Effect of leukoreduction on the metabolism of equine packed red blood cells during refrigerated storage.

BACKGROUND: Understanding of the biochemical and morphological lesions associated with storage of equine blood is limited. OBJECTIVE: To demonstrate the temporal sequences of lipid and metabolic profiles of equine fresh and stored (up to 42 days) and leukoreduced packed red blood cells (LR-pRBC) and non-leukoreduced packed RBC (nLR-pRBC). ANIMALS: Packed RBC units were obtained from 6 healthy blood donor horses enrolled in 2 blood banks. METHODS: Observational study. Whole blood was collected from each donor using transfusion bags with a LR filter. Leukoreduction pRBC and nLR-pRBC units were obtained and stored at 4°C for up 42 days. Sterile weekly sampling was performed from each unit for analyses. RESULTS: Red blood cells and supernatants progressively accumulated lactate products while high-energy phosphate compounds (adenosine triphosphate and 2,3-Diphosphoglycerate) declined. Hypoxanthine, xanthine, and free fatty acids accumulated in stored RBC and supernatants. These lesions were exacerbated in non-LR-pRBC. CONCLUSION AND CLINICAL IMPORTANCE: Leukoreduction has a beneficial effect on RBC energy and redox metabolism of equine pRBC and the onset and severity of the metabolic storage lesions RBC.

Caprine whole blood appears sufficiently stable after 21 days in storage to be suitable for transfusion.

OBJECTIVE: The objective of this study was to determine hematologic changes of stored caprine whole blood in citrate phosphate dextrose adenine solution over a 28-day period. SAMPLE: Ten 250-mL bags of whole blood were collected from 10 female Boer goats from Louisiana State University's Division of Laboratory Animal Medicine herd. METHODS: 10 healthy blood donor goats were selected, and 250 mL of whole blood was drawn from each and stored at 2.78 °C. At the time of collection and every 7 days for a total of 28 days, samples were obtained from the blood bags to determine biochemical and hematologic values of collected blood. Only 5 of the 10 donors had baseline blood bag samples obtained for biochemical evaluation on day 0. At the end of 28 days, the remaining blood was submitted for aerobic and anaerobic culture. RESULTS: Blood values remained within suitable limits for transfusion and below 1% hemolysis for up to 21 days in most samples. Packed cell volume did not change significantly from day 0 to day 28. Lactate significantly increased over the 28 days, though not as dramatically as expected on the basis of other blood storage studies. pH decreased due to anticoagulant acidity but did not drop below 7. Cultures were negative on all blood bags. CLINICAL RELEVANCE: Changes over time are similar to that in other species, and caprine blood appears biochemically and hematologically stable for up to 21 days in storage. In vivo trials are needed for safety and efficacy.

Discordance between ABC blood phenotype and genotype in a domestic short-haired cat.

An adult domestic short-haired feline leukemia virus-infected cat was referred for kidney failure and worsening anemia requiring transfusions. ABC blood typing was performed with an immunochromatographic strip assay at different occasions. Gel column systems were used for the major and minor crossmatching tests, and anti-A and anti-B titers were determined. No discrete A or B bands appeared on the immunochromatographic strips at any time point for the recipient cat. The recipient's plasma agglutinated RBCs from tested type A and B cats. The recipient's RBCs appeared compatible with plasma from 1 type A and 2 B donors, and incompatible with plasma from another type A cat. Genotyping of recipient blood revealed a single homozygous c.179G>T CMAH variant predicting a blood type B. These studies suggest an unusual weak type B or missing all ABC antigens. The latter resembles the exceedingly rare Bombay phenotype in the human ABO blood group system.

Retrospective study of canine blood xenotransfusion compared with type-matched feline blood allotransfusion to cats: indications, effectiveness, limitations and adverse effects.

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.

Successful blood transfusion in a Holstein cow experiencing hemorrhagic shock under general anesthesia.

A 2-year-old Holstein cow weighing 530 kg at 2 mo gestation was scheduled for a paracostal laparotomy and abomasotomy following diagnosis of a reticular foreign body causing obstruction and abomasal impaction. Hemorrhagic shock occurred during surgery, with a rapid, approximately 60% decrease in arterial blood pressure, and reflex tachycardia with a 2-fold increase in heart rate. Following identification of hemorrhagic shock, arterial blood pressure was supported by reducing the inhalant anesthetic requirement, positive inotropic support (IV dobutamine infusion), and IV fluid therapy. Hypertonic saline was administered IV for initial resuscitation of arterial blood pressure, followed by a whole blood transfusion to replenish red blood cells, support oxygencarrying capacity, and provide intravascular volume to maintain cardiac output and tissue perfusion. A gradual increase in arterial blood pressure and a decrease in heart rate were observed in response to treatment. This case report demonstrates the physiologic compensatory response to hemorrhagic shock and the treatment to stabilize cardiovascular parameters in an anesthetized cow. Key clinical message: This case illustrates the physiological reponses to acute hemorrhage under general anesthesia and the effects of various treatment interventions.

