Principles of transfusion medicine in small animals.

The purpose of this review was to provide the reader with an updated overview of small animal transfusion medicine, and an approach to integrating it into private practice, based on a review of the veterinary and human literature spanning the last 3 decades. Electronic, online databases that were searched included CAB International and Medline; multiple keywords or subject headings were searched that were appropriate to each of the sections reviewed: canine and feline blood groups, blood-typing and crossmatching, donors, blood collection, storage, blood components, blood transfusion, blood component therapy, blood substitutes, and adverse reactions. The safe use of blood component therapy requires knowledge of blood groups and antibody prevalence, and knowledge of the means to minimize the risk of adverse reactions by including the use of proper donors and screening assays that facilitate detection of serological incompatibility. The 2 assays available to the practitioner are crossmatching, which is readily done in-house, and blood typing. Blood typing is available in the form of a commercial testing kit, through use of purchased reagents, or via a request to an external laboratory. The risk of potentially fatal adverse reactions is higher in cats than in dogs. The decision to transfuse and the type of product to administer depend on several factors, such as the type of anemia and the size of the animal. In conclusion, transfusion medicine has become more feasible in small animal practice, with improved access to blood products through either on-site donors, the purchase of blood bank products, external donor programs, or the availability of blood component substitutes.     

Detection of bacterial contamination and DNA quantification in stored blood units in 2 veterinary hospital blood banks

Blood transfusions in veterinary medicine have become increasingly more common and are now an integral part of lifesaving and advanced treatment in small and large animals. Important risks associated with transfusion of blood products include the transmission of various infectious diseases. Several guidelines suggest what infectious agents to screen for in canine and feline transfusion medicine. However, while the risk of bacterial contamination of blood products during storage and administration has not been documented in veterinary medicine, it has emerged as a cause of morbidity and mortality in human transfusion medicine. Clinical experience shows that the majority of blood component bacterial contaminations are caused by only a few species. Unlike other types of bacteria, psychrotolerant species like Pseudomonas spp. and Serratia spp. can proliferate during the storage of blood units at 4°C from a very low titer at the time of blood collection to a clinically significant level (> 10⁵ CFU/mL) causing clinical sepsis resulting from red blood cell concentrate transfusions in human medicine. The purpose of this report was to describe the detection and quantification procedures applied in 4 cases of bacterial contamination of canine and feline blood units, which suggest the need for further investigations to optimize patients’ safety in veterinary transfusion medicine.     

Effect of atorvastatin in a case of feline multicentric lymphoma - Case report

A case of feline multicentric lymphoma is reported in an 8-year-old male cat weighing 4.7 kg. At the time of the clinical consultation the animal presented weight loss, anorexia and generalised lymphadenomegaly. After careful clinical observation and a detailed laboratory workup, the diagnosis of small cleaved cell lymphoma was established. It was classified as a stage III b multicentric lymphoma. Chemotherapy was initiated according to a classical COP protocol to which atorvastatin was added. After 34 months, the cat continues to enjoy an excellent quality of life with no clinical or haematological signs of lymphoma. This is the first report in clinical veterinary medicine about a new effective adjuvant therapy in feline multicentric lymphoma. Further studies are needed to confirm that the addition of atorvastatin can provide a regular, safe and improved treatment in feline lymphoma cases.     

Transfusion medicine in veterinary emergency and critical care medicine

Transfusion medicine is a vital part of veterinary emergency and critical care medicine. The goals of this article are to review blood banking and the transfusion principles surrounding care of the critically ill or injured small animal, to highlight the differences in emergency/critical care transfusions compared with standard transfusion medicine, and to discuss traumatic blood loss and sepsis as unique entities in emergency and critical medicine.     

The present and future of opioid analgesics in small animal practice

Opioids are the cornerstone for the treatment of acute pain in small animal patients. This is primarily because of their remarkable safety profile, high efficacy, and benefit of reversibility. There have been some significant advances in our knowledge on opioid pharmacology and clinical usage in companion animal medicine. This review discusses the progression of opioid use in small animal practice providing current misconceptions and controversies in light of routes of administration. Potential targets for research and drug development and novel therapies are discussed in addition to the concepts of glial cell modulators, individual variability, and opioid tolerance and hyperalgesia. The future brings an interesting perspective with the application of pharmacogenetics and individualized pain management in canine and feline practice.     

