Hemorrhage

primary hemostatic failure is loss of _____

platelets

secondary hemostatic failure is loss of ____

clotting factors

What causes hemoglobin defect>

inborn, carbon monoxide, acetaminophen

When we give blood, we increase O2 delivery by increasing the concentration of ___

Hb

What are clinical signs that a transfusion is needed?

tachycardia, lethargy, bounding pulse, pale MM, high RR, hypotension

What is whold blood?

half RBC half plasma

What is in packed red blood cells (pRBC)?

plasma removed, cell preservative, stored for 35 dyas

What are your replacement amounts for pRBC and whole blood?

1.5 ml/kg of pRBC (increases PCV by 1%), 2.0 ml/kg of whole blood (increases PCV by 1%)

“blood groups” are essentially _____

antigens from the same gene

What is the most antigenic blood type for dogs?

DEA 1

What does “DEA 1 pos” mean?

that dog will not develop antibodies to DEA 1

Do dogs have preformed antibodies at birth?

no

A dogs monoclonal antibody impregnated card starts to agglutinate. What does this mean?

DEA 1 positivecat

cats in europe are more often ___ typed

B

Type ____ cats have SEVERE reactions to type _____ blood

B, A

If a cat blood typing test is agglutinated at both A and B, what are your options?

1) AB cat 2) neoplasia

Do you type the cat recipient of blood?

ALWAYS

What is the purpose of crossmatching?

determining compatibilitiy

What is a major crossmatch?

donor RBC + recipient plasma

When should you crossmatch?

always if a cat, if they have had ANY previous transfusion (unless within the last 3-5 days)_

What indicates a patelet transfusion?

catastrophic bleeding, massive transfusion

What are the comm sites for primary hemostatic failure?

petechai, MM, black melena, brain, nose,

What is cryopreserved platelets?

preserved in DMSO

What does secondary hemostatic failure look like?

ecchymoses, third space bleeding, airway, conjunctivaWhat

What testing do you do to confirm secondary hemostatic failure?

PT, aPTT

What are the indications for a plasma transfusion?

prolonged clotting times AND clinical bleeding BEFORE a procedure, toxin induced

Is crossmatch necessary for a PLASMA transfusion?

no,donors should be naive

What is the difference between frozen plasma and fresh frozen plasma?

frozeen plasma still has Vk factors

What is your plasma dose?

10-20 ml/kg tocorrect coagulopathy

What should you use to correct consumptive/traumatic coagulopathy?

fresh whole blood or fresh plasma

What should you use as a transfusion for rodenticide?

fresh whole blood, frozen plasma, stored whole blood

When do you retest after a transfusion?

immedtiately

Will there be a change in platelt count after transfusion?

NO

T/F a blood filter is required for every transfusion

true

transfusions are typically given over ___ hrs

4

What is the fluid rate for a transfusion?

total vol needed divided by 4

When should you monitor after while giving transfusion?

every 15 mins

What is the major type of transfusion reaction? What causes this?

febrile non-hemolytic reactions, leukocyte antigens (aka pyrogenic cytokines)

How do you notice a febrile non-hemolytic reaction?

1degree increase in temp

How do you treat febrile non-hemolytic reaction?

slow down transfusion

How do you recognize a type 1 allergic reaction to transfusions in cats and dogs?

IgE mediated, seen more often with plasma, GI signs in dogs, resp distress in cats

How do you treat type 1 allergic reactions?

diphenhydramine + epi

What causes a type II reaction to transfusion?

pre existing IgG and IgM bind to RBC

Which type of reaction to transfusion cuases hemolysis?

typoe II

How do you treat type II hemlytic reaction?

stop transfusionWhat c

What color tubes can you type blood in?

LTT/GTT

What is cullen sign?

bruising of umbilicus

What is the blood volume of a dogs?

80-90 ml/kg

What are your fluid amounts for a dog with hemorrage?

