T8: Administering Medication and Fluids Flashcards
1
Q
General clinical equipment is used for consultation and diagnosis.
It includes:
A
- Thermometer (mercury, digital; rectal or aural): used to measure the animal’s temperature
- Otoscope or Auroscope: used to visually examine the ear canal, nostril, vagina etc.
- Ophthalmoscope: to examine the structures of the eye (e.g. retina, optic disc, blood vessels)
- Stethoscope: used to listen to the heart, lungs and gut sounds
- Laryngoscope: for examination of the back of the throat, larynx and pharynx.
2
Q
Medical equipment used in the standard administration of drugs and fluids includes
A
- Syringes of medication and solutions, and needles
- Catheters: stylet or butterfly
- Giving sets
- Fluid bags or bottles
- Infusion pumps
- Paediatric administration sets
3
Q
Should you use the smallest or largest syringe tgat will comfortably hold volume you wish to inject?
A
smallest
4
Q
Always use the smallest and finest needle that will perform the task, except for when using a ….?
A
catheter; use largest
5
Q
Things to consider when choosing a needle size are:
A
- The size of the animal
- Thickness of the skin
- Viscosity or “thickness” of the injected material
- How fast you want to give the injectionThe volume of the drug to be administered
- Veterinary preference: some vets will use one gauge or type of needles for each particular job
6
Q
Describe a winged needle catheter
A
Needles have plastic wings on the shaft to facilitate placement.
The needle size ranges from 25 to 19 gauges. Plastic tubing of various lengths extends behind the needle, which allows the operator to connect the syringe to the catheter without disturbing the needle.
These catheters are easy to place but difficult to maintain. They are used for smaller animals, and are best reserved for short term. They are the least stable type of catheter.
7
Q
Describe a over the needle catheter
A
Most common type of catheter used in veterinary practice.
They are a form of stylet catheters, and their main use is peripheral vein catheterisation.
These are generally presented as a soft Teflon outer tube reinforced by a steel needle on the inside to penetrate initially the skin and vein wall
8
Q
Describe a through the needle catheter
A
Used primarily in the jugular vein. The catheters are protected by a plastic sleeve to prevent contamination.
Once catheter is placed, and the needle withdrawn. most through the needle catheters require a needle guard. The needle guard protects the catheter from sticking the animal and shearing the catheter.
9
Q
Why give medication?
A
- Treat disease
- Control disease
- Prevent disease
- Minimise pain
- Restraint
10
Q
List the 4 basic routes of admin
A
- Topical (skin, eyes, ears)
- inhalation
- enteric (oral, rectal)
- parenteral injection
11
Q
Choice of injection route depends on:
A
- nature of drug
- nature of disease
- size of animal/ability to handle
- V of drug req
- req time of onset of action
- req length of action
- speed of absorption
12
Q
Describe the two methods for holding a syringe
A
- Between your thumb on one side of the barrel and the middle three fingers on the other. The little finger is used to press the plunger.
- Place the barrel between the index and middle finger. Use the thumb to press the plunger.
13
Q
What are the two broad effects a drug has on the body?
A
- LOCAL EFFECT - where the drug acts directly at the local area where it is administered eg skin creams, local anaesthesia
SYSTEMIC EFFECT - where the drug circulates via the blood stream to affect the body as a whole, including oral, parenteral and rectal routes of administration.
14
Q
Describe how a drug is absorbed into the blood stream
A
The drug is absorbed into blood stream.
→ It is then dispersed throughout the blood stream, and reaches a certain concentration evenly through the circulation
→ It is then carried around the body until it reaches the target site, where it leaves the blood stream and enters the target cells
→ At the target cells the drug affects the target cells only if it is at the sufficient concentration
→ There is only continuous action by the drug if the concentration of the drug in the blood stream remains high enough
15
Q
Drugs are continuously removed from circulation by which methods?
A
- Inactivation by liver
- Excretion by kidneys
- Volatile drugs breathed out by lungs (e.g. anaesthetics)
- Storage in fatty tissue (This means for some animals, the degree of fat of animal can effect the concentration and duration of activity of some drugs)
- As drug is lost, concentration lowers; the effect of the drug on the cells is lowered.
