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Objective: To describe the use of plasma transfusion in anaesthetized dogs, specifically the triggers for use, the population administered plasma, reported adverse events and human errors associated with transfusion., Study Design: Retrospective observational study., Animals: A total of 85 client-owned dogs., Methods: A search of electronic transfusion and anaesthetic records at a university teaching hospital was performed to identify dogs administered plasma during the study period (January 2017 to June 2021). Data collected included signalment, surgical procedure, intraoperative triggers for transfusion, the type of plasma, rate of transfusion and the presence of transfusion reactions, human errors or deviation from transfusion guidelines., Results: During this period, 85 dogs were administered plasma. Sepsis was diagnosed in 49/85 (58%) dogs, with 42/85 (49%) animals undergoing surgery for septic peritonitis. Perianaesthetic hypotension contributed to the decision to administer plasma in 67/85 (79%) dogs. In 33/85 (39%) dogs, hypotension was the only reason for transfusion, while 31/85 (36%) had other influencing factors, most commonly hypoproteinaemia. Fresh frozen plasma was administered in 95% of cases. Only 31% of transfusions were started at a slower 'test dose' rate and 79% of dogs administered boluses of plasma. No definite, probable or possible transfusion reactions were identified using current veterinary guidelines., Conclusions and Clinical Relevance: Plasma transfusions were commonly administered to dogs presenting with sepsis for haemodynamic optimization. Clinicians often chose to bolus plasma instead of initiating transfusions at the recommended initial slow starting rate. No transfusion reactions were identified; however, some reactions may have been masked by the effects of general anaesthesia and/or have been difficult to recognize in this critically ill canine population., (Copyright © 2024 The Author(s). Published by Elsevier Ltd.. All rights reserved.)

Objective: To describe changes in circulating hyaluronic acid (HA) concentration, a biomarker of endothelial glycocalyx degradation, after administration of fresh-frozen plasma (FFP) in critically ill dogs., Animals: 12 client-owned dogs receiving an FFP transfusion due to underlying disease., Methods: Plasma samples were collected for HA concentration measurement pre-FFP transfusion (T0) and 10 minutes (T10) and 90 minutes (T90) following completion of FFP transfusion of a minimum volume of 7 mL/kg. Hyaluronic acid was also measured in the transfused FFP units following in-house validation of a commercial HA assay on citrate phosphate dextrose-anticoagulated plasma. Potential associations of the difference between pre-FFP and post-FFP HA plasma concentrations with the volume of FFP transfused, the cumulative volume of IV fluids administered during the study period, and the HA concentration in the transfused unit were explored., Results: Concentrations of HA were not significantly different between pre- and post-FFP transfusion measurements. The volume of FFP transfused, the cumulative volume of other IV fluids administered during the study time, and the concentration of HA in the FFP units had no significant effect on the change in HA concentration following FFP transfusion in this study., Clinical Relevance: This pilot study did not demonstrate an association between FFP administration and changes in plasma HA concentration. The results of this study may serve to help design future research. A commercial assay was validated to measure HA in citrate phosphate dextrose-anticoagulated plasma.

A 5-month-old intact female Australian shepherd dog was referred to our clinic for neurologic signs including ataxia, a head tilt, and altered mentation following consumption of an unidentified rodenticide several days prior to developing clinical signs. A provisional diagnosis of bromethalin toxicosis had been made, given the neurologic signs seen and the general increased use of bromethalin-containing rodenticide products. However, on physical examination, the dog was noted to have scleral hemorrhage and bleeding at the venipuncture sites, which was inconsistent with bromethalin toxicosis. Coagulation testing was supportive of anticoagulant rodenticide toxicosis and the rodenticide was later identified as the first-generation anticoagulant rodenticide diphacinone. The neurologic signs seen were attributed to a coagulopathy causing multifocal hemorrhage into the central nervous system. Neurologic signs rapidly resolved following treatment with a frozen plasma transfusion and vitamin K 1 . This atypical presentation of an anticoagulant rodenticide toxicosis highlights the need for accurate product identification, if available, and thorough patient examination and laboratory testing. An atypical presentation of anticoagulant rodenticide toxicosis should be considered when neurologic signs are present with clinical bleeding, especially if the type of rodenticide is unknown, or even if it was not thought to have an anticoagulant as the active ingredient. Key clinical message: Given the change in commercially available rodenticide products, this case highlights the need for accurate product identification in cases of suspected toxicosis, and the variable clinical signs that can be seen following anticoagulant rodenticide toxicosis., (Copyright and/or publishing rights held by the Canadian Veterinary Medical Association.)

