Retrospective evaluation of admission total plasma protein as a predictor of red blood cell transfusion requirement in dogs diagnosed with traumatic and nontraumatic hemoabdomen: 90 dogs (2009–2019)

Abstract

Objective

To evaluate the association of admission total plasma protein (TPP) and the administration of red blood cell transfusions in dogs with diagnosed hemoabdomen. To secondarily evaluate additional point-of-care parameters associated with red blood cell transfusion administration.

Design

Retrospective study between 2009 and 2019.

Setting

University veterinary teaching hospital.

Animals

Ninety dogs admitted to a university veterinary teaching hospital after a diagnosis of traumatic or nontraumatic hemoabdomen (NTH).

Measurements and Main Results

Medical records were retrospectively reviewed; signalment, point-of-care diagnostics, and transfusion administration information was recorded. A total of 47 dogs (traumatic hemoabdomen 11/26; NTH 36/64) received packed red blood cell transfusions. For each 1 g/dL unit decrease in TPP, dogs had an increased odds ratio (OR) of 2.14 (95% confidence interval [CI]: 1.44–3.40, P < 0.001) of receiving a red blood cell transfusion. Dogs diagnosed with NTH were more likely to receive a red blood cell transfusion than dogs with a traumatic hemoabdomen (OR: 2.78, 95% CI: 1.11–7.141, P = 0.03). Lower PCV values (OR: 1.08, 95% CI: 1.04–1.12, P < 0.001), bicarbonate values (OR: 1.3, 95% CI: 1.09–1.56, P = 0.003), and base excess (OR: 1.27, 95% CI: 1.1–1.49, P = 0.003) were associated with a higher likelihood of red blood cell transfusion. Additionally, higher lactate (OR: 1.35, 95% CI: 1.16–1.63, P < 0.001) and Acute Patient Physiologic and Laboratory Evaluation (APPLE)_fast scores (OR: 1.10, 95% CI: 1.04–1.17, P < 0.001) were associated with increased red blood cell transfusion administration.

Conclusions

Low admission TPP, independent of low PCV, was associated with red blood cell transfusions regardless of underlying cause. For each 1 g/dL unit decrease in TPP on presentation, dogs were approximately 2 times more likely to receive a red blood cell transfusion during hospitalization. Other factors that were associated with increased transfusion administration included presenting PCV, PCV/TPP ratio, bicarbonate, base excess, lactate, and APPLE_fast scores.