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Blood transfusions in the dog and cat Part 2:

Indications and safe administration
ARTICLE in IN PRACTICE APRIL 1998
Impact Factor: 0.25 DOI: 10.1136/inpract.20.4.191

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133

2 AUTHORS:
Clare M Knottenbelt

Andrew Mackin

University of Glasgow

Mississippi State University

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Severe haemolytic anaemia

(PCV=9 per cent) in a six-year-old
Bichon frise. Although blood
transfusion in patients with
haemolytic anaemia may result in
further haemolysis ('fuelling the fire'),

this dog presented with signs of

severe anaemia (collapse and
dyspnoea) and transfusion was
required as a life-saving procedure

Blood transfusions in the dog and cat

Part 2: Indications and safe
CLARE KNOTTENBELT AND ANDREW MACKIN
administration
TECHNIQUES for the collection of blood from donor dogs and cats were described in the last issue in the
first part of this article (pp 110-114). Here, the indications for blood transfusions are reviewed and the
safe administration of blood and blood products discussed. The recognition and management of
transfusion reactions is also addressed.

INDICATIONS
Anaemia is the major indication for blood transfusion in
veterinary practice (see box). In particular, patients with
blood loss or non-regenerative anaemia will benefit from
transfusion. In non-regenerative anaemia transfused red
blood cells can have a normal lifespan (approximately
120 days in dogs, 70 days in cats). Transfusion may
therefore stabilise the patient for two to three months,
allowing further diagnostic tests or treatment to be instituted. In haemolytic anaemia, blood transfusions are
generally of transient benefit only, as transfused cells,
like the patient's own cells, will often be destroyed by
the haemolytic process and transfusion may arguably be
'adding fuel to the fire'. However, in patients with signs
of severe anaemia such as dyspnoea, weakness or neurological disturbances a blood transfusion may be lifesaving and allow time for more specific therapy for the
underlying cause of the haemolysis to be commenced.
Since patients with haemolytic and non-regenerative
anaemia are normovolaemic at the time of transfusion,
packed red cell transfusions, if available, are more
appropriate than whole blood (see later). In contrast,
whole blood is usually the treatment of choice in patients
with hypovolaemia secondary to blood loss anaemia.
Animals with congenital and acquired coagulopathies
will benefit from the administration of fresh blood, fresh
plasma or fresh frozen plasma to replenish clotting factors. Patients with severe thrombocytopenia may require
transfusions of fresh blood or platelet-rich plasma in
order to prevent life-threatening blood loss. In particular
circumstances patients benefit from the use of specific
plasma components such as albumin to maintain oncotic
pressure, or antithrombin III as part of the management
of disseminated intravascular coagulation.
InPractice i APRIL 1998

Maim indications for blood

transfusions

Clare Knottenbelt
graduated from
Bristol in 1994. She is
currently the Clinical
Studies Trust Fund
(Petsavers) resident in
small animal internal
medicine at the Royal
(Dick) School of
Veterinary Studies,
Edinburgh. She
gained the certificate
in small animal
medicine in 1997.
Her interests include
feline blood types,
transfusion medicine
and haematology.

* Anaemia
- Blood loss
- Haemolysis
- Non-regenerative anaemia

* Disorders of haemostasis
* Deficiencies of specific plasma components

WHEN TO TRANSFUSE?
The most important factor in determining the need for
transfusion is the clinical condition of the patient.
Transfusion is always indicated in an anaemic patient
that is exhibiting signs of clinical compromise such as
weakness, dyspnoea and ataxia. However, many patients
with quite severe anaemia will exhibit minimal associated clinical signs and often can survive for long periods
of time without transfusion. Many authors have recommended that transfusion automatically be performed
whenever a patient's packed cell volume (PCV) drops
below 20 per cent (Pichler and Turnwald 1985). Cats,
however, are known to tolerate anaemia well; they may
show only mild lethargy at a PCV of 10 to 15 per cent
and, provided they remain unstressed, can survive at a
very low PCV for a number of days. Dogs are somewhat
more sensitive to the effects of anaemia, which is often
detected earlier due to poor exercise tolerance, a clinical
sign rarely recorded in cats. Chronic anaemia in dogs
and cats tends to be much better tolerated than acute
anaemia.
191

