Hemolymphatic Articles Flashcards
Clinical features and outcome of dogs and cats with bidirectional and continuous right-to-left shunting patent ductus arteriosus - Greet 2021 (JVIM)
43 dogs + 3 cats.
CS - hindlimb collapse (16/43 dogs - 37%) most common in dogs.
MST - 626 d in dogs. R-CHF had shorter MST (58 d vs 1839 d). Sildenafil-treated had longer MST (1839 d vs 302 d). Sildenafil only independent predictor of survival.
Dogs + cats w/ reverse PDA have variable presentation and prog. Survival longer in animals prescribed sildenafil at DX. Dogs with R-CHF have worse outcome.
Clinicopathological findings in 41 dogs (2008-2018) naturally infected with Ehrlichia ewingii - Qurollo 2019 (JVIM)
41 E. ewingii + dogs.
Renal dx - 17.1%.
IMHA - 14.6%.
CS - joint pain (34.1%).
BW - abnormal lymphocyte counts (61.1%), neutrophilia (56.8%), ALP (57.1%), ALT (40%), SDMA (32.4%).
UA - proteinuria (74%) with quiet sed (80%).
Seropos by IFA - 43.6%.
ELISA - 82.9%.
Coinfxn - Bartonella (2.6%), Rickettsia rickettsii (30.8%), Lyme (2.4%).
Renal dx, IMHA, proteinuria, neutrophilia, abnormal lymph, ELEs common.
Clinical features of precursor-targeted immune-mediated anemia in dogs: 66 cases (2004-2013) - Assenmacher 2019 (JAVMA)
Med HCT 13% and Retic 17.9K.
BM - rubriphagocytosis in 61/66 (92%); collagen myelofibrosis in 31/63 (49%).
IM targeting of mature RBC uncommon.
All received immunosuppression - 55/66 (83%) developed regen at median 29 days. 40/55 (73%) remission at median 59 days.
Thrombosis in 9/66 (14%) and were associated w/ dec survival time.
MST ~ 913 days.
Most dogs w/ PIMA responded to prolonged immunosuppression.
Application of therapeutic plasma exchange in dogs with immune-mediated thrombocytopenia - Kopecny 2020 (JVIM)
4 dogs with IMT. All had severe bleeding requiring > 1 transfusion, unresponsive to conventional tx, or both.
3 sequential sessions - total 4.0 - 4.9 total plasma vol exchanged.
3/4 - TPE associated w/ improved clinical bleeding and PLT count in combo w/ immunosupp drugs.
1 euth after 3 treatments d/t persistent severe thrombocytopenia + hemorrhage.
TPE is safe and may be useful adjunct in management of IMT that is severe or refractory to traditional tx.
Ehrlichia canis in dogs experimentally infected, treated, and then immune suppressed during the acute or subclinical phases - Sato 2020 (JVIM)
7 Beagles infected w/ E. canis + given doxy x 4 weeks (3 inadvertently coinfected w/ Anaplasma/Babesia + treated accordingly).
All dogs completed immunosupp protocol w/ pred + cyclosporine.
No recrudescence of E. canis, A. platys, or B. vogeli based on CS, CBC, PCR, IFA, or flow for anti-PLT Ab.
E. canis IFA titers negative in 5/7 at end of immunosupp protocol and negative at ~ 6 mo in 5/5.
Dogs given 4-week course of doxy +/- imidocarb failed to show evidence of E. canis activation after admin of common immunosupp protocol.
Prevalence of Babesia spp. and clinical characteristics of Babesia vulpes infections in North American dogs - Barash 2019 (JVIM)
Babesia DNA in 269/9367 (2.9%) of North American dogs - B. gibsoni monoinfection (157 - 1.7%); B. vulpes monoinfection (19 - 0.2%); coinfection (29 - 0.31%).
43/48 (90%) B. vulpes infected dogs were Pit Bulls, with 36 involved in fights.
Coinfxn - Mycoplasma, HW, or Wohlbachia; coexposure - Bartonella, Ehrlichia, Rickettsia.
