is evolving, but there are no evidence-based guidelines to assist clinicians with treatment decisions. Likewise, the overall goals for treatment of ITP have not been established. Immunosuppressive doses of glucocorticoids are the first line treatment, but optimal treatment regimens beyond glucocorticoids remain uncertain. Additional options include secondary immunosuppressive drugs such as azathioprine, modified cyclosporine, and mycophenolate mofetil, usually selected based on clinician preference. Vincristine, human IV immunoglobulin (hIVIg), and transfusion of platelet or red blood cell-containing products are often used in more severe cases. Splenectomy and thrombopoietin receptor agonists are usually reserved for refractory cases, but when and in which patient these modalities should be employed is under debate. To develop evidence-based guidelines for individualized treatment of ITP patients, we asked 20 Population Intervention Comparison Outcome (PICO) format questions. These were addressed by 17 evidence evaluators using a literature pool of 288 articles identified by a structured search strategy. Evidence evaluators, using panel-designed templates and data extraction tools, summarized evidence and created guideline recommendations. These were integrated by treatment domain chairs and then refined by iterative Delphi survey review to reach consensus on the final guidelines. In addition, 19 non-PICO questions covering scenarios in which evidence was lacking or of low quality were answered by expert opinion using iterative Delphi surveys with panelist integration and refinement. Commentary was solicited from multiple relevant professional organizations before finalizing the consensus. The rigorous consensus process identified few comparative treatment studies, highlighting many areas of ITP treatment requiring additional studies. This statement is a companion manuscript to the ACVIM Consensus Statement on the Diagnosis of Immune Thrombocytopenia in Dogs and Cats.
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Affiliation(s)
- Dana N LeVine
- Department of Clinical Sciences, College of Veterinary Medicine, Auburn University, Auburn, Alabama, USA
| | - Robert Goggs
- Department of Clinical Sciences, College of Veterinary Medicine, Cornell University, Ithaca, New York, USA
| | - Barbara Kohn
- Small Animal Clinic, School of Veterinary Medicine, Freie Universität Berlin, Berlin, Germany
| | - Andrew J Mackin
- Department of Clinical Sciences, College of Veterinary Medicine, Mississippi State University, Mississippi State, Mississippi, USA
| | - Linda Kidd
- Linda Kidd Veterinary Internal Medicine Consulting, Carlsbad, California, USA
| | - Oliver A Garden
- School of Veterinary Medicine, Louisiana State University, Baton Rouge, Louisiana, USA
| | - Marjory B Brooks
- Department of Population Medicine and Diagnostic Sciences, College of Veterinary Medicine, Cornell University, Ithaca, New York, USA
| | - Erin R B Eldermire
- Flower-Sprecher Veterinary Library, College of Veterinary Medicine, Cornell University, Ithaca, New York, USA
| | - Anthony Abrams-Ogg
- Department of Clinical Studies, Ontario Veterinary College, University of Guelph, Guelph, Ontario, Canada
| | - Elizabeth H Appleman
- Department of Internal Medicine, The Animal Medical Center, New York, New York, USA
| | - Todd M Archer
- Bluff City Veterinary Specialists, Memphis, Tennessee, USA
| | - Domenico Bianco
- College of Veterinary Medicine, Western University of Health Sciences, Pomona, California, USA
| | - Shauna L Blois
- Department of Clinical Studies, Ontario Veterinary College, University of Guelph, Guelph, Ontario, Canada
| | - Benjamin M Brainard
- Department of Small Animal Medicine and Surgery, College of Veterinary Medicine, University of Georgia, Athens, Georgia, USA
| | - Mary Beth Callan
- Department of Clinical Sciences and Advanced Medicine, School of Veterinary Medicine, University of Pennsylvania, Philadelphia, Pennsylvania, USA
| | - Claire L Fellman
- Department of Clinical Sciences, Cummings School of Veterinary Medicine, Tufts University, North Grafton, Massachusetts, USA
| | - Jillian M Haines
- Department of Veterinary Clinical Sciences, College of Veterinary Medicine, Washington State University, Pullman, Washington, USA
| | - Anne S Hale
- Zia Pet Hospital, Rio Rancho, New Mexico, USA
| | | | - John M Lucy
- Oradell Animal Hospital, Paramus, New Jersey, USA
| | - Shana K O'Marra
- Northwest Veterinary Critical Care Services, Vancouver, Washington, USA
| | - Elizabeth A Rozanski
- Department of Clinical Sciences, Cummings School of Veterinary Medicine, Tufts University, North Grafton, Massachusetts, USA
| | - John M Thomason
- Department of Clinical Sciences, College of Veterinary Medicine, Mississippi State University, Mississippi State, Mississippi, USA
| | - Jenny E Walton
- Veterinary Apheresis Service UK, Washington, Tyne and Wear, United Kingdom
| | - Helen E Wilson
- Langford Vets, University of Bristol, Langford, Somerset, United Kingdom
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Thomas-Hollands A, Hess RS, Weinstein NM, Marryott K, Fromm S, Chappini NA, Callan MB. Effect of donor blood storage on gel column crossmatch in dogs. Vet Clin Pathol 2023; 52:30-37. [PMID: 36224702 DOI: 10.1111/vcp.13188] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/03/2022] [Revised: 07/07/2022] [Accepted: 08/08/2022] [Indexed: 11/29/2022]
Abstract
