Has your dog or cat ever needed a transfusion? Did you even know that was possible?! Well, it is!
Dr. Richard Stone, a board-certified internist and VP of Medicine for BluePearl Specialty and Emergency Animal Hospitals, enters the Chat Room to talk all about blood transfusions in pets. Dr. Jen the vet, Dr. Jason and Dr. Stone talk about why a pet might need a transfusion, some of the risks, and where all that blood comes from. Here's a link to Dr. Jen the vet's recent article on veterinary blood banks in Pet Vet Magazine: https://www.petvetmagazine.com/take-it-to-the-bank-the-advancement-of-veterinary-blood-transfusions/
For more info on Dr. Stone: https://bluepearlvet.com/our-leadership-team/
There's also a bit of V's View from Vet School tucked into this episode at the 11:30 mark! What is VMCAS and what does it have to do with applying to vet school? V's got a view on that!
For more information on applying to vet school via VMCAS: https://www.aavmc.org/becoming-a-veterinarian/how-to-apply/
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blood, transfusion, blood transfusion, cats, dog, red blood cells, pet, stone, vet, people, anemia, veterinarian, jason, donors, patient, question, cells, hemolysis, anemic, transfuse
This episode of chats with the Chatfields is brought to you by full bucket veterinary strength supplements.
Welcome to chats with the Chatfields. This is a podcast to expand your idea of what impacts veterinarians, pet owners, basically all animal lovers in the galaxy as humans, we are your hosts. I'm Dr. Jen
the vet. And I'm Dr. Jason.
And if you have not yet subscribed to our show, why not just go to Chatfieldshow.com And subscribe today. If you want to reach us, and you've got a message full of love and positivity. You can find me at Jen@Chatfieldshow.com
But for all of you other folks who just want to keep it real. You can find me at Jason@Chatfieldshow.com
Okay. Well, Dr. Jason, are you a little bit excited today?
I'm super excited even more than I always am I'm excited as normal times 10.
Okay, so, for all of you out there for the uninitiated. We are inviting an expert into the chat room today. As per the usual,
that's the usual one of us experts.
No, no, no. But we are inviting a very special guest because it is someone from the land of Dr. Jason
Yes, indeedy. Yes, indeedy, folks, that's a very, that's a very, very small landmass. The fact that he is someone that admits to that it's like we just gotta get them on. It's fantastic.
That's right. As soon as they commit, we say great. Now we got Yeah, I want to record now. Yeah. So let me tell you who this guy is because then I'm gonna remind you he comes from the land of Dr. Jason. Right. So joining that is a classmate of Dr. Jason from Texas a&m College of vet med. They graduated together.
Oh, no, sorry. I'm still I still mess that up. Right. Sorry.
Okay. That's the Aggie whoop. Yep. It's Dr. Richard stone. And he is like, he needs a bucket to carry around his letters in his title, I think great.
Take a deep breath. You take a breath and then you you, you you There you go. Now let us know what his title is.
Okay. So not only is he a DVM, a veterinarian, but he is a boarded specialist in small animal internal medicine, which is, I mean, that's crazy town, small animal internal medicine. He's also currently the vice president of medicine. At so I gotta take another breath for this. I
know. You're running out of breath.
He's the vice president of medicine at Blue Pearl specialists. And emergency care pet care. Hospital. No, I don't get it. Blue Pearl
just asked why don't you Why don't we bring in Richard and okay, you can tell us exactly how we're supposed to say all that. Okay,
Dr. Richard, tell me the name again. Because we just call it blue pearl.
You bet a lot of people just call it blue pearl. But that full name is Blue Pearl specialty and emergency Pet Hospital. Now
thank you very
much emergency rolls off the tongue.
It does. I think it means that whatever is ailing your pet, whenever it's ailing. You can find Dr. Stone and his team, right? That's right. Okay. Okay, but we're not going to talk about pearls and emeralds and rubies and whatever your favorite gemstone is. Today, we want to talk about something that I have recently discovered to be acutely of interest, which is transfusions, and pets. Right?
Yeah, that's super awesome. And Dr. Stone is gonna tell us all about it. We're gonna ask him questions. He's gonna let us know what's happening because everybody has heard of transfusions if you've watched TV, you've heard about it, but probably you don't know the ins and outs of it. There's a little more detail than just like, take some from a PUT IT IN be wha Bob's your uncle. That's just not how it works.