Background: Anecdotal evidence suggests plasma transfusions increase serum amyloid A (SAA) concentrations in healthy neonatal foals making this marker of inflammation inappropriate for therapeutic decision making in such animals., Hypothesis/objectives: Administration of hyperimmune fresh frozen plasma (FFP) increases SAA concentration in healthy foals and in foals with failure of transfer of passive immunity (FTPI)., Animals: Eighty-six healthy foals., Methods: Prospective cohort study. Foals <24 hours of age receiving plasma transfusion for treatment of FTPI (serum immunoglobulin G [IgG] concentrations <8 g/L; n = 17) or as a preventative measure for Rhodococcus equi infection (IgG >8 g/L; n = 33) were enrolled. A healthy nontransfused group of foals (IgG >8 g/L; n = 21) also was included. Serum amyloid A concentration was determined before (t0h) and after (t24h) administration of FFP. Changes in blood SAA concentration were assessed using linear regression models., Results: No statistical differences were found in SAA concentration at t0h or t24h among the 3 groups (P > .05, for all comparisons). The variation in SAA concentration before (t0h) and after (t24h) plasma transfusion showed that administration of FFP was not associated with the changes in SAA concentration (P > .05). An association between SAA concentration at t0h and at 24 hours (P < .05) was identified, where foals with higher SAA concentration at t0h also had higher SAA concentration at t24h., Conclusions and Clinical Importance: Administration of FFP to newborn foals was not associated with changes in SAA concentration., (© 2023 The Authors. Journal of Veterinary Internal Medicine published by Wiley Periodicals LLC on behalf of American College of Veterinary Internal Medicine.)

Objective: To describe the clinical features and outcome of a dog with anticoagulant rodenticide (diphacinone) exposure, which was subsequently diagnosed with a coagulopathy characterized by hemoperitoneum, and presumptive ureteral wall hemorrhage contributing to acute kidney injury (AKI)., Case Summary: A 4-year-old, female neutered Australian Cattle Dog was evaluated for an acute onset of lethargy, decreased appetite, and a mild right thoracic limb lameness. Radiographs and point of care ultrasound demonstrated retroperitoneal and peritoneal effusion. Diagnostic abdominocentesis confirmed hemorrhagic effusion. Complete blood count, biochemistry, and coagulation profile showed a regenerative anemia (PCV 32%), thrombocytopenia (platelets 96 × 10 9 /L [96 × 10 3 /µl]), azotemia (BUN 38.9 mmol/L [109 mg/dl], creatinine 512.8 µmol/L [5.8 mg/dl]), and coagulopathy (prothrombin time >100 s, activated partial thromboplastin time >42.3 s). The client reported access to anticoagulant rodenticide up to 72 hours prior to presentation. Ultrasonographic examination revealed bilateral pyelectasia and hydroureter with thickened distal ureteral walls at the level of the ureteral-vesicular junctions. The ultrasonographic conclusion was presumptive intramural ureteral hemorrhage resulting in ureteral obstruction. The patient was diagnosed with AKI with likely prerenal, renal, and postrenal components. Treatment included vitamin K and frozen plasma transfusion. The patient recovered fully and was discharged 3 days after presentation. Two days after discharge, the patient had improvement in azotemia (BUN 10.7 mmol/L [30 mg/dl], creatinine 176.6 µmol/L [2.0 mg/dl]). Gas chromatography-mass spectrometry confirmed presence of diphacinone in the blood. Repeat ultrasound and biochemistry 60 and 210 days, respectively, after discharge showed resolution of ureteral wall thickening, hydroureter, pyelectasia, and recovery of kidney parameters., New or Unique Information: Although nephropathies secondary to anticoagulant therapy have been described in people, the authors believe this is the first report of diphacinone anticoagulant rodenticide exposure contributing to an AKI secondary to obstruction from ureteral wall hemorrhage in the veterinary literature., (© Veterinary Emergency and Critical Care Society 2022.)

Objectives: The most common use of plasma transfusion is for haemostatic purposes, but coagulation factor activities in stored feline plasma are unknown. The concentration and stability of coagulation factors I (fibrinogen), II, V, VII, VIII, IX, X, XI and XII in feline fresh frozen plasma (fFFP) stored for 1 year were studied., Methods: Fifty-five units of fFFP were produced from 55 fresh whole-blood donations obtained from indoor healthy blood donor cats. Twenty-one units were stored for <2 weeks (T0) and 34 were stored for 1 year (T1). After the completion of storage, specific coagulation factor activities for factors II, V, VII, VIII, IX, X, XI and XII were tested using modified one-stage activated partial thromboplastin or prothrombin time assays. Fibrinogen was determined using the Clauss method., Results: Significantly decreased activities were observed for factors II (T0: 101.94% ± 19.06%; T1: 73.23% ± 39.06% [ P  = 0.001]), VII (T0: 102.78% ± 24.69%; T1: 60.08% ± 38.17% [ P <0.001 ]), VIII (T0: 77.52% ± 30.39%; T1: 50.32% ± 23.8% [ P  = 0.001]), XI (T0: 88.76% ± 22.73%; T1: 66.28% ± 22.2% [ P  = 0.001]) and XII (T0: 89.50% ± 21.85%; T1: 55.46% ± 23.18% [ P  <0.001]) when comparing units at time 0 and after 1 year of storage. No significant difference was observed for factors IX (T0: 84.86% ± 29.35%; T1: 71.37% ± 22.23% [ P  = 0.064]) and X (T0: 96.24% ± 25.1%; T1: 83.91% ± 49.54% [ P  = 0.236]). Unexpectedly, a significant increase was observed for factor V (T0: 71.94% ± 24.14%; T1: 97.89% ± 62.33%; P  = 0.046). Fibrinogen was 2.76 ± 1.09 g/l at T1. Factors VIII, XII and VII had the lowest mean activities after 1 year., Conclusions and Relevance: Although a decrease in most coagulation factors activities was noted with storage, 1-year-old fFFP was haemostatically active in vitro. The most suitable factors for quality control assessment of fFFP are factors VII and VIII. Approximately 13-20 ml/kg of fFFP is required to administer a minimum of 10 IU/kg coagulation factor activity.

