Retrospective evaluation of fresh frozen plasma use in 121 cats: 2009–2016

Abstract

Objectives To document indications for fresh frozen plasma (FFP) use in cats, doses administered, and frequency of adverse transfusion reactions (ATR). Design Retrospective observational study from January 2009 to November 2016. Setting Large urban referral and emergency facility. Animals One hundred twenty‐one client‐owned cats that received FFP. Interventions None. Measurements and Main Results Signalment, indication(s), dose, pre‐ and posttransfusion total plasma protein, prothrombin time, activated partial thromboplastin time, as well as possible ATR, primary disease process, and outcome were recorded. Doppler blood pressure was increased posttransfusion (mean pre 99.5 ± 30.8 mm Hg; post 108.5 ± 32.5 mm Hg, P = .027). Cats were significantly less likely to be coagulopathic posttransfusion (P < 0.001). Most common indications were suspected coagulopathy (n = 105, 83%), hemorrhage (n = 45, 35%), and hypotension (n = 32, 25%). Median dose was 6 mL/kg (interquartile range = 3 mL/kg) and was negatively correlated with body weight (r = –.598, P < 0.001). Possible ATR occurred in 17 of 108 (16%, 95% confidence interval [CI], 10–24%) of transfusions. Increased body temperature was most common in 11 of 108 (10%, 95% CI, 5–18%), followed by tachypnea/dyspnea in 8 of 108 (7%, 95% CI, 3–13%). Common primary disease processes included liver disease (n = 41, 34%), neoplasia (n = 19, 16%), and sepsis (n = 15, 12%). Overall mortality was 54%. Improvement of clotting times was associated with increased odds of survival (odds ratio = 2.4; 95% CI, 1.1–5.3; P = 0.023). Conclusions Clinician justifications for FFP transfusions are comparable to that reported in dogs; however, the mL/kg dose is lower. Coagulopathy and blood pressure significantly improve posttransfusion. Possible ATR were as frequent as that reported with feline packed RBCs transfusions and classified as mild.

Colloids Yes or No? - a “Gretchen Question” Answered

“…One study in 36 cats found that coagulopathies were the most common reasons for FFP transfusion (94% of cats) (203). The other study evaluated FFP transfusions in 121 cats and found coagulopathies (83%), hemorrhage (35%), and hypotension (25%) to be the main reasons for administration (204). Median doses reported in dogs are 14 ml/kg (small dogs) and 5 ml/kg (large dogs), due to the administration per unit or ½ unit per dog (197).…”

“…Another study reported median doses of 15-18 ml/kg (198). One study reported median doses of 6 ml/kg in cats (204).…”

“…In the other study (121 cats), Doppler blood pressure increased, and they were significantly less likely to be coagulopathic after transfusion. Similarly, 16% of the cats had possible reactions, such as increased body temperature (64% of cats with reactions) and tachypnea/dyspnea (47% of cats with reactions) (204).…”

Association of Veterinary Hematology and Transfusion Medicine (AVHTM) Transfusion Reaction Small Animal Consensus Statement (TRACS) Part 2: Prevention and monitoring

“…Prevalence of transfusion reactions and complications in veterinary studies varies from 0-38%, depending on the species, reaction definitions, and blood products used. [1][2][3][4][5][6][7] While there are consensus recommendations on blood donor screening for prevention of transfusion-transmitted infectious disease, 8 there are no publications that systematically examine the evidence for other prevention strategies. In addition, there is limited information on best practices for monitoring transfusions.…”

Stability of coagulation factors in feline fresh frozen plasma intended for transfusion after 1 year of storage

“…4 Only 33% of the recipients were bleeding at the time of transfusion in this feline study, so most of the transfusions were performed with a prophylactic goal. 4 In another recent study, doses of 2.15–10.85 ml/kg were effective for the treatment of prolonged prothrombin time and/or APTT in cats. Further in vivo prospective studies evaluating different fFFP doses are warranted.…”