Transfusion medicine in exotic pets

The decision to transfuse a patient should always be based on the packed cell volume and clinical status of the patient. This article discusses indications for transfusion and blood substitutes in exotic animal patients. The administration of blood products requires careful donor selection, knowledge of blood groups, cross-matching, and use of anticoagulants. Collection sites, volume, and administration techniques are given for different species of animals including birds, rabbits, and ferrets. Blood-transfusion therapy is not without risk. The frequency with which transfusion reactions occur in exotic pets is unknown. The most common transfusion reactions seen in small animals, along with suggested treatment, are discussed. The availability of blood products is limited in exotic pet medicine; therefore, the use of blood substitutes (Oxyglobin) has the advantage of long storage potential, no need for cross-matching, and no potential for disease transmission. General principles of blood substitutes and administration techniques will be discussed.     

A newly recognized blood group in domestic shorthair cats: the Mik red cell antigen

BACKGROUND: Naturally occurring alloantibodies produced against A and B red cell antigens in cats can cause acute hemolytic transfusion reactions. Blood incompatibilities, unrelated to the AB blood group system, have also been suspected after blood transfusions through routine crossmatch testing or as a result of hemolytic transfusion reactions. HYPOTHESIS: Incompatible crossmatch results among AB compatible cats signify the presence of a naturally occurring alloantibody against a newly identified blood antigen in a group of previously never transfused blood donor cats. The associated alloantibody is clinically important based upon a hemolytic transfusion reaction after inadvertent transfusion of red cells expressing this red cell antigen in a feline renal transplant recipient that lacks this red cell antigen. METHODS: Blood donor and nonblood donor cats were evaluated for the presence of auto- and alloantibodies using direct antiglobulin and crossmatch tests, respectively, and were blood typed for AB blood group status. Both standard tube and novel gel column techniques were used. RESULTS: Plasma from 3 of 65 cats and 1 feline renal transplant recipient caused incompatible crossmatch test results with AB compatible erythrocytes indicating these cats formed an alloantibody against a red cell antigen they lack, termed Mik. The 3 donors and the renal transplant recipient were crossmatch-compatible with one another. Tube and gel column crossmatch test results were similar. CONCLUSIONS AND CLINICAL IMPORTANCE: The absence of this novel Mik red cell antigen can be associated with naturally occurring anti-Mik alloantibodies and can elicit an acute hemolytic transfusion reaction after an AB-matched blood transfusion.     

Evaluation of an 18-micron filter for use in reptile blood transfusions using blood from American alligators (Alligator mississippiensis)

Blood transfusions are a common therapeutic procedure in small animal medicine and have been investigated in some exotic species but little information is available about their safety and efficacy in reptiles. In human pediatrics and small animal practice, the Hemo-Nate18-micro filter is used to prevent embolic clots and particulate waste from entering the recipient during a transfusion. The goal of this study was to determine the hemolytic effect of an 18-micro Hemo-Nate filter for whole blood cell transfusions in reptiles using the American alligator (Alligator mississippiensis) as a reptilian model. Results revealed no significant difference in free plasma hemoglobin between the unfiltered and filtered samples (P = 0.21). There was no difference in the prefiltration and postfiltration packed cell volume (PCV) (P = 0.41). Results suggest that an 18-micro Hemo-Nate filter does not cause hemolysis or decrease the PCV of small quantities of alligator blood.     

Feline transfusion practice in South Africa: current status and practical solutions

Blood transfusion therapy is often under-utilised in feline practice in South Africa. However, it is a technique that can be safely and effectively introduced in practice. Cats have naturally occurring allo-antibodies against the blood type that they lack, which makes blood typing, or alternatively cross-matching, essential before transfusions. Feline blood donors must be carefully selected, be disease free and should be sedated before blood collection. The preferred anticoagulant for feline blood collection is citrate-phosphate-dextrose-adenine. Blood can either be administered intravenously or into the medullary cavity, with the transfusion rate depending on the cat's hydration status and cardiac function. Transfusion reactions can be immediate or delayed and they are classified as immunological or non-immunological. Indications, methods and techniques to do feline blood transfusions in a safe and economical way are highlighted.     

