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Abstract Background Transfusions in camelid species are performed without evidence-based guidelines. Safe and recommended practices for administering blood products with maximal efficacy and minimal risk of reactions are needed. Hypothesis/Objectives To describe the indications for, methods of, and outcomes associated with transfusions in camelids and to identify risk factors for transfusion reactions (TRs) and death. Animals Two hundred four transfusions performed in 169 camelids at 2 referral hospitals. Methods A dual-center retrospective review of medical records from 2010 to 2024. Signalment, indication for transfusion, transfusion history, administration of premedication, presence of TRs, and survival to discharge were reviewed. Dose and rate of product administration were calculated. Data were described and analyzed with a generalized linear model. Results In less than 1-month-old crias, the most common indication for plasma transfusion was management of failure of transfer of passive immunity. The overall TR rate was 12%, and presence of TRs resulted in a lower probability of survival to discharge (54.6%; 95%CI, 34.0%-73.6% vs 76.5%; 95%CI, 69.5%-82.3%, respectively; P = .033). There was no difference in probability of a TR with respect to administration of premedication, rate of transfusion administration, or previous transfusions (P ≥ .06). Changes to vital signs were the most common findings suggesting a TR. Conclusions and Clinical Importance Blood products can fulfill many therapeutic needs in the treatment of camelid species with a reasonable expectation of safety. A history of prior transfusions does not appear to significantly affect the future risk of a TR.

Abstract Background Reported incidence of blood transfusion reactions (TR) varies greatly. Objective To prospectively evaluate the incidence of acute TRs in dogs receiving allogenic blood products, using consensus definitions, and to assess factors associated with TRs. Animals Dogs (n = 858) administered allogenic blood products (n = 1542) between March and November 2022. Methods Prospective, multicenter surveillance study occurring in referral hospitals in the United States, United Kingdom, and Australia recording TRs in dogs administered blood products as defined by the consensus guidelines published by The Association of Veterinary Hematology and Transfusion Medicine in 2021. Results The incidence of acute TR was 8.9% (95% CI 7.0-11.1) for packed red blood cells (pRBCs) and 4.5% (95% CI 2.9-6.6) for plasma products. The most frequently reported TRs were febrile nonhemolytic TRs (FNHTR; 4%, 95% CI 2.8-5.5) when administering pRBCs and allergic TRs (3.2%, 95% CI 1.80-5.10) when administering plasma products. A higher dose of pRBC (adjusted odds ratio [aOR] 1.04 [95% CI 1.00-1.08]) was associated with a higher odds of TR. Administration of pRBCs stored for longer than 28 days was associated with higher odds of FNHTR (aOR 4.10 [95% CI 1.58-10.65]) and acute hemolytic TR (AHTR; OR 15.2 [95% CI 3.35-68.70]) when compared with pRBCs stored for 14 days or fewer. Leukoreduction of pRBC was not associated with lower odds of developing a TR (OR 1.47 [95% CI 0.89-2.42]). Conclusions and Clinical Importance Clinicians should be mindful of the age and dose of pRBC prescribed to dogs.

An update on the 2005 American College of Veterinary Internal Medicine (ACVIM) Consensus Statement on blood donor infectious disease screening was presented at the 2015 ACVIM Forum in Indianapolis, Indiana, followed by panel and audience discussion. The updated consensus statement is presented below. The consensus statement aims to provide guidance on appropriate blood‐borne pathogen testing for canine and feline blood donors in North America.

Abstract Background Recognition of the feline red blood cell (RBC) antigen Mik and the presence of naturally occurring anti-Mik antibodies resulting in acute hemolytic transfusion reactions prompted the recommendation to perform a crossmatch before a cat's first RBC transfusion, but this guideline has not yet become a standard practice. Objective To determine the prevalence of naturally occurring non-AB alloantibodies detectable by tube crossmatch, and to compare transfusion outcomes in cats with and without a crossmatch performed. Animals Three hundred cats that received an RBC transfusion, with or without a major crossmatch performed. Methods Retrospective study. Results Major crossmatch incompatibilities were documented in 23 of 154 transfusion-naive cats (14.9%) and in 15 of 55 previously transfused cats (27%; P = 0.042). Type-specific packed RBCs (pRBCs) were administered to 167 and 82 cats with and without a crossmatch, respectively. Median volume of pRBCs administered during the first transfusion was 5.3 mL/kg (range, 2.4-18 mL/kg). Median change in PCV scaled to dose of pRBCs was +0.8%/mL/kg; administration of crossmatch-compatible pRBCs was not associated with a greater increase in PCV. Febrile transfusion reactions occurred more often in cats that received non-crossmatched (10.1%) compared to crossmatched (2.5%) pRBCs (P = 0.022). Seventy-six percent of cats that received pRBC transfusions survived to hospital discharge. A crossmatch was not associated with improved survival to discharge or at 30 or 60 days posttransfusion. Conclusions and Clinical Importance The prevalence of naturally occurring non-AB incompatibilities is sufficiently high to justify the recommendation to perform a crossmatch before all (including the first) RBC transfusions in cats.

