Major crossmatch compatibility of rabbit blood with rabbit, canine, and feline blood.

OBJECTIVE: To evaluate the major crossmatch compatibility between rabbit recipients, rabbit donors, and the major canine and feline blood types. DESIGN: Prospective in vitro study in December 2021. SETTING: Academic veterinary teaching hospital. ANIMALS: Whole blood samples were collected from 11 healthy New Zealand White rabbits (Oryctolagus cuniculus) with no previous transfusion history. Three pigtail segments were acquired from dog erythrocyte antigen (DEA)-1-positive, DEA-1-negative, and feline type A blood units. Whole blood was collected from a healthy type B blood donor cat. INTERVENTIONS: Blood from each rabbit recipient underwent a major crossmatch using standard tube crossmatch methodology with itself and the following donor blood types: rabbit, DEA-1-positive, DEA-1-negative, feline type A, and feline type B. MEASUREMENTS AND MAIN RESULTS: Self-crossmatches and crossmatches between rabbit recipients and conspecific donors were negative for hemolysis and agglutination. Crossmatches between rabbit recipients and canine and feline donors yielded no hemolysis but produced varying degrees of macroscopic and microscopic agglutination. Rabbit recipients had 1.4 (95% confidence interval: 1.1-1.8) times the risk of macroscopic agglutination when major crossmatched with canine blood compared to feline blood. No significant difference in agglutination was found between DEA-1-positive and DEA-1-negative or feline type A and type B donors. CONCLUSIONS: These findings support allogeneic blood transfusions between rabbits being highly compatible and suggest rabbits have naturally occurring alloantibodies against both canine and feline red blood cells. However, feline red blood cells had a lower rate of in vitro incompatibility on major crossmatch, suggesting potentially higher in vivo compatibility if an emergency xenotransfusion is needed. Further prospective research is needed to determine if xenotransfusion is associated with a higher incidence of acute and delayed transfusion reactions in rabbits than allogeneic transfusions.

Pancreatic Torsion Resulting in Acute Pancreatic Necrosis in a Young Dog.

We report a case of 7 mo old French bulldog who was referred to North Carolina State University Small Animal Emergency and Triage Services because of acute abdomen, regurgitation, lethargy, and fever. The patient had a history of pulmonic stenosis, which was corrected by balloon valvuloplasty 3 wk before presenting for the current complaint. The patient had nonspecific changes noted on blood work at his referring veterinarian. An abdominal ultrasound examination showed pathological changes that were supportive of a left-limb pancreatic torsion that was confirmed postmortem.

Presumed pituitary apoplexy in 26 dogs: Clinical findings, treatments, and outcomes.

BACKGROUND: Pituitary apoplexy refers to hemorrhage or infarction within the pituitary gland resulting in acute neurological abnormalities. This condition is poorly described in dogs. OBJECTIVES: To document presenting complaints, examination findings, endocrinopathies, magnetic resonance imaging (MRI), treatments, and outcomes of dogs with pituitary apoplexy. ANIMALS: Twenty-six client-owned dogs with acute onset of neurological dysfunction. METHODS: Retrospective case series. Dogs were diagnosed with pituitary apoplexy if MRI or histopathology documented an intrasellar or suprasellar mass with evidence of hemorrhage or infarction in conjunction with acute neurological dysfunction. Clinical information was obtained from medical records and imaging reports. RESULTS: Common presenting complaints included altered mentation (16/26, 62%) and gastrointestinal dysfunction (14/26, 54%). Gait or posture changes (22/26, 85%), mentation changes (18/26, 69%), cranial neuropathies (17/26, 65%), cervical or head hyperpathia (12/26, 46%), and hyperthermia (8/26, 31%) were the most frequent exam findings. Ten dogs (38%) lacked evidence of an endocrinopathy before presentation. Common MRI findings included T1-weighted hypo- to isointensity of the hemorrhagic lesion (21/25, 84%), peripheral enhancement of the pituitary mass lesion (15/25, 60%), brain herniation (14/25, 56%), and obstructive hydrocephalus (13/25, 52%). Fifteen dogs (58%) survived to hospital discharge. Seven of these dogs received medical management alone (median survival 143 days; range, 7-641 days) and 8 received medications and radiation therapy (median survival 973 days; range, 41-1719 days). CONCLUSIONS AND CLINICAL IMPORTANCE: Dogs with pituitary apoplexy present with a variety of acute signs of neurological disease and inconsistent endocrine dysfunction. Dogs that survive to discharge can have a favorable outcome.

Case report: Low dose dexmedetomidine infusion for the management of hypoglycemia in a dog with an insulinoma.