Right? Well, actually, I think, I don't know. That's what I'm saying. Yeah. Oh,
I don't know what that you can do this and animals. Yeah.
Like, oh, yeah, I think you're probably Dr. Stone. Like, do you find that something like pet owners are like, wait, what? What do you mean, we need a transfusion? Do y'all do that?
That does come up. You know, we see pets frequently, as I know, a number of veterinarians do where they're ill for a variety of reasons. And sometimes one of those illnesses is anemia, or a low red blood cell count. Okay, depending upon how severe that is, yeah, right, or how quickly it came on. They may need a transfusion. And when that conversation comes up, I would say at least half the time the client says, Wait a minute, how are you going to do that? Wow. Blood come from? Yeah,
yeah, half the time. That's crazy. I mean, it's hard. To be honest, it's hard for us and I don't mean this in any kind of, you know, authoritative way I read Yeah, any kind of bad way but we live in this world or you guys do but I used to live in the world went to school anyways. So we just think it's a normal thing. But you know, the most people, you know, maybe it's their first dog and they don't they don't it doesn't even cross their mind. So I, it's hard for us to sort of grasp that. But that is interesting. It is it is half. It's half.
No, crazy. I'll tell you like in my emergency clinics, which was not a specialty hospital to be sure I had no board had specialists running around.
Especially as you were there, Dr. Jenn. Ah,
thanks for that. I'm coughing you know what I'm coughing? Because Dr. Jason is trying to blow some smoke at me. That's why but Oh, I see. So at any any rate, I think people are concerned. And then if you think about it, then then you might wonder, Well, why would my pet need a transfusion? Do they need one right now? How would I even know? Right? And so, and Dr. Stone threw out there. If you have a pet that's anemic, right? The red bloods count is too low, which can happen quickly or slowly. But already, like pet owners, like, you know, most of their eyes are glazing over because their legs over? Yeah. What does that even mean? And how do I know? And so I guess that's let's, let's start there. Right? We're going to start there, we're going to end with like some story, you gotta give me some dirt on some something silly or stupid that Dr. Jason did in vet school? I like I would like some some ammo. Okay, but so let's start there. Right? How if I'm a pet owner? How do I know if my pet might need a transfusion? Or would I know?
You know, it's a great question. There's some subtle things that we can notice at home, that might indicate that we're anemic, meaning our red blood cell count is low. And, and I think it's important to remind ourselves to have like, what why do we have red blood cells? What is the purpose, right? And in for all of your listeners, it would be important to know that, hey, those red blood cells carry oxygen, you know, they've got a molecule hemoglobin inside of those cells circulating throughout the body that capture oxygen, and deliver that to the tissues in the body. So pick up that oxygen in the lungs deliver it to the tissues out in the body. And so we may notice subtle signs at home, like my pet is slowing down is lethargic, you know, less active or less, less exercise tolerant. One of the big things we may notice though, is if you look at their gums, their gums no longer have that nice, healthy pink color understanding some pets have kind of pigmented, darker colored gums. But if they start losing that pink hue that we expect, that could be a sign.
I was checking my gums because Dr. Stone said exercise intolerance was a sign and I'm like, oh, that's gotta be me. I'm checking to see if
you're huffing and puffing. That's taller. I
was maybe I wasn't naming on the blog. Thank you. Thank you, Dr. Stone.
Are they? Like, you know when cuz that only bring wants to play fetch like twice. You know, I throw the farm fresh Frenchie, because when I throw the toy, and on the third time, she looks at me like Well, I'm not going to get it you go get it? Is that excess exercise intolerance? She is intolerant of the exercise. That could be behavioral. It could also just be because she's the Frenchie.