Background The demand for blood transfusions in veterinary medicine is increasing in South Korea, particularly for canine patients. While dog erythrocyte antigen (DEA) 1 is a known cause of acute hemolytic reactions, previous studies have underscored the involvement of DEA 4 and Dal. However, research on these crucial antigens remains limited in South Korea compared to North America and Europe, resulting in a knowledge gap concerning transfusion risks. We aimed to investigate the prevalence of the Dal and DEA 1 and 4 blood types among canine blood donors and recipients in Seoul. Residual blood samples were collected from 105 donor and recipient dogs admitted to the Konkuk Veterinary Medical Teaching Hospital between April and September 2023. The DEA type 1 blood type was identified using immunochromatographic strip technology, while Dal and DEA 4 blood types were determined through agglutination reactions on specialized test cards. Results Among the 105 dogs, 74 (70.48%) tested positive for DEA 1, 97 (92.38%) were DEA 4-positive, and 81 (77.14%) were Dal-positive. Some breeds not previously associated with Dal-negative outcomes, including nine Labrador Retrievers, five Golden Retrievers, a Shepherd, a Siberian Husky, an American Bully, a Miniature Poodle, and a Pungsan dog, tested negative for Dal on agglutination tests. Similarly, three Labrador Retrievers, three Golden Retrievers, one Samoyed, and one Doberman Pinscher tested negative for DEA 4. Larger breeds generally exhibited a lower prevalence for all tested blood types. The prevalence of DEA 1 observed in this study (70.48%) is consistent with prior studies; however, Dal and DEA 4 exhibited lower prevalence rates than those reported in Europe and North Americas, with Dal at 77.14% (compared to 89.3–100%) and DEA 4 at 92.38% (compared to 98.8–100%). Notably, breeds such as Labrador Retrievers, the most represented breed in our sample, exhibited low prevalence, suggesting that they may be an optimal donor in Seoul. Conclusion The distributions of DEA 1, DEA 4, and Dal blood types may reveal distinct prevalence patterns in Seoul, South Korea, possibly due to geographical differences, as existing data primarily reflect findings from European and North American.

Abstract Background Novel feline RBC antigens might contribute to decreased efficacy of RBC transfusion and increased incidence of acute transfusion reactions (ATR). Objectives To examine the effect of major cross-match in transfusion-naïve anemic cats on the incidence of acute immunologic transfusion reaction and transfusion efficacy for up to 24 hours after transfusion. Animals Forty-eight client owned transfusion-naïve anemic cats. Methods Prospective, randomized, controlled study. All transfusion-naïve cats receiving packed red blood cells (pRBC) transfusions from January 2016 to August 2017 were eligible for inclusion. Cats in the study group received cross-match and blood type compatible pRBCs and cats in the control group received noncross-matched blood type compatible pRBCs. Incidence of ATR and change in PCV after transfusion was recorded. Results No significant difference in incidence of transfusion reactions between cross-matched and noncross-matched groups (CM+ 4/24; 17%, CM– 7/24; 29%, P = .16). No significant difference between groups in mean change in PCV after transfusion scaled to dose of pRBCs administered at any time point after transfusion (immediate: CM+ 0.62 ± 0.59, CM– 0.75 ± 0.48, P = .41; 1 hour: CM+ 0.60 ± 0.66, CM– 0.74 ± 0.53, P = .43; 12 hours: CM+ 0.70 ± 0.55, CM– 0.66 ± 0.60, P = .81; 24 hours: CM+ 0.64 ± 0.71, CM– 0.55 ± 0.48, P = .70). Conclusions and Clinical Importance Our results do not support use of the major cross-match test to increase efficacy of, and to decrease adverse events associated with, RBC transfusion in AB blood typed transfusion-naïve cats.

Abstract Background Feline blood transfusion is required for the treatment of various illnesses in cats, and the safety of donor cats is vital. Donor adverse reactions can include cardiorespiratory, venepuncture-related, and behavioral abnormalities. Hypothesis/Objectives To describe a large number of feline blood donation events and document use of sedation and anxiolysis, record volume of blood collected and describe the frequency, type, and risk factors for, adverse reactions. Animals The study included 7812 individual cats and 29 201 donation events at a blood banking center over 5 years. Methods Retrospective analysis of donation event records with signalment, donation volume, sedation status, donation number, and adverse reactions (acute and caregiver reported) recorded. Risk factors for adverse reactions were examined by stratifying data according to groups exposed to relevant predictors and calculating odds ratios with 95% and 99% confidence intervals (CIs). Results Adverse reactions were uncommon (0.29%, 2.88/1000 donor events) and most commonly were cardiorespiratory (0.08%, 0.75/1000 donor events) or behavioral (0.06%, 0.62/1000 donor events). The only risk factor significantly associated with adverse reactions was conscious donation, with conscious donors 4.4 times more likely to have an adverse reaction (95% CI, 2.5-7.9, P ≤ .0001). Conclusions and Clinical Importance Feline blood donation is associated with a low rate of adverse reactions. Sedation should be considered to reduce adverse reactions, and the environment and interactions optimized to reduce donor stress. Caregiver education on care postdonation could reduce behavioral adverse reactions.