BW - Anemia, thrombocytopenia, hyperglobulinemia, hypoalbuminemia, proteinuria.
B. vulpes infxn in domestic NA dogs commonly found w/ other coinfections inc. B. gibsoni and Mycoplasma. Dog-dog transmission may be important (similar to B. gibsoni).
Neutropenia in dogs receiving vincristine for treatment of presumptive immune-mediated thrombocytopenia - LaQuaglia 2021 (JVIM)
19/127 neutropenic (15%).
Cyclosporine sig associated w/ neutropenia (OR 12.97).
No diff median time to > 40K b/t neutropenic (4 days) and non-neutropenic (3 days).
Survival to discharge ~ 95% in both groups, but med duration of hosp sig longer in neutropenic (6 d vs 4 d).
Cyclosporine associated w/ neutropenia in vinc-treated dogs (may be related to effect on metabolism of vinc). Neut counts should be monitored in dogs receiving vinc, esp if administered w/ cyclosporine.
Evaluation of the effect of vincristine on platelet count in dogs with lymphoma - Campbell 2019 (JSAP)
Retrospective (59 lymphoma dogs).
PLT count higher and number of thrombocytopenic patients lower after vinc.
No diff in number of dogs w/ enlarged and elliptical PLT following vinc.
Vinc inc PLT in dogs w/ lymphoma. Not contraindicated to administer vinc to dogs w/ lymphoma that are thrombocytopenic.
Platelet number and function in response to a single intravenous dose of vincristine - Allen 2021 (JVIM)
10 purpose-bred dogs.
VInc inc PLT from day 0 to day 7 (225K –> 273K) vs controls (299K –> 214K).
Inc % reticulated (immature) PLT from day 0 to day 5 (3.6 to 6.1).
On all days, reticulated PLT had higher resting CD62P expression than mature (49.6% vs 10.2%). No diff in CD62P expression by reticulated PLT (in vinc or saline group) before or after thrombin stim.
Reticulated PLT released in response to vinc are functionally similar to mature PLT.
Pharmacokinetics of mycophenolic acid and its effect on CD4+ and CD8+ T cells after oral administration of mycophenolate mofetil to healthy cats - Slovak 2019 (JVIM)
10 healthy cats given MMF (10 mg/kg PO q12h, 15 mg/kg PO q12h, 15 mg/kg PO q8h) x 7 days.
All converted MMF –> MPA.
5/10 (50%) had SFX within ~ 1 week.
Mycophenolic acid was detected in all cats. 10 mg/kg PO q12h x 7 days was tolerated (n = 3). Efficacy of MMF as immunosuppressant and long-term safety in cats is unknown.
Detection and dynamics of anti-platelet antibodies in thrombocytopenic dogs with and without idiopathic immune thrombocytopenia - Shropshire 2020 (JVIM)
79 thrombocytopenic (28 primary ITP).
16/79 (20%) of non-ITP thrombocytopenic dogs positve for APA.
Melena at initial eval associated w/ dec survival to discharge (OR 0.06).
APA not associated w/ response to tx, but recurrence of Ab associated w/ relapse (OR 205).
No diff in % APA or PLT at initial diagnosis b/t responders or non-responders.
Serial monitoring of APA in primary ITP dogs appeared beneficial for determining relapse.
Splenectomy in the management of primary immune-mediated hemolytic anemia and primary immune-mediated thrombocytopenia in dogs - Bestwick 2022 (JVIM)
17 dogs (7 IMHA, 7 ITP, 3 both).
6/7 ITP dogs managed successfully w/ splenectomy as part of TX protocol (3 CR, 3 PR) though 1 developed IMHA.
4/7 IMHA dogs managed successfully w/ splenectomy as part of TX protocol (2 CR, 2 PR).
1/3 combined dogs responded completely to splenectomy.
Splenectomy considered successful and well tolerated in most cases of isolated ITP. Could not determine benefit for IMHA or combined.
Lyophilized platelets versus cryopreserved platelets for management of bleeding in thrombocytopenic dogs: A multicenter randomized clinical trial - Goggs 2020 (JVIM)
88 dogs with PLT < 50K + DOGiBAT > 2. 50 LP + 38 CPP.