Due to the time-limited intestinal uptake of colostral immunoglobulins, the suggested treatment of hypogammaglobulinemia in new-born foals is usually plasma transfusion. The aims of this study were twofold: firstly, to investigate the course of serum IgG concentration after plasma transfusion in newborn foals; and secondly, to determine the amount of transfusion required for a significant increase in serum IgG concentration. For this purpose, the IgG concentration was measured in 23 foals at three different points in time: before transfusion, 1 hour after transfusion, and 24 hours after transfusion. There was an increase in IgG concentration in the blood of 18 foals (78.3%). In five foals (21.7%), no increase in serum IgG concentration were detected after plasma transfusion. Transfusion of 1 mg IgG caused an average increase in IgG level of 0.03 mg/dl (0.001-0.268 mg/dl) 1 hour after transfusion. After 24 hours, the same amount of IgG caused a larger increase of 0.05 mg/dl (0.002-0.537 mg/dl). None of the foals demonstrated adverse reactions to the plasma transfusion. These values provide a guidance how much IgG is needed to increase serum IgG concentration to a desired level. However, this study has shown that there is a high variability in serum IgG concentration after plasma transfusion. Which highlights the necessity for monitoring IgG concentration following transfusion., (Copyright © 2022. Published by Elsevier Inc.)

Objective: To investigate the clinical outcome and complications associated with extracorporeal blood purification (EBP) using either hemodialysis (HD), hemodialysis and hemoperfusion (HD + HP), or therapeutic plasma exchange (TPE) for the management of acute toxin ingestion in small animals., Design: Retrospective, multicenter study from January 2011 to July 2018., Setting: One university teaching hospital and one private specialty hospital., Animals: Fifty-one dogs and 3 cats with a history of acute toxin exposure that could lead to severe morbidity and mortality, managed with different EBP techniques., Main Results: Nonsteroidal anti-inflammatory drugs (38/54, 52%), baclofen (8/54, 15%), and ethylene glycol (7/54, 13%) were the most common toxicities treated with EBP. Membrane-based TPE was used most commonly (22/54, 40.7%), followed by HD (17/54, 31.5%) and then HD + HP (15/54, 27.8%). There was an 83.3% (45/54) overall survival, with 88.9% (8/9) of nonsurvivors having clinical signs prior to therapy. One third (18/54) of the patients never developed clinical signs of toxicity. Treatment complications occurred in 44.4% (24/54) of the animals, although only 18.5% (10/54) of these complications, such as mild hypotension, thrombocytopenia secondary to the HP cartridge, facial swelling after plasma transfusion for TPE, bleeding from catheter size secondary to heparinization, or clotting of the system, could be attributed to the EBP treatment. None of the nonsurvivors died because of EBP complications., Conclusions: Early initiation of EBP therapy might be considered as an alternative route of decontamination in severe acute toxicities with high potential for significant morbidity and mortality. The survival rate in small animals undergoing EBP is high despite exposure to potential lethal doses of toxins, and survival appears to be more likely if clinical signs of toxicity are not present at the time of EBP. Continued research is warranted with randomized controlled clinical trials to further evaluate the clinical efficacy and benefit of EBP., (© Veterinary Emergency and Critical Care Society 2021.)

Objectives: To determine the impact of age on survival in horses with colitis and to elucidate whether a lower type-1/type-2 cytokine ratio or an exaggerated inflammatory state contribute to reduced survival in aged horses., Design: Part 1: Retrospective cohort analysis. Part 2: Analytic observational study., Animals: Part 1: One hundred twenty-four adult horses with colitis. Part 2: Twenty-nine adult horses with new diarrhea onset while hospitalized., Measurements and Main Results: Part 1: Patient signalment, select clinicopathological data, diagnoses, treatment, hospitalization length, and invoice were compared between survivors (n = 101) and nonsurvivors (n = 23). Only age and plasma transfusion retained statistical significance in the final multivariate outcome model, with 8.5 times lower odds of survival in transfused horses (95% confidence interval [CI], 2.6-27.2%). Additionally, the likelihood of nonsurvival increased by 11.8% (95% CI, 4-20.2%) for every year the horse aged (P = 0.002). Similarly, geriatric horses (≥20 years) were 15.2 times more likely to die than young-adults (2-12 years, P = 0.03), independent of financial investment, documented comorbidities, and duration of hospitalization. Part 2: Select cytokine analyses were performed on serum collected from hospitalized horses within 1 hour of diarrhea onset (T0) and 6 hours later. At T0, all recorded clinicopathological variables were comparable between geriatric and young-adult horses, suggesting a similar degree of systemic illness. The median concentration of type-2 cytokines interleukin-4 and interleukin-10, and type-1 cytokine interferon-γ did not differ between age groups. Inflammatory cytokines interleukin-6 and tumor necrosis factor-α were significantly higher in geriatric compared to young-adult horses at both sampling time points., Conclusions: Outcome of colitis was less favorable in aging horses and patients receiving a plasma transfusion. Although an exaggerated inflammatory state, based on increased interleukin-6 and tumor necrosis factor-α concentrations, in geriatric horses may contribute to reduced survival, a lower type-1/type-2 cytokines ratio was not identified in our geriatric population., (© Veterinary Emergency and Critical Care Society 2021.)

