Page 7 - Clinical Connections - Autumn 2024

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Page 7 - Clinical Connections - Autumn 2024
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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   Nylaֱs 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-  Nylaֱs 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 bloodֱ, I canֱt describe how wonderful
          canine donors. As Nylaֱs was an extremely   lack of response to immunosuppression ֱ   our family felt. Weֱd 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! Theyֱve 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
          Nylaֱs 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   RVCֱs 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, Nylaֱs blood smear showed that   01707 666399
                                              her platelet numbers had recovered.       Email:
                                                                                       qmhreception@rvc.ac.uk


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