16
Q
Describe oral admin and the A/D?
A
- Drugs administered per os can act locally in GIT or systemically by absorption into BS. Forms of per os medication include tablets, capsules, powder, syrup, solution, suspension and paste.
Advantages
- Least painful
- Usually easily administered by pet owner
- Strict sterility is not necessary
- Disadvantages
- Cannot give to vomiting/diarrhoeic patient
- Inhalation – possibility of choking, pneumonia
- Variable rate of absorption (gut contents)
- Animal resents administration
- Animal may spit or vomit it out
- Irritation of gut – possibility of vomiting, ulceration
- Difficult to alter doses
17
Q
Describe ID injection and its A/D?
A
- Fine needle is injected into skin –forms bleb. Commonly used for ID allergy testing.
- *Advantages**
- Absorption into blood results in good local effect
- Tiny amounts
- Disadvantages
- Technically difficult – easy to go through skin (subcutaneous)
- Can be painful and irritating
18
Q
Describe SC injection and its A/D?
A
- Under the skin. Commonly used for vaccinations, sedation, antibiotics and conditions such as vomiting.
- *Advantages**
- Simple procedure
- Least painful
- Relatively large volumes may be administered due to loose attachment of the skin to underlying tissue
- Can administer emulsions and suspensions safely (provided oil can be metabolised) without risk of embolism
- Disadvantages
- Slow speed of action – taking at least 15 minutes for therapeutic effect
- Absorption can vary with location of site, solubility of drug and environmental temperature
- Can get tissue reactions
- Not effective in shocked/dehydrated patients
- Irritant/acidic/alkaline substances will cause pain, inflammation and necrosis
19
Q
Describe IM injection and its A/D?
A
- Injected deep into muscle tissue, ensure you draw back to check for blood in hub of needle before injecting.
Advantages
- Faster absorption than SC
- Higher drug concentrations in blood than SC
- Prolonged duration of effect compared with intravenous route due to the slower absorption
- Can use with products unsuitable for intravenous administration – e.g. oil-based drugs
- Good for situations where restraint of animal for intravenous administration is not possible or appropriate – e.g. injured, fractious
- Disadvantages
- Must avoid nerves and bones
- Small volumes only
- Risk of abscess or tissue reaction
- More painful
- Product must be relatively non-irritant, or tissue damage will occur; causing the animal pain and the clinic the embarrassment of a lesion
20
Q
Describe IV injection and its A/D?
A
Aka venepuncture, administration of drugs directly into the vein. Used for rapid drug administration, IV fluid admin, blood transfusion and the collection of blood samples. Site depends on the method of animal restraint, but it is vital to find an accessible vein of sufficient size. Equipment used includes hypodermic needles, angiocaths, or butterfly needles.
Advantages
- Rapid rise of drug concentration with rapid systemic effect
- No delay in absorption compared to other routes of administration
- Best method to ensure an accurate dose
- Large quantities can be given over a long period of time (in drip)
- Allows administration of irritant drugs that would damage tissues if given via SC or IM. Care must still be taken to avoid leakage around the vein; catheterisation safeguards against this. If perivascular leakage does occur the areas must be diluted with sterile 0.9% saline solution
- Useful in shocked patient as would not get absorption via other routes
Disadvantages
- Risk of embolism – must not contain any particles (e.g. most penicillins) or oils; must not have air bubbles
- Requires more technical skill and precision to avoid damaging veins – veins are quite delicate and easily damaged and this damage can cause “blown” veins, bruising or the development of a haematoma
- Asepsis vital to prevent infection being carried around the body (septicaemia)
- Must be given slowly
21
Q
Describe the technique for admin of IV injection
A
- Safe restraint of animal with correct positioning
- Shave site
- Swab with antiseptic/alcohol
- Remove all air from syringe
- Raise vein – compress it proximally
- can use heat in lab animals
- Insert needle with bevel up
- Draw back for flash of blood to double check you are in the vein
- Release proximal compression
- Inject slowly
- When finished, withdraw needle quickly, apply pressure to site for 1 minute
- Check that no haemorrhage occurs
22
Q
DEscribe technique for IV catheter placement
A
- Prepare all equipment prior to procedure
- Safe restraint of animal with correct positioning
- Shave site
- Swab with antiseptic/alcohol
- Raise vein – compress it proximally
- Insert catheter into the skin over the vein at an angle of approx 30 degrees, with stylet bevel up
- Look for flash of blood
- Change angle to be more level with the angle of the vein
- Advance catheter over the stylet along the direction of the vein, while proximal compression is released
- Remove stylet
- Look for flash of blood to double check you are still in the vein
- Place catheter plug (injection port)
- Tape catheter into position
23
Q
How long can an IV catheter stay in place before removing it?
