Canine Component Table

Disease Process Whole Packed Red Fresh Frozen Frozen Plasma or Cryo- Colloid / Other Blood Blood Cells Plasma Cryo-Supernatant Precipitate Fluids

Regenerative anaemia

Non regenerative anaemia

Pancytopenia Fresh

Anaemia with hypoproteinaemia

Anaemia with hypovolaemia

Anaemia with coagulopathy

Von Willebrand factor deficiency (vWD) (Pre-surgery or as treatment for bleeding issue) Hypoproteinaemia See Guideline Albumin Equation below

Low immunoglobulin (Ig)

Haemophilia A Factor VIII (Pre-treatment or as treatment for bleeding issue)

Haemophilia B Factor IX (Pre-treatment or as treatment for bleeding issue)

DIC

Pancreatitis

Liver disease with coagulopathy

Liver disease with anaemia

Thrombocytopaenia# Fresh

Thrombocytopathia# Fresh

Neonatal isoerythrolysis

Rodenticide toxicity coagulopathy (Need to replace factors II, VII, IX and X) Data was provided by Dr Anne Hale

Indicates suitable blood products that can be utilised in treating the disease process Designates the superior product or combination of products of choice when more than one suitable product can be utilised # Note if or white blood cells are required FRESH must be collected and administered within six hours of collection however a limited number of viable platelets/wbc will be transfused. If associated with severe anaemia and fresh whole blood is not available, PRBC can be considered.

COMPONENT: Storage Indications for use Action Not indicated for Hazards Dosage and Administration instructions & shelf life Use an in line blood filter (170-260 microns) with all products

Whole Blood (Fresh), Symptomatic anaemia (blood Restores O2 carrying capacity Pharmaceutically treatable Immunologic transfusion Calculate dose and administer each unit < 4 hours. collected in CPD or CPDA loss) deficiency: Fresh and blood volume, if used anaemias (i.e. those that reactions (e.g Alloantibody As a general estimate, 2ml/kg of Whole Blood will raise PCV by Room temperature - after 12 Whole Blood is unlikely to have within 6 hours of collection, will respond to specific reactions, allergic reactions) 1% or the haemoglobin by 0.3g/dl. hours store 2-6ºC < 21 days as a significant therapeutic effect in supplies all coagulation non-transfusion therapy) Non - Immunologic transfusion Rate of Administration: Whole Blood (Stored) a severely thrombocytopaenic factors and some viable because of risks associated reactions (e.g Transfuse < 6 hours to have patient (GUIDELINE: 10ml/kg of platelets with transfusions and toxin accumulation in Start transfusion at a rate of 0.5-1ml/kg/hr for the first 15-30 any viable platelets and full fresh whole blood raises the products associated with minutes, then according to patients’ fluid status, if hypovolaemic, coagulation factors PLT count by 10 x 109/l) storing blood products, at rates up to doses (as fast as blood is being lost), 1 unit average volume = 450ml circulatory overload, infectious if normovolaemic 5-10ml/kg/hr, if compromised circulation Average PCV 45% unless disease transmission) (cardiovascular compromise/renal failure) 1-2ml/kg/hr. measured Pharmaceutically treatable (PRBC) Symptomatic anaemia in Restores O2 carrying capacity As for Whole Blood Calculate dose and administer each unit < 4 hours. in SAG-M nutrient solution presence of normovolaemia anaemias (i.e. those that Ammonia levels can increase As a general estimate, 1ml/kg of Packed Red Blood Cells will 2-6ºC without clotting factor deficits will respond to specific in stored red cell products. raise PCV by 1% or the haemoglobin by 0.3g/dl. 42 days from date of production non-transfusion therapy) These should be used with 1 unit average volume = 250ml because of risks associated caution in dogs with known Rate of Administration: as Whole Blood above. Average PCV 62% unless with transfusions. liver disease measured Clotting factor and platelet deficits Calculate dose and administer each unit < 4 hours. Standard Fresh Frozen Plasma (FFP) All coagulopathies Source of all clotting factors, Volume replacement alone Immunologic transfusion dose: 10-30ml/kg to effect. Severe coagulopathies require the < -18ºC Immunoglobin (Ig) transfer (i.e. immunoglobulins, albumin, Does not contain viable reactions (e.g allergic reactions) 1 year from date of production passive immunity) lipids and electrolytes platelets. Non - Immunologic transfusion higher end of the dose range. Hypoalbuminaemia – large Becomes FP after 1 year and will Pretreatment of vWD and Sole therapy for reactions (e.g circulatory volumes are required to increase circulating albumin by 10g/L – it store for a further 4 years haemophilia A patients before hypoalbuminaemia in the overload, infectious disease is considered that the risks of transfusing such large volumes, 1 unit average volume = 200ml invasive procedures absence of coagulopathy transmission) (risk of reaction as well as cost) negate plasma as an effective Can be considered for volume sole treatment for hypoalbuminaemia. resuscitation in acute trauma Rate of Administration: as Whole Blood above.

