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Module 15 > Approach to Therapeutics in Small Animal Hematopoietic Cases > Flashcards

Approach to Therapeutics in Small Animal Hematopoietic Cases Flashcards

1
Q

what are the components of blood and what are the products that can be made out of each

A
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2
Q

what are the types of blood products (5)

A
  1. fresh whole blood
  2. whole blood
  3. packed red blood cells (PRBC)
  4. fresh frozen plasma (FFP)
  5. frozen plasma (FP)
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3
Q

what does fresh whole blood contain (5)

A
  1. RBCs
  2. platelets
  3. WBCs
  4. plasma proteins
  5. all clotting factors
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4
Q

what does whole blood contain (3)

A
  1. RBC
  2. plasma proteins
  3. stable clotting factors
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5
Q

what does packed red blood cells contain

A

RBCs

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6
Q

what does fresh frozen plasma contain (3)

A
  1. all clotting factors
  2. vWF
  3. plasma proteins
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7
Q

what does frozen plasma contain (2)

A
  1. plasma proteins
  2. vitamin K dependent clotting factors (II, VII, IX and X)
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8
Q

what are the uses of fresh whole blood

A
  1. anemia (hemorrhage)
  2. thrombocytopenia
  3. pacytopenia
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9
Q

what are the uses of whole blood

A
  1. anemia (hemorrhage)
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10
Q

what are the uses of packed red blood cells (PRBC)

A

anemia (hemolysis, non-regenerative anemia, chronic blood loss)

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11
Q

what are the uses of fresh frozen plasma

A

coagulopathies (esp with liver disease, factor VIII deficiency, vWD)

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12
Q

what are the uses fo frozen plasma

A

coagulopathies of non-liable clotting factors (anti-coagulant rodent toxicity)

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13
Q

after you remove packed red cells from the fridge how long do you have before they go bad

A

4 hours

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14
Q

what cautions need to be taken when giving cats transfusions

A
  1. fresh whole blood only
  2. prone to volume overload
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15
Q

what are the canine blood groups

A

DEA (dog erythrocyte antigen) groups: 1.1, 1.2, 3, 4, 5, 6, 7, & 8 (DAL)

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16
Q

do dogs have alloantibodies

A

no naturally occuring ones

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17
Q

can you give a dog an unmatched donor

A

yes if it is their first transfusion ever

first transfusions rarely result in reactions

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18
Q

what needs to be done after a dog has had a previous transfusion

A

cross match prior to subsequent transfusions or unknown history

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19
Q

what blood type are greyhounds and GSDs usually

A

DEA 1.1 and 1.2 negative

very useful donors

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20
Q

what are the feline blood groups

A

A, B and AB

MIK antigen

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21
Q

what blood type is most common in felines

A

A

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22
Q

what is the rarest blood type in felines

A

AB

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23
Q

do cats have naturally occuring alloantibodies

A

yes

24
Q

do cats need to be blood typed for their first transfusion

A

yes

25
Q

what blood type is the most safe to transfuse to a blood type AB cat

A

type AB

26
Q

what blood type is the most safe to give to a blood type A cat

A

type A

B and AB will have a reaction

27
Q

what blood type is the most safe to give to a blood type B cat

A

B only

A and AB will result in fatal reaction

28
Q

what is the purpose of blood typing (3)

A
  1. minimize risk of reaction
  2. avoid formation of alloantibodies in future
  3. breed blood types not a rule
29
Q

how can you blood type

A

in house tests available (rapidvet)

30
Q

what is crossmatching

A

identifies reactions between the donor blood and the recipient blood using agglutination or hemolysis

31
Q

when is it difficult to crossmatch

A

cases with autoagglutination cannot be easily type or cross matched

32
Q

when should you cross match blood in dogs

A
  1. previous transfusion >4 days
  2. unknown transfusion history
  3. history of transfusion
  4. previous pregnancy
33
Q

when should you cross match a cat

A

every transfusion?

test for MIK antigen

34
Q

how do you decide whether or not an animal needs a transfusion

A

based on clinical signs

no PCV value that gives indication

chronic vs acute situations differ: chronic anemia tends to compensate more for anemia, acute trauma that is loosing blood but may have normal PCV because it hasn’t had time to drop yet