Transfusion sanguine réussie chez une vache Holstein en état de choc hémorragique sous anesthésie générale. Une vache Holstein de 2 ans pesant 530 kg à 2 mois de gestation devait subir une laparotomie paracostale et une abomasotomie à la suite du diagnostic d'un corps étranger réticulaire provoquant une obstruction et une impaction abomasale. Un choc hémorragique est survenu pendant la chirurgie, avec une diminution rapide d'environ 60 % de la pression artérielle et une tachycardie réflexe avec une augmentation du double de la fréquence cardiaque. À la suite de l'identification d'un choc hémorragique, la pression artérielle a été soutenue en réduisant le besoin d'anesthésique inhalé, un soutien inotrope positif (perfusion de dobutamine IV) et une thérapie avec des fluides IV. Une solution saline hypertonique a été administrée par voie intraveineuse pour la restauration initiale de la pression artérielle, suivie d'une transfusion de sang total pour rétablir la quantité de globules rouges, soutenir la capacité de transport d'oxygène et fournir un volume intravasculaire pour maintenir le débit cardiaque et la perfusion tissulaire. Une augmentation progressive de la pression artérielle et une diminution de la fréquence cardiaque ont été observées en réponse au traitement. Ce rapport de cas démontre la réponse physiologique compensatoire au choc hémorragique et le traitement pour stabiliser les paramètres cardiovasculaires chez une vache anesthésiée.Message clinique clé :Ce cas illustre les réponses physiologiques à une hémorragie aiguë sous anesthésie générale et les effets de diverses interventions thérapeutiques.(Traduit par Dr Serge Messier).

Human intravenous immunoglobulin use for hematological immune-mediated disease in dogs.

OBJECTIVE: To report on survival rates and risk factors in dogs with immune-mediated hemolytic anemia (IMHA) and immune-mediated thrombocytopenia (ITP) treated with human IV immunoglobulin (hIVIG; Privigen). We hypothesized that hIVIG could be used as a salvage treatment to improve survival and reduce the requirement for ongoing blood transfusion therapy in IMHA and ITP patients. ANIMALS: 52 client-owned dogs with IMHA or ITP were included, comprising 31 females (28 spayed and 3 entire) and 21 males (19 castrated and 2 entire). Miniature Schnauzers were the most common breed (5), with a further 24 different breeds identified. PROCEDURES: A retrospective cohort study was conducted between January 2006 and January 2022 that assessed the survival rates, risk factors, and need for ongoing transfusion in dogs with IMHA and ITP treated with hIVIG compared with those not receiving hIVIG. RESULTS: Of 36 dogs that did not receive hIVIG, 29 (80%) survived and 7 (24%) died, and of 16 dogs administered hIVIG, 11 (69%) survived and 5 (31%) died (P = .56). No effect of PCV at admission or age on the risk of death was detected (OR, 1.00; 95% CI, 0.94 to 1.08; P = .89; and OR, 1.10; 95% CI, 0.85 to 1.47; P = .47, respectively). CLINICAL RELEVANCE: This was the largest study to date of dogs with hematological immune-mediated disease treated with hIVIG. There was no difference in survival rates for dogs that received hIVIG versus those treated with standard immunosuppression. The benefit of hIVIG as a salvage treatment appears limited.

Blood types and antibody profiles of Straight Egyptian Arabian horses in Qatar: Preliminary results.

