ISSN 2398-2942      

Anemia: transfusion indications

icanis

Synonym(s): Blood transfusion


General principles

Blood types

  • Dogs have at least eight different blood groups called dog erythrocyte antigen (DEA) 1-7 Blood types.
  • DEA-1 has two subgroups: DEA-1.1 and 1.2.
  • DEA-1.1 is the most potent stimulator of isoantibody production and severe transfusion reactions may occur if a dog with DEA-1.1 antibodies is transfused with DEA-1.1-type blood.
  • DEA-1.2 and -7 are the next most immunogenic blood types.
  • The donor blood should preferably be DEA-1.1, -1.2 and -7 negative: but DEA-1.1 negative most important.
  • An in-house test kit is available to identify DEA-1.1 positive dogs (Rapid H canine 1.1).
  • Dogs often do not have naturally occurring allo-antibodies against other blood types so initial transfusion will not usually cause acute transfusion reactions.
  • Subsequent mismatched transfusion may result in acute transfusion reactions with these clinical signs:
    • Fever.
    • Tachycardia.
    • Tremors.
    • Urticaria.
    • Vomiting.
    • Hemoglobinuria.
    • Involuntary urination/defecation.

Transfusion

  • Major cross-match Blood: crossmatching should be performed before transfusion of any dog that has previously (>4 days) received a transfusion.
  • Stored blood should be warmed in a water bath first. In many cases blood can be administered at room temperature and this may result in less degradation of blood products.
    Do not exceed 37°C.If blood is heated to >38°C hemolysis will occur.
  • Blood should be given using a blood administration set with a 170 u filter to prevent clots entering the recipient.
    Do not administer crystalloids containing calcium or glucose or colloids through this line.
  • Transfuse slowly for 30 min (<5 ml/min) in case of transfusion reaction.
  • Monitor temperature, pulse and respiration rate frequently, especially at start since increases may be indicative of transfusion reaction.
  • Blood volume of a normovolemic dog is approximately 90 ml/kg.
  • Transfusion rate in normovolemic dog is 1-5 ml/kg/h and no more than 22 ml/kg/day.
    If cardiac failure, do not exceed 1-2 ml/kg/h.If hypovolemic, do not exceed 22 ml/kg/h.

Calculation of volume required

  • 2.2 ml whole blood/kg raises the PCV Hematology: packed cell volume by 1.0%.
  • Volume of donor blood required = bodyweight of recipient (kg) x 90 x ((desired PCV - PCV of recipient)/PCV of donor).

For patients with hemorrhagic anemia

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For patients with hemolytic anemia

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For patients with non-regenerative anemia

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Further Reading

Publications

Refereed papers

  • Recent references from PubMed and VetMedResource.
  • Giger U, Gelens C J, Callan M B et al (1995) An acute hemolytic transfusion reaction caused by dog erythrocytic antigen 1-1 incompatibility in a previously sensitized dog. JAVMA 206 (9), 1358-1362 VetMedResource.

Other sources of information

  • Helm J & Knottenbelt C (2010) Blood transfusions in dogs and cats 1. Indications. In Practice 32, 184-189.
  • Helm J & Knottenbelt C (2010) Blood transfusions in dogs and cats 2. Practicalities of blood collection and administration. In Practice 32, 231-237.
  • Abrams-Ogg A (2000) Practical Blood Transfusion. In: Manual of Canine and Feline Haematology and Transfusion Medicine. 1st edn. Day M J, Mackin A & Littlewood J D (eds). BSAVA Publications, Gloucester, pp 263-303.
  • Mills J (2000) Anaemia. In: Manual of Canine and Feline Haematology and Transfusion Medicine. 1st edn. Day M J, Mackin A & Littlewood J D (eds), BSAVA Publications, Gloucester, pp 29-42.

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