What to Expect if Your Dog Needs a Blood Transfusion
Dogs can suffer from severe blood loss or from diseases that require blood transfusions from a healthy dog so they can recover. But blood transfusions in dogs are much more complex because there are more canine blood types than in people. Keep reading to learn about canine blood typing and blood transfusion procedures.
Blood Types in Dogs
There are over a dozen canine blood types. Just like in people, the blood type of a dog is genetic. However, the blood group of each parent is inherited independently. This means that a dog’s blood type could be a combination of more than a dozen blood types.
The most common and medically important blood type combination in dogs is “dog erythrocyte antigen 1” (DEA 1). Some dogs are negative for DEA 1 while those that are positive can have DEA 1.1 or DEA 1.2.
How are blood transfusions performed in dogs?
There are several routes by which blood products can be administered. They include the following:
Intravenous (IV) route - The is the most common and most effective route for blood transfusion because the infused blood components are available to the blood circulation immediately.
Intraosseous route (directly into the bone marrow) - This route is used when access to blood vessels is difficult or unsuccessful. The intraosseous route is most commonly used in neonates (puppies). The blood components are available in the general circulation within a few minutes of transfusion. However, this route carries an increased risk of osteomyelitis (inflammation in the bone).
Intraperitoneal route - Blood is transfused within the peritoneum (the thin membrane that lines the walls of the abdomen). This route is painful and veterinarians refrain from using it unless absolutely necessary. The infused blood is completely absorbed, although its absorption is delayed. Only 50% of the infused blood components reach the general circulation in 24 hours, and about 70% after 28-72 hours. The risk of peritonitis (inflammation of the peritoneum) is high in blood transfusions via the intraperitoneal route.
During the transfusion, your dog should never be disconnected from the apparatus because of the danger of introducing bacterial pathogens.
Compatibility Testing (Blood Typing for Dogs)
Before any blood product is transfused, blood typing is performed to determine the DEA 1 status of your dog (the recipient). This can easily be performed with a special diagnostic kit.
Compatibility testing or cross-matching is important because it allows a compatible blood product to be administered. This can help reduce the risk of an adverse transfusion reaction during subsequent blood transfusions associated with DEA 1 sensitization.
Other indications for cross-matching before blood transfusion include the following:
- If the dog’s transfusion history is unknown
- An adverse reaction was experienced during previous blood transfusions
- The dog has been given a blood transfusion more than 4 days before
With a compatible cross-match, it’s unlikely that an acute hemolytic transfusion reaction (AHTR) would occur.
Preparing Your Dog for a Blood Transfusion
Before your dog undergoes a blood transfusion, you will be instructed about whether or not there is a need to fast your dog. Water, however, can be given.
Before the start of the transfusion, your pet’s vital signs will be obtained and used as baseline values. These include your dog’s pulse rate, respiratory rate, capillary refill time, rectal temperature, the color of the mucus membranes, and overall attitude. These baseline values will be compared with values of vital signs that are obtained during the transfusion process.
During the Blood Transfusion
The transfusion is started slowly to prevent transfusion reactions. Your dog will be closely monitored for signs of acute reactions during the transfusion.
The patient’s vital signs will be monitored at least every hour until the transfusion has been completed. The transfusion should be discontinued immediately if there is any sign of an adverse reaction. Your vet will decide whether it’s safe to continue with the transfusion based on the severity of the reaction. Ideally, blood transfusions in dogs should be completed within 4 hours to reduce the potential risks of bacterial contamination.
After the Blood Transfusion
Your dog needs to be monitored closely for signs of an adverse reaction during and after transfusion. Delayed transfusion reactions can develop 2-21 days after blood transfusion. These are the most common transfusion-related reactions.
Reactions during blood transfusions are categorized into - immune-mediated and non-immune mediated reactions:
There are two types of immune-mediated reactions that can occur during a blood transfusion - hemolytic and non-hemolytic:
- Hemolytic: Acute reactions during transfusions are caused by the presence of pre-existing antibodies or reactions from a previous transfusion. Although immune-mediated transfusions are the rarest among transfusion-related reactions, they are also the most serious.
- Non-Hemolytic Reactions: These reactions are the most transient and may be caused by the presence of antibodies to red blood cells, white blood cells, platelets, or plasma proteins.
Non-Immune Mediated Reactions
There are several causes of non-immune mediated reactions. These include the following:
- Overheating of blood products
- Transfusing red blood cells with a packed cell volume (PCV) that is greater than 80%
- Transfusing blood that was frozen, warmed, and then returned to the refrigerator
- Using catheters or needles that are too small
- Bacterial contamination of blood as a result of improper collection, storage, or administration
- Citrate toxicosis is a condition in which there is an inappropriate ratio between blood and citrate. Citrate is an anticoagulant that is used in blood products. Citrate toxicosis tends to occur in patients with liver disease receiving a substantial transfusion because their impaired liver is unable to efficiently metabolize citrate. Another reason for citrate toxicosis is there is not enough blood drawn into the collection bag that contains citrate during blood collection.
Can blood transfusion reactions be prevented?
Transfusing only the component that is required (e.g. fresh whole blood, plasma, red blood cells, etc.) can significantly reduce the product’s volume that is to be administered. This can eventually lead to reduced anaphylactic risk and any recipient sensitization to the unnecessary blood components that may increase the risk of adverse reactions to future transfusions.
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