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Transfusion practices for treatment of dogs hospitalized following trauma: 125 cases (2008–2013)

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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Meghan RespessDepartment 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 hospitalized because of traumatic injuries.

Design—Retrospective case series.

Animals—125 client-owned dogs.

Procedures—Medical records of dogs that sustained trauma and were hospitalized for ≥ 24 hours after emergency stabilization were reviewed. Admission characteristics and transfusion-specific data were assessed. Receiver operating characteristic curves were plotted to evaluate diagnostic utility of PCV and serum total solids concentration as predictors of transfusion in the study population.

Results—45 of 125 (36%) dogs received transfusions. Packed RBCs were the most commonly administered blood product (42/45 [93%]). Common reasons for transfusion included perioperative hemodynamic support and treatment of shock or worsening anemia. Dogs that underwent transfusion had higher mean heart rate, blood lactate concentration, and animal trauma triage scores, with lower mean PCV, serum total solids concentration, and rectal temperature at admission than dogs that did not undergo transfusion. Total solids concentration and PCV at admission were specific but insensitive predictors of subsequent transfusion. Most (109/125 [87%]) dogs survived to hospital discharge. Significantly fewer dogs that had transfusions survived, compared with dogs that did not have transfusions. Seven of 10 dogs that received massive transfusions survived to discharge.

Conclusions and Clinical Relevance—Apparent clinical triggers for the decision to perform blood transfusion in dogs hospitalized following traumatic injury included evidence of shock or worsening anemia on admission and requirement for perioperative hemodynamic optimization. Although dogs that received transfusions had a lower survival rate than dogs that did not, this was likely attributable to greater severity of injuries in the transfusion group.

Abstract

Objective—To describe transfusion practices for treatment of dogs hospitalized because of traumatic injuries.

Design—Retrospective case series.

Animals—125 client-owned dogs.

Procedures—Medical records of dogs that sustained trauma and were hospitalized for ≥ 24 hours after emergency stabilization were reviewed. Admission characteristics and transfusion-specific data were assessed. Receiver operating characteristic curves were plotted to evaluate diagnostic utility of PCV and serum total solids concentration as predictors of transfusion in the study population.

Results—45 of 125 (36%) dogs received transfusions. Packed RBCs were the most commonly administered blood product (42/45 [93%]). Common reasons for transfusion included perioperative hemodynamic support and treatment of shock or worsening anemia. Dogs that underwent transfusion had higher mean heart rate, blood lactate concentration, and animal trauma triage scores, with lower mean PCV, serum total solids concentration, and rectal temperature at admission than dogs that did not undergo transfusion. Total solids concentration and PCV at admission were specific but insensitive predictors of subsequent transfusion. Most (109/125 [87%]) dogs survived to hospital discharge. Significantly fewer dogs that had transfusions survived, compared with dogs that did not have transfusions. Seven of 10 dogs that received massive transfusions survived to discharge.

Conclusions and Clinical Relevance—Apparent clinical triggers for the decision to perform blood transfusion in dogs hospitalized following traumatic injury included evidence of shock or worsening anemia on admission and requirement for perioperative hemodynamic optimization. Although dogs that received transfusions had a lower survival rate than dogs that did not, this was likely attributable to greater severity of injuries in the transfusion group.

Contributor Notes

Dr. Respess’ present address is NorthStar VETS, 315 Robbinsville-Allentown Rd, Robbinsville, NJ 08691.

Presented in abstract form at the International Veterinary Emergency and Critical Care Symposium, San Diego, September 2013.

The authors declare that there were no conflicts of interest.

The authors thank Constance Barysauskas, Nisha Kini, and Bruce Barton for statistical assistance support.

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