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Blood Products
Universal Blood Donor Blood Products
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VITA-TECH distributes Hemopet canine universal donor blood products. Hemopet’s healthy donor dogs are maintained in a closed colony. All donors have blood type DEA 4 (C) and are tested negative for all other known canine red blood cell antigens, including DEA 1.1 (A1), DEA 1.2 (A2), and DEA y (Tr), the antigens associated with clinically significant transfusion incompatibilities in dogs. All donors receive on-site, 24 hour-a-day veterinary supervision and maintenance and have been serologically screened for:
Shelf-Life of Packed Red Blood Cells
A special nutrient solution (Adsol, Baxter Healthcare Corp.) is added to Hemopet’s units
of canine packed red blood cells during preparation to preserve and extend the shelf-life
from 28 to at least 37 days. The solution contains saline, dextrose, adenine, and mannitol.
Post transfusion viability studies in dogs have shown that 80% of the red cells in packed
cell units remain viable for 37 days, whereas 75-80% are viable for up to 44 days in the
presence of Adsol or equivalent nutrient solutions (Wardrop et al, J. Vet Int. Med. 5, 1991,
p. 148). Hemopet’s units of packed red blood cells display a conservative expiration dating
of 37 days from the time of collection.
If the units of packed cells you intend to transfuse are approaching the expiration date, most of the cells will still carry oxygen efficiently, however, a portion (20-25%) of these cells may be less functional or nonviable. Therefore, the dosage of packed cells to be transfused should be increased slightly to compensate for this reduction. For example: a dosage of 3-5 ml of packed red blood cells per pound of body weight is generally recommended to raise the PCV by 9 percentage points. If the red cell unit is within the first half of its shelf-life, 3 ml/lb should suffice. For older units, increasing the volume transfused to 5 ml/lb is advisable.
Uses of Fresh-Frozen Plasma
Fresh-frozen plasma is generally indicated for parental replacement of coagulation factors,
albumin, globulins, electrolytes and other nutrients of plasma. However, in clinically
significant hypoalbuminemia, secondary to chronic liver, kidney or gastrointestinal disorders,
it is generally impossible to provide sufficient plasma proteins by giving whole
plasma to resuscitate a depleted patient. Fresh-frozen plasma should not be used for routine
volume expansion; crystalloid or synthetic colloid solutions such as 6% Hetastarch,
Pentastarch, or Dextran 70 are preferred.
The volume of plasma transfused will depend upon the individual patients needs. This generally should not exceed 3-5 ml plasma per pound of body weight given once or twice daily and not more than 10 ml/lb during a 24 hour period for normovolemic animals. After thawing, the usual procedure is to filter the plasma through a standard drip type administration set or one of the special filter sets that adapt to a syringe or catheter for smaller volumes of plasma. The rate of plasma administration should be slow for the first 10-30 minutes to monitor for signs of adverse reaction. The average rate for normovolemic patients should not exceed 10ml/lb over 4 hours, and for hypovolemic patients, should not exceed 10ml/lb/hr. For acute needs, patients can usually tolerate transfusion given at 4-6 ml/min. For cardiac or other compromised patients at risk for circulatory embarrassment, the rate should be much slower (up to 2 ml/lb/hr). These products must not be mixed with or administered in the same intravenous or parental line with Lactated Ringer’s solution or any other solution containing divalent cations. The safest fluid to mix with or administer via the same infusion apparatus is 0.9% sodium chloride (NaCl). The preferred site for transfusion is intravenous because 100% of the infused material will circulate. An alternative site for very young or compromised animals is intraperitoneal, although it takes longer to circulate when given by this route. Intramedullary transfusion can also be used.
A. Treatment of Bleeding Disorders
von Willebrand Disease
Depending on the severity and cause of bleeding, the patient may also need packed red
blood cells if the hematocrit is at or below 15%. While fresh-frozen plasma can be used
successfully to control serious bleeding diseases such as hemophilia and the severe forms
of von Willebrand’s disease (von Willebrand factor level below 1 or 2%), the treatment of
choice for hemophilia A(factor VIII deficiency) and homozygous severe von Willebrand’s
disease is plasma cryoprecipitate, a concentrated form of fresh-frozen plasma. This plasma
concentrate product is maintained on a limited basis at some veterinary schools and
research facilities; canine cryoprecipitate is available commercially from Hemopet.
Routine use of cryoprecipitate for control or prophylaxis of mild hemophilia or von
Willebrand’s disease is not practical, however, because of its increased cost over whole
fresh-frozen plasma. This reflects the significant loss in yield (about two-fold) during the
concentration process. For the typical case of bleeding encountered with congenital and
acquired coagulation defects, cumulative experience to date has demonstrated the efficacy
and practicality of using fresh-frozen plasma.
Rodenticide Toxicosis
For cases of significant bleeding, fresh-frozen plasma is given twice daily for 3-5 days or
until bleeding ceases. For the typical case of rodenticide toxicosis with serious bleeding,
fresh-frozen plasma is given in one or two doses at 3-5 ml/lb over a 24 hour period along
with the appropriate dose of K1. Vitamin K1 therapy is then continued for the length of
time required depending upon the specific type of anticoagulant involved.
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