A
72 hours
24
Q
What is phlebitis?
A
inflammation of the vessel wall as a result of damage to the endothelial lining of the vein. Phlebitis is characterised by swelling, tenderness upon palpation, and erythema of the skin over the vessel
25
What is thrombosis?
Formation of a clot from fibrin and platelets. Thrombosis can result from endothelial trauma at the points between the catheter and the vessel wall.
Thrombosis is characterised by a vein the stands up without being held off and a thick cord-like feeling to the vein
26
What is catheter embolism?
occurs when a fragment of catheter becomes free and enters the circulation and lodges in the heart or lungs.
The catheter fragment results from a severing of the catheter
27
What is fluid infiltration?
diffusion of fluids into the surrounding tissues of the vein.
Signs of infiltration are swelling and tenderness proximal to the vein.
The skin may feel cool
28
What is the functions of blood?
* carry oxygen to the tissues and remove carbon dioxide from the tissues delivering it to the lungs to be exhaled
* carry nutrients (the result of digestion) such as glucose, fatty acids and amino acids to the tissues
* supply water to the tissues
* carry wastes (urea, acids and alkalis) away from the cells to the kidneys for excretion
* help regulate body temperature through vasodilation, vasoconstriction which allow the exchange of heat from the body, as the blood is warm it also carries heat around the body
* Stops haemorrhage by blood clotting mechanisms
* transports hormones and enzymes throughout the body
* protects the body against infection by transporting immune system cells, antitoxins and antibodies
29
Describe IP injections and its A/D?
iven around the umbilical area into the peritoneal cavity.
**Advantages**
* Simple procedure
* Can give large volumes
* Rapid absorption
* Useful when difficult to get a vein e.g. shock
**Disadvantages**
* Risk of peritonitis especially if poor asepsis
* Risk of puncturing organs – damage, haemorrhage, leakage of organ contents, infection and peritonitis
* Do not use irritant or oil-based drugs
* Drugs are absorbed via portal system and go to the liver where they may be inactivated
30
Describe IC injection and its A/D?
* administration of drugs directly into the heart through the chest wall, using a long-shafted needle.
* The animal should be in a state of unconsciousness for this method of administration.
* It is used to administer adrenaline in cases of emergency, to administer pentobarbital (lethabarb) for rapid euthanasia, or for blood collection in very small animals
* Advantages
Rapid action – good for euthanasia or emergency drug administration
Large volume of blood for collection from tiny animals
* Disadvantages
Painful, dangerous procedure
Must be extremely careful to minimise heart damage
Must be performed under general anaesthesia or a state of unconsciousness
31
What is an epidural injection?
drug is placed directly into the dural space around the lumbar spinal cord.
It is used to administer analgesia or anaesthesia.
Consequences of poor technique range from pain, infection/inflammation or haemorrhage, to damage to spinal cord and potential paralysis.
32
What are the A/D of topical meds?
**Advantages**
Simple to apply
Acts directly on target area
Non painful, non stressful
**Disadvantages**
Animal may lick medication or rub/wash it off
33
equipment needed for the administration of fluids and blood includes:
* Fluid bottle or bag
* Blood or plasma expander
* Administration set
* Infusion pump
* Paediatric administration set
* Catheter: either stylet or butterfly
* Tape (e.g. elastoplasts, vetwrap, transpore, leukoplast tape)
34
The veterinary nurse should be able to (in terms of setting up fluid therapy):
* Set up the drip line in an aseptic manner
* Calculate fluid rate
* Set the fluid drip rate
* Correctly add fluid additives
* Label the fluids
* Monitor and troubleshoot the fluid delivery system
* Regularly reassess the patient and adjust the fluid therapy plan accordingly
* Assess skin turgor, body weight, PCV/TPP, and USG
* Know how to maintain and setup fluid pumps, burettes and other delivery systems
35
What are the 5 different methods for administering fluid therapy?