Four dogs with anticoagulant rodenticide toxicosis were treated with intravenous vitamin K 1 in lieu of plasma transfusion due to client cost constraints. Two dogs experienced a suspected anaphylactoid reaction, necessitating cessation of the treatment in one dog. Prothrombin time was rechecked 1 h after treatment in the remaining three dogs and all results were within the normal reference range. All four dogs were discharged from hospital within 48 h of presentation. Intravenous vitamin K 1 rapidly reverses the coagulopathic state in dogs with anticoagulant rodenticide toxicosis. It is a viable alternative therapy to plasma transfusion if circumstances preclude its use; however, patients must be monitored for anaphylactoid reactions., (© 2020 Australian Veterinary Association.)

The goal of this study was to objectively assess the effect of a platelet-rich plasma (PRP) derivate in English bulldogs with stifle degenerative joint disease secondary to cranial cruciate ligament rupture (CCLR). We used a force platform and affixed electrogoniometers to measure peak vertical force (PVF), vertical impulse (VI), stance time (ST), and angular range of motion (AROM), from 12 lame client-owned English bulldogs with post-CCLR stifle joint abnormalities. The 12 affected subjects were treated with 4 intra-articular injections of PRP, at 30-day intervals. Ten untreated, sound English bulldogs were used as a reference group. Clinical outcomes were evaluated using a linear mixed effects model. Mean values of PVF, VI, ST, and AROM were improved within the first 3 months post-treatment in the CCLR group, with mean measured changes increasing to maximum 4.56% body weight gain, 1.5% body weight/second, 0.07 seconds, and 6.18 degrees, respectively. The effects declined progressively after the treatment interval, ending at nearly initial levels after 6 months. This study demonstrates that dogs with CCLR treated with intra-articular PRP had improved PVF, VI, ST, and AROM over time; the duration of effect was waning by the end of the post-treatment period.

Fluid therapy is essential in the treatment of emergent veterinary patients. Many different types of intravenous fluids are available, including crystalloids, artificial colloids, and natural colloids. The type, dose, and administration rate can determine the outcome in a critically ill patient. This article discusses the various types of fluids and their indication for use., (Copyright © 2013 Elsevier Inc. All rights reserved.)

This report discusses the diagnosis and treatment of afibrinogenemia in a Chihuahua. Prolongations of prothrombin time (PT), activated partial thromboplastin time (aPTT), and thrombin clotting time (TCT) together with fibrinogen assay results of either no or trace amounts of fibrinogen support a diagnosis of afibrinogenemia. Differential diagnoses include common coagulopathies, liver failure, and disseminated intravascular coagulation (DIC). Either aggressive cryoprecipitate or plasma transfusions are required to treat afibrinogenemia. The current guidelines for treatment of coagulopathies include plasma transfusions (either 15-30 mL/kg or until both PT and aPTT are normalized). This report describes a case in which bleeding persisted 2 days after standard plasma transfusion levels were administered and PT and aPTT levels had normalized. In this case, the bleeding was stabilized for up to 2 mo after administering > 54 mL/kg plasma. In human medicine, either cryoprecipitate or fibrinogen concentrate is used to increase blood fibrinogen levels to 100 mg/dL for minor bleeding and 200 mg/dL for major bleeding. Further studies are needed; however, the author of this report suggests that aggressive transfusions and monitoring are needed in veterinary afibrinogenemia cases.

Six dogs with lornoxicam induced severe gastrointestinal bleeding are described. The ingested dose ranged between 0.5 - 5.1 mg/kg BW (median 0.63 mg/kg BW). The severity of the bloodloss anemia was moderate to severe with PCV values ranging between 12 - 27 % (median 16 %) and serum albumin concentrations between 12 - 22 g/l (median 16 g/l). One dog had evidence of chronic thrombocytopathia over 13 days and clinicopathologic findings of gastrointestinal bleeding over 55 days. None of the dogs developed kidney injuries. The clinical condition required transfusion of blood products in 5 of 6 cases. One dog with a perforated duodenal ulcer and septic peritonitis survived until discharge but had to be euthanized later on due to recrudescent clinical signs (hematemesis, melena). The median length of hospitalisation was 12 days (5 - 14). No correlation was seen between the ingested dose and severity of clinical signs. Lornoxicam ingestion leads to severe and longlasting gastrointestinal bleeding in the dog and requires immediate intensive therapy.