Right? But you bring up a good point, which is the stuff that I'm mentioning the symptoms anyway, they could mean almost anything. So it's really important that if we see something like that, we have our primary veterinarian, take a look, evaluate for any obvious other causes for that. And if it leads them down the path of saying, Well, I do think the gums are a bit pale, I think we need to do some lab work some bloodwork count is
there i i was just gonna say this is a reason why when your veterinarian says to you, I need some more data, I need some more information, we need to do some blood work, find a way to say yes to that if you can, but realize that bloodwork is not going to fix your pet. Right? It's just going to help us determine what you need. And one of those things could indeed be a blood transfusion. Right? So so if you only have 10 shekels, you know, make your veterinarian aware that so you don't spend nine of them on bloodwork and you only have one left and you can't pay for the treatment. Right? So we got to know that upfront. Okay, so then just shekels wisely, whatever whatever that Yes. Well, because it doesn't really matter. There's never there's never enough like, you know, and that's a legitimate concern. I think that people need to need to recognize that your veterinarian at least if, like, if Dr. Jim, is your vet, like I don't care, I'm not judging you based on how much you're gonna spend on your pet. You're already a good owner because you didn't have to show up. Right? You didn't have to walk through the doors at the Blue Pearl veterinary No, the blue pearl, specialty and emergency care and hospital, right? Almost no, no, like a close eye. The place that I see pets is a lot easier. It's just New Tampa, New Tampa Animal Hospital. It's a lot easier. But of course of course we don't have a bunch of specialists running around either Okay, so So you walk in the room, or the vet walks in the room and says, We need a transfusion. So the next question Dr. Jason had, which was great, which is, where are you gonna get the blood from? And wait, Dr. Stone? I know you have an answer for that. Dr. Jason has an answer. We're gonna get both of those answers, or we're gonna get them after the break. Okay, so everybody Hang tight for coming back to talk about. Now what happens now you know, your pet needs a transfusion, what happened? All right, we'll see you on the other side. Dr. Jenn the vet, and I'm here with my friend and colleague, Dr. Keith lassen. He's got an incredibly interesting story all about full bucket health,
my college roommate and that school, housemate. Dr. Rob Franklin and I were collaborating on some cases, both of us were struggling with diarrhea in some of our patients, whether it was after a procedure or after after an illness. So we created a formulation. But we didn't want to just create a formulation. We also wanted to create a movement and animal health, for being able to help animals in need, through the use of bar products that we developed that really has resulted in our one for one giving program, which we're we're really proud of, as much as we are our formulations for dogs versus cats.
And so if you want to know more about their one for when giving it full bucket, or if you're interested in better supporting your dog, cat or horses, digestive health, head over to full bucket health.com to learn more.
All right, well, let's see what's happened in the world of bee.
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service announcement regarding them Cass which stands for veterinary medical class, college application specialists. No wait, that's not ready, services services. So Veterinary Medical College Application Services or vem. CASS is how pretty much everyone applying to vet school will be required to do so. And I want you to inform everyone listening of this process for some helpful guidance or just fun tidbits and info. I am sure everyone out there assume being smart and hardworking was all you needed to be to get into vet school, you will be wrong. Because along with navigating and completing all of your prerequisites for whichever program you decide you're interested in, you also will have to be savvy enough to navigate and complete the Venn cast application system, which is fairly difficult actually, most veterinary schools now use them cast for their application process. But fear not them. Cass has wonderful customer service individuals. So utilize that there's a number right on the screen when you go in there. Let's talk timeline. So Ben Cass opens January 15. Ish, it may vary from year to year, but it's in January for you to begin adding information to your application. This does not mean you can submit your application at that time. But it's a pretty long process and you're going to want to be able to get everything in in a timely manner. Then around June or July, you'll be able to actually submit your application to whichever schools you choose to. The benefit of Van casts is you can apply to multiple schools with this one application. But beware, you may also have to complete an application with the school and there may be additional application fees with the individual school. The applications are usually due around September 15. So that seems like a lot of time from January to September or even from June or July to September. But that time sneaks up on you, especially when you have to get all your transcripts said and your letters of recommendation and everything else. I hope that public service announcement was helpful to everyone or informative. Thanks for listening IV and that's my view. Want to share your view? Are you seeing what I'm seeing? Or do you have questions about that school? Send it to me at info at Chatfield show.com.
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Okay, and we're back and still in the chat room with us is Dr. Richard stone. We're talking all about blood transfusions and s because it's a thing. And so before the break I said that like imagine yourself where the veterinarian has just come in and they said your pet needs a transfusion. And I guess I should say we didn't really finish like why so they could have been like hit by a car. They could have had a dog fight. It could just be sick.