Feline systemic hypertension: Diagnosis and management

PRACTICAL RELEVANCE: the clinical importance of feline hypertension has been recognised for many years and most feline practitioners are quite familiar with this syndrome. Once systemic hypertension is identified, long-term management of the patient is needed to avoid catastrophic (eg, blindness due to retinal detachment) or subtle (eg, accelerated renal damage) target organ damage. PATIENT GROUP: feline systemic hypertension is most commonly a complication of renal disease and hyperthyroidism, both diseases of older feline patients. By 15 years of age, the probability of having at least one of these two diseases is high. As well cared for cats are living longer, optimal long-term management of feline hypertension in patients with concurrent diseases is an issue of clinical importance. CLINICAL CHALLENGES: obtaining accurate blood pressure measurements in patients that are anxious, fractious or just plain uncooperative remains a significant issue in feline medicine, as does confident analysis of results from these patients. DIAGNOSTICS: careful measurement of systolic blood pressure using Doppler or oscillometric techniques in conjunction with evaluation for evidence of hypertensive choroidopathy (funduscopic examination) and hypertensive cardiac changes (thoracic auscultation) are essential to the diagnosis of systemic hypertension in cats. Other diagnostic techniques, including evaluation of renal and thyroid function, are needed to detect the underlying disease condition. EVIDENCE BASE: numerous well-designed clinical studies have greatly advanced our understanding of the most appropriate methods of diagnosis and therapy of feline hypertension.     

CpG oligodeoxynucleotides stimulate canine and feline immune cell proliferation.

Oligodeoxynucleotides (ODNs) with unmethylated CpG dinucleotide motifs may be useful as non-specific immune system stimulants and adjuvants for protein or nucleic acid vaccines in humans and other primates. They may also be useful in cancer immunotherapy and in the modulation of allergic responses or mucosal immunity. To begin to determine the potential utility of CpG ODN technology in small animal veterinary medicine, we developed procedures to analyze the effects of CpG ODN on canine and feline blood, spleen and lymph node (LN) cells. We find that certain CpG ODN cause good lymphocyte proliferation (as monitored by [(3)H]-thymidine incorporation) in both canine and feline spleen and LN cells, but not in blood. This overall stimulatory effect of CpG ODN on spleen and LN cells is CpG dependent. The reverse sequences, GpC ODNs, do not cause significant lymphocyte proliferation in the cat; however, dogs are more sensitive to stimulation by the non-specific immune effects of the phosphorothioate backbone. We conclude that unmethylated CpG ODNs may also have potential uses as immune stimulants for vaccines and other antimicrobial agents in veterinary medicine for companion animals.     

Microparticles in Health and Disease

Microparticles (MPs), small membrane‐derived vesicles, are derived from many cell types and released into the circulation. Microparticles can express antigens, and contain cell surface proteins, cytoplasmic contents, and nuclear components from their cell of origin that determines their composition, characterization, and transfer of biologic information. Certain prompts for this release include shear stress, complement activation, proapoptotic stimulation, cellular damage, or agonist interaction with cell surface receptors. Release can be physiologic or pathologic and is associated with proinflammatory and procoagulant effects and has been implicated in thrombotic states. Microparticles also contribute to systemic inflammation and cardiovascular, hematologic, and oncologic disease states. The study of MPs in human medicine is rapidly advancing and extends into the physiology of health, the pathophysiology of disease, and the role of MPs in transfusion medicine. In veterinary medicine, published work on MPs has been limited to the area of inherited disorders, blood storage, and leukoreduction (LR). Microparticle research is still in its infancy, and this review should be seen as a snapshot of what is currently known. As research continues important limitations, including variations in preanalytic variables such as collection, storage, or centrifugation, and limitations of quantitation are coming to the forefront. Correlation of quantitation of MPs with assays of activity will hopefully shed light on the true nature of MPs in health and disease. This review will focus on the role of cellular exocytic vesiculation in health, disease, and transfusion medicine.     