Variant CJD (vCJD) is an incurable, infectious human disease, likely arising from the consumption of BSE-contaminated meat products. Whilst the epidemic appears to be waning, there is much concern that vCJD infection may be perpetuated in humans by the transfusion of contaminated blood products. Since 2004, several cases of transfusion-associated vCJD transmission have been reported and linked to blood collected from pre-clinically affected donors. Using an animal model in which the disease manifested resembles that of humans affected with vCJD, we examined which blood components used in human medicine are likely to pose the greatest risk of transmitting vCJD via transfusion. We collected two full units of blood from BSE-infected donor animals during the pre-clinical phase of infection. Using methods employed by transfusion services we prepared red cell concentrates, plasma and platelets units (including leucoreduced equivalents). Following transfusion, we showed that all components contain sufficient levels of infectivity to cause disease following only a single transfusion and also that leucoreduction did not prevent disease transmission. These data suggest that all blood components are vectors for prion disease transmission, and highlight the importance of multiple control measures to minimise the risk of human to human transmission of vCJD by blood transfusion.

Objective: To report on the incidence of transfusion reactions to commercial equine plasma in a hospital-based population of horses, to characterize these reactions and report on outcome., Design: Retrospective study., Setting: University teaching hospital., Animals: Client-owned horses referred to the University of Wisconsin., Interventions: Intravenous administration of 2 commercial equine plasma products when clinically indicated., Measurements and Main Results: Medical records of 107 horses that received plasma transfusions between 2003 and 2008 were evaluated. Transfusion reactions were recorded in 6 of 107 transfusions. All individuals were administered plasma from 1 commercial source. Foals <30 days of age received a hypergammaglobulinemic product and all adults received a lower IgG concentration product. No reactions were recorded in adults. In foals (<30 d) reactions were recorded in 6 of 69 cases (8.7%), all of which occurred in neonates <7 days of age (6/62; [9.7%]). The most frequent reactions were fever (4/6), tachycardia (2/6), tachypnea (2/6), and colic (2/6). All affected foals survived the reaction. There were no statistically significant differences (P<0.05) in any of the variables examined between those foals that did and those that did not experience transfusion reactions., Conclusion: The incidence of transfusion reactions was 8.7% in foals and 0% in adult horses in our referral population. Five of 6 foals responded to medical therapy and eventually received the clinically indicated transfusion. No transfusion related mortality occurred.

Objectives: To describe changes in fresh frozen plasma (FFP) utilization over a 10-year period at a veterinary teaching hospital. To evaluate the effect of FFP administration on specific laboratory parameters., Design: Retrospective observational study., Setting: University teaching hospital., Animals: Two hundred and eighty-three dogs and 25 cats., Interventions: A hospital database search was performed for all animals receiving FFP during the study periods., Measurements and Main Results: Medical records of patients receiving plasma transfusions from 2006 to 2008 and from 1996 to 1998 were reviewed. Data collected included indications for transfusion, transfused volume, concurrent therapies, clinicopathologic data pre- and post-transfusion, transfusion reactions, days of hospitalization, and outcome. FFP was administered to 112 dogs and 23 cats from 2006 to 2008 and to 171 dogs and 2 cats from 1996 to 1998. Significantly fewer patients received FFP for the treatment of hypoalbuminemia (2006-2008: 15% versus 1996-1998: 53%; P<0.001) or pancreatitis (2006-2008: 2% versus 1996-1998: 13%; P=0.001) and significantly more patients received FFP for coagulopathy (2006-2008: 80% versus 1996-1998: 31%; P<0.001) in the 2006-2008 group compared with the 1996-1998 group. For all patients receiving FFP, there was no difference in mean serum albumin concentration pre- and post-transfusion. Median prothrombin time and activated partial thromboplastin time were significantly decreased post FFP administration. No association was found between the volume of plasma administered and outcome., Conclusions: FFP utilization has changed significantly over a 10-year period. FFP was used most commonly in 2006-2008 for the correction of coagulopathy. FFP administration was associated with significant reduction in prothrombin time and activated partial thromboplastin time but did not significantly alter albumin concentration when administered at median doses of 15-18 mL/kg.

This case report describes the intralesional application of autologous conditioned plasma (ACP) in seven horses as treatment of severe tendinitis of the superficial digital flexor tendon, deep digital flexor tendon, or desmitis of the inferior check ligament. Follow-up data of the horses revealed a positive outcome in 10 to 13 months post injury. All horses treated with ACP were either performing in their previous work-load or were back in full training. Further studies with long-term follow-up will have to be performed to support these clinical intermediate-term observations.