BACKGROUND Compared with fresh blood, stored equine donor blood results in spurious tube crossmatch incompatibilities. Interpretation of blood crossmatch results is considered subjective. OBJECTIVES We aimed to determine if the duration of canine donor blood storage impacts compatibility testing using a standard gel column crossmatch and evaluate interobserver variation in the interpretation of crossmatch results. METHODS Observational study. Whole blood segments were obtained from 23 canine packed red blood cell (RBC) units for use in crossmatches after storage for 0, 7, 14, 21, 28, and 35 days. Major and minor crossmatches were performed using serum and RBCs, respectively, from two to three healthy "recipient" dogs per unit. All crossmatch results were interpreted by four observers, of whom three were blinded. RESULTS All major crossmatches (n = 61) were compatible on day 0 and remained compatible through day 35 of storage. All minor crossmatches (n = 69) were compatible at all time points, except for five donor pairs with 1 to 3+ agglutination. Repeat testing of these five donor pairs confirmed crossmatch incompatibilities on days 0 through 35, with no change in the degree of incompatibility over time. There was substantial agreement among four observers in determining compatibility (κ = 0.94) and scoring incompatibility (κ = 0.76). CONCLUSIONS The current practice of performing canine crossmatches with whole blood segments stored for up to 35 days is acceptable, with no spurious changes in compatibility expected over time. The substantial interobserver agreement suggests that the gel column is suitable for performing canine crossmatches in a laboratory setting with multiple personnel.
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Affiliation(s)
- Alison Thomas-Hollands
- Department of Clinical Sciences and Advanced Medicine, University of Pennsylvania, Philadelphia, Pennsylvania, USA
| | - Rebecka S Hess
- Department of Clinical Sciences and Advanced Medicine, University of Pennsylvania, Philadelphia, Pennsylvania, USA
| | - Nicole M Weinstein
- Department of Clinical Sciences and Advanced Medicine, University of Pennsylvania, Philadelphia, Pennsylvania, USA
| | - Kimberly Marryott
- Department of Clinical Sciences and Advanced Medicine, University of Pennsylvania, Philadelphia, Pennsylvania, USA
| | - Samantha Fromm
- Department of Clinical Sciences and Advanced Medicine, University of Pennsylvania, Philadelphia, Pennsylvania, USA
| | - Nicole A Chappini
- Department of Clinical Sciences and Advanced Medicine, University of Pennsylvania, Philadelphia, Pennsylvania, USA
| | - Mary Beth Callan
- Department of Clinical Sciences and Advanced Medicine, University of Pennsylvania, Philadelphia, Pennsylvania, USA
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3
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Herter L, Weingart C, Merten N, Bock N, Merle R, Kohn B. Response to letter regarding "Alloimmunization in dogs after transfusion: A serial cross-match study". J Vet Intern Med 2023; 37:10-11. [PMID: 36637067 PMCID: PMC9889672 DOI: 10.1111/jvim.16628] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/16/2022] [Accepted: 12/19/2022] [Indexed: 01/14/2023] Open
Affiliation(s)
- Lisa Herter
- Faculty of Veterinary MedicineClinic for Small Animals, Freie Universität BerlinBerlinGermany
| | - Christiane Weingart
- Faculty of Veterinary MedicineClinic for Small Animals, Freie Universität BerlinBerlinGermany
| | - Nina Merten
- Faculty of Veterinary MedicineClinic for Small Animals, Freie Universität BerlinBerlinGermany
| | - Nicole Bock
- Faculty of Veterinary MedicineClinic for Small Animals, Freie Universität BerlinBerlinGermany
| | - Roswitha Merle
- Department of Veterinary MedicineInstitute for Veterinary Epidemiology and Biostatistics, Freie Universität BerlinBerlinGermany
| | - Barbara Kohn
- Faculty of Veterinary MedicineClinic for Small Animals, Freie Universität BerlinBerlinGermany
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4
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Adamantos S, Safrany B. Current controversies in feline transfusion medicine. IN PRACTICE 2023. [DOI: 10.1002/inpr.174] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/22/2023]
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Herter L, Weingart C, Merten N, Bock N, Merle R, Kohn B. Alloimmunization in dogs after transfusion: A serial cross-match study. J Vet Intern Med 2022; 36:1660-1668. [PMID: 36161382 PMCID: PMC9511065 DOI: 10.1111/jvim.16521] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/03/2022] [Accepted: 08/02/2022] [Indexed: 02/03/2023] Open
Abstract
BACKGROUND Cross-matching is performed to determine the serological compatibility of donor and recipient blood. Current guidelines recommend that cross-matching should be performed in dogs when an initial transfusion was performed more than 4 days ago or when the transfusion history is unknown. HYPOTHESIS Determination at what time point alloantibodies are detected in dogs after transfusion. The hypothesis was that dogs would form alloantibodies within 4 days after a transfusion. ANIMALS Twenty-one anemic dogs were transfused and monitored for at least 4 subsequent days. Exclusion criteria were persistent red blood cell (RBC) agglutination and a previous transfusion. METHODS Prospective observational study. Cross-matching was performed before the initial DEA 1-compatible transfusion and on days 1, 2, 3, and 4 and if possible, between day 5 and 28, using the tube method without enhancement (major cross-match, recipient controls); recipients were monitored for transfusion reactions. RESULTS In 12/21 dogs a positive cross-match (microscopic degree of agglutination [AD] 1+ to 2+) was observed within 4 days after the transfusion. In a nonlinear regression model, no significant association was detected between type of anemia (P = .41), RBC storage time (P = .44), immunosuppressive treatment (P = .75) nor transfusion volume (P = .70) and the occurrence of positive cross-matches within 4 days after transfusion. Another 4 dogs developed a positive cross-match (microscopic AD 1+ to 2+) after 6 to 13 days. CONCLUSIONS AND CLINICAL IMPORTANCE Because production of alloantibodies was detected as early as 1 day after transfusion, cross-matching should be performed before every subsequent transfusion.