1 hr post trans - LP had superior change in DOGiBAT score and noninferior at 24 hours.
LP noninferior for change in PLT, need for additional RBC trans, and survival to discharge.
LP superior for change in HCT at 1 hour post trans and noninferior at 24 hours.
Canine LP product logistically superior and clinically noninferior to DMSO-stabilized canine CPP for management of bleeding in thrombocytopenic dogs.
Comparative analysis of the effect of IV administered acid suppressants on gastric pH in dogs - Kuhl 2020 (JVIM)
9 research Beagles.
Sig inc in mean pH, MPT > 3, and MPT > 4 for all 3 treatments (esomeprazole IV, pantoprazole IV, famotidine CRI).
Time effect did not differ b/t treatments for mean pH, MPT > 3, and MPT > 4 but only esomeprazole and famotidine CRI reached goals established for treatment of gastroduodenal ulceration in people.
Famotidine CRI + esomeprazole might be superior acid suppressants compared to standard doses of pantoprazole for first 72 hours of tx.
Randomised controlled trial of fractionated and unfractionated prednisolone regimens for dogs with immune-mediated haemolytic anaemia - Swann 2019 (Vet Rec)
Unfractionated (4 mg/kg PO q24h) or fractionated (2 mg/kg PO q12h). 17 in each group.
Number of cases insufficient to determine if unfractionated was inferior to fractionated.
TBili dec more rapidly in group 2 (fractionated) but PD improved more rapidly in group 1 (unfractionated).
BP + PU score higher and lymphocyte count lower in group 2 dogs (fractionated) over time.
Admin of same total daily dose of prednisolone as unfractionated resulted in fewer adverse effects but effect on survival could not be assessed.
Clinical, clinicopathologic, and gastrointestinal changes from administration of clopidogrel, prednisone, or combination in healthy dogs: A double-blind randomized trial - Whittemore 2019 (JVIM)
24 research dogs.
No clinical GIB.
Higher mucosal lesion scores in groups receiving pred and on day 14.
Ulcers in 4 pred dogs + 3 pred/clopidogrel dogs.
Odds of mucosal lesion scores > 4 were 7x higher for prednisone (43) and prednisone-clopidogrel (43.4) than placebo.
GIB/GIU occur commonly in healthy dogs administered pred or pred/clopidogrel, but not clopidogrel monotherapy. Though lesions severe in many cases, not accompanied by clinical signs.
Comparative analysis of the effect of PO administered acid suppressants on gastric pH in healthy cats - Ryan 2020 (JVIM)
12 research cats (esomeprazole 1 mg/kg PO q12h, lansoprazole 1 mg/kg PO q12h, dexlansoprazole 6 mg/kg PO q12h).
Lansoprazole had lower MPT of pH > 3 (8.8%) than dexlansoprazole (41.2%) or esomeprazole (54%).
Lansoprazole had lower mean pH (1.6) than dexlansoprazole (3.11) or esomeprazole (4.1).
Esomeprazole only tx to achieve goals defined for people in treatment of duodenal ulcers by day 4 (pH > 4, MPT 77.1%).
Orally administered esomeprazole may be a superior acid suppressant in cats compared to PO lansoprazole or dexlansoprazole.
Development and implementation of a hemovigilance program at a university veterinary teaching hospital - Haines 2022 (JVECC)
718 canine transfusions (4 WB, 400 pRBC, 300 FFP, 7 PRP, 7 CP).
124 feline transfusions (5 WB, 95 pRBC, 24 FFP).
32 reactions (27 canine, 5 feline) - febrile nonhemolytic most common (19/32 - 59%).
Overall rxn rate - 3.8% in dogs and 4.0% in cats.
Retrospective evaluation of fresh platelet concentrate administration in dogs: Patient characteristics, outcomes, and transfusion practices in 189 transfusion episodes (2008-2019) - Saint-Pierre 2023 (JVECC)
149 dogs (189 PC transfusions).
