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Transfusion practices for treatment of dogs undergoing splenectomy for splenic masses: 542 cases (2001–2012)

Alex M. LynchDepartment of Clinical Sciences, Cummings School of Veterinary Medicine, Tufts University, North Grafton, MA 01536.

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Therese E. O'TooleDepartment of Clinical Sciences, Cummings School of Veterinary Medicine, Tufts University, North Grafton, MA 01536.

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Jessie HamiltonDepartment of Clinical Sciences, Cummings School of Veterinary Medicine, Tufts University, North Grafton, MA 01536.

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Abstract

Objective—To describe transfusion practices for treatment of dogs undergoing splenectomy for splenic masses.

Design—Retrospective case series.

Animals—542 client-owned dogs.

Procedures—Medical records of dogs that underwent splenectomy for splenic masses at 2 referral institutions were reviewed. Variables of interest were compared between dogs that did and did not undergo transfusion. Multiple logistic regression analysis was performed to assess associations of transfusion with death during hospitalization and with 30- and 180-day survival rates.

Results—Transfusions were administered to 240 of 542 (44%) dogs; packed RBCs were the most frequently administered blood product. On admission, dogs that subsequently received transfusions had higher mean illness severity score, heart rate, respiratory rate, blood lactate concentration, and prothrombin time, with lower mean PCV, platelet count, serum total solids and albumin concentrations, and base deficit than dogs that did not receive transfusions. Hemoperitoneum and malignancy, especially hemangiosarcoma, were more common in the transfusion group. Overall, 500 of 542 (92%) dogs survived to discharge. Dogs that received transfusions had higher odds of death or euthanasia while hospitalized and lower odds of surviving to 30 or 180 days after hospital discharge than dogs that did not.

Conclusions and Clinical Relevance—Evidence of shock, anemia, and hypocoagulability were apparent triggers for the decision to perform blood transfusion in dogs undergoing splenectomy for splenic masses and were likely attributable to hemoperitoneum and related hypovolemia. Dogs undergoing transfusion more commonly had malignant disease and had greater odds of poor long-term outcome, compared with dogs that did not undergo transfusion.

Abstract

Objective—To describe transfusion practices for treatment of dogs undergoing splenectomy for splenic masses.

Design—Retrospective case series.

Animals—542 client-owned dogs.

Procedures—Medical records of dogs that underwent splenectomy for splenic masses at 2 referral institutions were reviewed. Variables of interest were compared between dogs that did and did not undergo transfusion. Multiple logistic regression analysis was performed to assess associations of transfusion with death during hospitalization and with 30- and 180-day survival rates.

Results—Transfusions were administered to 240 of 542 (44%) dogs; packed RBCs were the most frequently administered blood product. On admission, dogs that subsequently received transfusions had higher mean illness severity score, heart rate, respiratory rate, blood lactate concentration, and prothrombin time, with lower mean PCV, platelet count, serum total solids and albumin concentrations, and base deficit than dogs that did not receive transfusions. Hemoperitoneum and malignancy, especially hemangiosarcoma, were more common in the transfusion group. Overall, 500 of 542 (92%) dogs survived to discharge. Dogs that received transfusions had higher odds of death or euthanasia while hospitalized and lower odds of surviving to 30 or 180 days after hospital discharge than dogs that did not.

Conclusions and Clinical Relevance—Evidence of shock, anemia, and hypocoagulability were apparent triggers for the decision to perform blood transfusion in dogs undergoing splenectomy for splenic masses and were likely attributable to hemoperitoneum and related hypovolemia. Dogs undergoing transfusion more commonly had malignant disease and had greater odds of poor long-term outcome, compared with dogs that did not undergo transfusion.

Contributor Notes

Dr. Hamilton's present address is Hudson Animal Hospital, 30 High St, Hudson, MA 01749.

The authors declare that there were no conflicts of interest.

The authors thank Nisha Kini and Bruce Barton for statistical support.

Address correspondence to Dr. Lynch (amlynch85@gmail.com).