Red blood cell transfusions in veterinary medicine have become increasingly more common and are an integral part of lifesaving and advanced treatment of the critically ill. Common situations involving transfusions are life-threatening anemia from acute hemorrhage or surgical blood loss, hemolysis from drugs or toxins, immune-mediated diseases, severe nonregenerative conditions, and neonatal isoerythrolysis. Although transfusions can be lifesaving, they are also associated with adverse events that can be life threatening. This article reviews the principles for pretransfusion blood typing and compatibility testing and the types of transfusion reactions that exist despite test performance., (Copyright (c) 2010. Published by Elsevier Inc.)

Objective: Compare outcome of dogs that did and did not receive fresh frozen plasma (FFP) for treatment of pancreatitis., Design: Retrospective case series between 1995 and 2005., Setting: University referral hospital., Animals: Seventy-four dogs were enrolled with a total of 77 cases as 2 dogs had repeat episodes of pancreatitis. Diagnosis of pancreatitis was based on clinical signs, physical examination, and abdominal ultrasonographic examination., Interventions: The medical database was searched for dogs with a diagnosis of pancreatitis. Information collected included signalment, vital signs, CBC, use of FFP, length of stay, use of antimicrobials and supplemental nutrition, surgical intervention, preexisting illness, evidence of a coagulopathy and outcome. Outcome was compared between those patients that did and did not receive FFP., Measurements and Main Results: Fifty-nine dogs survived to discharge. Two dogs with repeat pancreatitis survived to discharge after each episode. Thirteen dogs died and 2 were euthanized. FFP was administered to 20 dogs. Two dogs that were hospitalized for repeat pancreatitis did not receive FFP. Seven of 20 (35%) cases that received plasma died or were euthanized compared with 6 of 57 (12%) cases that did not receive plasma. Plasma administration was significantly related to outcome (P<0.001). Severity of illness scores were difficult to assign, however, dogs meeting criteria for systemic inflammatory response syndrome were not more likely to receive FFP. Other therapies included supplemental nutrition, antimicrobials, and surgical intervention, which did not affect outcome., Conclusions: Mortality rate for those dogs receiving plasma was higher than those that did not. Severity of illness scores were difficult to assign; however, preexisting illness, evidence of systemic inflammatory response syndrome, and presence of a coagulopathy were not significantly different between the groups that did and did not receive FFP. No benefit for administration of FFP was noted. Additional investigation should be performed to confirm this result.

Thirteen dogs with primary immune-mediated hemolytic anemia received fresh-frozen plasma within 12 hours of admission, in addition to unfractionated heparin and other therapies, such as prednisone, azathioprine, and packed red blood cell transfusion. Antithrombin activity was quantified prior to transfusion and at 30 minutes and 48 hours after transfusion. Plasma antithrombin activity did not change significantly after a single plasma transfusion. There were no deaths in the first 48 hours of treatment. Thromboembolism was identified at necropsy in six of 10 dogs that died within 12 months of admission. There was no significant difference in the incidence of thromboembolism between the current treatment group and a historical control group.

Transfusion of blood products is a frequent necessity in small animal practice. Transfusion medicine has become more sophisticated with increased access to blood components, knowledge of blood types, and cross-matching requirements. Although potentially life saving, this procedure does carry some risk. In addition to selecting the appropriate blood product, several steps need to be completed to prepare the product for administration and the patient for receiving a transfusion.

Objective: To document reasons for use of fresh frozen plasma (FFP) in dogs and determine variables that apparently triggered the decision to use FFP., Design: Retrospective study., Animals: 74 dogs., Procedure: Medical records of dogs that received FFP at a veterinary teaching hospital during a 3-month period were reviewed., Results: The 74 dogs underwent 144 transfusion episodes (TE; a TE was defined as 1 day of transfusion therapy) and received 252 units (120 ml/unit) of FFP. Fresh frozen plasma was administered to provide coagulation factors (67 TE), albumin (91), alpha-macroglobulin (15), or immunoglobulins (19); for some TE, multiple clinical indications were identified. Variables that apparently triggered the decision to administer FFP included active hemorrhage with or without prolongation of coagulation times, low total plasma protein concentration, persistent vomiting associated with pancreatitis, and sepsis. Mean doses of FFP for each indication were between 8.5 and 9.4 ml/kg (3.9 and 4.3 ml/lb). Small dogs were generally given higher doses (mean dose, 13.9 ml/kg [6.3 ml/lb]) than large dogs (mean dose, 5.1 ml/kg [2.3 ml/lb]). Fifty (68%) dogs were alive at the time of discharge from the hospital., Conclusions and Clinical Relevance: Results suggest that FFP plays an important role in the care of critically ill dogs. Because the supply of FFP is limited, guidelines for when administration of FFP may be clinically useful should be developed.