Frozen Plasma (FP) Deficit in non-labile vitamin K Source of non-labile Volume replacement alone As Calculate dose and administer each unit < 4 hours. Standard < -18ºC dependent clotting factors clotting factors (II, VII, IX, X), Does not contain viable dose: 10-30ml/kg to effect. Hypoalbuminaemia – large volumes 5 years from date of production (II, VII, IX, X), Ig transfer immunoglobulins and albumin, platelets are required to increase circulating albumin by 10g/L – it is 1 unit average volume = 200ml Can be considered for volume lipids and electrolytes Sole therapy for considered that the risks of transfusing such large volumes, (risk resuscitation in acute trauma hypoalbuminaemia in the of reaction as well as cost) negate plasma as an effective sole absence of coagulopathy treatment for hypoalbuminaemia. Rate of Administration: as Whole Blood above.

Cryo-Precipitate (Cryo-P) Pre-treatment for vWD or Source of factor VIII, , Coagulopathies involving As Fresh Frozen Plasma Calculate dose and administer each unit < 4 hours. Standard < -18ºC haemophilia A before invasive vWF non-labile clotting factors (II, VII, dose is 1 unit/10kg. Additional amounts may be required for 1 year from date of production procedures or treatment of IX, X). As a source of albumin actively bleeding haemophiliacs/vWD. If used as a pre- active bleeding in these dogs 1 unit average volume = 60ml or immunoglobulin treatment of coagulopathy before surgery, the dose should be Cryo-Supernatant (Cryo-S) Source of non-labile clotting factors As Frozen Plasma given within 4 hours of the event. Vitamin K dependent (II, VII, IX, X), immunoglobulins and < -18ºC Rate of Administration: as Whole Blood above. coagulopathy, Ig transfer albumin, lipids and electrolytes. 1 year from date of production Can be considered for volume 1 unit average volume = 140ml The concentration of albumin in As Fresh Frozen Plasma resuscitation in acute trauma Cryo-S is slightly higher than in As Fresh Frozen or Frozen Plasma Fresh Frozen Plasma.

GUIDELINE RED CELL EQUATION: Volume of donor blood to be transfused = recipient weight (kg) x 90 (dogs) x (recipient desired PCV - current PCV/PCV of anticoagulated donor blood) GUIDELINE ALBUMIN EQUATION: Albumin deficit (g) = [desired alb (g/L) – current alb (g/L)] x BW(kg) x 0.3. Albumin level in donor plasma averages 25g/L.

INF/SIS/19/07 Edited by Simon Tappin MA VetMB CertSAM DipECVIM-CA MRCVS, Daniel Lewis Vet MB Cert VA DACVECC DECVECC MRCVS, Sophie Adamantos BVSc CertVA DACVECC DipECVECC MRCVS FHEA www.petbloodbankuk.org