Objective—To determine clinical characteristics of
dogs that received massive transfusion and identify
the underlying diseases, complications, and outcomes.
Procedure—Medical records of dogs receiving a
massive blood transfusion were evaluated for transfusion
volume, underlying disease process or injury,
benefits and complications of transfusion, and outcome.
A massive transfusion was defined as transfusion
of a volume of blood products in excess of the
patient's estimated blood volume (90 ml/kg [40 ml/lb])
in a 24-hour period or transfusion of a volume of blood
products in excess of half the patient's estimated
blood volume in a 3-hour period.
Results—Six dogs had intra-abdominal neoplasia
resulting in hemoabdomen, 3 had suffered a traumatic
incident resulting in hemoabdomen, and 6 had nontraumatic,
non-neoplastic blood loss. Mean volumes
of packed RBC and fresh-frozen plasma administered
were 66.5 ml/kg (30 ml/lb) and 22.2 ml/kg (10 ml/lb),
respectively. All dogs evaluated developed low ionized
calcium concentrations and thrombocytopenia.
Transfusion reactions were recognized in 6 dogs.
Four dogs survived to hospital discharge.
Conclusions and Clinical Relevance—Results suggest
that massive transfusion is possible and potentially
successful in dogs. Predictable changes in electrolyte
concentrations and platelet count develop. (J
Am Vet Med Assoc 2002;220:1664–1669)
To characterize the clinical features of dogs with precursor-targeted immune-mediated anemia (PIMA).
66 dogs with PIMA.
Electronic record databases of a teaching hospital were searched to identify dogs with a diagnosis of nonregenerative anemia between 2004 and 2013. Inclusion criteria included persistent nonregenerative anemia (Hct ≤ 30% and reticulocyte count < 76,000 reticulocytes/μL), cytologic findings supportive of ineffective bone marrow erythropoiesis, and absence of underlying disease. Information regarding clinical signs, clinicopathologic findings, treatment, and outcome was extracted from records of eligible dogs. A regenerative response was defined as a reticulocyte count > 76,000 reticulocytes/μL or sustained increase in Hct of > 5%. Remission was defined as a stable Hct ≥ 35%.
The median Hct was 13%, and reticulocyte count was 17,900 reticulocytes/μL. Rubriphagocytosis was identified in bone marrow aspirate samples from 61 of 66 dogs. Collagen myelofibrosis was detected in bone marrow biopsy specimens obtained from 31 of 63 dogs. Immune-mediated targeting of mature erythrocytes was uncommon. All dogs received immunosuppressive therapy. Fifty-five dogs developed a regenerative response at a median of 29 days, and 40 of those dogs went into remission at a median of 59 days after PIMA diagnosis. Thromboembolic events were confirmed for 9 dogs and were associated with a decreased survival time. Median survival time was 913 days for all dogs.
CONCLUSIONS AND CLINICAL RELEVANCE
Results indicated that most dogs with PIMA responded to prolonged immunosuppressive therapy. Studies to determine optimal immunosuppressive and thromboprophylactic protocols for dogs with PIMA are warranted.
OBJECTIVE To develop and characterize flow cytometric assays for detecting IgG bound to canine erythrocytes and bone marrow erythroid precursors.
SAMPLE Blood samples from 20 healthy and 61 sick dogs with (n = 33) or without (28) immune-mediated hemolytic anemia (IMHA) and bone marrow samples from 14 healthy dogs.
PROCEDURES A flow cytometric assay for measurement of IgG on RBCs was developed, and appropriate positive control cells were generated. Analytic and diagnostic performance were characterized. The RBC IgG assay was then combined with density-gradient fractionation of aspirated bone marrow cells and a 2-color process to yield an assay for detecting IgG on nucleated RBCs (nRBCs). Cell sorting and cytologic examination confirmed target cell populations, and anti–dog erythrocyte antigen 1 (DEA1) blood-typing serum was used to generate IgG-positive nRBCs.
RESULTS Within- and between-run coefficients of variation for the RBC IgG assay were 0.1% to 13.9%, and > 90% of spiked IgG-positive RBCs were detected. Diagnostic sensitivity and specificity of the assay for detection of IMHA were 88% and 93%, respectively. Cytologic findings for sorted bone marrow fractions rich in early-, mid-, and late-stage nRBCs from 3 healthy dogs indicated 89% to 98% nRBC purity. After IgG coating with anti-DEA1 blood-typing serum, IgG was detected on nRBCs from DEA1-positive, but not DEA1-negative, healthy dogs.
CONCLUSIONS AND CLINICAL RELEVANCE The developed RBC IgG assay had favorable analytic and diagnostic performance for detection of IMHA in dogs and was successfully adapted to detect IgG on canine nRBCs of various maturation stages. The findings supported the presence of DEA1 on canine nRBCs.
Objective—To determine whether multiple organ dysfunction syndrome (MODS) could be identified in dogs with sepsis secondary to gastrointestinal tract leakage, and whether the number of affected organ systems was significantly associated with mortality rate.
Design—Multicenter retrospective case series.
Procedures—Medical records for dogs treated surgically because of sepsis secondary to gastrointestinal tract leakage between 2003 and 2007 were reviewed. Sepsis was diagnosed on the basis of results of bacterial culture of peritoneal fluid, gross evidence of gastrointestinal tract leakage at surgery, or both. Renal dysfunction was defined as a ≥ 0.5 mg/dL increase in serum creatinine concentration after surgery. Cardiovascular dysfunction was defined as hypotension requiring vasopressor treatment. Respiratory dysfunction was defined as a need for supplemental oxygen administration or mechanical ventilation. Hepatic dysfunction was defined as a serum bilirubin concentration > 0.5 mg/dL. Dysfunction of coagulation was defined as prolonged prothrombin time, prolonged partial thromboplastin time, or platelet count ≤ 100,000/μL.
Results—89 (78%) dogs had dysfunction of 1 or more organ systems, and 57 (50%) dogs had MODS. Mortality rate increased as the number of dysfunctional organ systems increased. Mortality rate was 70% (40/57) for dogs with MODS and 25% (14/57) for dogs without.
Conclusions and Clinical Relevance—Results indicated that MODS, defined as dysfunction of at least 2 organ systems, can be identified in dogs with sepsis and that organ system dysfunction increased the odds of death.