The characterization of the blood groups, antibody profiles, and its distribution pattern among different horse breeds and geographic locations, can be very useful in life-threatening situations where a blood transfusion is needed, and compatibility tests are not readily available. This study estimated the distribution of blood types and antibody profiles in Straight Egyptian Arabian horses from Qatar. A total of 20 Straight Egyptian Arabian horses, from multiple origins and genetic background were included. Venous blood from each horse was typed and screened for anti-red blood cell (RBC) hemolytic and agglutinating antibodies. Descriptive statistical analysis and Fisher Exact test were applied, considering 95% confidence interval (95% CI). All included horses (100%) had Aa and Ca blood types (95% CI: 83.2%-100.0%). Other blood types found less frequently included Ua (50%), Qc (45%), Pa (40%), Qb (25%) and Qa (5%). Only horses with travel history developed anti-RBC antibodies (6 out of 9), however, no horse carried more than one type of anti-RBC antibodies, supporting the premise that environmental factors may influence the development of alloantibodies. Although pre-transfusion testing regardless the circumstances should be prioritized, even considering a small population of horses, our findings suggest that Straight Egyptian Arabian horses in Qatar could be safely used as blood donors, due to the apparent omnivalence of Aa and Ca blood types and lower incidence of alloantibodies, important in emergency situations where pre-transfusion testing is unavailable.

The effect of flow rate and catheter diameter on hemolysis during blood transfusions using canine packed red blood cells.

OBJECTIVE: To evaluate the degree of hemolysis in canine packed RBCs at varying catheter sizes and flow rates as determined by RBC count, Hct, hemoglobin, creatine phosphokinase, and phosphorus. This study hypothesized that changes in flow rate and catheter diameter would change the degree of hemolysis. SAMPLE: A fresh unit of canine RBCs. PROCEDURES: A fresh unit of purchased canine packed RBCs was run through an IV infusion pump through 5 different catheter sizes (16, 18, 20, 22, and 24 gauge) at 5 different rates (50, 250, 500, 750, and 999 mL/h). Each sample was submitted for a CBC and chemistry, and RBC count, hemoglobin, hematocrit, creatine phosphokinase, and phosphorus were specifically evaluated to assess for the degree of hemolysis. RESULTS: Compared to the control, flow rate did not significantly affect the degree of hemolysis. Smaller catheter sizes had a significantly increased hemolysis (P < .05) based on variables to evaluate hemolysis (RBC count, Hct, hemoglobin, creatine phosphokinase, and phosphorus). This study's hypothesis was upheld in association with the catheter diameter but was rejected with flow rate. CLINICAL RELEVANCE: Blood transfusions are a common practice in veterinary medicine as treatment of anemia and hemorrhage. Hemolysis was greater when small catheter sizes were used. Larger catheters are recommended when feasible when performing transfusions.

Effect of donor blood storage on gel column crossmatch in dogs.

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.

Prevalence of dog erythrocyte antigen 1 in a population of dogs tested in California.

BACKGROUND: Multiple studies have evaluated the breed-specific prevalence of dog erythrocyte antigen (DEA) 1 in various geographic regions. However, few large-scale studies exist that describe breed prevalence of DEA 1 in the United States. KEY FINDINGS: From January 2000 to October 2020, 6469 dogs had their RBC antigen type determined and were included in the study. The overall prevalence of DEA 1 in all dogs was 61.2%. Of 50 breeds with sample sizes ≥20, 8 breeds had a high prevalence (≥90%) of DEA 1-positive blood type: Basset Hound, Bernese Mountain Dog, Brittany, Dachshund, Miniature Pinscher, Miniature Schnauzer, Pug, and Rottweiler. Four breeds had a high prevalence (≥90%) of DEA 1-negative blood type: Boxer, English Bulldog, Flat-Coated Retriever, and French Bulldog. Numerous breeds with a sample size <20 and ≥5 were found to have 100% prevalence of a DEA 1 blood type, although these findings need to be confirmed with a larger sample size. No statistical difference in any breed based on sex was found. The results in this study are consistent with previously reported data in other countries. SIGNIFICANCE: Knowledge of regional breed differences in DEA 1 prevalence can help to improve selection and recruitment of appropriate blood donor dogs.

Blood Transfusion from a Magellanic Great Horned Owl (Bubo virginianus magellanicus) to a Barn Owl (Tyto alba): A Successful Case of Xenotransfusion.

This report describes successful transspecies blood transfusion from a Magellanic horned owl (Bubo virginianus magellanicus) to a barn owl (Tyto alba). The barn owl was admitted to a wildlife rehabilitation center with severe anemia (packed cell volume [PCV] = 6.7%) from suspected anticoagulant rodenticide poisoning. Procedures performed included patient stabilization, pharmacological treatment, and persistent monitoring following the blood transfusion. The patient's PCV was measured daily, increasing progressively, and attaining a normal value for the species (PCV > 40%) on the eighth day posttransfusion. With no possibility of obtaining a same-species donor and because of the serious condition of the patient and unfavorable prognosis, a decision was made to perform the xenotransfusion. The result was a successful recovery and ultimately the release of the owl into its natural habitat. We concluded that xenotransfusion for avian species should be considered in cases with no possibility of obtaining a homologous donor.

