Page 7 - Clinical Connections - Autumn 2024

Transfusion medicine
POMERANIAN WITH IMTP SAVED BY BLOOD

DONATIONS

Sarah Tayler, Lecturer in Small Animal Internal Medicine
hen three-year-old Pomeranian Investigations and surgery Discharge and recovery
Nyla came into season it lasted Nyla’s investigations were consistent with After spending 16 days in the QMHA, Nyla
W longer than usual. She became immune-mediated thrombocytopenia, and returned home. The family and their other
lethargic, lost her appetite, blotches immune suppression was commenced with dog, Ace, had been lost without her.
appeared on her abdomen and she had dexamethasone (a steroid medication to Nyla's owner, Jo Barrowcliff, commented:
ongoing bloody vulval discharge. suppress the abnormal immune response) “Nyla was severely anaemic and continually
As a result, Nyla was referred to the RVC, the day following admission. needed blood transfusions to keep her alive.
where she was diagnosed with immune- Nyla’s haemometra was considered likely We were desperately losing hope. I was glad
mediated thrombocytopenia (IMTP). to be a consequence of oestrus occurring she had the RVC the experts to deal
She was in hospital for more than a while Nyla was thrombocytopenic. However, with her. When the vet rang and said:
fortnight and supported by numerous as it was possible this represented an ongoing ‘I have good news, Nyla has platelets in
clinicians, as well as products donated by immunological trigger – and there was a her blood’, I can’t describe how wonderful
canine donors. As Nyla’s was an extremely lack of response to immunosuppression – our family felt. We’d gone through weeks of
complex case, the transdisciplinary an ovariohysterectomy was performed six heartbreak thinking we would lose her.”
approach fostered by RVC Small Animal days later. Jo added: “We owe her blood donors so
Referrals was invaluable to her survival and The surgery was risky as, at that stage, much! They’ve enabled our beautiful dog to
recovery. Nyla still had no platelets, and therefore live and come home to us. Nyla would have
Nyla was initially presented to the was at much higher risk of significant intra- most certainly died if this service was not
Emergency and Critical Care (ECC) operative bleeding, which the surgeons available.”
Service at the Queen Mother Hospital for had to manage. She was anaesthetised
Animals (QMHA). She was transferred to by the Anaesthesia and Analgesia team,
the Internal Medicine Service the following who monitored her parameters closely
day, who worked closely with the ECC, during surgery and ensured that Nyla was
Diagnostic Imaging Service, Anaesthesia comfortable throughout the operation.
and Analgesia Service and the Soft Tissue Thankfully, due to their combined expertise,
Surgery Service to enable Nyla to make a the surgery went smoothly, with minimal
recovery. bleeding.
She had multiple trips to the QMHA Nyla needed eight blood transfusions
Intensive Care Unit and received close during her treatment at the QMHA. She
nursing care from nurses from both the received a combination of packed red blood
Internal Medicine and ECC services cells and fresh whole blood transfusions
throughout her stay. All staff involved in from four different dogs. These quickly
Nyla’s care got to know her happy-go-lucky helped to restore her red blood cell count.
personality while she was hospitalised. With every transfusion Nyla required close
monitoring from the nurses in ICU to ensure
Nyla in hospital that she was tolerating the transfusion well,
with no adverse effects.
Without the availability of these blood
products Nyla would not have survived. Nyla back at home
The Blood Donor Programme team works
incredibly hard with our amazing blood The Blood Donor Programme is
donors and their owners to make sure we supported by the Animal Care Trust, the
have blood available for patients at their RVC’s registered charity.
time of need.
Nyla also was commenced on further
immunosuppressant therapy (azathioprine)
alongside her steroid treatment two days
after surgery and received an injection
of vincristine to try to boost the number
of platelets being released by her bone
marrow two days after that.
Thankfully after more than two weeks of For small animal referrals, please call:
treatment, Nyla’s blood smear showed that 01707 666399
her platelet numbers had recovered. Email:
qmhreception@rvc.ac.uk

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