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Affiliation(s)
- Lisa Herter
- Clinic for Small Animals, Faculty of Veterinary MedicineFreie Universität BerlinBerlinGermany
| | - Christiane Weingart
- Clinic for Small Animals, Faculty of Veterinary MedicineFreie Universität BerlinBerlinGermany
| | - Nina Merten
- Clinic for Small Animals, Faculty of Veterinary MedicineFreie Universität BerlinBerlinGermany
| | - Nicole Bock
- Clinic for Small Animals, Faculty of Veterinary MedicineFreie Universität BerlinBerlinGermany
| | - Roswitha Merle
- Institute for Veterinary Epidemiology and Biostatistics, Department of Veterinary MedicineFreie Universität BerlinBerlinGermany
| | - Barbara Kohn
- Clinic for Small Animals, Faculty of Veterinary MedicineFreie Universität BerlinBerlinGermany
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6
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Cannavino A, LeVine D, Blais MC. Characterization of post-transfusion anti-FEA 1 alloantibodies in transfusion-naive FEA 1-negative cats. J Feline Med Surg 2022; 24:e124-e130. [PMID: 35510900 PMCID: PMC9160940 DOI: 10.1177/1098612x221094502] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
Abstract
Objectives The aim of this study was to characterize anti-feline erythrocyte antigen (FEA) 1 alloantibodies following sensitization of FEA 1-negative cats, including their rate of appearance, agglutination titer over time and immunoglobulin class. A secondary aim was to obtain polyclonal anti-FEA 1 alloantibodies to increase the availability of FEA 1 blood typing. We also describe a case study documenting an acute hemolytic transfusion reaction in a transfusion-naive FEA 1-negative feline patient that received FEA 1-positive blood. Methods In this prospective clinical study, 35 cats with blood group type A underwent extensive blood typing for FEA 1–5. Two cats were identified as FEA 1-negative; these cats were transfused uneventfully with 50 ml of FEA 1-positive, but otherwise compatible, packed red blood cells. Post-transfusion blood samples were collected routinely as long as anti-FEA 1 alloantibodies were detected. Appearance of anti-FEA 1 alloantibodies was detected using a gel column crossmatch method. Results Anti-FEA 1 alloantibodies were detected as early as 5 days post-transfusion and remained detectable for over 400 days in one cat. Agglutination titers in both cats were relatively weak (1:1 to 1:8). The main immunoglobulin class was IgM. Conclusions and relevance Transfusion of FEA 1-negative, transfusion-naive cats with FEA 1-positive blood results in production of post-transfusion anti-FEA 1 alloantibodies as early as 5 days post-transfusion. Our results confirm the potential immunogenicity of FEA 1 and support crossmatching prior to a blood transfusion, even in transfusion-naive cats. Further studies are needed to better document the clinical importance of these post-transfusion antibodies, as well as to facilitate routine blood typing for the FEA 1 antigen in cats.