Alloimmunization in dogs after transfusion: A serial cross-match study.

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.

Comparison of a commercial immunochromatographic strip crossmatch kit and standard laboratory crossmatch methods for blood transfusion compatibility in dogs.

OBJECTIVE: To evaluate agreement between 2 standard laboratory (SL) methods and an immunochromatographic strip (ICS) method to crossmatch dogs receiving RBC transfusions. A second objective was to evaluate uninterpretable SL crossmatch results as compared to ICS in the presence of autoagglutination. DESIGN: Prospective observational study (September 2018 to October 2019). SETTING: University teaching hospital. ANIMALS: Forty anemic dogs receiving RBC transfusions. INTERVENTIONS: None. MEASUREMENT AND MAIN RESULTS: All dogs received DEA 1-negative packed RBCs. Three crossmatch methods were evaluated against the same unit transfused to each dog: SL method performed at institutional laboratory (SL-I), SL method sent to a commercial laboratory (SL-C), and a commercially available point-of-care ICS method. Major and minor crossmatches were incompatible for 2.5%/7.5% of ICS tests, 82.5%/52.5% of SL-I tests, and 52.5%/27.5% of SL-C tests. Agreement between ICS and SL-C major (κ = 0.05) and minor (κ = 0.02) crossmatches and between ICS and SL-I major (κ = 0.009) and minor (κ = 0.03) crossmatches was slight. Agreement between SL-C and SL-I major (κ = -0.06) and minor (κ = -0.12) crossmatches was poor. Results of major and minor crossmatches were uninterpretable due to autoagglutination in 38%/38% for SL-I and 29%/18% for SL-C crossmatches. ICS method was interpretable for 93% (major) and 98% (minor) crossmatches. After exclusion of uninterpretable SL pairings, agreement still remained poor to slight between all tests. Only 1 of 40 dogs (2.5%; 95% confidence interval: <1.0%-13.2%) had an immediate immunological transfusion reaction. CONCLUSIONS: Lack of agreement between all methodologies was noted. The high level of incompatibility predicted by SL methods despite lack of clinically relevant reactions suggests a high false incompatibility rate as compared to the ICS test. ICS testing was also able to give results more frequently in the face of autoagglutination. Further work is needed to investigate the ICS method's ability to predict clinically significant transfusion reactions.

Characterization of post-transfusion anti-FEA 1 alloantibodies in transfusion-naive FEA 1-negative cats.

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.

Collection and administration of blood products in horses: Transfusion indications, materials, methods, complications, donor selection, and blood testing.

BACKGROUND: Blood transfusion is a lifesaving treatment for horses with acute hemorrhage and other causes of anemia. Transfusions improve oxygen delivery to the tissues via increased blood volume and hemoglobin concentration. Certain aspects of equine blood transfusion are challenging, especially in the field situation, and practitioners may be unfamiliar or feel overwhelmed with the process. An understanding of the indications, materials, methods, and techniques as well as donor selection and possible complications will help practitioners successfully implement blood transfusion in clinical practice. PROCEDURES: Blood transfusion involves several steps including appropriate donor selection, cross-matching, blood collection, and administration, as well as monitoring and handling of transfusion reactions. Guidance for each of these steps are detailed in this review. SUMMARY: Blood transfusion is an effective and often lifesaving treatment for managing diseases of blood loss, hemolysis, and decreased RBC production. Equine practitioners require a thorough understanding of the indications for blood transfusion, the immunological principles behind compatibility testing and transfusion reactions, and the technical skills to aseptically collect and administer blood products KEY POINTS: Equine practitioners require a thorough understanding of the indications for blood transfusion, the immunological principles behind compatibility testing and transfusion reactions, and the technical skills to aseptically collect and administer blood products. Because there are over 400,000 possible equine RBC phenotypes, no universal donor exists, and some blood type incompatibilities are likely between any donor and recipient. Therefore, prior to any blood transfusion, donor and recipient blood should be cross-matched Inadequate delivery of oxygen (Do2 ) to the tissues, resulting from low hemoglobin (Hb) concentration, is the most important indication for blood transfusion Neonatal isoerythrolysis most commonly occurs following an anamnestic response in late gestation; it rarely occurs following a primary exposure because the immune response is not strong enough to produce clinically significant alloantibody titers.