Andrew Mackin is
a 1983 graduate of
Murdoch University.
He has worked at
veterinary schools in
Australia, Canada and
the UK, and has
obtained specialist
level qualifications in
small animal medicine
in North America,
Australia and the UK.
He recently left the
'Dick' to take up the
post of assistant
professor in small
animal internal
medicine at
Mississippi State
University.

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Pale mucous membranes

may be the only sign of
anaemia in patients with
chronic anaemia. While dogs
commonly present with
lethargy and exercise
intolerance, these
symptoms are rarely
recorded in the cat. This
particular patient, with
moderate to severe chronic
anaemia, showed only mild
lethargy

Given these considerations, a sensible approach

would be to recommend transfusion if a patient is
exhibiting significant clinical signs of anaemia, if the
PCV is less than 10 per cent or if the PCV has fallen
rapidly to less than 20 per cent in dogs or 15 per cent in
cats. When the bone marrow response is minimal or
absent the patient is unlikely to be able to replenish its
own cells (at least in the short term), and earlier transfusion may be indicated in order to prevent further deterioration in clinical condition.
In patients that do not require immediate life-saving
transfusions the following simple diagnostic tests should
be performed prior to blood transfusion, since the results
may determine the benefits of transfusion. In all cases,

t (.

'U"
4ok-

t(K1

Microhaematocrit tube revealing severe anaemia.

Measurement of PCV using microhaematocrit tube
centrifugation provides an indication of the degree of
anaemia and a baseline for continued monitoring. Blood
transfusion is indicated if the PCV is below 10 per cent or
has rapidly fallen to below 20 per cent in dogs

In Practice 0 APRIL 1998

blood should be collected from the patient prior to

administration of a transfusion as the results of these
tests may be important in formulating a prognosis.
* PCV or haematocrit (determines the degree of
anaemia before transfusion, thereby providing a baseline
for continued monitoring).
* Examination of blood smears to determine:
- reticulocyte count (following new methylene blue
staining); ie, is anaemia regenerative or non-regenerative?
- potential aetiologies; for example, Haemobartonella
felis (in cats), or the presence of leukaemia (abnormal
differential white blood cell
count or abnormal white
blood cells).
* Feline leukaemia virus
(FeLV) antigen and feline
virus
immunodeficiency
(FIV) antibody testing
(although transfusions are not
contraindicated in retroviruspositive cats, the poorer
prognosis may influence the
decision to transfuse).
* Evaluation of serum or
plasma for the presence of
icterus or haemoglobinaemia.
* Evaluation of haemostatic parameters, such as
platelet count, prothrombin
time and activated partial
thromboplastin time, if a
bleeding disorder is suspected.
* Performance of a slide
agglutination and/or Coombs
test if immune-mediated
haemolysis is suspected.
Further tests may be
performed, as indicated, to
determine the underlying
cause of the anaemia (eg,
routine clinical chemistry,
radiography, bone marrow
aspiration and biopsy).
193

Microhaematocrit tube
revealing icteric serum. The
presence of serum icterus
indicates that an underlying
haemolytic process may be
the cause of the anaemia

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BLOOD ADMINISTRATION

VOLUME REQUIRED BY RECIPIENT

Transfusion to a normal PCV is unnecessary to alleviate
clinical signs, and will remove the stimulus for the
patient to increase its own marrow red cell production.
Usually a post-transfusion PCV of 20 per cent in cats
and 25 to 30 per cent in dogs will be sufficient to reverse
the signs of anaemia without significantly dampening the
regenerative response. Transfusion of large volumes of
blood may be needed to achieve these ideal end-points in
severely anaemic patients. Fortunately, however, even a
small rise in recipient PCV is often sufficient to alleviate
a life-threatening anaemic crisis.
To calculate the blood volume required by the
recipient, the equation given in the box below is used
(Pichler and Tumwald 1985).

