Retrospective evaluation of the indications, safety and effects of fresh frozen plasma transfusions in 36 cats (2014-2018).

OBJECTIVES: The goals of this study were to classify the indications, risks, effects on coagulation times and outcomes of cats receiving fresh frozen plasma (FFP) transfusions in clinical practice. METHODS: This was a retrospective study of FFP transfusions administered in two referral hospitals from 2014 to 2018. Transfusion administration forms and medical records were reviewed. Information was collected on indication, underlying condition, coagulation times and signs of transfusion reactions. Seven-day outcomes after FFP administration were also evaluated when available. RESULTS: Thirty-six cats received 54 FFP transfusions. Ninety-four percent of cats were administered FFP for treatment of a coagulopathy. Twenty cats had paired coagulation testing before and after FFP administration. Eighteen of these cats had improved coagulation times after receiving 1-3 units of FFP. Eight of the 36 cats had probable transfusion reactions (14.8% of 54 FFP transfusions). These reactions included respiratory signs (n = 4), fever (n = 2) and gastrointestinal signs (n = 2). Five of the eight cats with probable reactions had received packed red blood cells contemporaneously. Overall mortality rate during hospitalization was 29.7%, with 52.8% (n = 19/36) of cats confirmed to be alive 7 days after discharge. CONCLUSIONS AND RELEVANCE: This retrospective study shows that FFP transfusions improve coagulation times in cats. Transfusion reactions are a risk, and risk-benefit ratios must be measured prior to administration and possible reactions monitored. In the study cats, the FFP transfusions appeared to be a tolerable risk given the benefit to prolonged coagulation times.

Evaluation of risk factors associated with recurrent obstruction in cats treated medically for urethral obstruction.

OBJECTIVE: To determine risk factors for short-term recurrent urethral obstruction in cats after treatment by means of urinary catheterization and hospitalization. DESIGN: Prospective case series. ANIMALS: 83 client-owned cats. PROCEDURES: Physical examination findings, laboratory abnormalities, treatment decisions, and environmental changes were evaluated as risk factors for recurrent urethral obstruction in the 30 days following hospital discharge. RESULTS: Of the 68 cats with completed follow-up surveys, 10 had an episode of recurrent urethral obstruction. Older cats were significantly more likely to have recurrent urethral obstruction. No specific laboratory abnormalities were associated with the risk of recurrent urethral obstruction. Longer duration of catheterization was significantly associated with a decreased risk of recurrent urethral obstruction. Duration of hospitalization and volume of IV fluids delivered were not significantly associated with recurrent urethral obstruction. Increasing water availability after discharge was associated with a decreased risk of recurrent urethral obstruction. There was no association between diet and recurrent urethral obstruction. CONCLUSIONS AND CLINICAL RELEVANCE: Results of this study suggested that longer duration of catheterization may be associated with a lower probability of short-term recurrent urethral obstruction in male cats. Older cats were at higher risk for recurrent obstruction. Owners should be encouraged to increase water availability after discharge in cats treated for urethral obstruction to decrease the likelihood of recurrence.

Noncardiogenic pulmonary edema.

Pulmonary edema may develop secondary to several cardiogenic and noncardiogenic conditions. Cardiogenic pulmonary edema (CPE) is associated with heart disease, an elevation in left atrial pressure, and an increase in pulmonary venous and capillary pressures. In contrast, noncardiogenic pulmonary edema (NCPE) can occur without pathologic cardiac disease and an elevation in left atrial pressure. NCPE has been associated with an increase in capillary membrane permeability with or without an increase in hydrostatic pressure. Signalment, history, and thoracic radiography may help distinguish NCPE from CPE. Some types of NCPE are self-limiting, and treatment may be largely supportive; others may require pharmacologic intervention and advanced respiratory support.

Urinary electrolytes, solutes, and osmolality.

Urine chemical analysis can extend "beyond the dipstick" with an understanding of renal physiology and expected changes in electrolyte and solute handling. Urine electrolytes, such as sodium and chloride, can be helpful in discerning prerenal azotemia from acute renal tubular damage, which occur secondary to nephrotoxins or ischemia. Urine osmolality also is essential in determining appropriate antidiuretic hormone action and renal water handling. Urine solutes, such as albumin and brush border enzymes, may be more sensitive than plasma markers for early renal dysfunction. This article reviews these topics and the use of "extended" urine indices in veterinary medicine.

Packed red blood cell transfusions in dogs with gastrointestinal hemorrhage: 55 cases (1999-2001).

Fifty-five dogs received packed red blood cell (PRBC) transfusions for gastrointestinal (GI) hemorrhage during a 26-month period (1999 to 2001), accounting for 11.7% of the PRBC transfusions in that time. Thirty-nine (61%) dogs had an intestinal pathology (primary or secondary) as the cause of GI hemorrhage, including intestinal masses, gastroenteritis, hepatic disease, and renal disease. Nonsteroidal and steroidal anti-inflammatory drug use was found frequently in dogs with GI hemorrhage. Sixteen (39%) dogs were identified as having immune-mediated thrombocytopenia (IMT) and associated GI hemorrhage. Dogs with IMT received more transfusions of PRBC than nonIMT dogs (P<0.03) and received a significantly larger total volume of PRBC (P<0.01) during hospitalization.