20ml/kg - cystalliod, 5ml/kg - colloid/hyerptonic saline

Why do you NOT give manitol to a dog with hemorrhage?

lose more than you gain via loss through kidneys

Will PCV be normal with hemorrhage?

yes, but TP will be low

What is you first imaging ddx?

ultrasound FAST

You crossmatch a dog and he is DEA (+). Can you give this dog negative blood?

Yes, but only the first time

How do you calculate how much whole blood a patient needs?

ideal recipient blood volume x (desired PCV-PCV)/donor PCV

How many ml of WB = 1% PCV?

2ml/kg

How many ml of pRBC = 1% PCV?

1.5ml/kg

What would be a blood work test to do during hemorrhage?

platelet and PT/aPTT

On a TFAST, you see a solid white line. What does this mean?

the white line is pleura, and since you see it you can rule out a pneumo

How do you know how much to bolus during hemorrahge?

¼ of a shock dose (aka blood vol) which = 90m;/kg

When might you choose to give low vol fluid resus (e.g. colloid or hypertonic)?

When the animal is too big that it takes too long to give the appr amount of fluid

What protein sample will contain fibrinogen?

plasma protein (EDTA tube)

What does plasmaprotein contain?

clotting F and fibrinogen

What tube do you use for serum protein? For plasma protein?

red, EDTA

When should an Ecoli vax be given to cows?

pre-colostrum

death occurs at ____% dehydration

12

What does it mean if the LN on necropsy are edematous?

starvation

What agents are ALWAYS in healthy calves and how do you treat if they become infectious?

corona/crypto, hygene, nutrition, fluids

TP = ___ + _____

alb + globulins

What agents tell you about hydration sattus?

PCV, TP, ALb

An increase in BUN, Cr, and Phos indicates…

pre renal or renal azo

a decrease in IgG, GTT, and globulins in a calf indicate ____

FPT

a calf has poor mentaiton and low BCS. Which parameter is causing both of these?

low glucose

calves with diearrhea are alkalotic or acidodic?

acidodic

What are the cuases of hypoalb?

PLE (uncomm in calves), inflamm, liver insufficiency (wouldn’t be herd problem)

Low TCO2 means ____

acidosis (low bicarb)

What are the two causes of met acidosis (low TCO2)?

titrational (ketones, lactate) or secretional (diarrhea)(

How do you calc AG>

Ag = (Na+K) - (HCO3 + Cl)

Assume any calf with an arrhythmia is _____

hyperkalemic

Why is Resorb bad?

not even alkalining

What is the spectrum for penicillin G?

gram + and anaerobes

T/F you can use Baytril/enrofloxacin to calves

false, no EL use

What is the First defense vax for and when do you give it?

corona and E coli, must be given before abs closes (12 hrs)

What is the BEST source of rota/corona virus ab?

colostrum

what is the max fiber in milk replacer/

<0.15%, calves start utilizing plants at 2-3 wks (not MAIN component)

How much fat should be in milk replaer?

at least 20%

How much portein should be in mlik replacer?

at least 22%

What bacteria impacts really young calves?

ETEC at <5d

Salmonella is usually caused by ___

feeding dumpmilk to calves

C. perfringens usually occurs bc of ___

incorrect mixing in dairy cattle,

When do you see C. perfringens in beef calves?

best cows, eating the most at creep feeding

What is a dx test for salmonella?

fecal culture

Why do you do a CBC on salmonella calves?

ID sepsis!!

What electrolyte imblaance is common in diarrhea calves?

hyperkalemia

What are the most impotant agents in rehydrating compounds for calves?

sodium, alkalinizing agent, (acetate), dextrose, chloride/potassium

What is the maintenance rate for fluids in cows?

60(calves) - 100 (cows) ml/kg/d

What is the flow rate for calves?

85 ml/kg/h

How do you get daily fluid requirement for calves?

deficit + maintenance + ongoing losses