Acute Pancreatitis in Dogs: Advances in Understanding, Diagnostics, and Treatment

This article reviews the use of transfusion medicine in veterinary medicine and discusses current research regarding donor screening and component therapy. Typing and crossmatching methodologies are discussed. Available components, potential uses, and controversies in treatment are also discussed.

Transfusion Medicine in Small Animals

Objective
To assess changes in serum albumin concentration (ALB), colloid osmotic pressure (COP), and Doppler blood pressure (DBP) following transfusion of 5% lyophilized canine-specific albumin (CSA) in hypoalbuminemic dogs following surgical source control for septic peritonitis.

Design
Prospective randomized clinical trial November 2009 – November 2010.

Setting
University teaching hospital.

Animals
Fourteen client-owned dogs with hypoalbuminemia (<27 g/L [2.7 g/dL]) following surgical source control for septic peritonitis.

Interventions
Dogs were randomized to clinician-directed therapy (CDT) and CSA groups. Dogs enrolled in the CSA group received 800 mg/kg of CSA within 24 hours following surgical intervention.

Measurements and Main Results
At enrollment, ALB, COP, and DBP were not different between groups. ALB, COP, and DBP were significantly increased in the CSA group 2 hours following completion of the transfusion compared with the CDT group (P = 0.0234, 0.0078, 0.0156, respectively). In comparison to the CDT group, there was a significant change in ALB in the CSA group 24 hours after transfusion (P = 0.0039), but no difference in COP (P = 0.3914) or DBP (P = 0.5145). ALB was significantly higher in the CSA group at 24 hours compared with the CDT group (P = 0.0367) At the time of death or discharge, there was no difference between groups regarding ALB, COP, or DBP, but an association between ALB and survival was identified (P = 0.0273). One dog experienced tachypnea during transfusion of CSA; this dog died of unknown respiratory causes 120 hours after transfusion.

Conclusions
The administration of CSA in dogs with septic peritonitis results in an increase in ALB, COP, and DBP 2 hours after administration. An increase in ALB persisted at 24 hours compared with a CDT group. Administration of this product was not associated with owner-reported delayed adverse events in this population of dogs.

The use of canine-specific albumin in dogs with septic peritonitis.

Objective

To review the pathogenesis and clinical consequences of coagulation abnormalities accompanying hepatobiliary disorders and to highlight the need for further studies to characterize these derangements and their treatment options in small animal patients.



Data Sources

Veterinary and human medical literature: original research articles, scientific reviews, consensus statements, and recent texts.



Summary

The liver plays an important role in the production and clearance of many components of coagulation. A wide range of hemostatic derangements can occur in patients with hepatobiliary disease including alterations in platelet number and function, coagulation factor levels, anticoagulants, vascular endothelial function, and fibrinolysis. As these hemostatic alterations include both pro- and anticoagulation pathways, the net result is often a rebalanced hemostatic system that can be easily disrupted by concurrent conditions resulting in either clinical bleeding or thrombosis. Conventional coagulation tests are inadequate at identifying the spectrum of coagulation alterations occurring in patients with hepatobiliary disease, but their evaluation is necessary to assess bleeding risk and provide prognostic information. A paucity of information exists regarding the treatment of the coagulation derangements in small animals with hepatobiliary disease. Extrapolation from human studies provides some information about potential treatment options, but further studies are warranted in this area to elucidate the best management for coagulation abnormalities in dogs and cats with hepatobiliary disease.



Conclusion

Hepatobiliary disease can have profound effects on coagulation function leading to hypercoagulable or hypocoagulable states. Overall coagulation status with hepatobiliary disease depends on both the type and severity of disease and the presence of associated complications.

Coagulation in hepatobiliary disease

The use of whole blood and/or blood products is indicated in ruminant medicine. The goal of this article is to summarize previous literature on blood groups in ruminants and camelids, list indications for transfusion, and describe collection and transfusion techniques applicable to small ruminants and cattle that can be used in practice.

https://www.vetfood.theclinics.com/article/S0749-0720(14)00028-0/pdf

Update on the use of blood and blood products in ruminants.

Objectives – To describe changes in fresh frozen plasma (FFP) utilization over a 10-year period at a veterinary teaching hospital. To evaluate the effect of FFP administration on specific laboratory parameters.



Design – Retrospective observational study.



Setting – University teaching hospital.



Animals– Two hundred and eighty-three dogs and 25 cats.



Interventions – A hospital database search was performed for all animals receiving FFP during the study periods.



Measurements and Main Results – Medical records of patients receiving plasma transfusions from 2006 to 2008 and from 1996 to 1998 were reviewed. Data collected included indications for transfusion, transfused volume, concurrent therapies, clinicopathologic data pre- and post-transfusion, transfusion reactions, days of hospitalization, and outcome. FFP was administered to 112 dogs and 23 cats from 2006 to 2008 and to 171 dogs and 2 cats from 1996 to 1998. Significantly fewer patients received FFP for the treatment of hypoalbuminemia (2006–2008: 15% versus 1996–1998: 53%; P<0.001) or pancreatitis (2006–2008: 2% versus 1996–1998: 13%; P=0.001) and significantly more patients received FFP for coagulopathy (2006–2008: 80% versus 1996–1998: 31%; P<0.001) in the 2006–2008 group compared with the 1996–1998 group. For all patients receiving FFP, there was no difference in mean serum albumin concentration pre- and post-transfusion. Median prothrombin time and activated partial thromboplastin time were significantly decreased post FFP administration. No association was found between the volume of plasma administered and outcome.



Conclusions – FFP utilization has changed significantly over a 10-year period. FFP was used most commonly in 2006–2008 for the correction of coagulopathy. FFP administration was associated with significant reduction in prothrombin time and activated partial thromboplastin time but did not significantly alter albumin concentration when administered at median doses of 15–18 mL/kg.

Sara J. Snow

Papers

Trends in plasma transfusion at a veterinary teaching hospital: 308 patients (1996-1998 and 2006-2008)

General Approach to the Acute Abdomen