Incidence of dogs possessing red blood cells with high K in Japan and East Asia

Effects of handling and storage on potassium concentration in plasma and serum samples obtained from cats

OBJECTIVE

To compare potassium concentrations in feline plasma and serum samples analyzed promptly after collection or after 20 to 28 hours of refrigerated storage.

ANIMALS

41 cats.

PROCEDURES

A venous blood sample was obtained from each cat. Aliquots were placed in 2 tubes without anticoagulant (blood was allowed to clot to derive serum) and 2 tubes with heparin (to derive plasma). One serum and 1 plasma sample were kept at room temperature and analyzed within 60 minutes after collection (baseline); the other serum and plasma samples were analyzed after 20 to 28 hours of refrigerated storage. At both time points, serum and plasma potassium concentrations were measured.

RESULTS

Median baseline serum potassium concentration (4.3 mmol/L) was significantly higher than median baseline plasma potassium concentration (4.1 mmol/L). The median difference between those values was 0.4 mmol/L (95% CI, 0.2 to 0.5 mmol/L). Compared with their respective baseline measurements, the median serum plasma concentration (4.8 mmol/L) and median plasma potassium concentration (4.6 mmol/L) were higher after 20 to 28 hours of refrigeration.

CLINICAL RELEVANCE

Results indicated that with regard to potassium concentration in feline blood samples, clotting or refrigerated storage for 20 to 28 hours results in a significant artifactual increase. Detection of an unexpectedly high potassium concentration in a cat may represent pseudohyperkalemia, especially if the blood sample was placed in a no-additive tube, was stored for 20 to 28 hours prior to analysis, or both.

Effect of Leukoreduction on Hematobiochemical Parameters and Storage Hemolysis in Canine Whole Blood Units

Simple Summary

During the storage of blood units, cells undergo many changes, defined as storage lesions; these are biochemical, morphological and immunological modifications and seem to be responsible for adverse post-transfusion effects in recipients. The pre-storage leukoreduction seems to reduce them. The aims of this study are both to evaluate the human filter effectiveness and the effect of pre-storage leukoreduction in stored canine whole blood units. We tested whole blood units, leukoreduced and not, obtained from seven enrolled subjects, until the 42nd day. The white blood cell (WBC) and platelet (PLT) counts are reported to express the leukoreduction effectiveness. As indicators of storage-induced hemolysis, the lactate dehydrogenase activity (LDH) and sodium, potassium, and chlorine electrolytes were measured in plasma, and the red blood cell (RBC) count, hemoglobin concentration (Hgb), and hematocrit (Hct) were obtained with the complete blood count (CBC). The mean corpuscular volume (MCV) values and morphological index obtained from blood smear evaluation were used as indices of morphological changes. We observed that the leukoreduction filter for human use is equally effective on canine whole blood and that leukoreduction has a partially protective role to prevent some storage lesions.

Abstract

Storage lesions (SLs) occur when the red blood cell quality is altered during the preservation of blood units. Pre-storage leukoreduction would limit the number of SLs. The aims of this study were to evaluate the effectiveness of a leukoreduction filter for human use and the effect of pre-storage leukoreduction on some ematobiochemical parameters in stored canine whole blood. Seven canine blood units were tested. Each one was divided into two units—one leukoreduced (LRWB) and one non-leukoreduced (nLRWB). On each unit, we determined the complete blood count (CBC), lactate-dehydrogenase (LDH), electrolytes (Na⁺, K⁺, Cl⁻), morphological index (MI) and hemolysis, on storage days 0, 7, 14, 21, 28, 35, and 42. Leukoreduction allowed a 98.30% recovery of the RBC count, retaining 99.69% and 94.91% of WBCs and PLTs, respectively. We detected a significant increase of LDH and MI with strongly higher values in nLRWB compared to LRWB. A progressive increase in electrolytes and LDH concentrations was observed as indices of stored hemolysis. LDH showed significantly lower values in LRWB units compared to nLRWB, suggesting its release from leukocytes. In the majority of units, hemolysis reached 1% on the 42nd day of storage. We assert the human leukoreduction filter effectiveness on canine whole blood, and we recommend using nLRWB before day 14, especially for critically ill patients. The difference of the basal hemolysis (day 0) percentages observed between subjects suggests that more studies should be performed to confirm a possible inter-individual donor biological variability of RBC membrane resistance, as happens in humans.