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Affiliation(s)
- Alyssa Cannavino
- Department of Clinical Sciences, Faculty of Veterinary Medicine, Université de Montréal, Saint-Hyacinthe, QC, Canada
| | - Dana LeVine
- Department of Clinical Sciences, Bailey Small Animal Teaching Hospital, College of Veterinary Medicine, Auburn University, Auburn, AL, USA
| | - Marie-Claude Blais
- Department of Clinical Sciences, Faculty of Veterinary Medicine, Université de Montréal, Saint-Hyacinthe, QC, Canada
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Taylor S, Spada E, Callan MB, Korman R, Leister E, Steagall P, Lobetti R, Seth M, Tasker S. 2021 ISFM Consensus Guidelines on the Collection and Administration of Blood and Blood Products in Cats. J Feline Med Surg 2021; 23:410-432. [PMID: 33896248 PMCID: PMC10741281 DOI: 10.1177/1098612x211007071] [Citation(s) in RCA: 13] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/04/2023]
Abstract
PRACTICAL RELEVANCE Blood and blood products are increasingly available for practitioners to use in the management of haematological conditions, and can be lifesaving and therapeutically useful for patients with anaemia and/or coagulopathies. It is important for feline healthcare that donors are selected appropriately, and transfusions of blood or blood products are given to recipients that will benefit from them. Complications can occur, but can be largely avoided with careful donor management and recipient selection, understanding of blood type compatibility, and transfusion monitoring. CLINICAL CHALLENGES Feline blood transfusion, while potentially a lifesaving procedure, can also be detrimental to donor and recipient without precautions. Cats have naturally occurring alloantibodies to red cell antigens and severe reactions can occur with type-mismatched transfusions. Blood transfusions can also transmit infectious agents to the recipient, so donor testing is essential. Finally, donors must be in good health, and sedated as appropriate, with blood collected in a safe and sterile fashion to optimise the benefit to recipients. Transfusion reactions are possible and can be mild to severe in nature. Autologous blood transfusions and xenotransfusions may be considered in certain situations. EVIDENCE BASE These Guidelines have been created by a panel of authors convened by the International Society of Feline Medicine (ISFM), based on available literature. They are aimed at general practitioners to provide a practical guide to blood typing, cross-matching, and blood collection and administration.
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Affiliation(s)
| | - Eva Spada
- Veterinary Transfusion Research Laboratory
(REVLab), Department of Veterinary Medicine (DIMEVET), University of Milan,
Italy
| | - Mary Beth Callan
- Department of Clinical Sciences and Advanced
Medicine, School of Veterinary Medicine, University of Pennsylvania,
USA
| | - Rachel Korman
- Cat Specialist Services, Underwood, Queensland,
Australia
| | - Ellie Leister
- Pet Intensive Care Unit, Underwood, Queensland,
Australia
| | - Paulo Steagall
- Department of Clinical Sciences, Faculty of
Veterinary Medicine, Universite de Montréal, QC, Canada
| | - Remo Lobetti
- Bryanston Veterinary Hospital, Johannesburg,
South Africa
| | | | - Séverine Tasker
- Bristol Veterinary School, University of
Bristol, Langford, UK; and Linnaeus Group, Shirley, UK
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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 2: Prevention and monitoring. J Vet Emerg Crit Care (San Antonio) 2021; 31:167-188. [PMID: 33751789 DOI: 10.1111/vec.13045] [Citation(s) in RCA: 23] [Impact Index Per Article: 7.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/29/2020] [Accepted: 02/06/2021] [Indexed: 12/15/2022]
Abstract
OBJECTIVE To systematically review available evidence to develop guidelines for the prevention of transfusion reactions and monitoring of transfusion administration in dogs and cats. DESIGN Evidence evaluation of the literature (identified through Medline searches through Pubmed and Google Scholar searches) was carried out for identified transfusion reaction types in dogs and cats. Evidence was evaluated using PICO (Population, Intervention, Comparison, Outcome) questions generated for each reaction type. Evidence was categorized by level of evidence (LOE) and quality (Good, Fair, or Poor). Guidelines for prevention and monitoring were generated based on the synthesis of the evidence. Consensus on the final recommendations and a proposed transfusion administration monitoring form was achieved through Delphi-style surveys. Draft recommendations and the monitoring form were made available through veterinary specialty listservs and comments were incorporated. RESULTS Twenty-nine guidelines and a transfusion administration monitoring form were formulated from the evidence review with a high degree of consensus CONCLUSIONS: This systematic evidence evaluation process yielded recommended prevention and monitoring guidelines and a proposed transfusion administration form. However, significant knowledge gaps were identified, demonstrating the need for additional research in veterinary transfusion medicine.