Here we report the comparative efficacy of fresh-frozen plasma (FFP) and cryoprecipitate in the treatment of 2 inherited bleeding disorders in dogs. The dogs were divided into 3 groups, consisting of 4 Doberman Pinschers with type I von Willebrand's disease (vWD) (group 1), 1 Scottish Terrier with type III vWD (group 2), and 4 German Shepherd Dogs with hemophilia A (group 3). In vWD, therapeutic efficacy was determined by the ability of the products to increase von Willebrand factor antigen (vWf:Ag) concentrations above 35 canine units (CU)/dL and to correct the prolonged buccal mucosal bleeding time. Therapeutic efficacy in hemophilia A was assessed by the ability of the products to increase the factor VIII coagulant (FVIII:C) activity above 30 CU/dL. In both groups 1 and 2, higher increases in vWf:Ag were achieved with cryoprecipitate than with FFP, despite a significantly smaller total amount of vWf:Ag (in CU) being infused with cryoprecipitate. The maximum vWf:Ag attained after infusion in group 1 was dependent on both the baseline vWf:Ag concentration and on the type of infusion product. The dogs with vWD in both groups also displayed a delayed increase in FVIII:C activity after infusion of both plasma products, which is characteristic of the disease. In group 3, cryoprecipitate achieved similar increases in FVIII:C activity compared to FFP, although a significantly lesser amount of FVIII:C (in CU) was delivered with cryoprecipitate. Six of the 9 dogs treated with FFP experienced adverse effects ranging from mild pruritus to pallor and weakness, whereas none of the 9 dogs treated with cryoprecipitate had any observable adverse reactions (P = .009). Based on its efficacy and safety, we recommend cryoprecipitate over FFP for treatment or prophylaxis of hemorrhagic episodes in dogs with vWD or hemophilia A.

In our patients, haemophilia A was observed in German shepherd dogs and Siberian huskies. Frequently occurring clinical symptoms were excessive bleeding from the gums, when getting adult teeth, and haematomas in the regions of the proximal hindleg, the knee joint as well as the chest or abdominal wall, respectively. The activated partial thromboplastin time (aPTT) as a screening test of the intrinsic coagulation system reflects sensitively also a mildly reduced factor VIII:C activity which may be present for example during substitution therapy. Therefore, the aPTT is well suited for screening for haemophilia A. In haemophilic dogs suffering from hypovolaemic shock due to a considerable acute blood loss, besides the aPTT also the prothrombin time and partly the platelet number were beyond the respective reference range due to loss and consumption of coagulation factors and thrombocytes. For substitution therapy, fresh frozen plasma was used in the first line. Administered at a dose of 15 or 20 ml/kg BW, it caused an increase of factor VIII:C activity by 20 or 33%, respectively. 24 hours after the end of infusion the mean of the remaining activity increase in comparison with the value measured immediately after substitution was 27%. The fast, biphasic elimination of factor VIII:C in some cases required a repeated application until clinical recovery. Desmopressin acetate given at a dose of 1 microgram/kg KGW intravenously or subcutaneously to two dogs each did not cause a distinct increase of the factor VIII:C activity, and is, therefore, not an efficacious supplementary therapy to substitution therapy in haemophilic dogs.

A 6 months old male crossbred dog became conspicuous because of a considerable haematoma in the region of the left thigh without recognizable exterior trauma. The results of the screening tests of the haemostatic system (distinctly prolonged activated partial thromboplastin time [aPTT], normal thromboplastin time and platelet count as well as a shortening of thrombin time) yielded a tentative diagnosis of haemophilia. Haemophilia B could be diagnosed on the basis of a distinctly and isolated reduced factor IX activity (8%, reference range: 70-140%). Two infusions with 20 ml/kg BW fresh frozen plasma each caused a clear clinical recovery of the patient. In addition, the efficacy of plasma infusion was documented in vitro by a temporary increase of factor IX activity as well as repeated measurements with the resonance thrombograph and of the aPTT.

Veterinary blood component preparation methods are based on human protocol with veterinary modification. This article covers the practical aspects of donor selection, blood collection, and the various options for separation of whole blood into components. Obligations are met to ensure high quality products yet allowances are made where possible to account for problems that are unique to veterinary medicine.

Therapy with blood and blood products related to hemostatic disorders in small animal practice is reviewed. Administration of platelet rich plasma and platelet concentrates in thrombocytopenia or thrombopathia is discussed. Vascular purpuras, vasculitis, and vascular inherited defects are also considered. Inherited coagulation disorders are summarized and the therapeutic choices in treating these disorders are also proposed. In addition, acquired coagulation disorders are briefly reviewed.

Administration of blood components instead of whole blood has become the most important means of transfusion support in dogs and in some settings in cats as well. Component administration entails the transfer of biological material and carries an inherent risk of disease transmission and adverse reactions. This article reviews the indications, pretransfusion considerations, and follow up in small animal patients receiving blood component therapy.

Blood component therapy may be required for a variety of pathologic reasons in the cancer patient. The tumor itself not only affects various cell lines, but treatment with chemotherapeutic agents can induce cytopenias. In addition, chronic and acute hemorrhage can be caused by tumor erosion and rupture or by paraneoplastic coagulopathies. Component replacement will depend on the underlying hematologic deficiencies and should be performed in conjunction with treating the cause of the deficiency.

The administration of blood or its components can provide the life-saving element for a critically ill small animal patient. Shock from acute massive hemorrhage produces catastrophic cardiovascular changes requiring rapid, accurate resuscitation techniques for survival. Bleeding that occurs more slowly allows for the opportunity to discover and treat the inciting cause and to administer specific blood component.