ASAS Centennial Paper: The future of teaching and research in companion animal biology in departments of animal sciences

Departments of animal sciences must be relevant to a society in which a small number of people can raise almost all the food animal products needed. The declining number of people involved in animal agriculture has decreased enrollment of students interested in food animals in many departments of animal science. However, several departments welcomed students from a diverse background and began research on animals other than food animals. In many states, the undergraduate enrollment is made up primarily of students interested only in companion animals. A benefit of this is that we have recruited new students into animal agriculture and they have gone on to excellent careers. We have a new challenge now: how to maintain and expand the efforts in teaching, research, and outreach of companion animal science. Departments wishing to expand in teaching have examples of successful courses and curricula from other departments. Some departments have expanded their teaching efforts across their own university to teach about pets to a wider audience than their own majors; other departments can follow. In research, a small number of faculty have been able to establish extramurally funded projects on pets, including horses. But it will be difficult for more than a handful of departments to have a serious research effort in dogs, cats, birds, fish, or exotic animals. Departments will have to make a concerted effort to invest in such endeavors; joint ventures with other universities and colleges of veterinary medicine (or medicine) will probably be required. Funding sources for "traditional" efforts in nutrition, reproduction, and physiology are small and inconsistent; however, with the progress of the equine, canine, and feline genome projects, there should be opportunities from federal funding sources aimed at using animal models for human health. In addition, efforts in animal behavior and welfare can be expanded, perhaps with some funding from private foundations or animal-supportive organizations.     

Progress in the discovery and definition of monoclonal antibodies for use in feline research

The practice of veterinary medicine and research into both animal diseases and animal models of human disease are restricted by the scarcity of monoclonal antibodies (mAb) that react with animal proteins. One way to enlarge the repertoire of mAb to animal leukocyte differentiation antigens (LDA) is to test mAb specific to other species for cross-reactivity to the species of interest. We have tested a panel of 380 commercially available anti-human mAb for cross-reactivity to feline LDA. Twenty-six of these mAb cross-react with cat LDA and 19 others are of questionable cross-reactivity. Definition of mAb specificity in the cat is being investigated by multi-color flow cytometry (FCM) to compare test mAb specificity with that of mAb to known feline LDA. The addition of these cross-reactive mAb to the anti-feline mAb currently available will enhance studies in comparative medicine.     

Increasing patient safety in veterinary transfusion medicine: an overview of pretransfusion testing

Objectives – To review the principles and available technology for pretransfusion testing in veterinary medicine and discuss the indications and importance of test performance before RBC transfusion.
Data Sources – Current human and veterinary medical literature: original research articles and scientific reviews.
Summary – Indications for RBC transfusion in veterinary medicine include severe anemia or tissue hypoxia resulting from blood loss, decreased erythrocyte production, and hemolyzing conditions such as immune-mediated anemia and neonatal isoerythrolysis. Proper blood sample collection, handling, and identification are imperative for high-quality pretransfusion testing. Point-of-care blood typing methods including both typing cards and rapid gel agglutination are readily available for some species. Following blood typing, crossmatching is performed on one or more donor units of appropriate blood type. As an alternative to technically demanding tube crossmatching methods, a point-of-care gel agglutination method has recently become available for use in dogs and cats. Crossmatching reduces the risk of hemolytic transfusion reactions but does not completely eliminate the risk of other types of transfusion reactions in veterinary patients, and for this reason, all transfusion reactions should be appropriately documented and investigated.
Conclusion – The administration of blood products is a resource-intensive function of veterinary medicine and optimizing patient safety in transfusion medicine is multifaceted. Adverse reactions can be life threatening. Appropriate donor screening and collection combined with pretransfusion testing decreases the occurrence of incompatible transfusion reactions.     

波斯猫传染性肠炎的病理学观察及输血疗法

对 2 5例自然发病的波斯猫传染性肠炎进行了病理学检查 ,提供了具有诊断意义的病理变化 ,同时对 2 6例患有传染性肠炎的病波斯猫 ,采用康复血静脉输血和母体供血均疗效显著     

Survey of veterinary conference attendees for evidence of zoonotic infection by feline retroviruses