I think anything that can that causes major blood losses is the primary reason for For
Yeah, they could also have a weirdo, not weirdo, but less common autoimmune disorder where their body's immune system is attacking the red blood cells, right? Like,
that's right, you bring up a good point, which is like if we talk about anemia, that there's multiple causes for it. And the transfusion can help us in the short term, stabilize the situation. But we still need to understand why did the anemia occur? Why don't we have enough red blood cells in circulation and your categories are right? Could be blood loss, right, there was some sort of trauma event or gastrointestinal bleeding or something like that, or, or it could be hemolysis, which means the red blood cells are actually being destroyed in circulation and not being lost, they're being destroyed. And that could be caused by certain infectious diseases. It could be caused by the immune system attacking its own body. It could be caused by certain toxins, guys remember, like, right, pennies have a lot of zinc in them. And if a dog eats a penny, that zinc just gets unloaded and gastric acid goes into the circulation and destroys red cells. So blood loss or hemolysis. Those are the two big categories for why I might very quickly go from having plenty of red blood cells to having not enough now I'm anemic and I need a transfusion.
What about zinc? I mean, what about sorry, nickels? Because I thought that I thought, Is it zinc that's in the penny? Or is it copper? That causes the thing? Well,
it's both there was a particular year, which I can't remember off the top of my head where they shifted from going, Oh, my
gosh, you're fired. Copper connait. You're an expert. What do you don't know the year that was in the opposition, and he's willing to
go with the 70s. So it went from being all copper. Now there's zinc. Now they're predominantly sick. And that's a big deal. Oh,
okay. So not only are they eating your money, literally, then you got to pay to take care of them because they ate your money. Terrible. Oh, my gosh, because that is lucky. She's cute. Okay, so so so any of those reasons, you could find yourself standing there across from the vet at the exam table, and they're saying, hey, we need to transfuse them. Right. And just just for like, the sake of thoroughness, the reason like, what's the measurement that they're going to tell us is too low?
Oh, great question. So there's a couple of different terms you might hear thrown out there. If you're sitting across from the veterinarian, and they're telling you your pets anemic, they may mention red blood cell count. They may mention hematocrit, ding, ding, ding. That's the one I like. That's the one you like you're getting me. Yeah. Or they mentioned packed cell volume. Oh, and that one, right. And so dramatic written packed cell volume. They're not exactly the same, but they're pretty close. And basically what it means is, if I look at a volume of blood, it's a mix of red blood cells, white blood cells, platelets, cells, and then a bunch of fluid, right? Yeah, yeah, well, I want to know how much of all of that all of that volume of blood is actually red blood cells. And for a normal dog, let's say it's going to be somewhere in the range of 35 to almost 50% of that blood volume is made out of red blood cells. So if they come to you and say, look, the hematocrit is 19%. Or the pack cell volume is 20%. What they're saying is, you have far fewer red blood cells comprising your blood than you normally would. And that's why we need to do the transfer.
Yeah, it's to dilute is to dilute it's like when you make tea with it with your tea bag, right? Like you need to you can make it really weak, or you can actually open the tea bag up and make it sludgy if you want to, because that's also another problem, right? Like if it's too we have too many red blood cells. So that's a whole different issue. That's another episode. Right? And so, yeah, so Okay, so it's too diluted, we don't have enough red blood cells to carry the oxygen. When you transfusion, so Dr. Jason Oh,
finally, I mean, you Teza had an answer, like 20 minutes ago, and I've been ready, like my hand like horshack right now. Oh, I'm ready. I'm ready. I got this one. Okay, guys, so ask the question. I think I think I know what you're going to ask, I think actually have a decent answer. So
I used to get this in the emergency clinic all the time. When I would say are we going to do a blood transfusion? The owners would be like, where are you going to get that?
Right. All right, blood. I'm ready. I'm ready for my big
cousin. In the human world. Where did they get it? Jason? Where do they were?
My guess is they're gonna get it from another animal. An unsuspecting I don't have any idea but they're gonna get it from another animal I give It's a dog. They're gonna get it
from a dog versus a plant. You mean like another as
making fun of my answer. I'm pretty sure Richard
did. Did you carry him through vet school? Is this
Yes, he did. he'll never admit it. What 100% Richard carried me through vesicle Oh, god.
Okay. All right, Dr. Stone, where are you going to get the blood? Well,
it is true that the blood comes from another animal. Species was correct. Dog. Right? Yeah. But there's a lot that goes into how we collect that blood. How do we get that blood because we don't just randomly go to another patient and say, Okay, we need some blood. Right? There's there's a process by which we collect blood, just like I mean, we're used to seeing this on the human side.