Objective: To describe the use of a low dose dexmedetomidine infusion as preoperative treatment for hypoglycemia secondary to a functional pancreatic tumor in a dog. Case summary: An 8.7-year-old castrated male Hungarian Vizsla presented for further evaluation of persistent hypoglycemia after the referring veterinarian established a tentative diagnosis of insulinoma based on paired insulin and glucose measurements. Abdominal ultrasound and computed tomography demonstrated evidence of a pancreatic mass with possible hepatic metastases. Attempts to aspirate the lesions under ultrasound guidance were unsuccessful, and the dog was hospitalized overnight for planned surgical resection of the presumed pancreatic tumor and biopsy of the hepatic lesions the following day. In response to a progressive increase in patient anxiety and agitation trazodone was prescribed ~5 mg/kg orally every 8 h and gabapentin at ~7 mg/kg every 8 h. As the dog continued to remain anxious dexmedetomidine at a dose of 1 mcg/kg was administered intravenously immediately followed with an infusion of dexmedetomidine at 1 mcg/kg/h. The anxious behaviors were successfully controlled with minimal cardiovascular side effects. Serial blood glucose measurements obtained during this time demonstrated euglycemia. The dog remained euglycemic while receiving dexmedetomidine for the remainder of the pre-operative period and for duration of hospitalization following surgical resection and biopsy. New or unique information provided: This case report demonstrates a possible role for dexmedetomidine to counteract hypoglycemia in dogs with insulinomas.

Three-dimensional bladder ultrasound to measure daily urinary bladder volume in hospitalized dogs.

BACKGROUND: Urinary bladder volume (UBV) and urine residual volume (URV) provide important information for hospitalized dogs and might allow recognition of urine retention. OBJECTIVE: Using 3-dimensional (3D) ultrasound to monitor daily URV is a safe and effective way to recognize urinary retention. ANIMALS: Twenty-five client-owned hospitalized dogs. METHODS: Prospective, observational study. UBV and URV were measured using 3D ultrasound daily at approximately the same time. UBV was measured, the dog was taken for a 5-minute controlled leash walk, then URV was estimated. Concurrent use of opioids, anesthetics, and fluids administered IV were recorded. RESULTS: Daily URVs were >0.4 mL/kg in 22 of 25 dogs on at least 1 day of hospitalization. Seventeen of 25 dogs had an abnormal URV at the time of discharge. Of 18 dogs that were anesthetized while hospitalized, 16 had a URV >0.4 mL/kg with a mean of 4.34 mL/kg (range, 0.5-13.4 mL/kg). No statistical difference in degree of URV was found based on the use of anesthesia, administration of fluids IV, or opioids. Weight was significantly associated with URV; dogs <10 kg had a higher URV per unit mass than dogs >10 kg (P = .001). CONCLUSIONS AND CLINICAL IMPORTANCE: Use of a 3D ultrasound device to measure daily UBV and URV in hospitalized dogs provides a safe estimate of bladder volume in real-time. Monitoring daily URV might help in early identification of patients that are retaining urine, thereby preventing potential adverse effects of urethral catheterization or prolonged urinary retention.

Association of Veterinary Hematology and Transfusion Medicine (AVHTM) Transfusion Reaction Small Animal Consensus Statement (TRACS). Part 1: Definitions and clinical signs.

OBJECTIVE: To use a systematic, evidence-based consensus process to develop definitions for transfusion reactions in dogs and cats. DESIGN: Evidence evaluation of the literature was carried out for identified transfusion reaction types in dogs and cats. Reaction definitions were generated based on synthesis of human and veterinary literature. Consensus on the definitions was achieved through Delphi-style surveys. Draft recommendations were made available through industry specialty listservs and comments were incorporated. RESULTS: Definitions with imputability criteria were developed for 14 types of transfusion reactions. CONCLUSIONS: The evidence review and consensus process resulted in definitions that can be used to facilitate future veterinary transfusion reaction research.

Association of Veterinary Hematology and Transfusion Medicine (AVHTM) Transfusion Reaction Small Animal Consensus Statement (TRACS) Part 2: Prevention and monitoring.

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.

Association of Veterinary Hematology and Transfusion Medicine (AVHTM) transfusion reaction small animal consensus statement (TRACS). Part 3: Diagnosis and treatment.

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.

Evaluation of the Lactate Plus monitor for plasma lactate concentration measurement in dogs.