How much to transfuse?

Blood volume to be transfused = k x Weight (kg) x (Required PCV - Recipient PCV)
PCV of donated blood
k = 90 in dogs, 66 in cats

Examples
* A cat weighing 4 kg, with a PCV of 10 per cent, receiving donated blood with
a PCV of 35 per cent, requires 75 ml of blood to reach a target PCV of 20 per
cent, while a cat with a PCV of 5 per cent would require 113 ml of blood (which
would need to be collected from two cats or a very heavy donor!)
* A 15 kg dog with a PCV of 10 per cent, receiving donated blood with a PCV of
40 per cent, would require at least 500 ml of blood to reach a target PCV of
25 per cent

them. Blood should not be administered concurrently

with (ie, through the same catheter as) intravenous fluids
containing calcium or glucose.
Blood should be gently warmed to 37C before
administration in order to reduce blood viscosity,
prevent patient chilling and minimise vasoconstriction.
If blood is overheated, clotting and haemolysis can
occur. If it is necessary to warm blood quickly, warming
of the tubing as the blood is administered is preferable
to warming the blood collection bag excessively. Once
the bag has been warmed it should be used within
24 hours.
The speed of administration must take into account
the condition of the patient (Tumwald and Pichler 1985).
Normovolaemic recipients can be given 5 to 10 ml
blood/kg/hour; this amount can be increased in hypovolaemic patients, up to a maximum of 20 ml/kg/hour.
Although a standard maximum transfusion volume of
20 ml/kg/day is often recommended, much greater
volumes can safely be given in certain circumstances,
such as in animals with severe ongoing haemorrhage.
In patients suffering from cardiovascular dysfunction
or renal failure, the flow should be restricted to
2 ml/kg/hour to avoid circulatory overload due to a
sudden expansion in blood volume. Vomiting during
transfusion can be associated with flow rates which are
too rapid.

NB. Since the volume of blood required by the recipient is heavily dependent on
the donor's PCV, it is important, whenever possible, to choose donors with a PCV
within the top half of the normal range.

ROUTE OF ADMINISTRATION
Ideally, blood should be given into a cephalic or jugular
vein via an intravenous catheter. In severely hypotensive
or paediatric patients, the blood can be given into the
proximal femur using an 18 to 20 gauge intravenous
needle or a spinal needle placed in the trochanteric fossa.
Extraction of blood from the marrow cavity into the
bloodstream is highly efficient and marrow transfusion is
therefore almost as effective as direct intravenous infusion. Blood is absorbed from the marrow at a rate of one
drop per minute, but may be administered at a faster rate
by using an infusion pump.
Intraperitoneal administration of blood is an inefficient method of administration, achieving only a 40 per
cent extraction rate (Turnwald and Pichler 1985)

WIOIM
t t,.

%
I

METHOD OF ADMINISTRATION
Blood should be administered through a filtered giving
set specifically designed for blood products, to reduce
the risk of cellular aggregates and microthrombi entering
the circulation and leading to pulmonary capillary damage and pulmonary oedema. This is particularly important when blood has been stored following collection.
The filters present in standard giving sets are too small
and will tend to clog when blood is administered through
194

The administration of blood

through a filtered giving set
specifically designed for
blood products will reduce
the risk of microthrombi
entering the circulation. This
is particularly important
when blood has been stored
prior to transfusion