Evaluation of hematologic, biochemical, and blood gas variables in stored canine packed red blood cells, and the impact of storage time on blood recipients

BACKGROUND

Canine packed red blood cells (pRBCs) can be stored under refrigeration for several days; however, cellular metabolism remains active inside the units, thus producing substances that affect their quality.

OBJECTIVES

We aimed to evaluate hematologic, biochemical, and blood gas variable alterations that occur in canine pRBCs during storage, and their effects on recipient clinicopathologic parameters.

METHODS

The study was conducted in two phases. In phase I, 15 pRBC units containing CPDA-1 were stored for 28 days; samples were collected weekly from the units of days 0 to 28 to measure the packed cell volume (PCV), pH, partial pressure carbon dioxide (PCO₂ ), partial pressure oxygen (PO₂ ), concentrations of lactate and potassium, and the percent hemolysis. In phase II, another 22 canine pRBC units stored for different time periods (maximum of 21 days) were transfused, and the recipients were evaluated before and after transfusion for changes in clinical parameters (heart rate, respiratory rate, systolic arterial pressure, and rectal temperature) and hematologic variables (PCV, lactate and potassium concentrations, pH, PCO₂ , the ratio of arterial oxygen partial pressure to fractional inspired oxygen [PO₂ /FiO₂ ] ratio, oxygen saturation [SaO₂ ], base excess, and bicarbonate [HCO₃ ]).

RESULTS

In the pRBC units, the PCV increased from 70% to 78.33%, the lactate concentration increased 627%, the potassium concentration increased 183%, the percent hemolysis reached 0.69%, and the pH decreased 9% after 28 days. However, the dogs who received transfusions were not negatively affected. There was a significant increase in PCVs, and a significant decrease in heart rates.

CONCLUSION

Canine pRBCs undergo hematologic, blood gas, and biochemical alterations during storage; however, the transfusion of pRBCs stored for up to 21 days increased PCVs without causing harm to the dogs.

Histograms of Complete Blood Counts in Dogs: Maximizing Diagnostic Information

Histograms, which are an integral part of the automated complete blood count, are now available through most of the automatic hematology analyzers used in veterinary clinical practice. Data concerning the size and number of blood cells are graphically presented in histograms, and their variations are also illustrated. Important information that is not apparent from numerical results are sometimes provided by histograms. Histograms are also referred to as frequency distribution curves and are essentially graphs resulting from the placement of the sizes of cells on the x-axis and the number of cells on the y-axis. Typically, automated analyzers provide histograms for each class of blood cells, that is, for erythrocytes, leukocytes, and platelets. Thus, when the erythrocyte histogram shows asymmetry with a right shift, it means the size of the erythrocytes is greater than normal (macrocytosis); when it presents a left shift, the size of the erythrocytes is less than normal (microcytosis). When two peaks are found in the curve, two populations of erythrocytes coexist, as in the case of a blood transfusion or therapeutic response. In the leukocyte histogram, three peaks are found: the closest to the y-axis (left) corresponds to the lymphocytes, the middle to the monocytes, and the right to the polymorphonuclear cells (neutrophils, eosinophils, and basophils). Finally, in platelet histogram, asymmetry with a right shift suggests the presence of giant platelets or schistocytes. Although the histogram is not recommended as a stand-alone test, it allows the practitioner to observe abnormalities in the distribution curve that correspond to abnormalities in the size or number of cells, and to quickly make diagnostic or therapeutic decisions that are particularly important in emergencies.