26.2% ITP, 14.8% dec BM prod, 8% massive transfusion, 2.0% congenital thrombocytopathia, 39.6% severe thrombocytopenia of other causes, 9.4% misc w/o thrombocytopenia.
78.5% had > 1 site of hemorrhage - GI 59.7% and skin 52.3%.
15.7% prophylactic and 83.6% therapeutic. Med PLT change ~ 5K with post PLT sig higher than pre PLT. Inc greater in prophylactic than therapeutic group.
Survival to discharge 59.1%.
RXN suspected 1.2%.
ITP most common DX that resulted in PC trans. PC administered to animals w/ active bleeding more commonly than prophylactic. Most hemorrhaging into mult organ systems, esp GI + skin. PC trans typically safe and median PLT inc after trans.
Accuracy of point-of-care crossmatching methods and crossmatch incompatibility in critically ill dogs - Marshall 2021 (JVIM)
Lab tube agglutination (LAB-CM) and gel POC (GEL-CM) - Kappa agreement could not be calc d/t lack of incompatible results.
Kappa agreement b/t LAB-CM and immunochromatographic POC (IC-GM) was 0.16 indicating NO agreement.
LAB-CM incompatibilty in transfusion naive dogs (25%) vs prev trans dogs (35%).
Compared to lab methods, POC methods lacked Se. Dogs had similar rates of major incompatibility regardless of trans history. This suggests CM testing prior to trans be considered in all dogs however study did not investigate clinical relevancy of incompatible LAB-CM.
Hemostatic capacity of canine chilled whole blood over time - Edwards 2021 (JVECC)
Clotting strength of chilled blood maintained up to 21 d despite sig dec in PLT aggregation to ADP, collagen, or y-thrombin, sig prolongation of PT/aPTT, and reduced speed of clot formation (K time, alpha angle).
Fibrinogen conc, WBC, RBC, and PLT count did not change over time.
Chilled canine WB loses small percentage of clot strength through 21 d of refrigerated storage. Further research needed to determine if hemostatic potential is clinically relevant in hemorrhaging dogs requiring surgery/undergoing trauma.
Exploration of risk factors for non-survival and for transfusion-associated complications in cats receiving red cell transfusions: 450 cases (2009 to 2017) - Martinez-Sogues 2020 (JSAP)
Indications - blood loss (44.9%), ineffective erythropoiesis (37.5%), RBC destruction (22.5%).
Complications ~ 10.2% and 20.2% mortality after transfusion.
Mean inc in PCV greater for crossmatched (7.2%) vs not (4.0%).
Nonsurvival associated with higher PCV before trans, low temp before trans, anemia d/t blood loss, and number of trans.
Older age of transfused blood associated w/ nonsurvival and transfusion-related complications.
Major crossmatch before transfusion tended to have greater efficacy and transfusion of older blood might have detrimental effects on survival.
Identification of 5 novel feline erythrocyte antigens based on the presence of naturally occurring alloantibodies - Binvel 2021 (JVIM)
Incompatibilities by random crossmatch 3.9% resulting in at least 7% type A cats having NOAb.
Blood typing and agreement analyses with 7 new NOAb allowed ID of 5 presumably distinct FEA.
FEA 1 (84%) and 5 (96%) most prevalent. Only FEA 1-negative status associated w/ higher risk of NOAb (16.7% of FEA 1-negative having NOAb wvs 5.1% FEA 1-positive).
First step of FEA identification outside AB system. Because of prevalence and association w/ NOAb, FEA 1 may correspond to Mik antigen.
Characterization of post-transfusion anti-FEA 1 alloantibodies in transfusion-naive FEA 1-negative cats - Cannavino 2022 (JFMS)
Anti-FEA 1 alloantibodies detected as early as 5 days post-transfusion and remained detectable for over 400 days in one cat.
Agglutination titers in both cats were relatively weak (1:1 to 1:8). Main class was IgM.
Trans of FEA 1-neg, transfusion-naive cats with FEA 1-pos blood results in prod of alloantibodies as early as 5 days. Results confirm potential immunogenicity of FEA 1 and support crossmatching prior to transfusion even in naive cats.