* **Oral**
- rapid admin, minimal side effects. Inadequate for animals w/ acute or extensive fluid loss or vomiting patients
* **SC**
- not suitable for shock, can only be used in patients who will tolerate repeated injection. Only isotonic fluid. skin necrosis/infection may occur.
* **IV
- **for vascular V restoration, superior route to all others w/ except. of intraosseous. iso, hyper, hypo tonic sol. may be admin.
* **Intraosseous
- **admin via bone marrow, short term admin, good for small/young animals where quick venous access not possible. may need LA
* **IP
- **only used in sml animal where no other access possible. fluids admin into IP cavity. Peritonitis or abdominal abscess may occur
36
What three categories are crystallids (a type of fluid) divided into?
* **isotonic same as blood, fluid does not cross in or out of cells**
* **hypotonic \< [] than blood fluid drawn into cells**
* **hypertonic \> [] than blood fluid drawn away from cells**
37
Give examples of isotonic fluids and some A/D?
* 0.9% saline
* Hartmann's
* Lactated ringers solution
* ringer solution
* Normosol-R
* inexpensive, readily available
* unsuitable for maintenance solution as too high in NaCl and not high enough in K
38
Give examples of hypotonic fluids and some A/D?
* 0.45% NaCl
* 2.5% dextrose -maintenance fluid, K often added
* not good for shock
39
Give examples of hypertonic fluids and some A/D?
* 7% NaCl -hypertonic saline
* immediate rapid fluid resuscitation
* expensive
* causes increased bleeding
40
What are colloids?
* type of fluid
* plasma expanders
* consisting of plasma, whole blood and synthetic colloids eg dextran, gelatines
* help w/ treatment of hypovolaemia and low BP
* expensive
* may cause anaphalaxis
* associated w/ acute renal failure and bleeding disorders
41
What is the calculation for drops per minute?
dividing ‘total infusion volume (ml) x drops/ml’ by ‘total infusion time (min)’.
42
What are the 3 ways fluids may be delivered via (like diff kinds of pumps)
* **Gravity flow**
- infusion pressure dependant on height of fluids above patient.
* **Syringe pumps**
- for v. small patients at constant rate,or to infuse meds at constant rate.
* **Fluid infusion pumps
- **programmable, machine pumps by intermittently squeezing IV tubing (peristaltic). Do not use for blood transfusions.
43
**_developing a fluid therapy plan_**
Whta are the basic components of a fluid therapy plan?
the determination, calculation, and replacement of the volume deficit (percent dehydration), abnormal on going losses; and maintenance needs.
44
What % of the body is water?
What is this water divided into?
approximately 60 - 70% water. This is divided into intracellular and extracellular fluids. Two thirds of the water in the body is within the cells of the body (intracellular) whilst the remaining third is outside of the cells (extracellular). The body maintains fluid balance on a constant basis.
45
How are fluids gained?
Oral intake
metablism in body
46
What are the aims of fluid therapy?
Rehydrate (replace fluid deficits)
Maintain normal hydration
Replace lost blood volume
Provide oxygen carrying capacity
Replace essential electrolytes and nutrients
Act as a vehicle for continuous intravenous infusion of drugs
47
Disorders and imbalances in the animal’s fluid balance may arise from:
Not eating / drinking
Fluid loss such as vomiting, diarrhoea or bleeding
Disease with accompanying polyuria
Any disease, state or injury that prevents or decreases the oral intake of fluids
Shock
48
Typically in veterinary clinics we use fluid therapy to treat the following:
Shock
Dehydration
Electrolyte imbalances
Acid –base disturbances
49
Loss of fluid from body by vomitting or diarrhoea will affect the animal's.........
electrolyte balance and acid-base balance
50
How can we determine if an animal has an electrolyte balance?
serum samples which are analysed for the electrolyte levels for sodium, potassium, chlorine and bicarbonate (Na, K, Cl and HCO3 respectively).