In Practice * APRIL 1998

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BLOOD PRODUCTS

In certain clinical conditions, such as chronic haemorrhagic, haemolytic or non-regenerative anaemia,

thrombocytopenia, clotting factor deficits or hypoalbuminaemia, the administration of specific blood products may
be more appropriate than whole blood transfusions. In
chronic haemorrhagic, haemolytic or non-regenerative
anaemia the patient is normovolaemic and requires only
packed red cells to resolve the symptoms associated with
anaemia. Patients with thrombocytopenia or clotting
factor deficiencies often do not need red cells, and will
benefit from the administration of platelet-rich plasma
and plasma, respectively.
Since one unit of fresh whole blood can be separated
into two or even three blood products, the use of appropriate products for specific clinical situations ensures
that maximum benefits are obtained from each individual donation. Although blood products are not yet
available commercially in the UK, separation of red cells
and plasma is often feasible in a practice environment at
minimal expense.

Antithrombin III (present in fresh plasma) should be

administered to patients suffering from disseminated
intravascular coagulation.

PACKED RED BLOOD CELLS

Transfusion of packed red cells is the treatment of choice
for severe anaemia where the patient is normovolaemic
at the time of transfusion. This is particularly useful in
patients with cardiac or renal disease which would be at
risk of circulatory overload from the administration of
whole blood. Once plasma has been decanted from the
whole blood (as discussed above), the remainder of the
blood bag can be administered as a packed cell transfusion. The red cell concentrate is usually mixed with
saline to improve the flow rates through the catheter; the
addition of saline does not result in the same volume
expansion as would an equivalent volume of plasma,
as saline is rapidly redistributed throughout both the
intravascular and extravascular compartments. Crystalloid
solutions containing calcium should not be used, as the
addition of calcium can result in clot formation

PLATELETS

PLASMA
Plasma can be decanted from centrifuged or sedimented
whole blood and stored in a freezer for several months.
In order to decant plasma from whole blood, blood bags
(dogs) or syringes (cats) of fresh whole blood may be
placed upright in a refrigerator for six to 12 hours. In
some patients, sedimentation of fresh red cells allows
extraction of a usable volume of supernatant plasma.
Plasmalred cell separation via sedimentation, however,
is never as consistent or as complete as that obtained by
using a blood bank centrifuge. Although such centrifuges are not usually available in general practice, they
may on occasion be available for use at local human
transfusion centres.
Fresh plasma contains albumin, clotting factors and
immunoglobulins and, as such, its administration is
beneficial in animals with hypoalbuminaemia or clotting
disorders (including disseminated intravascular coagulation), or in those in which transfer of passive immunity
has failed. Plasma is indicated in situations such as
hypovolaemia or hypoalbuminaemia as it maintains the
oncotic pressure of the blood. Patients with severe
hypoproteinaemia will benefit from a plasma transfusion
prior to and during anaesthesia for diagnostic and therapeutic procedures.
Plasma should be given in preference to whole blood
to patients with clotting defects unless the clotting disorder has resulted in a major bleed and subsequent blood
loss anaemia. Since clotting factors are amenable to
freezing, plasma can be stored for prolonged periods
provided it is freshly harvested from whole blood and
frozen within six hours of collection. Frozen plasma harvested from whole blood more than six hours after collection may contain minimal amounts of many clotting
factors and is therefore not appropriate for the treatment
of conditions where transfusion of clotting factors is
indicated, such as haemophilia A. In patients with von
Willebrand' s disease, plasma transfusions should be
administered prior to and during surgery. The subcutaneous administration of desmopressin (1 pg/kg)
to the donor 30 to 60 minutes before blood collection
may increase von Willebrand' s factor levels within
the collected blood (Nichols and Hohenhaus 1994).
InPractice * APRIL 1998

Impractically large volumes of blood are typically

required to restore platelet numbers in patients with
thrombocytopenia. However, while whole blood is a
very inefficient method of restoring platelet numbers,
whole blood transfusions are indicated when bleeding
has resulted in hypovolaemia or marked anaemia. Low
speed centrifugation produces a plasma supematant
which is rich in platelets (platelet-rich plasma).
Transfusion of multiple units of platelet-rich plasma may
be successful in reversing thrombocytopenia, at least
temporarily, but requires access to multiple donors and a
blood bank centrifuge. In general, it is severe blood loss
anaemia that is most effectively treated with blood transfusions, while other therapy is directed at the cause of
the thrombocytopenia.