Right. Richard, can I stop you for just a second? I know you're about to get into it. And I don't see but I want I want to clarify something. I was watching The Walking Dead the other day. Okay. Okay. All right. Yeah. So I mean, it's super true, right? This is definitely the zombie apocalypse situation. No, no, it's true. They literally took a tube stuck in somebody's neck. And then random blood right to the other person's, you know, other other jugular, I guess, I don't really know where they put it, but they knew the other person. Isn't that not what happens? Same? Right.
There may be something about zombie blood that I don't know about. But that's
not a zombie. It was just on The Walking Dead. It was to humans. Yeah. So that doesn't happen that way. differently, or differently than
I'll be. Oh,
wait a second. But wait a second. I mean, it may not be right. But it's not wrong. Like, because that's how they started doing it with people first, right? They just hook you up to another person. Of course, it didn't turn out well for the other person every time, like, depending on how much they took. But, you know, I mean, you can do it that way. That's less than ideal. Okay, so, Dr. Stone, we can get it from another
dog. We can get it from another dog. And you know, there are actual blood banks. You know, we see this on the human side we're very familiar with, okay, you know, the big bus or van pulls up and they have all the equipment and people donate blood and the bloodmobile.
Yeah, right. You get a t shirt and some more, you get t shirt.
Maybe, yeah, maybe a cookie. Yeah. Right. There's that. On the veterinary side that the way like the nuts and bolts of how this works is we would have a pool of donors, a group of donor pets, okay. And that we can get into how the blood is taken and all that it's actually not very dramatic. It's actually very, very well tolerated. But the point is, we collect the blood from healthy donors. Okay. Okay. That's
the other thing. He said the word healthy. Like, I'm wondering about diseases like how do I know that you're not going to give my pet a disease from that blood?
Great Call. So you have to screen that blood. So there's some things we want to know. We want to know that the pet is healthy. Pet is free of disease. And there's there's a list of different diseases that we test for that we screened for from our donors before we even collect their blood. Right. And yeah, there's actually like heartworm,
tech Tick Tick diseases,
I'm gonna guess mainly blood borne diseases,
blood borne diseases. All right.
Got it. You got it. I think I'll follow and picking up what you're laying down here. You got
it, but but even just their overall health has to be good as well. In addition to all that investigation, we do to make sure they don't have any blood borne diseases, the donors, overall health has to be good. So usually, we're looking at relatively younger adult dogs, larger dogs, because they have a bigger blood volume, and they're free of diseases because they've been screened.
Okay, so, so we're going to, we're going to get the blood. And then, and in humans, we know there's different types of blood, right? There's a B, there's a B, and then there's like, oh, and then everything is positive and whatever. Are there different blood types on dogs? Or does it not matter?
It does matter? It's a great question. So there are different blood types. It sounds a little bit different in dogs versus people. We use these the the nomenclature we use the names we use is DEA and it's dea 1.1 dea 1.2 DEA for you can go down the list but the DEA part stands for dog or erythrocyte antigen.
Oh, not dragging.
Jennifer, you said DEA she got a little worried. They're just like, wait, what? What's happening here, but just just to clarify. erythrocyte is another fancy word for red blood cell. Exactly.
Okay. That's cool. Yeah. Okay, nailed it. Good show. Jason remembers that. I was out on a limb there for a second. Yeah. Okay. So um, so there's different types of blood in dogs. We haven't even talked about cats. Ooh,
good point, Kathy. Because
they're just small dogs. Oh, no,
not right. Here on chats. We know that cats are not just small dogs. No, I but we also know that Frenchie is our cats kind of, but yeah, okay. Yeah, they are. Anyhow. Okay, so what about cats because cats Cats have all the same risks for the need of a blood transfusion. Is it the same? Could you do dog to cat or cat to dog? You can't? Right?
Good. No good question. Good question. So cats do also have blood types. And their their naming system is more similar to humans, there's type A and type B. And cats are exquisitely sensitive to getting they have to get the right kind of blood cap to cat. So the predominant type that we see in the United States is type A, there are some Well, right.
I think you need something else. Oh, cats are exquisitely sensitive. Alright, and they have to have type a type. Right? Yeah,
right. Well, there are some cats that are Type B, you know, we think of some of the more exotic breeds Persians cats like that there's a subset, maybe 2% that are that are type B. Cats are very sensitive with respect to their immune systems if they get the wrong kind of blood cat to cat. That being said, there is a such thing as what we call a Zeno transfusion, which means blood from one species to go into another species. And you in theory, in a pinch, if we didn't have the right match of blood, you can ask now this sounds outrageous. You can give dog blood to a cat if it was a life threatening emergency, but we prefer not to do that we prefer to give type A blood to a type A cat type B blood type B cat,
can you imagine? Right? Zombie Apocalypse? Can you imagine the cat like waking up? Or like realizing like you totally say, the blood we gave you was from a dog that can be so ashamed.