OBJECTIVE: To compare the Lactate Plus handheld monitor to a reference blood gas analyzer for determining plasma lactate concentrations in canine whole blood. DESIGN: Prospective observational study. SETTING: University teaching hospital. ANIMALS: Ninety-four dogs hospitalized or admitted through the emergency service provided 125 blood samples. Only dogs that required a venous or arterial blood gas evaluation as a part of their diagnostic assessment or ongoing management were included. INTERVENTIONS: None. MEASUREMENTS AND MAIN RESULTS: Canine whole blood samples were assayed for plasma lactate concentration with a reference blood gas analyzer and the Lactate Plus monitor. Correlation and Bland-Altman analyses were used to compare results between the 2 methods. A subset of blood samples was repeatedly analyzed with the Lactate Plus to assess monitor precision. Plasma lactate measurements from the Lactate Plus monitor showed excellent correlation with those from the reference analyzer (ρ = 0.98, P < 0.0001). Bland-Altman analysis revealed a small bias (0.1296). Agreement between the 2 methods was less consistent for lactate concentrations >5 mmol/L. The coefficient of variation ranged from 0-26.2% (median, 3.7%) and was <15% for 50/53 samples. CONCLUSIONS: The Lactate Plus provides a fast and affordable method to measure plasma lactate concentration in dogs. Results showed excellent agreement with the reference analyzer and precision of the instrument was acceptable.

The effect of blood usage protocol on the age of packed red blood cell transfusions administered at 2 veterinary teaching hospitals.

BACKGROUND: Controversy exists regarding the optimal duration of storage of units of canine packed red blood cells (PRBC) prior to transfusion, resulting in different blood usage strategies between hospitals. Two hospitals were studied: At North Carolina State University (NCSU), usage protocol dictates that the oldest units of PRBC (stored the longest) are prioritized for transfusion; whereas, at Ontario Veterinary College (OVC), units of PRBC are sorted according to age (days after collection) and PRBC are selected for transfusion according to clinician or technician discretion, such that PRBC could be administered after any storage duration, with no preference given to older units. OBJECTIVE: To evaluate differences in the age of PRBC administered to dogs at 2 veterinary hospitals with different age-related PRBC usage protocols during a 1-year period (2010-2011). KEY FINDINGS: The average age of units of PRBC administered at NCSU was older than that at OVC (P < 0.001). Additionally, a higher number of PRBC units older than 14 days old were transfused at NCSU (P < 0.001), and the age of the oldest administered PRBC unit was also older at NCSU (P < 0.001). NCSU discarded approximately 15 expired PRBC units, whereas OVC discarded 96 expired PRBC units during the study period. SIGNIFICANCE: A standardized protocol for the priority administration of the oldest stored PRBC resulted in the administration of significantly older PRBC, but fewer expired units of PRBC were discarded.

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.

Serological and molecular prevalence of selected canine vector borne pathogens in blood donor candidates, clinically healthy volunteers, and stray dogs in North Carolina.

BACKGROUND: Canine vector borne diseases (CVBDs) comprise illnesses caused by a spectrum of pathogens that are transmitted by arthropod vectors. Some dogs have persistent infections without apparent clinical, hematological or biochemical abnormalities, whereas other dogs develop acute illnesses, persistent subclinical infections, or chronic debilitating diseases. The primary objective of this study was to screen healthy dogs for serological and molecular evidence of regionally important CVBDs. METHODS: Clinically healthy dogs (n = 118), comprising three different groups: Gp I blood donor candidates (n = 47), Gp II healthy dog volunteers (n = 50), and Gp III stray dogs (n = 21) were included in the study. Serum and ethylenediamine tetraacetic acid (EDTA) anti-coagulated blood specimens collected from each dog were tested for CVBD pathogens. RESULTS: Of the 118 dogs tested, 97 (82%) dogs had been exposed to or were infected with one or more CVBD pathogens. By IFA testing, 9% of Gp I, 42% of Gp II and 19% of Gp III dogs were seroreactive to one or more CVBD pathogens. Using the SNAP 4DX assay, Gp I dogs were seronegative for Anaplasma spp., Ehrlichia spp., and B. burgdorferi (Lyme disease) antibodies and D. immitis antigen. In Gp II, 8 dogs were Ehrlichia spp. seroreactive, 2 were infected with D. immitis and 1 was B. burgdorferi (Lyme disease) seroreactive. In Gp III, 6 dogs were infected with D. immitis and 4 were Ehrlichia spp. seroreactive. Using the BAPGM diagnostic platform, Bartonella DNA was PCR amplified and sequenced from 19% of Gp I, 20% of Gp II and 10% of Gp III dogs. Using PCR and DNA sequencing, 6% of Gps I and II and 19% of Gp III dogs were infected with other CVBD pathogens. CONCLUSION: The development and validation of specific diagnostic testing modalities has facilitated more accurate detection of CVBDs. Once identified, exposure to vectors should be limited and flea and tick prevention enforced.