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Affiliation(s)
- Elizabeth B Davidow
- Veterinary Clinical Sciences, Washington State University, Pullman, Washington, USA
| | - 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, North Carolina, USA
| | - Katherine J Nash
- VetMED Emergency and Specialty Veterinary Hospital, Phoenix, Arizona, USA
| | - Adesola Odunayo
- Department of Small Animal Clinical Sciences, University of Tennessee, Knoxville, Tennessee, 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, Mississippi, USA
| | | | - K Jane Wardrop
- Veterinary Clinical Sciences, Washington State University, Pullman, Washington, USA
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Odunayo A, Nash KJ, Davidow EB, Blois SL, Goy-Thollot I, Harris L, Humm K, Musulin S, Sharp CR, Spada E, Thomason J, Walton J, Jane Wardrop K. Association of Veterinary Hematology and Transfusion Medicine (AVHTM) transfusion reaction small animal consensus statement (TRACS). Part 3: Diagnosis and treatment. J Vet Emerg Crit Care (San Antonio) 2021; 31:189-203. [PMID: 33751797 DOI: 10.1111/vec.13043] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/31/2020] [Accepted: 02/06/2021] [Indexed: 01/15/2023]
Abstract
OBJECTIVE To systematically review available evidence to develop guidelines for diagnosis and treatment of transfusion-associated reactions in dogs and cats. DESIGN Standardized and systemic evaluation of the literature (identified through Medline via PubMed and Google Scholar searches) was carried out for identified transfusion reaction types in dogs and cats. The available evidence was evaluated using PICO (Population, Intervention, Comparison, Outcome) questions generated for each reaction type. The evidence was categorized by level of evidence (LOE) and quality (Good, Fair, or Poor). Guidelines, diagnostic, and treatment algorithms were generated based on the evaluation of the evidence. Consensus on the final guidelines was achieved through Delphi-style surveys. Draft recommendations were disseminated through veterinary specialty listservs for review and comments, which were evaluated and integrated prior to final publication. RESULTS Medline via PubMed and Google Scholar databases were searched. There were 14 Population Intervention Comparison Outcome questions identified and corresponding worksheets were developed focusing on the diagnosis and treatment of transfusion-associated reactions in dogs and cats. Fourteen guidelines and four algorithms were developed with a high degree of consensus. CONCLUSIONS This systematic evidence evaluation process yielded recommended diagnostic and treatment algorithms for use in practice. However, significant knowledge gaps were identified, demonstrating the need for additional research in veterinary transfusion medicine.
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Affiliation(s)
- Adesola Odunayo
- Department of Small Animal Clinical Sciences, University of Tennessee, Knoxville, Tennessee, USA
| | - Katherine J Nash
- VetMED Emergency and Specialty Veterinary Hospital, Phoenix, Arizona, USA
| | - Elizabeth B Davidow
- Veterinary Clinical Sciences, Washington State University, Pullman, Washington, USA
| | - Shauna L Blois
- Department of Clinical Studies, Ontario Veterinary College, University of Guelph, 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, North Carolina, 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, Mississippi, USA
| | | | - K Jane Wardrop
- Veterinary Clinical Sciences, Washington State University, Pullman, Washington, USA
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10
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Binvel M, Arsenault J, Depré B, Blais MC. Identification of 5 novel feline erythrocyte antigens based on the presence of naturally occurring alloantibodies. J Vet Intern Med 2020; 35:234-244. [PMID: 33336860 PMCID: PMC7848337 DOI: 10.1111/jvim.16010] [Citation(s) in RCA: 9] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/31/2020] [Revised: 12/06/2020] [Accepted: 12/07/2020] [Indexed: 11/29/2022] Open
Abstract
Background Since the discovery of the Mik antigen, several studies have described blood incompatibilities unrelated to the AB system in cats. Objective To estimate the prevalence of cats with non‐AB incompatibilities associated with naturally occurring alloantibodies (NOAb), and to begin mapping the corresponding feline erythrocyte antigens (FEA). Animals Two hundred and fifty‐eight type A cats. Methods Prospectively, cats were evaluated for the presence of NOAb by crossmatching in groups of 4‐6 cats. When NOAb were detected in a cat, its plasma was used as reagent to assess for the presence of the corresponding FEA in all cats included thereafter, and agreement observed between results of this extensive blood typing was evaluated. Results The chance of detecting incompatibilities by randomly crossmatching 2 cats was 3.9%, which resulted in at least 7% of type A cats having NOAb. Blood typing and agreement analyses performed with 7 newly detected NOAb allowed the identification of 5 presumably distinct FEA. Feline erythrocyte antigens 1 and 5 were most frequent with prevalence of 84% and 96%, respectively. Only FEA 1‐negative status was associated with a higher risk of presenting NOAb; with 16.7% of 42 FEA 1‐negative cats having NOAb compared to 5.1% of 216 FEA 1‐positive cats. Conclusions and Clinical Importance This study represents a first step of FEA identification outside the AB system. Because of its prevalence and association with NOAb, FEA 1 might correspond to the Mik antigen.