TRANSFUSION REACTIONS
Provided a matched transfusion is given and blood has
been stored and administered appropriately, transfusion
reactions should be rare. Patients receiving blood or
blood products should, however, be monitored closely
during the transfusion period. If symptoms associated
with a potential transfusion reaction are recorded (see
table on page 198), the transfusion should be stopped
and the cause of the reaction investigated.
The most common types of specific transfusion reactions and complications are listed in the box below.

Transfusion ractions
cmMpl cations
*
*
*
*
*
*
*
*

Haemolysis
Acute hypersensitivity reactions

Pyrexia
Bacterial contamination of blood bag
Hypocalcaemia (citrate toxicity)
Vomiting
Circulatory overload
Transmission of infectious diseases
195

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*.

Urticaria (especially in dogs)

Erythema or pruritus
Vomiting
Vocalisation (cats)
Pyrexia
Depression
Dyspnoea, tachypnoea or coughing
Tachycardia or bradycardia
Tremors or convulsions
Shock
Cardiopulmonary arrest
Anorexia (delayed)
Jaundice (delayed)

Jaundice: a sign
of a potential transfusion
reaction

Practical guidelines for suspecte

haemolytic transfusion
ions
* Stop the transfusion
* Maintain intravenous line and administer crystalloid solutions
* Watch for evidence of shock or disseminated
intravascular coagulation; monitor temperature;
check serum and urine for evidence of haemoglobinaemia and haemoglobinuria, respectively
* Treat shock with more aggressive fluid therapy
and corticosteroids if required
* Administer supportive therapy (eg, oxygen sup-

plementation, antihistamines, adrenaline)

* Check blood bag for evidence of lysis (by capillary tube centrifugation) and collect sample of
blood for culture and sensitivity
* Check blood typing or cross-matching

Although transfusion reactions can be due to poor

storage or administration
techniques, most significant
reactions are associated with
the administration of mismatched transfusions. Some
clinicians recommend slow
flow rates (0.5 mllkglhour)
during the first 30 minutes of
transfusion in order to detect
unexpected transfusion reactions (Turnwald and Pichler
1985). The administration of
even small test volumes
of
blood
to
feline
recipients,
is
however,
dangerous and can result in
rapid and severe transfusion
reactions.

even small volumes of mismatched blood are administered as a first transfusion, due to the presence of naturally occurring alloantibodies. Type B cats which receive
type A blood are at greatest risk of a haemolytic reaction
owing to the high levels of naturally occurring antibody
that they possess (see box below).
In both dogs and cats the acute haemolytic reaction
is characterised clinically by depression, recumbency,
cardiac arrhythmia, apnoea, seizures or signs of shock.
Patients may urinate, defecate, salivate or vocalise (cats)
and subsequently become tachycardic and tachypnoeic
for a prolonged period. Haemoglobinaemia and haemoglobinuria can occur within hours of transfusion but are
only clinically apparent when large volumes of blood are
transfused. The rapid destruction of transfused red cells
will also result in a dramatic fall in the recipient's PCV.

Acute haemolysis associated with mismatched

transfusions
Acute haemolysis results from the destruction of donor
erythrocytes by alloantibodies and occurs during or soon
after transfusion. Acute haemolytic reactions associated
with mismatched transfusions are rare in first transfusions in dogs due to the low incidence of naturally
occurring antibodies against dog erythrocyte antigens
(DEA) 1.1 and 1.2. However, the risk is much greater in
subsequent transfusions due to induction of these antibodies (Harrell and Kristensen 1995).
In cats, transfusion reactions associated with A/B
mismatched transfusions can be life-threatening when

Delayed haemolytic transfusion reactions

Delayed haemolytic reactions result in a reduction in the
lifespan of the transfused red cells. In cats, they are associated with the induction of antibodies to red cell antigens other than the AB group or the induction of anti-B
antibodies in type A cats without naturally occurring
alloantibodies. In dogs, delayed haemolytic reactions
occur in association with the induction of antibodies
against DEA 1.1, 1.2 and other red cell antigens by a
first or previous transfusion; due to the absence or low
titres of these antibodies at the time of first transfusion,
they may not be detected by cross-matching techniques.
Transfused red cells are removed one to three weeks
after transfusion.

