Blood Transfusions in Dogs and Cats Receiving Hemodialysis: 230 Cases (June 1997-September 2012).

BACKGROUND: Multiple factors exist that contribute to anemia in dogs and cats receiving hemodialysis, can necessitate transfusion. OBJECTIVES: To describe blood product usage in dogs and cats with acute and chronic kidney disease that were treated with intermittent hemodialysis to determine risk factors associated with the requirement for blood product transfusion. ANIMALS: 83 cats and 147 dogs undergoing renal replacement therapy at the Animal Medical Center for acute or chronic kidney disease. METHODS: Retrospective medical record review of all dogs and cats receiving renal replacement therapy for kidney disease, from June 1997 through September 2012. RESULTS: Blood products (whole blood, packed RBCs, or stromal-free hemoglobin) were administered to 87% of cats and 32% of dogs. The number of dialysis treatments was associated with the requirement for transfusion in cats (adjusted OR 2.21, 95% CI 1.13, 4.32), but not in dogs (adjusted OR 0.98, 95% CI 0.95, 1.03). Administration of a blood product was associated with a higher likelihood of death in dogs (OR 3.198, 95% CI 1.352, 7.565; P = .0098), but not in cats (OR 1.527, 95% CI 0.5404, 4.317, P = .2). CONCLUSIONS AND CLINICAL IMPORTANCE: Veterinary hospitals with a hemodialysis unit should have reliable and rapid access to safe blood products in order to meet the needs of dogs and cats receiving dialysis.

The use of darbepoetin to stimulate erythropoiesis in anemia of chronic kidney disease in cats: 25 cases.

BACKGROUND: Anemia is present in 30-65% in cats with chronic kidney disease (CKD) and few long-term treatment options exist. Darbepoetin is effective in treating anemia of kidney disease in humans and may be used in cats. HYPOTHESIS/OBJECTIVE: To evaluate the use of darbepoetin, a recombinant analog of human erythropoietin, to stimulate erythropoiesis, and to effectively treat anemia of kidney disease in cats. ANIMALS: Twenty-five of 66 cats that received ≥ 2 doses of darbepoetin at the Animal Medical Center between January 2005 and December 2009 were included in this study. METHODS: Cats were included in the study if they received darbepoetin and follow-up data were available for at least 56 days and had CKD as a primary clinical diagnosis. Cats were excluded if they were treated with darbepoetin but did not have kidney disease. Response to treatment was defined as reaching or exceeding a target packed red blood cell volume or hematocrit of 25%. RESULTS: Fourteen of 25 cats responded. Thirteen of those 14 cats received a dosage of 1 µg/kg/wk or higher. Presumptive adverse effects included vomiting, hypertension, seizures, and fever. CONCLUSIONS AND CLINICAL RELEVANCE: Darbepoetin is effective for treatment of anemia of kidney disease in cats. Pure red cell aplasia appears to be less common with darbepoetin than with epoetin usage.

[Primary choriocarcinoma of the cervix]. / Choriocarcinome primitif du col.

We report a case of primary choriocarcinoma of the cervix in which the patient died 9 months later. The treatment consisted to administer 5 cycles of chemotherapy pre-operatively and a colpohysterectomy. The pathogeny is a cervical migration of trophoblastics cells after a normal or molar pregnancy which degenerate to choriocarcinoma.

[Placenta percreta and uterine rupture. Apropos of 2 cases]. / Placenta percreta et rupture utérine. A propos de deux observations.

The authors present two cases of uterine rupture by placenta percreta at 27 and 36 weeks of gestation. Conservative treatment was used in the first case, and radical in the second. Concerning placenta percreta, an overview is presented. The pathophysiology is unclear, but a perturbation in the equilibrium between the trophoblast and the caduque is accepted. Many factors, maternal uterine and placental, contributes to this situation. Clinical presentations are hemorrhage, uterine inversion or rupture. The disappearance of the retroplacental anechogenic zone is the recent ultrasound's contribution to the early diagnosis. The treatment is either radical which is the treatment of choice or conservative and the methotrexate could be an interested option.