51
What are the two most common replacement fluids?
0.9% Saline (NaCl) or Hartmann’s
52
The state of the patient determines route of fluid admin.
IV is used for...?
IO is used for...?
SC is used for...?
* IV = shock or GIT disease
* IO = when catheter cannot be placed. Injected into humerus, femur, tibia, wing of the ilium
* SC = not suitable for shock or severe dehydration.
53
\*WHAT ARE THE 3 MOST COMMON USES FOR FLUID THERAPY?
SHOCK
DEHYDRATION
MAINTENANCE
54
Shock can be caused by many different disease states, including:
dehydration
blood loss
allergies
infection (commonly septic shock or endotoxaemia in horses)
trauma
55
What is shock and what are the symptoms?
Shock is where there is profound circulatory collapse leading to inadequate tissue oxygenation and perfusion.
Symptoms of shock include:
Decreased skin tone (elasticity)
Sunken eyes
Dry membranes
Increased heart rate
Pale mucus membranes
Slow capillary refill time
Weak femoral pulse
Cool extremities
Delayed jugular refill time
Weight loss (important in very small animals)
Increased respiratory rate
56
\*WHAT IS THE GENERAL FLUID RATE FOR A SHOCK PATIENT?
80 - 90ML/KG/HOUR
may need two catheters to administer
57
**_calculating shock rates_**
What is the shock rate for a dog?
90ml/kg/hr
A dog that weighs 20kg (20kgx90ml/kg/hr) would be given 1800ml in the first hour.
58
**_calculating shock rates_**
What is the shock rate for a cat?
60ml/kg/hr
thus the average 4kg cat would need to receive 240ml in the first hour (4kg x 60ml/kg/hr = 240ml/hr).
59
When would hypertonic saline be used to treat shock?
severe shock and endotoxic shock.
only small volumes are required to produce the same level of improvement as would be achieved through infusion of larger volumes of Hartmann’s or 0.9% NaCl.
able to do this as highly concentrated and once in blood, draws fluid out of tissues and cells back into the circulation.
short term fluid, in small amounts until the animal is stabilised and is then changed to a maintenance fluid.
NOT suitable for patients w/ congestive heart failure
60
When would colloids be used to treat shock?
draws water into the circulation from the tissues and lymphatics.
Colloids are able to produce a longer lasting effect than hypertonic saline and as colloids are lower in sodium they do not produce hypernatraemia (elevated blood Na).
added risk to haemorrhage patients or those destined for surgery as large doses of the synthetic colloids such as Hetastarch™ and Dextrans-70™ can cause a coagulopathy (bleeding tendency).
61
Suggested fluid rates for cats and dogs for different fluids \*\*\*\*\*\*
62
An initial bolus dose is added to the total volume of shock fluid therpay. What % is this?
25% of total V to be infused
For example, for a cat the shock rate is 60ml/kg. A 25% bolus would be 0.25 x 60 = 15ml/kg (this would be the volume infused per kg). If the cat weighed 4kg then it would receive 4kg x15ml/kg =60mls as an initial bolus and the animal would then be reassessed to see if it were responding to the treatment.
63
What is the main aim when treating a dehydration patient?
what do we look at in a phys exam of dehy patient?
replace the fluid deficit (i.e. how much fluid it has lost). In order to do this we must first determine how dehydrated the animal is.
Look at gums (tacky), eyes (sunken), skin turgor
64
List the levels of dehydration and the corresponding clinical signs
65
What is the rule of thumb for fluid therapy?
always individualise fluid therapy and tailor to each patient and constantly re-evaluate and reformulate according to changes in status.
66
To determine the volume of fluid to be given to a DHD patient, we need to determine:
* **Maintenance rate** -normal MR is 60ml/kg/day or 2.5ml/hour
* **Surgical/anaesthetic rate** -usually \<10ml/kg/hr or surgery time
* **Deficit** -due to dehy, is the % dehy multiplied by patient BW
* **Ongoing losses** -normal (breathing, salivation etc) and abnormal (injury, disease)
*
67
a 20kg dog that is vomiting which is 10% dehydrated. Its fluid plan for the next 24 hours would be:
(Total fluid volume = Maintenance + Dehydration + ongoing losses)
Maintenance = 20kg x 60ml/kg =1200ml
Dehydration = 10% of 20kg = 2000ml
Ongoing losses (estimated) =480ml
Total =3680ml
Thus the dog would need to receive 3680ml over the next 24 hours.
