Canis ISSN: 2398-2942

Anemia: transfusion indications

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

For patients with hemolytic anemia

For patients with non-regenerative anemia