Abstract Background The reported incidence of blood product transfusion reaction (TR) in cats varies greatly. Objective Evaluate the incidence and practices surrounding acute TRs in cats receiving feline blood products, using Transfusion Reaction Small Animal Consensus Statement (TRACS) definitions. Animals Cats (n = 444) that received feline blood products (n = 608) between March 2022 and January 2024. Methods Prospective, multicenter observational study at referral hospitals (n = 14) in the United States, United Kingdom, and Australia documenting the incidence of acute TRs in cats receiving allogenic blood transfusions. Results Acute TR incidence was 7.8% (95% confidence interval [CI], 5.6–10.6) for red blood cell (RBC)-containing products and 1.1% (95% CI, 0.0–5.9) for plasma products. Febrile nonhemolytic transfusion reactions (FNHTRs) were the most common in RBC-containing products (incidence, 5.7%; 95% CI, 3.8–8.1). Age of RBC unit (adjusted odds ratio [aOR], 1.04 per day; 95% CI, 1.00–1.07) and administering a RBC unit with an infusion pump rather than a syringe driver (aOR, 4.7; 95% CI, 1.43–15.54) were associated with an increased odds of FNHTR. Of transfusions discontinued (n = 28) because of a potential TR, 46.4% did not fulfill TRACS criteria for any TR. Death occurred within 24 h of a transfusion event in 18.3% but was not associated with the development of a TR (odds ratio [OR], 0.76; 95% CI, 0.29–1.99). Conclusions and Clinical Importance Transfusion reaction incidence in cats, as defined using TRACS guidelines, is reported. Febrile nonhemolytic TRs were the most common and were associated with increasing RBC unit age and administering RBC via an infusion pump.

Abstract Immune-mediated hemolytic anemia (IMHA) causes severe anemia in dogs and is associated with considerable morbidity and mortality. Treatment with various immunosuppressive and antithrombotic drugs has been described anecdotally and in previous studies, but little consensus exists among veterinarians as to the optimal regimen to employ and maintain after diagnosis of the disease. To address this inconsistency and provide evidence-based guidelines for treatment of IMHA in dogs, we identified and extracted data from studies published in the veterinary literature. We developed a novel tool for evaluation of evidence quality, using it to assess study design, diagnostic criteria, explanation of treatment regimens, and validity of statistical methods. In combination with our clinical experience and comparable guidelines for humans afflicted with autoimmune hemolytic anemia, we used the conclusions of this process to make a set of clinical recommendations regarding treatment of IMHA in dogs, which we refined subsequently by conducting several iterations of Delphi review. Additionally, we considered emerging treatments for IMHA in dogs and highlighted areas deserving of future research. Comments were solicited from several professional bodies to maximize clinical applicability before the recommendations were submitted for publication. The resulting document is intended to provide clinical guidelines for management of IMHA in dogs. These guidelines should be implemented pragmatically, with consideration of animal, owner, and veterinary factors that may vary among cases.

Abstract Background Blood typing for the A and B antigens is essential and crossmatching testing is generally recommended before transfusing blood to cats. Objective To evaluate 2 crossmatch (XM) tests. Animals Forty-nine healthy domestic shorthair cats that had not received a blood transfusion. Methods Prospective study. Blood samples were typed for AB using immunochromatographic and flow cytometric techniques. A gel column (GC) and a feline antiglobulin-enhanced gel column (AGC) XM tests were used for crossmatching. Results The population included 34 type A, 13 B, and 2 AB cats, with concordant results (r = 1, P < .005) by flow cytometry and immunochromatographic strip kit. The plasma from type A cats had either no or weak anti-B alloantibodies. The plasma of 12 of 13 type B cats contained strong anti-A alloantibodies. For crossmatching, plasma to RBC pairings were prepared using the GC (n = 446) and AGC (n = 630) tests. Both methods showed compatibilities in 329 and incompatibilities in 102 pairings including all A-B mismatches. Additionally 15 pairings showed agglutination by the AGC but not GC method. Fourteen incompatibilities outside the expected A-B mismatches were only revealed by AGC. Conclusions and Clinical Importance AB typing using immunochromatographic strip is as accurate as laboratory flow cytometry. The 2 XM methods had good agreement with additional incompatibilities being recognized by the AGC XM beyond A-B incompatibilities. In clinic, feline AB typing and sensitive XM test kits are available and recommended before each transfusion, although the clinical implications of incompatible XM test results and clinical benefits of such crossmatching have not been documented.