4) Those breeds most often affected in our case population are Cocker Spaniels, Poodles (all varieties), Golden Retrievers, Doberman Pinschers, Miniature Schnauzers, Akitas, Beagles, Rottweilers, Lhasa Apsos, German Shepherds, Shih Tzus, Terriers, and mixed breeds of these backgrounds. Any of the nearly 50 breeds predisposed to thyroid disease are at risk for an immune-mediated condition. Thyroid supplementation at 0.1 mg/10 lb given twice daily is essential for cases with concomitant thyroid disease and is helpful to stimulate the bone marrow whether or not thyroid tests indicate hypothyroidism. It also enhances platelet function.
5) Anabolic steroids (nandrolone decanoate, Deca Durabolin, 2-5 mg/kg given once a week for 4-6 doses) is given to stimulate the marrow.
6) Hematinics containing iron and vitamin B12 have been helpful.
7) In poorly responsive immune thrombocytopenias (1TP), an initial dose of vincristine (Oncovin, 0.01 mg/lb IV) may be helpful to release remaining platelet stores, and danazol (Danacrine, 2.5-5 mg/lb BID initially and then tapered to SID) has been effective along with steroids and thyroid for longterm maintenance.
8) The most severe cases with autoagglutinating red cells or profound thrombocytopenia may recover completely with the aggressive therapeutic approach outlined above, although a subset of these dogs convert to having a chronic low-grade nonresponsive anemia over the long term.
9) Cases with the best overall prognosis tend to be younger animals in which the underlying primary "trigger" of the immune-mediated disease was hypothyroidism, a drug which is withdrawn, or a recent vaccination/toxic exposure. Correction of the thyroid disease with serial monitoring of thyroid function to establish the appropriate maintenance dose of hormonal supplement is important.
Shelf-life of Packed Red Blood Cells
A special nutrient solution (Adsol, Baxter Healthcare Corp.) is added to our units of canine packed red blood cells during preparation to preserve and extend the shelf-life from 28 to at least 37 days. The solution contains saline, dextrose, adenine. and mannitol. Post-transfusion viability studies in dogs have shown that 80% of the red cells in packed cell units remain viable for 37 days, whereas 75-80% are viable for up to 44 days in the presence of Adsol or equivalent nutrient solutions (Wardrop et al, J. Vet. Int. Med. 5, 1991, p.148). Hemopet's units of packed red blood cells display a conservative expiration dating of 37 days from the time of collection.
If the units of packed cells you intend to transfuse are approaching the expiration date, most of the cells will still carry oxygen efficiently. However, a portion (20-25%) of these cells will be less viable or nonviable. Therefore, the dosage of packed cells to be transfused should be increased slightly to compensate for this reduction. For example: a dosage of 3-5 nil per pound of packed red blood cells is generally recommended to raise the PCV by 9 percentage points. If the red cell unit is within the first half of its shelf-life, 3 ml per pound should suffice. For older units, increasing the volume transfused to 5 ml per pound may be advisable.