Evaluation of frequency and intensity of asymptomatic anisocytosis in the Japanese dog breeds Shiba, Akita, and Hokkaido

Microcytosis is observed in healthy Japanese breed dogs. The aim of the study was to evaluate the frequency and intensity of asymptomatic anisocytosis using a three-grade scale in Japanese dog breeds with special emphasis on the following indices: mean cell volume, mean cell haemoglobin, mean cell haemoglobin concentration, and red blood cell distribution width. The retrospective study included analyses of blood morphology and blood smear for clinically healthy Japanese dog breeds Shiba, Akita, and Hokkaido aged from 6 months to 14 years, performed as a part of preventative care. A total of 74 dogs of both sexes were qualified for the study. The group included both neutered and non-neutered animals (Akita – 17 females, 12 males, Shiba – 24 females, 18 males, Hokkaido – 2 females, 1 male). The blood smear revealed significant anisocytosis in 60.8% and mild anisocytosis in 28.4% of the tested dogs – 89.2% in total. Microcytosis was reported for 25.7% of the tested Japanese breed dogs. Reduced mean cell haemoglobin and mean cell haemoglobin concentration were diagnosed in 75.7% and 40.5% of dogs, respectively. Red blood cell distribution width as an anisocytosis indicator exceeded the norm in 12% of the tested dogs. Compared to mixed breed dogs, the Japanese breeds had a reduced mean cell volume, mean cell haemoglobin concentration and significant anisocytosis in the blood smear as well as a higher red blood cell distribution width indicator. Veterinarians should consider these differences when interpreting the results of morphological blood tests.

Spurious Results in Mineral and Electrolyte Analysis

Assessment of health status and the course of treatment of patients are often determined by results obtained from analysis of blood parameters. Errors in results can occur and cause inappropriate interpretation of laboratory data and, therefore, disease states. Electrolytes and minerals are particularly prone to spurious results; therefore, it is critical that factors influencing inappropriate resulting be recognized, and steps taken to minimize them.

Akita dogs possess GLUT1 in erythrocytes, and Na,K-ATPase activity enables more efficient ascorbic acid recycling

We investigated hematologic characteristics of healthy Akita dogs. All were found to contain glucose transporters, GLUT1 and GLUT4, in erythrocyte membrane, whereas Beagle and any other Western dogs have only GLUT4. Of 47 Akitas, ten showed high K and low Na concentrations with elevated glutathione (GSH) in erythrocytes due to Na,K-ATPase activity in the membrane (HK). Akitas showed increased capacity for recycling vitamin C or ascorbic acid (AA) from oxidized ascorbic acid (DHA) compared to Beagle dogs. Particularly, HK Akitas performed even greater AA recycling and ferricyanide reduction than normal Akitas which have normal GSH, low K and high Na concentrations (LK). All HK Akitas also had stomatin in erythrocyte membrane, while half of LK Akitas had it at lower levels than HK Akitas. Stomatin did not have any influence on AA recycling. GLUT1, Na,K-ATPase and stomatin in erythrocytes are characteristics of Akita dogs, and the high prevalence of these proteins suggests their positive roles in biological efficiency.

Age-related changes in hematologic and serum biochemical variables in dogs aged 16-60 days

BACKGROUND

The literature reporting hematologic and serum biochemical variables in puppies is limited. As puppies are physiologically different from adult dogs, an age effect would be expected.

OBJECTIVES

We aimed to describe age-related changes in hematologic and serum biochemical variables in puppies aged 16-60 days and compare the results to reference intervals (RI) for adults. Our second aim was to determine RI for this age group.

METHODS

A total of 227 blood samples were collected from 101 clinically healthy puppies, mainly mixed breeds. To assess the effect of age, the results were compared to RI for adult dogs, and variations within the age period 16-60 days were studied. Reference intervals for the groups 16-24, 28-45, and 46-60 days of age were determined.

RESULTS

Lower values in puppies compared to adults were found for RBC, HGB, HCT, concentration of albumin, globulin, total protein, creatinine, and sodium:potassium ratio. Higher values in puppies compared to adults were found for activities of ALP and CK, and concentrations of inorganic phosphorus, calcium, and potassium. For MCV, MCHC, albumin:globulin ratio, and glucose concentration, different values in puppies compared to adults were found for some of the age groups. No age-specific differences were found compared to RI for adults regarding WBC, absolute counts of lymphocytes, neutrophils, monocytes, eosinophils, and platelets, RDW, activities for AST, ALT, amylase, lipase, and concentrations of bile acids, cholesterol, urea, sodium, and chloride.

