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Anemia: transfusion indications

ffelis

Synonym(s): Blood transfusion


General principles

Blood types

  • Cats have three blood groups Blood types.
  • Group A 85-95% of all UK cats (99% of all domestic short and long haired cats in USA - nearly all Siames  Siamese /Burmese Burmese group A).
  • Group B (most of remaining cats - British domestic shorthair British shorthair and Birmans Birman and Rex Devon Rex  Cornish Rex breeds have higher incidence of group B than other breeds).
  • Group AB (rare approx 0.1% population).
  • Cats with Group A blood have natural anti- B antibodies and vice versa.
  • Transfusion of Type A blood into Type B cat results in acute intravascular hemolysis.
  • Type B blood transfused into a cat with type A blood group is less clinically significant but results in reduced post-transfusion red cell survival time.
  • An in-house test kit is available to perform blood typing Blood typing: in-house card   Blood typing: in-house strip test .
  • Mismatched transfusion may result in acute transfusion reactions with these clinical signs:
    • Fever.
    • Tachycardia.
    • Tremors.
    • Urticaria.
    • Vomiting.
    • Hemoglobinuria.
    • Involuntary urination / defecation.
  • Transfusion reactions can also occur in matched transfusions due to white blood cell or platelet sensitivity.
  • Non-immunological transfusion reactions can also occur, eg circulatory overload, bacterial contamination, citrate toxicity, air embolisms, microembolisms and hypothermia.

Transfusion

  • Major and minor cross-match Blood: crossmatching should be performed before transfusion Blood transfusion.
  • Stored blood should be warmed carefully first.
    If blood is heated to >50°C hemolysis will occur.
  • Blood should be given using a blood giving set with a 170u filter to prevent clots entering the recipient.
  • 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.
  • Transfusion rate in normovolemic animal is 1-5 ml/kg/hour and no more than 22 ml/kg/hour.
  • Can be given by intraosseous route Intraosseous needle placement in kittens or animals with no accessible veins.
    If cardiac failure, do not exceed 1-2 ml/kg/hour.If hypovolemic, do not exceed 22 ml/kg/hour.

Selection of donor

  • Up to 50-60 ml can be taken (not greater than 11 ml/kg) every 3-4 weeks.

Calculation of volume required

  • 2.2 ml whole blood/kg raises the PCV Hematology: packed cell volume by 0.01 l/l.
  • Volume of donor blood required = bodyweight of recipient (kg) x 70 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.
  • Knottenbelt C M, Addie D D, Day M J et al (1999) Determination of the prevalence of feline blood types in the UK. JSAP 40 (3), 115-118 PubMed.
  • Giger U, Bücheler J (1991) Transfusion of type-A and type-B blood to cats. JAVMA 198 (3), 411-418 PubMed.

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.
  • Mills J (2000) Anemia. In: Manual of Canine and Feline Haematology and Transfusion Medicine. 1st Edn. Eds Day M J, Mackin A & Littlewood J D, BSAVA Publications, Gloucester, pp 29-42.

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