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Affiliation(s)
- Marie Binvel
- Department of Clinical Sciences, Faculty of Veterinary Medicine, Université de Montréal, Saint-Hyacinthe, Canada
| | - Julie Arsenault
- Department of Pathology and Microbiology, Faculty of Veterinary Medicine, Université de Montréal, Saint-Hyacinthe, Canada
| | - Boris Depré
- Emergency and Critical Care, Adomvet, Lyon, France
| | - Marie-Claude Blais
- Department of Clinical Sciences, Faculty of Veterinary Medicine, Université de Montréal, Saint-Hyacinthe, Canada
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11
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McDermott FM, Maloney S, McMillan C, Snead E. The Prevalence of Blood Groups in Domestic Cats in the Saskatoon and Calgary Areas of Saskatchewan and Alberta, Canada. Front Vet Sci 2020; 7:160. [PMID: 32373632 PMCID: PMC7186432 DOI: 10.3389/fvets.2020.00160] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/02/2020] [Accepted: 03/05/2020] [Indexed: 11/25/2022] Open
Abstract
The purpose of this study was to evaluate blood types of domestic cats in two cities in Western Canada (Saskatoon, Saskatchewan and Calgary, Alberta), as well as to determine the risk of mismatched transfusion and neonatal isoerythrolysis. Several cat studies around the world have shown variability in the prevalence of blood types in domestic and pedigree cats. Canadian data based on feline blood types is based out of Montreal. In this study the cohort of cats revealed a higher than anticipated prevalence; of 5% type B and 0.6% AB blood types. In our study, blood typing was performed in 400 domestic cats; 200 in Saskatoon and 200 in Calgary. Blood typing was performed using the gel tube method and the risk of transfusion mismatch (MT) was estimated by adding the risk of a major transfusion reaction and the risk of a minor transfusion reaction. The risk of neonatal isoerythrolysis (NI) was estimated according to the equation (p2)(q2) + 2pq(q2), with q being the b allele frequency and p = 1 – q. There was an identical frequency for feline blood types in both Saskatoon and Calgary cats, with 96% type A, 4% type B, and 0% AB. Based on these percentages, the risks of MT and NI in domestic cats were 7.6 and 4 % respectively. The frequency of type B cats in the population was similar to that in the previous Canadian study. These results demonstrate regional differences in prevalence of type B blood in domestic shorthairs across the world and serve to reinforce recommendations to blood type prior to transfusion or mating.
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Affiliation(s)
- Fergal M McDermott
- Department of Small Animal Clinical Sciences, Western College of Veterinary Medicine, University of Saskatchewan, Saskatoon, SK, Canada
| | - Stephanie Maloney
- Department of Veterinary Clinical and Diagnostic Science, Faculty of Veterinary Medicine, University of Calgary, Calgary, AB, Canada
| | - Chantal McMillan
- Department of Veterinary Clinical and Diagnostic Science, Faculty of Veterinary Medicine, University of Calgary, Calgary, AB, Canada
| | - Elisabeth Snead
- Department of Small Animal Clinical Sciences, Western College of Veterinary Medicine, University of Saskatchewan, Saskatoon, SK, Canada
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12
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Nectoux A, Guidetti M, Barthélemy A, Pouzot-Nevoret C, Hoareau GL, Goy-Thollot I. Assessment of risks of feline mismatched transfusion and neonatal isoerythrolysis in the Lyon (France) area. JFMS Open Rep 2019; 5:2055116919863175. [PMID: 31384478 PMCID: PMC6651689 DOI: 10.1177/2055116919863175] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022] Open
Abstract
Objectives The aims of this study were to update the prevalence of different feline blood types in the Lyon (France) area, as well as to determine the risk of mismatched transfusion (MT) and neonatal isoerythrolysis (NI) in kittens with parents of unknown blood type. Methods Blood samples were obtained from blood donor cats and cats admitted to an intensive care unit in Lyon. AB blood typing was performed using an immunochromatographic strip. The risk of MT was estimated by adding the risk of a major transfusion reaction and the risk of a minor transfusion reaction. The risk of NI was estimated according the equation (p²)(q²) + 2pq(q²), with q being the b allele frequency and p = 1 - q. The results were analysed by absolute and relative frequency analysis and multivariate analysis. Results The cohort study population included 320 non-pedigree cats and 37 pedigree cats. The prevalence of blood types A, B and AB was 84.3%, 14.0% and 1.7%, respectively. Considering non-pedigree cats, the prevalence of types A, B and AB was 83.7%, 14.4% and 1.9%, respectively. There were no significant differences of blood type distribution by sex (P = 0.73) or by breed (P = 0.90). Based on these percentages, the risks of MT and NI in non-pedigree cats were 24.3% and 12.3%, respectively. Conclusions and relevance The prevalence of type B cats is high in the Lyon area and associated with high risks of MT and NI. These results confirm the importance of performing blood typing prior to any blood transfusion or mating.
