Transfusion OF blood in anemic animals

BY:- Dr. YASMEEN AHMED Dr. AJAY SRIVASTAVA

Blood transfusion is the process of transferring blood or blood-based products from one patient into the circulatory system of another.

INDICATIONS OF BLOOD INDICATIONS OF BLOOD TRANSFUSIONTRANSFUSION

ANAEMIA :- ANAEMIA :- a)Acute haemorrhagica)Acute haemorrhagic b)Chronic haemorrhagicb)Chronic haemorrhagic c)Haemolytic anaemiac)Haemolytic anaemia

BLEEDING DISORDERSBLEEDING DISORDERSHYPOPROTEINAEMIAHYPOPROTEINAEMIABURNSBURNSTo provide specific & non-specific To provide specific & non-specific

resistance against infection.resistance against infection.

Whole blood preferred:- Haemorrhagic Whole blood preferred:- Haemorrhagic anaemiaanaemiaPacked blood cells:- Haemolytic Packed blood cells:- Haemolytic

anaemiaanaemiaPlasma:- Bleeding disorders, Plasma:- Bleeding disorders,

hypoproteinemia , Burns.hypoproteinemia , Burns.Serum:- Immunity. Serum:- Immunity.

50% of transfused blood entered the 50% of transfused blood entered the circulation within 24 hrs.circulation within 24 hrs.

Max. conc. of transfused cells in Max. conc. of transfused cells in circulation :-2-3 days after injection.circulation :-2-3 days after injection.

Satisfactory in case of piglets.Satisfactory in case of piglets. Indicated in shocked & uncooperative Indicated in shocked & uncooperative

animals.animals.

Valuable in replacement of erythrocytes.Valuable in replacement of erythrocytes. Treatment of hemolytic anaemia in lambs.Treatment of hemolytic anaemia in lambs.

Not satisfactory for treatment of hypovolumic Not satisfactory for treatment of hypovolumic shock.shock.

Absorption of RBC is delayed.Absorption of RBC is delayed. Not recommended in Ascitis,Peritonitis, Not recommended in Ascitis,Peritonitis,

Abdominal distention,Peritoneal adhesion.Abdominal distention,Peritoneal adhesion.

Best method in large % of cases.Best method in large % of cases. Slow I.V. drip usually most desirable Slow I.V. drip usually most desirable

method.method. Jugular vein is preferred.Jugular vein is preferred. Dogs:- Cephalic or Recurrent tarsal Dogs:- Cephalic or Recurrent tarsal

vein.vein.

Satisfactory in treatment of hypovolumic Satisfactory in treatment of hypovolumic shock.shock.

Therapeutic effects of transfusion Therapeutic effects of transfusion delivered by I.V. injection are extremely delivered by I.V. injection are extremely rapid.rapid.

Suitable method when large volume of Suitable method when large volume of blood is transfused.blood is transfused.

Useful in emergency cases.Useful in emergency cases.

Administration at too rapid rate:-Administration at too rapid rate:- a) overloading of circulationa) overloading of circulation b) acute heart failureb) acute heart failureOther complications:- Other complications:- a) Heart rate increases a) Heart rate increases

rapidlyrapidly b) Weaknessb) Weakness c) Dyspnoea precede c) Dyspnoea precede

collapse collapse

Limited application in kittens & Limited application in kittens & small dogs.small dogs.

75.3% of RBC transfuse into 75.3% of RBC transfuse into medullary cavity remain intact.medullary cavity remain intact.

Maximal uptake obtained in 5 Maximal uptake obtained in 5 minutes. minutes.

Provide rapid access to central Provide rapid access to central

compartment of circulatory system.compartment of circulatory system. Demonstrate efficacy & onset of action.Demonstrate efficacy & onset of action.

Contraindicated for placement of Bone Contraindicated for placement of Bone marrow needle :- Skeletal abnormality, marrow needle :- Skeletal abnormality, skin & wound infection, abscess & skin & wound infection, abscess & fracture.fracture.

Contraindicated :- Septic shock.Contraindicated :- Septic shock.

Less frequently used.Less frequently used.Less than 3% of RBCs are absorbed, Less than 3% of RBCs are absorbed,

97% are destroyed.97% are destroyed.

HORSE:- 10-20 ml/ kg/ hr.HORSE:- 10-20 ml/ kg/ hr. CATTLE:- 4.5 l/ hr.CATTLE:- 4.5 l/ hr.

100 drops/ min.100 drops/ min. Amount of blood required for transfusion Amount of blood required for transfusion

depends on:- a) Size of recepientdepends on:- a) Size of recepient b) Volume of blood loss.b) Volume of blood loss.

Due to a blood type incompatibility.Due to a blood type incompatibility. It is a class II (Ag-Ab) hypersensitivity It is a class II (Ag-Ab) hypersensitivity

reaction.reaction. Common reaction, particularly in dogs & Common reaction, particularly in dogs &

horses.horses. Reaction time depends upon the type of Reaction time depends upon the type of

antibody involved (IgM or IgG).antibody involved (IgM or IgG). Hemolysis can be :- a) ExtravascularHemolysis can be :- a) Extravascular b) Intravascular b) Intravascular

Result of extravascular hemolysis.Result of extravascular hemolysis.May occur in dogs :- incompatible May occur in dogs :- incompatible

blood on first transfusion.blood on first transfusion.Usually mild & may not be Usually mild & may not be

recognised.recognised.Common signs are :- fever, Common signs are :- fever,

anorexia & jaundice.anorexia & jaundice.Minimized by using cross Minimized by using cross

matching or cross-matched blood.matching or cross-matched blood.

