The first transfusion history dates back in 1665 in dog
India is a hub of growing elite pet owners and urbane animal lovers. Due to the absence of the established blood banks and the proper blood group repository across various cities in India, there is an absolute necessity of a need based transfusion in dogs in case of anaemia due to Haemoprotozoan infections which accounts for 31.86 per cent (Baidya et al., 2015) or suffering from a trauma. This is called transfusion trigger.
Component therapy is considered the optimal method of transfusion since it allows specific transfusion therapy red blood cells for anemia and plasma to provide deficient coagulation factors. The use of whole blood in the anemic animals wastes the plasma, which could be used to control haemorrhage in a dog with anticoagulant rodenticide ingested dog with anemia secondary to chronic renal failure require coagulation factor. Thus establishment of a canine blood bank as per specific needs across various cities can come as a relief to pet owners who had to scout the city in search of blood for their ailing pets.
Blood Grouping in Animals
Blood groups are determined by specific antigens on the surface of erythrocyte (Agglutinogens) and antibodies present in plasma (Agglutinins). There are two types of antibodies to blood group antigens.
- Naturally occurring antibodies (alloantibodies): They are usually less immunogenic and will not able to produce hemolytic reactions.
- Acquired antibodies: They are produced after exposure to a blood group antigen (mostly through blood transfusion). They are strongly immunogenic and can produce severe hemolytic reactions on mismatched antigens.
Unlike humans the naturally occurring blood group antibodies in animals are less immunogenic and thus the first blood donation for an animal can be done from any animals of same species without any hemolytic reactions but thereafter, the donor blood will have to match to prevent possible complications.
Canine Blood Types
- There are 8 major blood groups in the dog, labeled as DEA (dog erythrocyte antigen) 1 to 8.
- DEA 4 is having highest population incidence.
- The major antigens are DEA 1.1 and DEA 1.2. Dogs can be positive for either (not both) DEA 1.1 or 1.2 or are negative for both.
- Acute hemolytic transfusion reactions only occur in DEA 1.1 and 1.2 negative dogs when the transfusion is made from DEA 1.1 and 1.2 positive donors.
- The normal lifespan of compatible transfused erythrocytes in dogs is approximately 21 days which may decrease to minutes to 12 hours after acute hemolytic transfusion reaction.
- DEA 3-, 5- and 7-negative dogs do have naturally occurring antibodies to DEA 3, 5 and 7 positive red cells, these blood groups do not incite severe hemolytic reactions.
- Neonatal isoerythrolysis has been reported in DEA 1 negative female dogs (previously sensitized to DEA 1 positive cells) mated to DEA 1.1 positive male dogs.
- Dogs positive for DEA 4 and negative for other DEA group can act as universal donors (e.g. Greyhounds and Indian Chippiparai).
- There are two new blood groups namely Dalmations (Dal) and Kai (Kai-1 and 2). Based upon the identification of an acquired alloantibody in a Dalmatian, a presumably new common blood type named Dal was identified. Dalmatians lacking the Dal antigen are likely at risk of delayed and acute hemolytic transfusion reactions.
- The new blood types called Kai 1 and Kai 2, are unrelated to DEA 1, 3, 4 and 7 and Dal. These dogs are most commonly found in North America.
Universal Blood Donor
- 15 ml of blood per kg body weight can be collected from dog in every 6 weeks.
- Dogs negative for DEA 1.1 can be considered universal donors for first-time transfusion recipients.
- A dog is considered a universal donor when negative for DEA 1.1, 1.2, 3, 5, 7 and positive for DEA 4.
Selection of Donor
- Blood grouping should be performed to select permanent blood donors. They must be issued donor certificates.
- All donors should be healthy young adults that have never been transfused.
- All the donors should be evaluated for routine physical, hematological and clinical chemistry. Proper clinical history of the expected donor should be collected where the dog should not have cancer or tuberculosis.
- Donor should be properly vaccinated and should be tested free of blood parasites and other infectious diseases (Ehrlichia spp, Babesia spp, Anaplasma spp and Mycoplasma hemocanis or Mycoplasma haemofelis).
- To avoid interference with platelet function, donors should not be sedated with acepromazin.
- Donor must weigh 25 kg and should be above 6 years of age. In case of a bitch, the uterus should remain intact.
Blood collection includes sedation and standard procedure. Blood should be refrigerated (4 0C) in plastic blood collection bags. Heparin is not recommended for blood collection because it activates platelets, but if still used 5 U per mL of blood is sufficient. Recommended volume to collect is 10-15 ml/kg – maximum 60 ml unit. Once the donor is sedated, the donor should be placed either in lateral or sternal recumbency with head elevated. While the blood is drawn – if the blood flows, continue, if not, a small amount of negative pressure on the syringe as the primed butterfly needle is adjusted until flow begins. Blood should not be drawn rapidly and the donor should be monitored for respiration and pulse rate.
Recommended fluid therapy is 10 ml/kg/hr crystalloid for 3 hours.
Blood collected in heparin as anticoagulant must be used immediately. Survival and functional usefulness of erythrocytes decrease with increased storage temperature and time because of glucose consumption and depletion of ATP and 2, 3- DPG. Blood should be collected into latex free plastic bags or plastic syringes to preserve platelets.
Anticoagulants for Preservation of Blood for Transfusion
The common anticoagulants for the preservation of blood for transfusion are citrate-phosphate-dextrose-adenine (CPDA-1) and acid-citrate-dextrose (ACD) which are capable to store whole blood up to 21 days after collection. During preservation, some physio-biochemical and metabolic alterations occur which require proper monitoring and subsequently appropriate mitigation strategies should be adopted.
Indication for Blood Transfusion
- Severe anemia caused by Hemorrhage, hemolysis, ineffective erythropoiesis, immune-mediated hemolytic anemia (IMHA), hemoprotozoan infection
- Chronic inflammatory or infectious disease or neoplasia.
- Primary or secondary clotting factor deficiencies
- Donor must be healthy.
- Collection and transfusion sets must be sterile.
- Blood must be brought to room temperature before transfusion.
- Careful grouping and cross matching is necessary.
- Transfusion should be given slowly and under observation.
- Most of the hazards can be avoided by autologous transfusion during planned surgery.
Before transfusion, cross matching is an essential pre-requisite to identify the compatibility of the donor and recipient. The study the surveillance of incidence of the dog erythrocyte antigen (DEA) and its sub types with the preparation of a database in every city is the need of the hour. The blood typing card can be issued in favour of the dog. The identification of “universal donors” with current typing resources for future blood transfusion is highly necessary. Therefore an established blood bank and blood group repository across various cities in India will definitely help the pet owners for transfusion triggers in veterinary emergency and critical care medicine.
Dr. Smruti Smita Mohapatra, Ph.D. Scholar
Department of Veterinary Physiology, Faculty of Veterinary & Animal Sciences, WBUAFS, Kolkata, West Bengal- 700037, India. (E) [email protected].
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