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Affiliation(s)
- Alexandra Nectoux
- Intensive Care Unit (SIAMU), University of Lyon, VetAgro Sup, Marcy l'Etoile, France
| | | | - Anthony Barthélemy
- Intensive Care Unit (SIAMU), University of Lyon, VetAgro Sup, Marcy l'Etoile, France
| | - Céline Pouzot-Nevoret
- Intensive Care Unit (SIAMU), University of Lyon, VetAgro Sup, Marcy l'Etoile, France
| | - Guillaume L Hoareau
- Clinical Investigation Facility, David Grant USAF Medical Center, Travis AFB, CA, USA
| | - Isabelle Goy-Thollot
- Intensive Care Unit (SIAMU), University of Lyon, VetAgro Sup, Marcy l'Etoile, France
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Abstract
"The wall-less, hemotropic, mycoplasma species Mycoplasma haemofelis, "Candidatus Mycoplasma turicensis" and, to a lesser extent, "Candidatus Mycoplasma haemominutum" have the potential to induce clinical hemolytic anemia in infected cats. Prevalence varies markedly between infecting species, complicated by a chronic carrier state. Accurate and prompt confirmation of infection and identification of the infecting hemoplasma species enables appropriate antibiotics (eg, tetracycline; fluoroquinolone) to be prescribed. Although cats with hemoplasmosis respond rapidly to antibiosis and supportive care, initial monotherapy treatment rarely results in clearance of infection. A protocol now exists for the clearance of the most pathogenic feline hemoplasma M haemofelis."
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Affiliation(s)
- Emi N Barker
- Langford Vets, University of Bristol, Bristol BS40 5DU, UK.
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14
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Zaremba R, Brooks A, Thomovsky E. Transfusion Medicine: An Update on Antigens, Antibodies and Serologic Testing in Dogs and Cats. Top Companion Anim Med 2019; 34:36-46. [DOI: 10.1053/j.tcam.2018.12.005] [Citation(s) in RCA: 15] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/01/2018] [Revised: 12/27/2018] [Accepted: 12/28/2018] [Indexed: 12/23/2022]
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15
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Goy-Thollot I, Nectoux A, Guidetti M, Chaprier B, Bourgeois S, Boisvineau C, Barthélemy A, Pouzot-Nevoret C, Giger U. Detection of naturally occurring alloantibody by an in-clinic antiglobulin-enhanced and standard crossmatch gel column test in non-transfused domestic shorthair cats. J Vet Intern Med 2018; 33:588-595. [PMID: 30557453 PMCID: PMC6430866 DOI: 10.1111/jvim.15381] [Citation(s) in RCA: 16] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/18/2018] [Accepted: 11/13/2018] [Indexed: 02/06/2023] Open
Abstract
Background Blood typing for the A and B antigens is essential and crossmatching testing is generally recommended before transfusing blood to cats. Objective To evaluate 2 crossmatch (XM) tests. Animals Forty‐nine healthy domestic shorthair cats that had not received a blood transfusion. Methods Prospective study. Blood samples were typed for AB using immunochromatographic and flow cytometric techniques. A gel column (GC) and a feline antiglobulin‐enhanced gel column (AGC) XM tests were used for crossmatching. Results The population included 34 type A, 13 B, and 2 AB cats, with concordant results (r = 1, P < .005) by flow cytometry and immunochromatographic strip kit. The plasma from type A cats had either no or weak anti‐B alloantibodies. The plasma of 12 of 13 type B cats contained strong anti‐A alloantibodies. For crossmatching, plasma to RBC pairings were prepared using the GC (n = 446) and AGC (n = 630) tests. Both methods showed compatibilities in 329 and incompatibilities in 102 pairings including all A‐B mismatches. Additionally 15 pairings showed agglutination by the AGC but not GC method. Fourteen incompatibilities outside the expected A‐B mismatches were only revealed by AGC. Conclusions and Clinical Importance AB typing using immunochromatographic strip is as accurate as laboratory flow cytometry. The 2 XM methods had good agreement with additional incompatibilities being recognized by the AGC XM beyond A‐B incompatibilities. In clinic, feline AB typing and sensitive XM test kits are available and recommended before each transfusion, although the clinical implications of incompatible XM test results and clinical benefits of such crossmatching have not been documented.
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Affiliation(s)
| | - Alexandra Nectoux
- SIAMU (ICU), Université de Lyon, VetAgro Sup, APCSe, Marcy l'Etoile, France
| | | | | | | | | | - Anthony Barthélemy
- SIAMU (ICU), Université de Lyon, VetAgro Sup, APCSe, Marcy l'Etoile, France
| | | | - Urs Giger
- Section of Medical Genetics (PennGen), University of Pennsylvania, Philadelphia, Pennsylvania
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16
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McClosky ME, Cimino Brown D, Weinstein NM, Chappini N, Taney MT, Marryott K, Callan MB. Prevalence of naturally occurring non-AB blood type incompatibilities in cats and influence of crossmatch on transfusion outcomes. J Vet Intern Med 2018; 32:1934-1942. [PMID: 30307648 PMCID: PMC6271279 DOI: 10.1111/jvim.15334] [Citation(s) in RCA: 22] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/27/2018] [Revised: 08/31/2018] [Accepted: 09/05/2018] [Indexed: 11/28/2022] Open
Abstract
BACKGROUND Recognition of the feline red blood cell (RBC) antigen Mik and the presence of naturally occurring anti-Mik antibodies resulting in acute hemolytic transfusion reactions prompted the recommendation to perform a crossmatch before a cat's first RBC transfusion, but this guideline has not yet become a standard practice. OBJECTIVE To determine the prevalence of naturally occurring non-AB alloantibodies detectable by tube crossmatch, and to compare transfusion outcomes in cats with and without a crossmatch performed. ANIMALS Three hundred cats that received an RBC transfusion, with or without a major crossmatch performed. METHODS Retrospective study. RESULTS Major crossmatch incompatibilities were documented in 23 of 154 transfusion-naive cats (14.9%) and in 15 of 55 previously transfused cats (27%; P = 0.042). Type-specific packed RBCs (pRBCs) were administered to 167 and 82 cats with and without a crossmatch, respectively. Median volume of pRBCs administered during the first transfusion was 5.3 mL/kg (range, 2.4-18 mL/kg). Median change in PCV scaled to dose of pRBCs was +0.8%/mL/kg; administration of crossmatch-compatible pRBCs was not associated with a greater increase in PCV. Febrile transfusion reactions occurred more often in cats that received non-crossmatched (10.1%) compared to crossmatched (2.5%) pRBCs (P = 0.022). Seventy-six percent of cats that received pRBC transfusions survived to hospital discharge. A crossmatch was not associated with improved survival to discharge or at 30 or 60 days posttransfusion. CONCLUSIONS AND CLINICAL IMPORTANCE The prevalence of naturally occurring non-AB incompatibilities is sufficiently high to justify the recommendation to perform a crossmatch before all (including the first) RBC transfusions in cats.
