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1 mg / ml) can be prescribed at low doses to stimulate platelet release from the bone marrow [ 4 ]. Vincristine is also used to manage common cancers; therefore, cytotoxic protocols must be followed to ensure the safety of practice employees and anyone who handles the patient. Peach did not receive vincristine, due to a positive response to the treatment she was already receiving.
Transfusion
Blood typing was performed, revealing Peach ' s blood type to be DEA 1.1 positive. Peach received a transfusion of packed RBCs to improve the oxygen-carrying capacity of her blood by increasing her haematocrit without administering the larger fluid volume associated with whole-blood transfusion [ 7 ].
Cardiovascular parameters were recorded for Peach before the transfusion to establish a baseline for monitoring for potential transfusion reactions. As Peach was already tachycardic at the start of the transfusion, signs of a reaction may have included the development of new arrhythmias, a further increase in heart rate, failure of the heart rate to decrease despite increased blood oxygen-carrying capacity, pyrexia, hypotension and vomiting.
Formula for calculating the volume of packed RBCs to be administered
Volume( ml) = Y × bodyweight( kg) ×( required PCV – recipient PCV) / donor PCV
Y represents the estimated total blood volume in ml / kg bodyweight.
Calculation in this case Volume = 90 × 10.8( 30 % – 12 %) / 60 % = 290 ml
Peach was housed in the intensive care unit for close and continuous monitoring during the transfusion. The transfusion began at an initial rate of 0.5 ml / kg / hour( 5.4 ml / hour) for 30 min [ 7 ]. Once there was no evidence of a transfusion reaction, the rate was increased to 81 ml / hour for the rest of the transfusion.
Observations were recorded every 5 min for the first 30 min, and then every 15 – 30 min depending on patient stability. Peach became progressively more cardiovascularly stable as the transfusion proceeded, and she was noticeably brighter by the midpoint of the transfusion( Figure 1). No transfusion reactions were observed.
Figure 1. Peach during monitoring.
Nursing considerations
Nursing a patient with IMTP can be challenging, and veterinary nurses play a vital role in helping to stabilise and manage the patient. It is important to consider the accommodation provided. Accommodation must be suitably padded, to reduce the risk of localised haemorrhage from small traumas to the body. Stress levels must be kept to a minimum, allowing the patient to settle and avoid injury, which may cause a spontaneous bleed [ 4 ]. The kennel should be easily accessible for frequent patient monitoring.
Patients should be walked in a harness, avoiding the use of slip leads, to reduce excess pressure on the neck, which would risk spontaneous bleeding. Soft food should be offered to avoid causing trauma to the gums. Gentle handling must be maintained; if the patient becomes distressed while being handled, this should be stopped and tried again after a break.
Use of the jugular vein should be avoided for venepuncture, due to the relatively high pressure within this vein [ 4 ]. Blood samples should be collected from a peripheral vein and a pressure dressing applied afterwards. Intramuscular injections should be avoided to reduce the risk of haematomas developing at the injection site. In dogs with IMTP, invasive procedures such as cystocentesis or feeding tube placement should be avoided where possible, as these patients may be predisposed to spontaneous and procedureassociated haemorrhage [ 4 ].
Volume 41( 4) • August 2026
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