Abstract

Blood product transfusion is a common and essential therapeutic modality in veterinary medicine; however, this therapy is not commonly undertaken in cetacean species due to potential adverse effects that may occur, particularly with the increased risk of reactions with repeated transfusions. This case study is the first known report of multiple blood transfusions administered from two separate donors to a single Truncatus aduncus recipient.

A captive adult female Truncatus aduncus presented after a short period (four days) of reduced appetite. Bloods were collected revealing a mild leucocytosis with a relative neutrophilia and a mild anaemia (haematocrit of 26%). On day eight black tarry faeces were observed. Repeated blood work revealed a rapid decline in haematocrit with a reading of 11%. Immediate blood transfusion was elected.

Donor #1 and #2: Blood was collected from two healthy male adult T. aduncus and macro-agglutination was performed to confirm a feasible match between donor and recipient. The caudal peduncle and dorsal tail fluke veins were utilized for blood collection.

Blood transfusion #1: 600 mls of whole blood was transfused over 1.5 hours. 1.5 hours into transfusion the animal went into respiratory arrest and required emergency stabilization until spontaneous breathing reoccurred. It is unlikely the respiratory arrest was a transfusion reaction but rather a decompensation during the procedure due to the unstable physiological state at which the individual was at during the transfusion.

Blood transfusion #2: A second transfusion from donor #1 was recommenced 1 hour ceasing the first transfusion. A further 400 mls was administered intravenously utilizing the dorsal tail fluke vein without any further decompensation or reaction noted.

Blood transfusion #3: A haematocrit 12 hours post transfusion #1 was 15.8% and it was elected to repeat the transfusion to administer the remainder of the blood volume collected from donor #1. A further 800 mls was administered over 2 hours without any adverse effects. Haematocrit immediately post transfusion #3 was 19.3%.

Blood transfusion #4: 48 hours after transfusion #3 was administered a haematocrit of 13.1% was measured and a further transfusion was elected. A second donor was utilized for this and 600 mls of whole blood was administered over 1 hour without any adverse reactions. The dorsal tail fluke vein was utilized for administration of blood in all the transfusions.

Premedications received prior to each transfusion consisted of chlorpheniramine maleate (Histamil®) 22 mg/kg and dexamethasone 0.05 mg/kg with half dose administered IV and half administered IM. With subsequent transfusions, due to the short time frames, these two doses were halved. Midazolam 0.5 mls IM (0.5 mg/kg) was administered prior to the first transfusion but was not utilized in subsequent transfusions.

Over the course of sixty-eight hours a single individual received 2.4 litres of whole blood from two separate donors. Upon addressing the primary cause of the anaemia, gastritis due to foreign body ingestion, the anaemia resolved. It is evident from this case study that blood transfusions from multiple donors to a single recipient is a feasible and safe method to stabilize severely anaemic cetaceans whilst the primary problem is being addressed.

Acknowledgements

The author wishes to thank Dr. David Blyde and Dr. Jenny Meegan and the team at National Marine Mammal Foundation for their input and contributions to the case.

*Presenting author