35
Q

can you raise the number of platelets with a blood transfusion

A

No it isnt possible to increase the platelet numbers with currently available transfusion fluids

but fresh whole blood –> can provide enough platelets to stop active hemorrhage (more beneficial than using stored whole blood)

36
Q

what are the benefits from obtaining blood products from a bank

A
  1. allows donor screening/typing
  2. convenient for donor
  3. increased availability for the patient
  4. products are tailored to individual needs
37
Q

what are the conditions for canine blood donation (8)

A
  1. 1-8 years old
  2. over 25kg
  3. fully vaccinated and wormed (lung worms too)
  4. healthy and not receiving any medication
  5. never travelled outside UK
  6. not received a transfusion previously
  7. never had puppies and is not pregnant
  8. has a good temperament
38
Q

if sedation is needed to collect blood from a donor dog what could you use

A

butorphanol

39
Q

what is the max amount a canine can donate

A

18ml/kg every 8 weeks

40
Q

what are the conditions for feline blood donors (9)

A
  1. over 4 kg
  2. fully vaccinated and wormed
  3. healthy and not receiving any medication
  4. FIV/FeLV negative
  5. mycoplasma felis PCR negative
  6. never travelled outside UK
  7. has not recieved a transfusion previously
  8. has never had kittens and is not pregnant
  9. has a good temperament
41
Q

what is crucial when collecting blood for donation

A

anticoaglulant/blood ratio

too much AC –> citrate toxicity –> citrate binds calcium –> hypocalcemia leading to cramps, seizures, respiratory arrest

42
Q

how is blood administered

A

peripheral vein via an IV catheter (>22 gauge if possible)

infusion pumps (check if able to use blood products)

blood giving set filter

no medications/solutions should be given through same tubing (except 0.9% NaCl or plasma)

given within 4 hours

educate owners

43
Q

can you administer IVFT concurrently with blood products

A

lactated ringer’s solution through the same line as the blood shoul dbe avoided because calcium within the fluid precipitates with anticoagulants present in WB and pRBCs

unless they are extremely hypovolemic, blood admin should be adequate fluid therapy

44
Q

what is the formula used to determine required volume of blood

A

k x body weight x (desired PCV - recipient PCV)/donor PCV

k = 90 for dogs

k = 60 for cats

2ml/kg donor blood will raise recipient PCV 1%

2ml pRBCs raise recipient PCV by 2%

45
Q

how much blood does a 10kg dog require

the donor PCV is 70%

A

required volume of blood = 90 x 10kg x (25% desired PCV - 10 recipient PCV)/70 (pRBCs) donor PCV

= 90 x 10 x 15/70

= 193 mls

46
Q

how do you calculate the rate at which to give blood

A

take into account the condition of the patient

47
Q

what is the transfusion rate in the first 15-30 mins

A

first 15-30 mins: 0.5-2 ml/kg/hr

48
Q

what is the transfusion rate if you have a normovolemic and no reaction

A

normovolemic and no reaction: 5-10 mls/kg/hr

49
Q

what is the transfusion rate in a compromised heart/kidney function patient

A

compromised heart/kidney: 4 ml/kg/hr MAX

50
Q

what is the transfusion rate for a hypovolemic and no reaction patient

A

hypovolemic and no reaction: 20ml/kg/hr

51
Q

what is the maximum volume of transfusion

A

22ml/kg

52
Q

what are immunological transfusion reactions that can occur

A

hemolytic: acute (Ag-Ab complex formation) or delayed (2-21 days after)

53
Q

what are non-immunological transfusion reactions

A
  1. too rapid infusion rate
  2. volume overload
  3. microbial contamination
  4. thrombosis
  5. air embolus, TRALI
54
Q

what are signs of a tranfusion reactions (11)

A
  1. tachycardia or bradycardia

2 dyspnea, tachypnea or coughing

  1. pyrexia
  2. depression
  3. vocalizing
  4. vomiting
  5. urticaria, erythema, pruritus (anaphylactic reactions)
  6. shcok
  7. tremors and convulsions
  8. cardiopulmonary arrest
  9. jaundice, hemoglobinuria, anorexia (delayed)
55
Q

how do you treat transfusion reactions

A
  1. stop transfusion immediately
  2. monitor patient
  3. oxygen +/- artifical ventilation
  4. adrenaline IV
  5. IV fluids
  6. antihistamines (piriton) and H2 blockers
  7. dexamethasone
  8. anti-emetics

Module 15 (27 decks)

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