01 — Clinical focus
Read the trajectory, not one value
Rate of change, ongoing loss, perfusion, lactate, mentation and anticipated clinical course all affect the decision. Acute and chronic anaemia cannot be interpreted the same way.
When blood products are indicated.
A working reference for veterinary teams on where packed red blood cells and fresh frozen plasma have a role in small animal practice. This page describes indication categories. It is not a protocol, and it does not replace your own clinical judgement about a specific patient.
On transfusion triggers.
We have deliberately not published haematocrit thresholds on this page. The decision to transfuse rests on the whole patient: the rate of change, the presence of ongoing loss, oxygen delivery, tachycardia, lactate, mentation and anticipated trajectory. A chronically anaemic dog can be comfortable at a number that would be an emergency in an acute bleed. Treat the animal, not the value.
Packed red blood cells
When oxygen-carrying capacity is the problem.
Red cells are indicated where the patient cannot deliver enough oxygen to tissue, rather than wherever the haematocrit looks low. Packed cells rather than whole blood avoids giving volume to a patient who does not need it.
Indication
Immune-mediated haemolytic anaemia (IMHA)
Among the most common reasons a dog needs red cells. Destruction can outpace even a vigorous regenerative response, and patients often present profoundly anaemic and hypoxic. These patients need a cross-match rather than an assumption, because autoantibody complicates compatibility testing and many have been transfused before.
Indication
Tick-borne disease with severe anaemia
Babesiosis, ehrlichiosis and anaplasmosis are a leading cause of transfusion-requiring anaemia in Indian small animal practice. Babesia in particular can produce rapid haemolysis in an otherwise healthy young dog. Red cell support buys time while specific therapy takes effect.
Indication
Acute haemorrhage: trauma and surgery
Road traffic accidents, splenic rupture, haemoabdomen, and intraoperative or post-operative bleeding. In acute blood loss the haematocrit lags behind the true deficit, so the clinical picture matters more than the first number you get.
Indication
Chronic blood loss
Gastrointestinal ulceration, neoplastic bleeding, severe hookworm or flea burden. These patients compensate over weeks and can tolerate remarkably low haematocrits, so the decision to transfuse rests on clinical signs and trajectory rather than a single threshold.
Indication
Non-regenerative anaemia
Chronic kidney disease, bone marrow disease, chronic inflammatory disease and pure red cell aplasia. Transfusion is supportive rather than curative here, and repeated transfusion raises the risk of sensitisation, which makes typing and cross-matching progressively more important.
Indication
Perioperative support
Planned support for a patient going into a procedure with a marginal haematocrit, or where significant blood loss is anticipated. Planned transfusions are the ones we can prepare for best, so tell us early.
Fresh frozen plasma
When the problem is clotting, or protein.
Plasma carries coagulation factors, albumin, immunoglobulins and antiproteases. It is not a volume expander and it is not a substitute for red cells, and using it as either is the most common way it gets wasted.
Indication
Anticoagulant rodenticide toxicity
A frequent emergency presentation, and one where plasma is genuinely lifesaving. Vitamin K antagonism depletes factors II, VII, IX and X, and while vitamin K1 is the definitive treatment it takes hours to restore synthesis. Plasma replaces the missing factors immediately in a patient who is already bleeding.
Indication
Hepatic coagulopathy
The liver synthesises most clotting factors, so significant hepatic dysfunction produces a coagulopathy that no amount of vitamin K will fix. Relevant before liver biopsy or any invasive procedure in a patient with compromised hepatic function.
Indication
Disseminated intravascular coagulation (DIC)
Consumptive coagulopathy secondary to sepsis, heatstroke, neoplasia, pancreatitis or severe trauma. Plasma replaces consumed factors and antithrombin while the underlying trigger is addressed. Plasma alone will not resolve DIC if the primary process is untreated.
Indication
Hypoproteinaemia and hypoalbuminaemia
Protein-losing enteropathy, protein-losing nephropathy, severe burns and extensive wounds. Plasma provides albumin and oncotic support, though large volumes are needed to move albumin meaningfully, so it is generally one part of a broader plan.
Indication
Severe acute pancreatitis
Plasma supplies alpha-macroglobulins and antiproteases alongside coagulation factors, and is used in severe cases, particularly where there is evidence of consumptive coagulopathy or significant protein loss.
Indication
Sepsis
Septic patients frequently develop coagulopathy, hypoalbuminaemia and antithrombin depletion together. Plasma addresses several of these at once while source control and antimicrobial therapy do the definitive work.
Indication
Congenital coagulopathies
Von Willebrand disease, haemophilia A and haemophilia B. Usually needed around surgery, dentals or trauma in a known affected animal. If you have a diagnosed patient in your practice, register them with us in advance so we are not sourcing under pressure.
Transfusion planning
Four decisions before administration begins.
Product selection is one part of the case. Patient trajectory, compatibility, baseline observations and a monitoring plan determine whether the transfusion is managed safely.
02 — Clinical focus
Establish compatibility
Type the patient and review every previous transfusion. Cross-match any previously transfused patient and any case in which immune-mediated disease complicates interpretation.
03 — Clinical focus
Record a baseline
Document PCV or haematocrit, total solids, temperature, pulse and respiratory rate before administration. Without a baseline, a reaction can be difficult to distinguish from the underlying disease.
04 — Clinical focus
Plan monitoring and reaction response
Observe closely from the start of administration, record changes, stop and assess when a reaction is suspected, and report the outcome. That record matters if the patient needs another transfusion.
Choosing a component
Quick reference.
| Presenting problem | Component | Notes |
|---|---|---|
| Anaemia, no bleeding tendency | Packed red cells | Avoids unnecessary volume. Cross-match if previously transfused. |
| Coagulopathy, normal haematocrit | Fresh frozen plasma | Rodenticide, hepatic disease, congenital factor deficiency. |
| Massive acute haemorrhage | Both | Large-volume red cell replacement without plasma risks a dilutional coagulopathy. |
| Hypoalbuminaemia, no anaemia | Fresh frozen plasma | Substantial volumes needed. Consider as part of a wider plan. |
| Severe babesiosis | Packed red cells | Alongside specific antiprotozoal therapy. Monitor for ongoing haemolysis. |
| Sepsis with DIC | Fresh frozen plasma | Adjunctive. Source control remains the definitive treatment. |
Before you transfuse
Things worth doing every time.
- Type the patient. Especially any animal likely to need repeat transfusion.
- Cross-match if there is any transfusion history, and in any immune-mediated process.
- Record a pre-transfusion baseline. PCV, total solids, temperature, pulse and respiratory rate. Without it you cannot tell a reaction from the underlying disease.
- Monitor closely through the first fifteen minutes. Most acute reactions declare themselves early.
- Report reactions to us, including mild febrile ones. It is how the service gets safer.
What we need from you
To fill a request quickly.
- Species, breed, age and body weight
- Presenting problem and working diagnosis
- Current PCV or haematocrit, and total solids
- Blood type, if known
- Transfusion history, including anything years ago
- Whether the case is elective or an emergency
- Your veterinary registration details, if you are not yet registered with us
For registered veterinary practitionersThis page describes indication categories and transfusion-planning considerations. It is not a treatment protocol for an individual patient.
Recipient care, monitoring and follow-up
Talk to us about a case.
If you have a patient now, or a known coagulopathic animal you would like on our radar before they need us, get in touch. Registered practices get the current product schedule and our contact protocol for urgent requests.