Products

Crossmatching red cells with the patient is strongly recommended; patients can have a transfusion reaction even with their first transfusion.

Felines should always be blood typed and crossmatched prior to transfusing as they have naturally occurring alloantibodies.

​To avoid circulatory overload dosage calculations and flow rates should be calculated as part of the total 24-hour fluid volume.

Patients should be regularly monitored throughout the transfusion. CABB provides a transfusion monitoring form with every blood product.

All blood products require the use of a blood filter. Use a standard blood filter when transfusing amounts more than 50 mL. Microaggregate filters are available for transfusing amounts less than 50 mL.

SALINE ONLY! ​Never use Ringer’s lactate or other dextrose solution. Do not add these solutions to a blood product or run at the same time as the transfusion (even if the lines are in different limbs). LRS is not compatible with the anticoagulant used in blood products and will cause clotting and/or hemolysis.

Thaw or warm blood products at temperatures not exceeding 37° C. NEVER use a microwave oven.

Frozen blood products are fragile. Seams and ports may crack or split if the unit is handled roughly or undergoes a rapid temperature change. Enclose the unit in a zipper style plastic bag when thawing.

Blood products should always be administered using gravity feed or syringe push. Do not administer blood products through an IV pump as it can cause hemolysis.

The rate of transfusion is governed by the clinical condition of the recipient. Blood products may be transfused as quickly as the patient can tolerate it but should be completed within 4 hours with some exceptions. Rapid transfusion is essential if the patient is in acute shock from blood loss. Normally, a slow drip for the first 10 to 30 minutes is advised. Most acute reactions occur during this time period and the transfusion can be stopped before a large amount has been transfused. The rate can be increased if the patient is tolerating the infusion well.​

All blood donor programs must consider weakly DEA 1+ dogs to be DEA 1+ positive for the safety of DEA 1- recipients. For a more detailed explanation, please refer to the blog post “What is the significance of DEA 1 weakly positive donors?”. 

Fresh Frozen Plasma contains all blood clotting factors including the heat labile Factors V and VIII.

Plasma contains all blood clotting factors with reduced amount of the heat labile Factors V and VIII.

Fresh Frozen Plasma is used to treat a suspected or known deficiency or malfunction in clotting Factors V and VIII. It is also used to replace all clotting factors if a patient has had a massive bleed where its total blood volume has been replaced in less than 24 hours. Fresh Frozen Plasma is also used to treat disseminated intravascular coagulation (DIC).

Both Fresh Frozen Plasma and Plasma can be used to treat conditions such as parvovirus infection, coumarin/warfarin toxicosis, albumin replacement, passive immunity to orphaned neonates. In a case of parvovirus infection, Fresh Frozen Plasma should be reserved to treat severe intestinal bleeding.

Whenever possible, use Plasma if the patient does not require Factor V and VIII correction or replacement. This allows for a more efficient use of available blood products.

Remember: Always use a blood filter when transfusing Plasma and Fresh Frozen Plasma.

Fresh Frozen Plasma and Plasma are available in two sizes to suit the patient’s needs:

Full Size » 200 mL
Half Size » 100 mL

Crossmatching a dog with AIHA is an extremely difficult situation. The patient’s autoantibody is coating its own red cells. Free autoantibody in the patient’s serum will attach to any red cell encountered. In most cases, a crossmatch is interpreted as inconclusive because the control test (mixture of patient’s serum and patient’s red cells) and all red cell units matched will be positive. No conclusion as to compatibility can be drawn.
When the decision is made to transfuse and the crossmatch is inconclusive, what is the blood of choice?

The dog’s blood type is known

Use donor blood of the same blood type. This will prevent the formation of an immune antibody.

The dog’s blood type is unknown

• Alvedia Quick Test can be used to determine a canine blood type (most card test typing is usually inconclusive for AIHA patients) Although DEA 1.1 negative blood is often a preferred choice, DEA 1.1 Positive blood is a viable option.

The development of immune antibodies usually takes about three days. If the dog develops immune antibodies to the transfused red cells, the cells would be destroyed at the same rate as the patient’s own red cells. The chills, rigor, and fever associated with a hemolytic reaction are usually not seen. However, the survival of the transfused cells would be short and the benefits of the transfusion short-lived.

DEA 1 is considered the most clinically significant blood group in dogs due to its very strong antigenicity and risk of hemolytic transfusion reaction on subsequent transfusions to DEA 1 negative dogs. For a more detailed explanation and description of other canine blood types, please refer to the blog post “What are the clinically significant canine blood types?”.

The formula for calculating blood transfusion dosage depends on the type and severity of anemia that your patient is experiencing. Click here to read more about the formulas used to calculate transfusion volumes for administration.

Crossmatching will prevent some, but not all, transfusion reactions. If you believe that the patient is reacting to the blood product, use the following steps:

1. STOP THE TRANSFUSION
2. DETERMINE THE TYPE OF REACTION
3. INITIATE APPROPRIATE TREATMENT IF NECESSARY

The symptoms of a transfusion reaction are similar in several types of reactions. Many of these symptoms may also be due to the underlying disease condition or patient stress. Recording the patient’s vital signs and conditions before starting the transfusion and regular monitoring during the transfusion will assist in determining if a reaction is truly occurring.

• Permanently discontinuing the transfusion is not always necessary depending on the type and severity of the reaction.
• Transfusion reactions are caused by immune or non-immune mechanisms. Reactions that occur within 24 hours from the start of infusion are acute reactions. Those that occur after 24 hours from the start of the infusion are delayed reactions.

Treatment is based on the type and severity of the reaction presented. Reactions can range from an “annoyance” level to life-threatening. Acute reactions must be addressed quickly.

General Rules of Thumb

Hemolytic reaction – Keep an intravenous line open with saline. Treat hypotension with fluid replacement. Induce and maintain urinary flow to prevent renal shutdown.

Febrile reactions – Administer antipyretics based on the severity of the reaction. The transfusion can be re-started if the reaction is mild.

Anaphylactic reaction – Treat mild anaphylaxis with antihistamines and re-start the transfusion if desired. Follow standard treatments for anaphylaxis based on the severity of the reaction.

As with administration of any treatment, there are immunologic and nonimmunologic complications to be aware of when administering a transfusion. Please click here to read more about these risks.

During the storage period for blood components, certain artifacts develop which are completely normal. This sheet will help you to differentiate normal from abnormal storage changes.

Concentrated Red Cells and Whole Blood

Plasma and Fresh Frozen Plasma

It is best practice to try to incorporate major crossmatch testing into the pre-transfusion plan for all feline patients when the time and resources permit it. For a more detailed explanation, please refer to the blog post “Do recipient cats need to be crossmatched?”. 

When a cat is emergently in need of blood and there are no compatible feline products available, canine blood can be administered, but only once and with informed consent from the owner. For a more detailed explanation, please refer to the blog post “Can you give dog blood to cats?”.