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SMALL ANIMAL > 4.3.4: Blood groups and transfusion medicine > Flashcards

4.3.4: Blood groups and transfusion medicine Flashcards

1
Q

How many equine blood groups are there and what are they called?

A
  • 7 groups
  • A, C, D, K, P, Q, U
  • Lowercase letters represent allelic factors
  • Aa, Qa, Ca are the most immunogenic blood groups
  • Majority of horses lack naturally occurring antibodies
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2
Q

How should you select an equine blood donor?

A
  • Donors should ideally be geldings
  • Aa, Qa, Ca = most immunogenic blood groups so ideally from a breed (e.g. standardbred) with a low prevalence of these
  • Cross-matching is essential
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3
Q

What are the feline blood groups and which ones have antibodies against each other?

A
  • Types: A, B and AB (rare)
  • Type A carry weak anti-Type B antibodies
  • Type B carry very strong anti-Type A antibodies
  • Type AB carry no antibodies against type A or B
  • Mik = newly recognised blood group in DSH
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13
Q

What happens if you give Type A blood to a Type B cat?

A
  • Severe acute intravascular haemolysis of Type A blood
  • Within seconds of receiving transfusion
  • May be fatal!
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14
Q

What happens if you give Type B blood to a Type A cat?

A
  • Extravascular haemolysis (milder clinical signs than intravascular)
  • Low half-life of RBCs
  • PCV will fall to pre-transfusion level within days
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15
Q

True/false: in an emergency, you can get away without blood-typing donor and recipient cats.

A

False
Always blood-type even in an emergency!

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16
Q

What is feline neonatal isoerythrolysis?

A
  • When Type A or AB kittens are born from a Type B queen
  • “Fading” kittens
  • Breeders should be urged to type the queen (and then the tom if the queen is found to be Type B)
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21
Q

What canine blood groups are there and which one(s) have most transfusion significance?

A
  • DEA 1, 3, 4, 5, 6, 7, 8; DAL; Kai 1 and 2
  • We no longer use subgroups e.g. 1.1, 1.2 etc.
  • DEA 1 antigen has the most transfusion significance (highly antigenic) and is the one we have a commercial test kit for
  • 70% of dogs are DEA 1 +ve
  • 30% of dogs are DEA 1 -ve
22
Q

True/false: most dogs do not have pre-formed antibodies against non-self canine blood types.

A

True

23
Q

What blood type should you give to a DEA 1 +ve dog?

A

DEA 1+ve blood
Where possible give +ve to +ve, and -ve to -ve

24
Q

True/false: in an emergency, you can give a canine patient DEA 1-ve blood.

A

True
But in emergencies only; this is not recommended.

25
Q

What happens if you give DEA 1 +ve blood to a DEA 1 -ve patient?

A
  • You will sensitise them
  • This means if they later have more DEA 1 +Ve blood, they could suffer an acute haemolytic transfusion reaction which could be fatal!
26
Q

What happens if you give DEA 1 -ve blood to a DEA 1 +ve dog?

A
  • No adverse effects
  • However this is not a good use of DEA 1 -ve blood (this is in the minority and should be reserved for DEA 1 -ve patients)
27
Q

What is cross-matching and why would you do it?

A

Cross-matching: in-vitro tests looking for potential reactions between a donor’s and a patient’s blood. These show as agglutination or haemolysis.
* Cross-match for additional blood groups that don’t have specific in-house tests

28
Q

When should you cross-match?

A
  • Cats have naturally occurring antibodies -> cross-match prior to transfusion and definitely prior to subsequent transfusion
  • Cross-match dogs if recipient has been previously transfused >4 days prior/ if history of previous transfusion reaction/ if transfusion history unknown
29
Q

What are some imminent triggers for blood transfusion?

A
  • Evidence for circulatory collapse
  • Rapid drop in PCV to <20% in dogs
  • Rapid drop in PCV to <15% in cats
  • Absolute PCV of 15-20% depending on history and clinical signs
  • PCV <10-12% -> organ hypoxia is imminent!
  • Signs of organ hypoxia e.g. CNS
  • Concern that PCV will fall over period of time when transfusion would be difficult to organise
30
Q

What is a single unit of whole blood? What is fresh vs stored?

A

450ml
* Fresh = transfused within 8 hrs collection. Contains all blood components.
* Stored = refrigerated<4C and stored for up to 3 weeks. Lacks platelets, WBCs, and labile clotting factors e.g. Factors V and VIII and vWF.
* Generally used in acute blood loss/active bleeding

31
Q

Cryoprecipitate and its uses

A
  • Cryoprecipitate: plasma fraction separated from fresh frozen plasm
  • Contains concentrated labile clotting factors including fibrinogen, vWF, Factor VIII
  • Shelf life 1 year
  • Used in pre-treatment for vWD
32
Q

Autologous transfusion and its benefits

A

Autologous transfusion: the collection of blood from a single patient and re-transfusion back to the same patient when required.
✅ Reducing potential for exposure to allogenic blood
✅ Reduces risk of new infectious diseases
✅ Reduces chances of transfusion reactions
✅ Immediate availability

33
Q

Canine blood donors must be…

A
  • Fit and healthy
  • 1-8 y.o.
  • > 25kg
  • Good temperament
  • Never travelled abroad
  • Vaccinated
  • Not on any medication
34
Q

Feline blood donors must be…

A
  • Healthy
  • 1-8 y.o.
  • > 4kg lean bodyweight
  • Preferably indoor cat
  • (Do FeLV/FIV testing if outdoor cat)
35
Q

What sedative/ anaesthetic combination could you give to a feline blood donor?

A

Ketamine + midazolam

36
Q

Volume to transfuse =

A

(Target PCV- recipient PCV)/ Donor PCV x kg x N

Where N = 90 (dogs), N= 60 (cats)

37
Q

2ml tranfused whole blood/kg of recipient weight raises PCV by

A

1%

38
Q

1ml transfused pRBCs/kg recipient weight raises PCV by

A

1%

39
Q

What is an appropriate transfusion rate?

A
  • In the stable patient: 0.5-1.0ml/kg/hr; monitor for 15-30 mins for reaction, then can increase to 4-6ml/kg/hr
  • The unit should be given within 4hrs
  • In an emergency (severe acute haemorrhage), give red cells as fast as necessary
40
Q

Clinical presentation of transfusion reaction

A
  • Increase in temperature
  • Change in HR/RR
  • Change in mm colour
  • Visible oedema
  • GI signs

More severe signs also possible

41
Q

Clinical signs of acute haemolytic transfusion reaction

A

This occurs when there is blood type incompatibility
* Fever
* Tachycardia
* Dyspnoea
* Muscle tremors
* Vomiting
* Weakness
* Collapse
* Haemoglobinaemia
* Haemoglobinuria
* Shock
* Death

42
Q

Treatment of acute haemolytic transfusion reaction

A
  • Stop transfusion immediately
  • Give IV fluids
  • ± corticosteroids
43
Q

Delayed haemolytic reaction

A
  • Extravascular haemolysis
  • Occurs 3-21 days post-treatment
  • -> reduced lifespan of donated erythrocytes
44
Q

Clinical signs and treatment of delayed haemolytic reaction

A
  • Hyperbilirubinaemia
  • ± bilirubinuria

Specific treatment not generally required

SMALL ANIMAL (90 decks)

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