CONCLUSIONS

Our results support that age has a significant effect on several hematologic and serum biochemical values in puppies, warranting age-specific RI.

Red blood cell storage lesion

OBJECTIVE

To summarize current understanding of the mechanisms responsible for changes occurring during red blood cell (RBC) storage, collectively known as the storage lesion, and to review the biological and clinical consequences of increasing storage time of RBCs.

DATA SOURCES

Human and veterinary clinical studies, experimental animal model studies, and reviews of the RBC storage lesion with no date restrictions.

HUMAN DATA SYNTHESIS

Experimental studies have characterized the evolution of human RBC and supernatant changes that occur during storage and form the basis for concern about the potential for harm from long-term storage of RBCs. Although 4 randomized controlled trials of varying sizes failed to find an association between RBC storage time and negative clinical outcomes, a recent meta-analysis and numerous observational clinical studies have demonstrated that transfusion of old versus fresh stored RBCs is associated with an increased risk of morbidity and mortality, particularly among trauma victims and cardiac surgery patients. Potential clinical consequences of RBC transfusion following development of the storage lesion include risk of organ dysfunction, organ failure, infections, and death.

VETERINARY DATA SYNTHESIS

Experimental animal models have contributed to the evidence supporting adverse consequences of the RBC storage lesion. Studies on relevant RBC storage issues such as the effect of different preservative solutions and leukoreduction have been completed. Transfusion with RBCs stored for 42 days increases mortality in dogs with experimental sepsis.

CONCLUSION

Storage of RBCs induces progressive biochemical, biomechanical, and immunologic changes that affect red cell viability, deformability, oxygen carrying capacity, microcirculatory flow, and recipient response. Most reports in the human and veterinary literature support the concept that there are deleterious effects of the RBC storage lesion, but additional studies with improved experimental design are needed to identify compelling reasons to modify current blood banking and transfusion practices.

Aquaporin-1 expression in canine peripheral erythrocytes and its relation to cell volume

To evaluate the relationship between aquaporin-1 (AQP1) expression and the cell volume of red blood cells (RBCs), canine peripheral RBCs were separated according to specific gravity, and expression of the AQP1 protein on the membrane of RBCs was compared using anti-dog AQP1 polypeptide serum. Western blot analysis indicated that there was no significant difference in AQP1 expression between large and small cell fractions. In addition, the AQP1 expression of inherited high K/low Na RBCs which are known to be 20% larger than normal RBCs, was comparable to that of normal RBCs. These results suggest that AQP1, the major water channel in RBCs, does not determine the cell volume of peripheral canine RBCs.

Aquaporin 1 expression in tissues of canines possessing inherited high K+ erythrocytes

We investigated the expression of aquaporin 1 (AQP1) in tissues from canines with an inherited anomaly that causes their erythrocytes to have high K⁺. Northern blot analysis revealed abundant AQP1 expression in lung and kidney, though little expression was found in spleen. Using anti-C-terminus for dog AQP1, abundant expression was shown in kidney, trachea, and eye, but little expression was shown in pancreas and cerebrum, indicating that AQP1 expression in canine tissues is similar to that noted in other mammals.

Phylogenetic studies of dogs with emphasis on Japanese and Asian breeds

The first domestication of the dog occurred in East Asia, and major ancestor of the dog was a wolf subspecies, Canis lupus chanco. This finding derives from data on the nucleotide sequences of mtDNA and the frequency of genes controlling blood protein polymorphisms in various subspecies of wolves and dog breeds around the world. The results of the allele frequency distribution of genes controlling 16 blood protein polymorphisms, and the incidence of dogs possessing erythrocytes with high potassium (HK) in Japan, East Asia and Europe allowed us to posturate the following hypothesis about the origins of Japanese dogs and the history of their development. In the Jomon period the first dogs entered the Japanese archipelago from southern or northern continental Asia. These dogs eventually spread throughout Japan. Then, during the Yayoi and Kofun periods, other dogs were brought over via the Korean Peninsula, and crossbreeding occurred with the original dogs. The resulted offspring can be assumed to be the ancestors of most of the Japanese breeds that exist today. Ethological studies have revealed a significant breed difference in behavioral traits among canine breeds with Japanese dogs, showing more aggressive dispositions than most of European dogs.