There are two main reasons for blood component therapy: the need for an increase in oxygen-carrying capacity and improved hemostasis. Additionally, blood component therapy is used to increase plasma protein concentrations. Component therapy entails separating whole blood into its cellular and plasma components and administering the appropriate blood component based on the patient's needs. General considerations such as compatibility, defined expectations of benefits, and topics including specific disease screening, preparation of blood components, preparation of blood products for administration, and typing and crossmatching in relation to blood component therapy and its application in companion animal practice are discussed.

A 9-year-old female Kerry Blue Terrier with postoperative hemorrhage and prolonged activated partial thromboplastin and activated clotting times was determined to have factor XI deficiency. Transfusions of fresh-frozen plasma given on 4 consecutive days transiently returned the values for activated clotting time and plasma factor XI activity to within reference range limits and controlled the hemorrhage. Analysis of data from 10 other factor XI-deficient Kerry Blue Terriers with a tendency for mild posttraumatic or postoperative bleeding was suggestive of an autosomal mode of inheritance, with a mild tendency for posttraumatic or postoperative bleeding in homozygous and heterozygous dogs. Factor XI deficiency is the only contact phase protein defect that causes a bleeding disorder in animals, which can be explained by the fact that thrombin is more efficient than factor XIIa in activating factor XI. Factor XIa plays a key role in sustaining coagulation.

One hundred and thirty-one dogs received 163 packed RBC transfusions in 1989, and records from these dogs were examined. Seventy percent had anemia from blood loss, 22% from hemolysis, and 8% from bone marrow hypoplasia. Forty-seven percent (62 dogs) survived hospitalization. Thirty-seven percent (49 dogs) required anesthesia for a surgical procedure. Thirteen percent (17 dogs) had acute or delayed transfusion reactions, but all of these dogs survived hospitalization. There was no age, breed, or sex predilection. Criteria used to determine transfusion need included anemia (measured by PCV); history of acute blood loss; need for anesthesia; and evidence of weakness, tachypnea, or tachycardia. Twenty-four percent (32 dogs) scored < 5 on the transfusion-need assessment scale. These dogs may have had falsely low scores because of rapid blood loss from surgery or trauma without reflection in the PCV.

A protocol was developed for preparation of platelet concentrates (PC) to support thrombocytopenic dogs. Four clinically normal dogs with platelet counts that ranged from 200 to 330 x 10(9) platelets/L were used as donors. One unit (450 ml) of blood was collected by venipuncture into a double blood bag. Whole blood (WB) was centrifuged for 4 minutes at 1,000 x g (braking time = 2 minutes, 30 seconds) to prepare platelet-rich plasma (PRP). The PRP was expressed into the satellite bag and was centrifuged for 10 minutes at 2,000 x g (braking time = 2 minutes, 36 seconds). The platelet-poor plasma was expressed, leaving 40 to 70 ml of plasma and the pelleted platelets in the satellite bag. The resulting PC was left undisturbed for 60 minutes to promote disaggregation, and the platelets were then resuspended by gentle manual agitation. Forty-eight PC were prepared. Mean (+/- SD) platelet yield from WB to PRP was 78 (+/- 13)% (range, 35 to 97%); yield from PRP to PC was 94 (+/- 6)% (range, 75 to 100%); and overall yield (PC from WB) was 74 (+/- 13)% (range, 36 to 91%). Mean PC platelet count was 8.0 (+/- 3.0) x 10(10) platelets/PC (range, 2.3 to 13.4 x 10(10) platelets/PC). The WBC content was 0.1 to 2.3 x 10(9) platelets/PC, representing 3 to 74% of WBC in the WB. Hematocrit was 0.1 to 26.2%. Results of bacterial and fungal culturing were negative. The PC were irradiated (18 Gy) and transfused to 5 cross-matched dogs undergoing bone marrow transplantation that developed profound thrombocytopenia of up to 8 weeks' duration.(ABSTRACT TRUNCATED AT 250 WORDS)

The processing of blood into various components and the knowledge of component usage enables veterinarians to support and beneficially treat more animals. Blood products include packed red blood cells; fresh frozen, fresh, and modified plasma; cryoprecipitate; platelets; and concentrates. Some methods of preparation of blood products and storage are presented.

Although the technique of transfusing blood from one dog to another has been known for centuries, transfusion is not easily accomplished in clinical veterinary medicine. There is a lack of blood typing reagents, suitable donors, and commercial blood banks. This situation is beginning to change, and this article focuses on practical and accessible transfusion methods for dogs. Also discussed are recommendations regarding the type of blood product to be used in specific situations, routes of administration for blood products, and complications of blood transfusion.

Canine von Willebrand's disease (vWD) is the most common inherited bleeding disorder of purebred dogs. Optimum treatment of affected dogs is influenced by the presence of concurrent disorders, especially thyroid insufficiency, and the nature of hemostatic stress encountered. Blood component therapy, most specifically the use of cryoprecipitate, provides the most effective transfusion support for severely affected dogs.