Indications

Transfusion therapy is indicated for MWDs experiencing any condition (trauma, neoplasia, other) that results in acute blood loss or clinical anemia, or that significantly increases their bleeding risk (e.g., severe thrombocytopenia, Acute Traumatic Coagulopathy/Trauma-Induced Coagulopathy,8 other). Consider transfusion therapy as a first-line intervention for perioperative hemodynamic optimization in MWDs that have suffered major trauma. These guidelines focus on transfusion for MWDs injured as the result of trauma in a forward deployed environment and will focus only on canine blood products expected to be found in theater – specifically canine Whole Blood, Fresh Frozen Plasma and Freeze Dried Plasma. These guidelines should therefore not be used for all conditions.

Table 1. Definitions

Standard transfusion triggers are generally not applied to canine medicine but rather the clinical condition of the MWD is assessed to determine the appropriateness of a transfusion. The following should be considered in the assessment for blood transfusion needs in a MWD:

Table 2. Mechanism of injury, anatomical site and severity of injury

Used collectively, the MOI (e.g., blunt force from primary blast wave), anatomical injury patterns (e.g., thoracic versus abdominal), external physical examination findings (e.g., bruising around the umbilicus, distended abdomen with positive fluid wave test, localized pain or tenderness, etc.) and accompanying vital parameters may increase the index of suspicion and direct attention to the most likely sources of occult hemorrhage.

Table 3. Physical parameters and laboratory indicators to evaluate the presence of hemorrhagic circulatory shock warranting hemostatic resuscitation
Table 4. Modified Animal Trauma Triage (ATT) Score
Table 5. Diagnostic Recommendations
Table 6. Clinical and diagnostic considerations for predicting transfusion needs
Table 7. Canine Vital Signs - Perfusion parameters based on severity of circulatory shock

*Normal values are for a RESTING state. Exercise/ activity, pain, stress will result in higher HRs.

Table 8. Available blood products and indications for use
Table 9. Indications for blood products use by condition