Massive transfusion in dogs: 15 cases (1997-2001)

OBJECTIVE

To determine clinical characteristics of dogs that received massive transfusion and identify the underlying diseases, complications, and outcomes.

DESIGN

Retrospective study.

ANIMALS

15 dogs.

PROCEDURE

Medical records of dogs receiving a massive blood transfusion were evaluated for transfusion volume, underlying disease process or injury, benefits and complications of transfusion, and outcome. A massive transfusion was defined as transfusion of a volume of blood products in excess of the patient's estimated blood volume (90 ml/kg [40 ml/lb]) in a 24-hour period or transfusion of a volume of blood products in excess of half the patient's estimated blood volume in a 3-hour period.

RESULTS

Six dogs had intra-abdominal neoplasia resulting in hemoabdomen, 3 had suffered a traumatic incident resulting in hemoabdomen, and 6 had non-traumatic, non-neoplastic blood loss. Mean volumes of packed RBC and fresh-frozen plasma administered were 66.5 ml/kg (30 ml/lb) and 22.2 ml/kg (10 ml/lb), respectively. All dogs evaluated developed low ionized calcium concentrations and thrombocytopenia. Transfusion reactions were recognized in 6 dogs. Four dogs survived to hospital discharge.

CONCLUSIONS AND CLINICAL RELEVANCE

Results suggest that massive transfusion is possible and potentially successful in dogs. Predictable changes in electrolyte concentrations and platelet count develop.

GSH depletion, K-Cl cotransport, and regulatory volume decrease in high-K/high-GSH dog red blood cells

Thiol reagents activate K-Cl cotransport (K-Cl COT), the Cl-dependent and Na-independent ouabain-resistant K flux, in red blood cells (RBCs) of several species, upon depletion of cellular glutathione (GSH). K-Cl COT is physiologically active in high potassium (HK), high GSH (HG) dog RBCs. In this unique model, we studied whether the same inverse relationship exists between GSH levels and K-Cl COT activity found in other species. The effects of GSH depletion by three different chemical reactions [nitrite (NO(2))-mediated oxidation, diazene dicarboxylic acid bis-N,N-dimethylamide (diamide)-induced dithiol formation, and glutathione S-transferase (GST)-catalyzed conjugation of GSH with 1-chloro-2,4-dinitrobenzene (CDNB)] were tested on K-Cl COT and regulatory volume decrease (RVD). After 85% GSH depletion, all three interventions stimulated K-Cl COT half-maximally with the following order of potency: diamide > NO(2) > CDNB. Repletion of GSH reversed K-Cl COT stimulation by 50%. Cl-dependent RVD accompanied K-Cl COT activation by NO(2) and diamide. K-Cl COT activation at concentration ratios of oxidant/GSH greater than unity was irreversible, suggesting either nitrosothiolation, heterodithiol formation, or GST-mediated dinitrophenylation of protein thiols. The data support the hypothesis that an intact redox system, rather than the absolute GSH levels, protects K-Cl COT activity and cell volume regulation from thiol modification.

Relation between erythrocyte reduced glutathione and glutamate concentrations in Korean Jindo dogs with erythrocytes possessing hereditary high activity of Na-K-ATPase and a high concentration of potassium

The concentrations of sodium, potassium, reduced glutathione (GSH) and free amino acids and Na-K-ATPase activity in erythrocytes were examined in 35 purebred Jindo dogs in Korea. The incidence of Jindo dogs with a high potassium concentration and high activity of Na-K-ATPase in erythrocytes (HK phenotype) was 25.7%. The erythrocyte GSH concentration in HK Jindo dogs varied widely, from 2.45 to 12.38 mmol/l of RBCs, and was positively correlated with the erythrocyte glutamate concentration. These results indicate that HK Jindo dogs have normal to very high levels of erythrocyte GSH, which might result from the varying quantity of Na-dependent glutamate influx in the erythrocytes.