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Affiliation(s)
- Megan E. McClosky
- Department of Clinical Sciences and Advanced MedicineSchool of Veterinary Medicine, University of PennsylvaniaPhiladelphiaPennsylvania
| | - Dorothy Cimino Brown
- Department of Clinical Sciences and Advanced MedicineSchool of Veterinary Medicine, University of PennsylvaniaPhiladelphiaPennsylvania
| | - Nicole M. Weinstein
- Department of PathobiologySchool of Veterinary Medicine, University of PennsylvaniaPhiladelphiaPennsylvania
| | - Nicole Chappini
- Department of PathobiologySchool of Veterinary Medicine, University of PennsylvaniaPhiladelphiaPennsylvania
| | - Michael T. Taney
- Department of Clinical Sciences and Advanced MedicineSchool of Veterinary Medicine, University of PennsylvaniaPhiladelphiaPennsylvania
| | - Kimberly Marryott
- Department of Clinical Sciences and Advanced MedicineSchool of Veterinary Medicine, University of PennsylvaniaPhiladelphiaPennsylvania
| | - Mary Beth Callan
- Department of Clinical Sciences and Advanced MedicineSchool of Veterinary Medicine, University of PennsylvaniaPhiladelphiaPennsylvania
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17
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Priolo V, Masucci M, Spada E, Proverbio D, Pennisi MG. Naturally occurring antibodies in cats against dog erythrocyte antigens and vice versa. J Feline Med Surg 2018; 20:690-695. [PMID: 28840776 PMCID: PMC11104140 DOI: 10.1177/1098612x17727232] [Citation(s) in RCA: 13] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/15/2024]
Abstract
Objectives The aim of this study was to investigate the presence of naturally occurring antibodies against canine erythrocyte antigens in cats and vice versa. The influence of canine and feline blood type on cross-match results was also studied. Methods Blood samples from 34 cats and 42 dogs were used to perform test tube major and minor cross-match tests and blood typing. Blood from each cat was cross-matched with blood from 2-6 dogs, for a total of 111 cross-match tests. Haemolysis, macro- and microagglutination were considered markers of a positive cross-match. Results Eighty-three overall major cross-match tests were positive at 37°C, 86 at room temperature and 90 at 4°C. The minor cross-match tests were positive in all but two cross-matches performed at 37°C, all tests performed at room temperature and all but one test performed at 4°C. No cats tested totally negative at both major and minor cross-matches performed with samples from any single dog. Prevalence of warm natural antibodies against canine erythrocyte antigens was lower in type B cats than in type A cats, regardless of the blood type of donor dogs. Conclusions and relevance This study reveals a high prevalence of naturally occurring antibodies in cats against dog erythrocyte antigens and vice versa, and suggests that transfusion of cats with canine blood is not recommended as a routine procedure owing to the potential high risk of either acute severe or milder transfusion reactions.
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Affiliation(s)
- Vito Priolo
- Department of Veterinary Science, University of Messina, Polo Universitario Annunziata, Messina, Italy
| | - Marisa Masucci
- Department of Veterinary Science, University of Messina, Polo Universitario Annunziata, Messina, Italy
| | - Eva Spada
- Veterinary Transfusion Research Laboratory (REVLab), Department of Veterinary Medicine, University of Milan, Milan, Italy
| | - Daniela Proverbio
- Veterinary Transfusion Research Laboratory (REVLab), Department of Veterinary Medicine, University of Milan, Milan, Italy
| | - Maria Grazia Pennisi
- Department of Veterinary Science, University of Messina, Polo Universitario Annunziata, Messina, Italy
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