HAEMOLYSIS

Mismatched transusions in cats

Type B cats receiving type A blood
Massive intravascular haemolysis of type A (donor)
cells occurs due to the presence of high-titred,
naturally occurring anti-A antibodies. This early
reaction, which may be fatal, can occur following
administration of very small volumes of mismatched
blood (Callan and Giger 1994).

198

Type A cats receiving type B blood

Type A cats often have weak anti-B alloantibodies and
hence transfused type B (donor) cells can have a mean
half-life of as little as two days. Although haemolysis
occurs, it is extravascular and therefore clinical signs
are much milder. The main clinical significance is that
the PCV will fall to pre-transfusion levels within days
of the transfusion (Callan and Giger 1994).
In Practice * APRIL 1998

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Pre-transfusion haemolysis
Haemolysis can also occur during storage of whole
blood, particularly if the blood is subjected to overheating or freezing or has become contaminated with
microbes (Harrell and Kristensen 1995). The concurrent
administration of blood and hypotonic solutions via the
same catheter can also result in red cell lysis through
osmotic 'cell bursting'.

ACUTE HYPERSENSITIVITY REACTIONS

Allergic reactions to transfused allergens are rare, but
can occur during transfusion of whole blood and blood
products (Harrell and Kristensen 1995). They develop
within 45 minutes of the start of the transfusion and, in
severe cases, can result in cardiopulmonary arrest. Any
evidence of anaphylaxis, such as urticaria, pruritus, erythema, anxiety, vomiting or dyspnoea, therefore warrants
discontinuation of the transfusion and treatment for an
anaphylactic reaction (corticosteroids, antihistamines,
oxygen as required and adrenaline in severe cases).

Steps for avoiding transfusion

reations and compikations
* Always blood type or cross-match feline donor
and recipient. Ideally cross-match canine donor and
recipient or use a DEA 1.1- and 1.2-negative donor
* Administer transfusion at an appropriate rate
according to the patient's condition:
- 2 ml/kg/hour for patients with heart disease or
renal failure
- 5 to 10 ml/kg/hour for normovolaemic patients
- up to 20 ml/kg/hour for hypovolaemic patients
* Maintain sterility of blood bags when storing
blood and avoid prolonged storage
* Collect blood in an appropriate volume of
anticoagulant and use a filtered giving set for
administration
* Watch the recipient closely during the first 15
minutes of transfusion for any signs of a potential
reaction

