FUN WITH BLOOD

1. FUN WITH BLOOD Canine blood donation and transfusion • ANNE CORRIGAN • ERIN SPITZER

2. Why blood is important to you • Better understanding of canine blood • Historical donation procedures and complications • Better therapies and results

3. Agenda • Blood donors • canine blood types • blood donor selection • procedures for donation • Blood donees • reasons for transfusions • crossmatching • procedures for transfusions

4. Canine blood types (DEA group) • dog erythrocyte antigen • 1.1, 1.2, 1.3 allelic • 3 • 4 universal • 5 • 6 universal • 7

5. Blood Typing • Why type? • 1.1, 1.2, 1.3 negative dogs • 1.1 antigen and hemolysis • agglutination and shortened RBC lifespan • 1.1 card typing

6. Products used at MSU • Whole Blood • Packed RBCs (pRBC) • Fresh Frozen Plasma • Platelet concentrate

7. Donors-initial screening • 40 lbs+, heartworm negative, easy to work with, and healthy (cute helps a lot!!) • Vaccines • DA2PL • Rabies • Bordetella • Typing

9. Donors-laboratory tests • CBC, CHEM, UA, Fecal, vWF

10. Donors-laboratory tests • Blood borne parasites • Erlichia risticii • Erlichia canis • Babesia canis • Rickettsia rickettsii • Borellia bergdorferi

11. Blood Donations • Donations • collection supplies • collection procedures

22. Blood Donations Storage procedures • pRBC-35 days in Adsol • FFP 1 year <18C • Platelet Concentrate, 6 mos. <20C • Whole blood is not stored at MSU, used within 4 hours

23. Benefits of being a blood donor • $20 credit every other donation • 40# bag of Eukanuba food every other donation • Yearly physicals and blood tests • Iron supplements

24. “Mommy, I don’t feel so good…”

25. Why crossmatch? • Avoid immune mediated transfusion reactions • Doesn’t take the place of blood typing the recipient but allows you to prescreen for antibodies in the recipient’s blood that will lyse donor RBCs

26. What patients should you crossmatch? • Crossmatch any dog that had a previoustransfusion or pregnancy • Crossmatching should be repeated if there are 4 days or more between transfusions

27. Performing a major crossmatch • Usually takes about 40 minutes • Collect 1 mL of serum from the prospective recipient • Collect 2 mL of packed RBCs from the prospective donor (site coupler on donor bag or collection line segment) and place in red top tube

28. Preparing donor RBCs for crossmatch • Centrifuge donor RBCs at 3400 rpm for 2 minutes and then decant liquid • Wash packed donor RBCs by filling tube with saline, resuspending cells, and centrifuging again for 1 minute. • Decant liquid. • Repeat washing 2 times.

29. Preparing crossmatch tubes • Place 0.2 cc of packed donor RBCs and 4.8 cc 0.9% saline in a glass tube labeled with donor ID (this creates a 4% solution of donor RBCs) • Place 2 drops of recipient serum and one drop of donor RBC solution (4%) into 3 tubes - these will be used for the crossmatch

30. Incubation of crossmatch and control tubes • Prepare 3 control tubes by placing 2 drops saline and one drop donor RBCs into them • Incubate 1 crossmatch and 1 control tube at each of the following temperatures: • 25 degrees C (room temp) • 37 degrees C (running hot water, incubator) • 4 degrees C (refrigerate) “You’re supposed to be talking about dogs…”

31. Reading the results • After incubation centrifuge all tubes for 1 minute • Observe all tubes for agglutination or hemolysis - a crossmatch is considered positive if either is observed • If control tubes show agglutination/hemolysis - cross match can’t be interpreted (hemolytic anemia)

33. Some indications for blood transfusions • Whole blood - anemia (w/ or w/o a coagulation factor deficiency) • Packed RBCs - anemia due to blood loss, hemolysis, bone marrow dysfunction • Fresh frozen plasma - coagulation factor deficiencies, DIC • Platelets - bone marrow transplantation, thrombocytopenia

37. Before you perform a transfusion • Check the unit of blood or plasma - a brown discoloration means there is bacterial contamination • Make sure you are using the right unit by checking the label for species and blood type

38. Refrigerated/frozen units • Blood warming is not usually necessary unless a massive transfusion is being given (then warm to room temp) • Heating may cause RBC deterioration or bacterial growth • Plasma must be thawed before use - it will be frozen

39. Giving a blood transfusion • Administer to the patient through catheter IV with a filter • Blood can be given with an intraosseous catheter in cases of vascular collapse or in neonates

40. Rates of transfusion • Rate depends on condition of the animal and what you are giving (whole blood, plasma, etc) • To reduce potential for bacterial growth, give transfusion within a 4 hour time span • Animals that are in shock should be transfused as quickly as possible • Plasma can be given more quickly than whole blood

41. Complications of transfusions • Immunogenic hemolytic transfusion reaction (DEA 1.1, 1.2, 1.3) • Delayed reactions of this form can be noticed with 3, 5, 7 • Non-immunogenic hemolytic transfusion reaction (bacterial contamination, etc) • Infectious disease transmission • Tick borne diseases • Alloimmunization of recipients • Even if we know that the animal is 1.1 positive they can still have a mismatch at any level • Febrile reactions • Allergic reactions • Circulatory overload • Pulmonary thromboembolism

43. Fun Donor Factoids… • Labrador Retrievers >95% are 1.1 positive • German Shepherd, some Doberman lines, and Greyhounds are DEA 4 • PCV • Babesia (50%) • Northern breeds (Huskies, Malamutes) tend not to be universal • Bubba

44. Extra Special Thanks to… Alice Parr, LVT

45. Extra Special Thanks to… Gretchen McDaniels, LVT

46. Extra Special Thanks to… Anne Hale, DVM

47. Extra Special Thanks to… Baby Tucker Chadwick, M.B.B.B.P.E.

48. References Hale, Anne DVM. “Guidelines for use of Blood and Blood Components: Canine and Feline” 1st ed. Midwest Animal Blood Services, Inc. 1999. Ettinger, S. and Feldman, E. Textbook of Veterinary Internal Medicine. WB Saunders Co: 2000. 5th ed, Vol 1.

49. THE END – ANY QUESTIONS??