OBJECTIVE: To examine exposure risks, possibility of zoonosis, and potential disease associations for feline retroviruses among a group of occupationally exposed individuals. DESIGN: Unlinked voluntary cross-sectional epidemiologic survey. SAMPLE POPULATION: 204 veterinarians, laboratory scientists, and other occupationally exposed individuals who attended a veterinary conference on feline geriatric medicine. PROCEDURE: Blood was collected from participants who also completed a 13-question survey requesting demographic, occupational, exposure, and health information. Blood specimens were fractionated into plasma and mononuclear cell components. Plasma was tested for antibodies against feline immunodeficiency virus (FIV) and feline foamy virus (FeFV), as well as p27 antigen of FeLV. Mononuclear cell lysates were tested for FeLV provirus. RESULTS: Subjects reported extensive duration of work with cats (mean, 17.3 years) and multiple high-risk exposures (eg, cat bites, scratches, and injuries with sharp instruments) per year. However, neither serologic nor molecular evidence of zoonosis with any of the 3 feline retroviruses was detected. CONCLUSIONS AND CLINICAL RELEVANCE: Veterinarians encounter occupational exposures to animal material that place them at high risk for zoonoses. For feline retroviruses, the risk of zoonosis among healthy adult humans appears to be extremely small. However, potential for retroviral zoonosis, especially for viruses such as FeLV and FeFV that can replicate in human cells, cannot be eliminated, and universal precautions to reduce potential exposures should be used when handling sick cats.     

Prevalence of feline blood groups in the Montreal area of Quebec,Canada

The feline AB blood group system has clinical significance because type B cats have natural alloimmune anti-A antibodies which can cause isoerythrolysis of the newborn and life-threatening transfusion reactions. In the United States, the prevalence of type B blood is estimated to be 1% to 2%. This study determined the prevalence of feline AB blood groups among 207 potential blood donor cats that included 178 domestic cats, in the Montreal area of Quebec, Canada. Blood typing was performed using a standardized tube technique. Blood types AB and B were confirmed using a backtyping technique. The frequency of blood types among the studied population was as follows: 95.2% type A, 4.4% type B, and 0.48% type AB. Among domestic cats, the frequency was 94.4% for type A, 5% for type B, and 0.6% for type AB. The frequency of type B was higher than expected, which reinforces the recommendation to ensure blood compatibility of the recipient and donor before transfusion through typing and possibly cross-matching as well.     

Blood-component therapy: selection, administration and monitoring

Transfusion of blood products is a frequent necessity in small animal practice. Transfusion medicine has become more sophisticated with increased access to blood components, knowledge of blood types, and cross-matching requirements. Although potentially life saving, this procedure does carry some risk. In addition to selecting the appropriate blood product, several steps need to be completed to prepare the product for administration and the patient for receiving a transfusion.     

A novel MCT1 and MCT4 dual inhibitor reduces mitochondrial metabolism and inhibits tumour growth of feline oral squamous cell carcinoma

Monocarboxylate transporters (MCTs) support tumour growth by regulating the transport of metabolites in the tumour microenvironment. High MCT1 or MCT4 expression is correlated with poor outcomes in human patients with head and neck squamous cell carcinoma (HNSCC). Recently, drugs targeting these transporters have been developed and may prove to be an effective treatment strategy for HNSCC. Feline oral squamous cell carcinoma (OSCC) is an aggressive and treatment‐resistant malignancy resembling advanced or recurrent HNSCC. The goals of this study were to investigate the effects of a previously characterized dual MCT1 and MCT4 inhibitor, MD‐1, in OSCC as a novel treatment approach for feline oral cancer. We also sought to determine the potential of feline OSCC as a large animal model for the further development of MCT inhibitors to treat human HNSCC. In vitro, MD‐1 reduced the viability of feline OSCC and human HNSCC cell lines, altered glycolytic and mitochondrial metabolism and synergized with platinum‐based chemotherapies. While MD‐1 treatment increased lactate concentrations in an HNSCC cell line, the inhibitor failed to alter lactate levels in feline OSCC cells, suggesting an MCT‐independent activity. In vivo, MD‐1 significantly inhibited tumour growth in a subcutaneous xenograft model and prolonged overall survival in an orthotopic model of feline OSCC. Our results show that MD‐1 may be an effective therapy for the treatment of feline oral cancer. Our findings also support the further investigation of feline OSCC as a large animal model to inform the development of MCT inhibitors and future clinical studies in human HNSCC.