ICTERUS OF SCLERA & MUCUS MEMBRANE

Reported in cats, dogs, cows, pigs & horses.Reported in cats, dogs, cows, pigs & horses.Clinical signs :- weaknessClinical signs :- weakness failure to thrivefailure to thrive haemoglobinuriahaemoglobinuria deathdeathNeonatal immune-mediated Neonatal immune-mediated

thrombocytopenia reported.thrombocytopenia reported.Occur when a female animal of one blood Occur when a female animal of one blood

type is mated to a male of another.type is mated to a male of another.

Usually due to Anaphylactic reaction.Usually due to Anaphylactic reaction.Mediated by IgE antibody which Mediated by IgE antibody which

activate Mast cells.activate Mast cells.Frequently seen with infusion of Frequently seen with infusion of

plasma.plasma.Can occur on first transfusion.Can occur on first transfusion.Minimize by pre-treatment with Minimize by pre-treatment with

Antihistaminics & slow transfusion Antihistaminics & slow transfusion rate.rate.

MINOR SKIN REACTIONSMINOR SKIN REACTIONS:-:-PruritisPruritisFacial edemaFacial edemaWhealsWhealsUrticariaUrticaria SEVERE ALLERGIC REACTIONSSEVERE ALLERGIC REACTIONS:-:-Broncho-constrictionBroncho-constrictionCardiopulmonary arrestCardiopulmonary arrest

Produces mild & transient fever.Produces mild & transient fever.Most common type:- observed with Most common type:- observed with

whole blood.whole blood.Suspected:- when temperature Suspected:- when temperature

increase of atleast 1˚C with no other increase of atleast 1˚C with no other cause.cause.

Can occur on first transfusion.Can occur on first transfusion.Vomiting & tremor may be seen.Vomiting & tremor may be seen.

Reported in Dogs with Haemophilia A.Reported in Dogs with Haemophilia A.Occur due to development of platelet Occur due to development of platelet

specific Antibody.specific Antibody.Platelet count may normalized within Platelet count may normalized within

4-6 days of Corticosteroid therapy.4-6 days of Corticosteroid therapy.

Similar to Neonatal Isoerythrolysis.Similar to Neonatal Isoerythrolysis.Recognised in Pigs.Recognised in Pigs.Develop Thrombocytopenia.Develop Thrombocytopenia.Clinical signs:- Cutaneous Clinical signs:- Cutaneous

haemorrhagehaemorrhage..

TRANSFUSION REACTION BY COMPONENTS OF BLOOD

PRODUCT CONTENT REACTION Whole blood RBCs, WBCs,

Plasma, Platelets, Anticoagulant

Fever Acute hemolytic rxn Vol. overload

Packed RBCs RBCs Acute hemolytic rxn Fever

Fresh frozen plasma

Plasma, Anticoagulants,All clotting factors,Ig’s

Vol. overload Allergic rxn Fever

Platelet rich Platelet rich plasmaplasma

Platelets, Platelets, PlasmaPlasma Allergic rxnAllergic rxn

FeverFever

Frozen plateletsFrozen platelets 1×10¹¹ 1×10¹¹ platelets,platelets,PlasmaPlasma

BradycardiaBradycardia

Cryo poorCryo poor plasmaplasma

Factors II, IV, Factors II, IV, IX, XIX, X

Allergic rxnAllergic rxn FeverFever

Cryo pptCryo ppt Factors VIII, Factors VIII, XIII,FibrinogenXIII,Fibrinogen

Allergic rxnAllergic rxn FeverFever

Reasons :-Reasons :- A)Failure to administer sufficient blood.A)Failure to administer sufficient blood. B)Irreversible changes occur in patient.B)Irreversible changes occur in patient. C)Short survival of transfused RBCs.C)Short survival of transfused RBCs. In Horses, survival of RBCs:- 60-100% at 4 daysIn Horses, survival of RBCs:- 60-100% at 4 days In Cattle RBCs remain in recepient circulation:-upto In Cattle RBCs remain in recepient circulation:-upto

24 hr.24 hr. Main site of RBC destruction:- Lung & Spleen. Main site of RBC destruction:- Lung & Spleen.

CURRENT VETERINARY THERAPY-IX SMALL ANIMAL PRACTICE:- CURRENT VETERINARY THERAPY-IX SMALL ANIMAL PRACTICE:- ROBERT W. KIRKROBERT W. KIRK

VETERINARY HEMATOLOGY AND CLINICAL CHEMISTRY:- VETERINARY HEMATOLOGY AND CLINICAL CHEMISTRY:- MARY MARY ANNAL THRALL, DALE C, BAKER, E DUAVE ANNAL THRALL, DALE C, BAKER, E DUAVE

VETERINARY MEDICINE-A TEXTBOOK OF DISEASE OF VETERINARY MEDICINE-A TEXTBOOK OF DISEASE OF CATTLE,SHEEP,PIG,GOAT AND HORSES:- CATTLE,SHEEP,PIG,GOAT AND HORSES:- OTTO M. RADOSTITS, OTTO M. RADOSTITS, CLIVE C. GRAY, DOUGLAS C. BLOOD, KENNETH W. HINCHCLIFF.CLIVE C. GRAY, DOUGLAS C. BLOOD, KENNETH W. HINCHCLIFF.

SCHALM’S VETY. HEMATOLOGY:- SCHALM’S VETY. HEMATOLOGY:- NEMI C. JAIN.NEMI C. JAIN.

HANDBOOK FOR VETY. CLINICIANS:- HANDBOOK FOR VETY. CLINICIANS:- BHIKANEBHIKANE