Whole blood transfusion in common marmosets: a clinical evaluation.

In veterinary medicine, blood transfusion is commonly performed on companion animals. The common marmoset is a small nonhuman primate with increasing popularity as an animal model in biomedical research. Because of its small whole blood volume, the marmoset is at high risk of exsanguination, and blood transfusion is required to care for life-threatening bleeding. However, few clinical evaluations exist on transfusions for marmosets. This study performed whole blood transfusion with cross-matching on nine marmosets and surveyed the therapeutic effects. Recipients included clinical cases with persistent bleeding, anemia, and coma, as well as animals subjected to postoperative bleeding prophylaxis. Donors were selected from healthy marmosets, including littermates. Cross-match assay before transfusion were all negative, and recipients showed no visible signs of transfusion-related adverse reactions. Whole blood transfusions caused hemostasis and successful recovery in bleeding marmosets, including long-term improvement of anemia cases. Our results indicated that blood transfusion is effective for marmosets with severe anemia and persistent hemorrhage from both non-experimental and surgical causes. Furthermore, DNA sequencing for blood-group classification revealed that all subject marmosets were type A, suggesting that the risk of blood type mismatch may be low in this species.

Hemorrhagic shock and hemostatic resuscitation in canine trauma.

Hemorrhage is a significant cause of death among military working dogs and in civilian canine trauma. While research specifically aimed at canine trauma is limited, many principles from human trauma resuscitation apply. Trauma with significant hemorrhage results in shock and inadequate oxygen delivery to tissues. This leads to aberrations in cellular metabolism, including anaerobic metabolism, decreased energy production, acidosis, cell swelling, and eventual cell death. Considering blood and endothelium as a single organ system, blood failure is a syndrome of endotheliopathy, coagulopathy, and platelet dysfunction. In severe cases following injury, blood failure develops and is induced by inadequate oxygen delivery in the presence of hemorrhage, tissue injury, and acute stress from trauma. Severe hemorrhagic shock is best treated with hemostatic resuscitation, wherein blood products are used to restore effective circulating volume and increase oxygen delivery to tissues without exacerbating blood failure. The principles of hemostatic resuscitation have been demonstrated in severely injured people and the authors propose an algorithm for applying this to canine patients. The use of plasma and whole blood to resuscitate severely injured canines while minimizing the use of crystalloids and colloids could prove instrumental in improving both mortality and morbidity. More work is needed to understand the canine patient that would benefit from hemostatic resuscitation, as well as to determine the optimal resuscitation strategy for these patients.

Randomized double-blinded clinical trial on acute transfusion reactions in dogs receiving leukoreduced versus nonleukoreduced packed red blood cells.

BACKGROUND: Leukoreduction of blood products is commonly performed in human medicine, but its effect on outcome or incidence of transfusion reactions (TRs) in dogs is unknown. OBJECTIVES: To prospectively evaluate the incidence of acute TRs in, and the outcome of, dogs receiving either leukoreduced (LR) or nonleukoreduced (N-LR) packed red blood cells (PRBC). ANIMALS: Dogs (n = 194) administered PRBC between August 2017 and June 2020. METHODS: Prospective randomized double-blinded clinical trial. Dogs were randomized to receive either LR or N-LR PRBC and clinicians, nurses and investigators were blinded to the group allocations. The incidence of TRs, change in PCV, hospitalization duration, and survival to discharge were recorded. RESULTS: Out of the 194 dogs, 96 received LR and 98 received N-LR PRBCs. The mean 12-hour change in PCV value was +9.22% (SD 5.27%) for dogs that received N-LR and +10.69% (SD 6.44%) for dogs that received LR PRBC (effect size 0.26, 95% confidence interval [CI] -0.02 to 0.55), which was not significantly different (P = .08). TRs were documented in 16/194 (8.24%) dogs, with 1/194 (0.51%) being a mild allergic reaction, while 15/194 (7.73%) had suspected febrile nonhemolytic TRs (FNHTRs). FNHTR incidence was not significantly different between the LR (6/96, 6.25%, 95% CI 2.8-13.56) and N-LR (9/98, 9.18%, 95% CI 4.92-17.11) groups (P = .81). Of the 156 dogs that survived to discharge, 80/156 received N-LR PRBC and 76/156 received LR PRBC which was not significantly different (P = .66). CONCLUSIONS AND CLINICAL IMPORTANCE: A clinical advantage of using LR over N-LR PRBC in terms of TRs and increase in PCV after transfusion was not detected.