Retrospective evaluation of fresh platelet concentrate administration in dogs: Patient characteristics, outcomes, and transfusion practices in 189 transfusion episodes (2008–2019)

Abstract

Objective To describe patient characteristics, underlying disease processes, clinical outcomes, transfusion dose and type (therapeutic or prophylactic), platelet count changes, and adverse events associated with platelet concentrate (PC) administration in dogs. Design Retrospective study. Setting University teaching hospital. Animals A total of 149 dogs, representing 189 PC transfusion episodes. Interventions None. Measurements and Main Results In this population, 39 of 149 dogs (26.2%) were diagnosed with primary immune‐mediated thrombocytopenia, 22 of 149 (14.8%) had decreased bone marrow production, 12 of 149 (8.0%) received PC during a massive transfusion, 3 of 149 (2.0%) had congenital thrombocytopathia, 59 of 149 (39.6%) had severe thrombocytopenia of other causes, and 14 of 149 (9.4%) underwent transfusion for miscellaneous causes without a documented severe thrombocytopenia. In 117 of 149 dogs (78.5%), >1 site of hemorrhage was noted. The most common sites of hemorrhage were the gastrointestinal (GI) tract in 89 of 149 (59.7%) and the skin in 78 of 149 (52.3%). Overall survival to discharge was 59.1% (88/149). The median PC dose was 0.8 units per 10 kg of body weight per transfusion episode (range: 0.2–6.7). Of 189 episodes, 29 of 189 (15.7%) were prophylactic, and 158 of 189 (83.6%) were therapeutic. For 99 of 189 transfusion episodes, paired pre‐ and postplatelet counts were available within 24 hours. The median platelet count change was 5.0 × 109/L (5000/μL; range: –115 × 109/L to 158 × 109/L [–115,000 to 158,000/μL]); the posttransfusion platelet count was significantly higher than pretransfusion (P < 0.0001). The increase in platelet count after transfusion was greater in the prophylactic group than the therapeutic group (P = 0.0167). Transfusion reactions were suspected during 2 of 168 episodes (1.2%). Conclusions Immune‐mediated thrombocytopenia was the most common disease process that resulted in PC transfusion. PC was more frequently administered to animals with active hemorrhage rather than prophylactically, and most dogs had evidence of hemorrhage in multiple organ systems, particularly the GI tract and skin. PC transfusions typically appeared safe, and the median platelet count increased after transfusion.

ACVIM consensus statement on the treatment of immune thrombocytopenia in dogs and cats

“…Although these studies are not of ITP, they suggest that platelet transfusion in dogs with clinical bleeding secondary to ITP is a reasonable treatment option. One retrospective study of 149 dogs, including 39 (26%) with probable pITP, that received fresh platelet concentrates was reviewed 145 . The study design precluded an assessment of the impact of platelet transfusion on outcome.…”

“…One retrospective study of 149 dogs, including 39 (26%) with probable pITP, that received fresh platelet concentrates was reviewed. 145 The study design precluded an assessment of the impact of platelet transfusion on outcome. This study compared pretransfusion and posttransfusion platelet counts and observed a significant increase in platelet count after transfusion in dogs with pITP.…”