If it were 10% dehydrated (from the above chart) it may already be showing signs of shock so the vet may choose to increase the fluid delivery rate initially until the animal starts to improve.
A rough rule is to give replace half of the deficit in the first 4 hours and the remainder over 20 hours.
In the first 4 hours:
Maintenance/6 = 1200/6 = 200ml (4 hours worth is 1/6 of 24 hours)
Dehydration/2 = 2000/2 =1000ml (half the deficit)
Ongoing losses/6 = 480/6 = 80ml
Total = 1280ml over 4 hours
Fluid rate would be 1280/4 = 300ml per hour for the first 4 hours
The fluid rate would then be altered for the next 20 hours:
Maintenance 5/6 x 1200 = 1000ml (20 hours worth is 5/6 of 24 hours)
Dehydration ½ x 2000 =1000ml (the remaining ½ of the deficit)
Ongoing 5/6 x 480 =400ml
Total =2400mls over 20 hours
Fluid rate would be 2400/20 =120mls per hour for the remainder of the day.
A replacement rate should not exceed 88ml/kg/hr.
68
What are the clinical signs that an animal may be overloaded with IVF?
Respiratory crackles
Heart murmur
Gallop rhythms
Oedema
Frothy watery discharge from the nose
69
What fluid is typically used for maintenance?
hypotonic crystalloid such as 0.45% NaCl + 2.5% Glucose.
Maintenance fluids must provide the animal with its normal fluid intake, allow for normal losses of fluid from the body.
A typical maintenance rate is 60ml/kg/day or 2.5ml/kg/hr
70
Why do we give potassium supplementation to patients on maintenance fluid?
The composition of a maintenance fluid is one that is low in sodium (40 – 60 mol / L) and high in potassium (13-20 mol / L). Under normal conditions the body tends to retain sodium and excrete potassium.
A patient may develop hypernatraemia (high blood Na) or hypokalaemia (low blood K) if fluids such as 0.9% Saline or Hartmann’s are used solely for maintenance needs, and no other source of free water is available.
For those animals that are not permitted to drink or eat, the potassium (K) must be added to the fluids, typically it is added a KCl (potassium chloride).
71
Potassium chloride (KCI) is added to fluids if patient is:
Is not eating
Is still vomiting
Has diarrhoea
Is hypokalaemic and is on fluid therapy
72
Potassium must not be added to fluids at a rate faster than
0.5 mEq/kg/hr
73
What is the average water intake and output for horse?
What is the fluid rate for a horse?
**average water intake for a horse is 54ml/kg/day**
**average output is 19L/day**
The fluid rate for a horse is usually calculated on **50ml/kg/day plus the ongoing losses.**
The horse has poor renal conservation of potassium and so any horse that is not eating will lose a lot of potassium.
74
When is plasma used as a fluid therapy?
in patients with a low total protein (TP). This is because IV fluids alone may further dilute the protein that is still in the circulation, this would lead to ascites and oedema.
Colloids such as Hetastarch and Dextran-70 may be used in place of plasma to replace fluid volume in hypoproteinaemic (low plasma protein) patients.
75
Why do animals receive blood transfusions (BT)?
At what PCV does at animal require a BT?
What if PCV cannot be determined?
to **replace blood losses from trauma, coagulopathies or during surgery.**
BT requirement is based on PCV, haemoglobin levels and clinical signs. If an animals **PCV is \<21%** then a transfusion is indicated.
If PCV cannot be attained, eg during acute haemorrhage, determining factor is oxygen saturation. if the **oxygen saturation of the blood or the oxygen delivery to the tissues is compromised then a transfusion is indicated.**
76
What are the 8 different kinds of blood products?