PYREXIA
Transfusion-related pyrexia is the most common transfusion reaction and is characterised by an increase in body
temperature of 1C or more within four hours of the feeding around the time of transfusion. If no other symptransfusion (Turnwald and Pichler 1985). Pyrexia may toms of transfusion reaction or haemolysis are evident,
be related to bacterial contamination of transfused blood the transfusion can be continued after 15 minutes at a
or an acute reaction caused by antibodies to platelets, slower rate.
white blood cells or plasma proteins which are not
detected by blood typing or cross-matching. The blood CIRCULATORY OVERLOAD
bag should be evaluated for evidence of bacterial conta- Circulatory overload is a common transfusion complicamination (see below) and the patient should be examined tion in small animals and is most often associated with
for evidence of haemolysis. Fortunately, non-infectious, rapid administration of whole blood to patients with
non-haemolytic pyrexia - the most common cause of cardiac disease, renal failure or normovolaemic anaemia
pyrexia - is usually transient and does not require (Turnwald and Pichler 1985). Circulatory overload with
treatment.
pulmonary oedema is characterised clinically by tachycardia, tachypnoea, dyspnoea and coughing. The use of
BACTERIAL CONTAMINATION OF BLOOD BAG
appropriate flow rates and packed red cell transfusions
Incorrect collection or storage of whole blood can result rather than whole blood reduces this problem. If circulain bacterial contamination of the blood prior to adminis- tory overload is encountered, the transfusion should be
tration. Bacteria will survive refrigeration and start to stopped immediately and frusemide and oxygen given as
multiply if the blood is warmed. Pyrexia will develop necessary to control the symptoms.
within 15 minutes of the start of blood administration
and may be accompanied by other signs such as shock, TRANSMISSION OF INFECTIOUS DISEASES
abdominal pain, vomiting and diarrhoea. If bacterial con- The risk of transmission of infectious disease via transtamination is suspected, the bag should be checked for fusion cannot be completely eradicated. However, in
evidence of haemolysis (by spinning down the bag or a order to minimise it all donors should be healthy and
sample of blood from the bag) and a sample of donated fully vaccinated. Feline donors should be indoor cats that
blood submitted for culture and sensitivity. Antibiotics have been tested for FeLV, FIV and Hfelis. In endemic
should be administered and supportive therapy provided areas, canine donors should be tested for heartworm,
as necessary.
rickettsial diseases and blood parasites such as Babesia
canis.

HYPOCALCAEMIA
Clinical signs of hypocalcaemia (tremors, vomiting and
cardiac arrhythmia) are occasionally associated with the
rapid administration of large amounts of citrate anticoagulant (which chelates calcium) (Tumwald and Pichler
1985). In practice, this is a rare problem unless inappropriate amounts of anticoagulant have been used, the
patient has severe liver disease (causing failure of citrate
metabolism) or very large volume transfusions are given
rapidly.

VOMITING
Vomiting is common during and after transfusions and
may be associated with rapid administration of blood or
In Practice * APRIL 1998

SUMMARY
Blood transfusions can be life-saving in a number of
clinical situations and, provided a few simple guidelines
are followed, there is little risk of associated complications. The main problem in veterinary practice is finding
an appropriate donor when blood is needed. If donors are
identified prior to the need for blood, blood collection
and administration can be performed within an hour of
identifying a need for transfusion.
It is likely that blood transfusions will be used with
increasing frequency within veterinary practice.
199

References

CALLAN, M. B. & GIGER, U.

(1994) Transfusion medicine. In:
Consultations in Feline Internal
Medicine. Ed. J. R. August.
Philadelphia, W. B. Saunders.
pp 525-532
HARRELL, K. A. & KRISTENSEN,
A. T. (1995) Canine transfusion
reactions and their
management. Veterinary Clinics
of North America: Small Animal
Practice 25, 1333-1361
NICHOLS, R. & HOHENHAUS,
A. E. (1994) Use of the

vasopressin analogue
desmopressin for polyuria and
bleeding disorders. Journal of
the American Veterinary Medical
Association 205, 168-173
PICHLER, M. E. & TURNWALD,
G. H. (1985) Blood transfusion
in dogs and cats, Part I.
Physiology, collection, storage
and indications for whole blood

therapy. Compendium on
Continuing Education for the
Practicing Veterinarian 7, 64-71
TURNWALD, G. H. & PICHLER,
M. E. (1985) Blood transfusion
in dogs and cats, Part II.
Administration, adverse effects
and component therapy.
Compendium on Continuing
Education for the Practicing
Veterinarian 7, 115-122

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Blood transfusions in the dog and cat Part

2: Indications and safe administration
Clare Knottenbelt and Andrew Mackin
In Practice 1998 20: 191-199

doi: 10.1136/inpract.20.4.191

Updated information and services can be found at:

http://inpractice.bmj.com/content/20/4/191

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