(blood transfusion)
* **Auto transfusion**
- animals own haemorrhaged blood that does not contain bacteria, pus, urine etc
* **Fresh whole blood**
- must be used w/in 8hrs of collection
* **stored whole blood**
- stored in fridge; will lose platelets an coag factors
* **packed RBC's**
- rbc once plasma removed, often added to crystalloid fluid for anaemia, acute bleeding, haemolysis
* **platelet-rich plasma/platelet concentrates**
- NA in Aus.
* **fresh frozen plasma**
- plasma + coags (not platelets) from FWB that is frozen w/in 6hrs of collection
* **frozen plasma**
- has been frozen after 8hrs or stored for longer than 12months
* **Cryoprecipitate**
- FFP thawed in fridge and insoluble part precipitates, contains von willebrand factor, fibrinogen and factor VIII.
77
What are the characteristics that a canine blood donor should have?
Adult (\>1 year old)
\>25 kg – this will produce 450ml unit of blood
Current vaccination
Not on medication except parasiticides
PCV \> 40
Good temperament to avoid need for sedation
Never had a blood transfusion prior
Blood typed and cross matched.
Free of Heartworm infection and receiving heartworm prophylaxis
Can done every 3 weeks
Ideally should be DEA 1.1 negative (universal donors)
78
How many blood transfusions can you give to a dog before cross matching?
1
79
Which dog blood type is the universal blood donor?
DEA1.1
80
What are the ideal characteristics of a feline blood donor?
Indoor, solitary cats to reduce carrying infections.
Younger adults
Good natured - most will still require sedation (may be an issue with the donor’s owners?)
Large, lean, \>5kg
Shorthair for easy vein access
PCV\>35
Fully vaccinated
Full CBC, biochemistry, UA, negative for FIV, FeLV , FIP, Haemobartonella, Toxoplasma
Never had a transfusion
High performance diet
Blood typed and cross matched
81
Why is blood typing/matching vital in cats?
Cats have blood types of A, B and rarely AB.
If type A is given to a type B, the cat can suffer a fatal transfusion reaction.
If type B is given to a type A cat there will be a lesser reaction but the blood transfusion will be ineffective as the cells will be destroyed.
Without cross matching there is a 23% chance of a fatal transfusion reaction.
82
What anticoagulant solutions are used in blood samples/collections?
**Citrate-phosphate-dextrose-adenine (CPDA-1)** – use 1ml CPDA-1 to 7-9 ml blood.
**Acid-citrate-dextrose (ACD)** – use 1ml ACD to 7ml blood
83
What G needle should you use for a dog blood collection? How many g can dog give?
For cat? How many ml can a cat donate?
* 16G needle for dog; can give 450g
* 19 - 21G butterfly needle for cat; can give 10 - 12ml
84
Describe the blood cross-matching technique
* 2ml EDTA blood from both animals, labelled
* Centrifuge 1 min at 3000 g.
* Remove plasma to labelled tubes
* Draw up 0.1 ml RBCs, add to 5 ml 0.9% saline, mix.
* Centrifuge this suspension for 1 minute. Discard the supernatant. Add another 5ml saline, mix, centrifuge, discard supernatant, do this washing 3 times.
* In a 3ml test tube put 2 drops of recipient plasma and 2 drops of donor RBC suspension. Mix well, leave at room temp for 30mins.
* In a 3 ml test tube put 2 drops of recipient’s RBCs and 2 drops of donor plasma. Mix well, leave at room temp for 30mins.
* Make controls using donor’s and recipient’s own RBCs and plasma as above.
* Read – check for agglutination and haemolysis; place a drop on a slide and look for agglutination under microscope with 40x magnification. If there is agglutination (clumping) or lysis of the RBC then this indicates the animals are incompatible.
85
What are the clinical signs of a blood volume overload (transfusion)?
Increased RR
Dyspnoea
Nasal discharge
86
What are the clinical signs of a haemolytic reaction? (blood transfusion; may occur 2-21 days later)
Pyrexia or hypothermia
Tachypnea
Salivation
Tachycardia
Weakness
Muscle tremors
Vomiting
Collapse
Haemoglobinaemia
Haemoglobinuria
Renal failure
87
What are the clinical signs of non-haemolytic reactions?
(blood transfusion)
Urticaria
Pruritis
Neurological signs
Vomiting
Occasionally anaphylaxis can occur.