Like get it out of me. I want no part of you in me.
I can only imagine. So okay. So I think that's interesting, because when you talk about Zeno transfusion, because recently I had reason to become acquainted with the historical events and Transfusion Medicine.
short lesson on like, Dr. Stone is talking about, I mean, I don't know how recent this is, this could be 20 years, it could be five years. I don't know how often. How long have we been doing this? Right? How long has it been humans, pets, whatever has been we've been doing sort of transfusions, like a lot
of like a long time. 100 years or? Yeah, like, centuries? Yeah. Because Holy cow. Well, because, I mean, they recognized back back in the day, you know, a couple centuries ago that people recognized Hey, bloods important it with compatibility with life. Okay, you know, like, you sort of need that. And so they would transfuse people from other people. But first, they tried transfusing people with lambs blood. And they had some success, right. So like, there were six people they wrote about, I think only four of them died.
Oh, good. Yeah, that's two out of six ain't bad, I guess. Right, right. Are those two
Yeah. And then they they transfuse people from other people. But then sometimes the donor died. You know, there's a Mac, you can't take sanguine ate them while you're trying to save the other person. Although, and back in those days, remember, there was like a severe class distinction, right? So it'd be like the servant class. And so they'd be like, well, we'll get another one. Another one. Yeah. I mean, people did horrible things to other people in the history of the planet. And then after that, like because people there were such horrible outcomes. They banned it globally. So we went a long time and nothing. But then they had the bright idea to transfuse people with wait for it. Milk. Ah,
have you ever heard of that? Dr. Stone milk? I think I did read that on the internet one time on Instagram or something, but I didn't really believe it. But you're telling me it's true. Dr. Stone you ever heard of that? Shall we? not heard of that? That sounds imagine how that would go right? So just don't worry about I'm gonna put this listen, you drink milk on your baby. So it makes perfect sense. I'm gonna put some more milk inside of you to save you alive? Well, but like
in the early 1900s. They thought milk was a great medicinal thing, right? They thought milk cured TB. Right? Even though actually milk was the source of the TB infection. Anyway, so I'm sure like 50 years from now they're gonna say some of the stuff that we do medically is crazytown. Right.
But it's stuff that you do. But listen, that's all interesting. It's very good, brief history situation. Thank you. Welcome back out of the weeds. They're on point here, because we had a couple of things mentioned that I'm very interested in learning about one being blood banks for animals. Yeah. Cool. I don't know if we were finished. And if you're finished with the blood typing, and all that kind of Yeah, I think so. Well, but the other thing was the hours and hours of this stuff. Yeah. But
the other thing I think that pet owners should be aware of is that like there's because there can be adverse reactions, right. That's why I'm saying they killed people when They would do transfusions because your your body reacts to foreign proteins, right? And so your veterinarian if they're going to transfuse your dog is going to prepare your dog or your cat, right? Like me. I'm not as fancy as Dr. Stone. I'm not an internist. I give him steroids. Drill
is gonna hang up.
Steroids are good when used appropriately. appropriately. That's right. They're not evil. They hold no ill will. Right.
And so on off the soapbox, let's Yeah, well,
because you know, it's like some younger veterinarian, don't worry, like, oh, with steroids, you know, sorry, steroids are helpful in many situations, including when you're trying to tamp down an adverse reaction to a blood transfusion. Yeah. So what are you pre med with Dr. Stone? What do you think?
You know, pre med is a great question, a great topic to tackle because there's some controversies about whether to pre med or not to pre med, I'll tell you, when you mentioned the preparing for a blood transfusion, there's a few things worth pointing out one, for the donor, we make it extremely safe, right? We are very, very strict with the volume of blood that we can collect, right how much they can donate to the point where we're actually weighing it with a grand scale, we're not just going based on the volume or weighing it as we go to make sure they're taking out precisely the safe amount. Okay. And then before we do the transfusion, that the recipient, the patient that needs the blood, we need to understand, okay, what is their blood type, and then we can actually do a cross match and say, Okay, I'm gonna take a little bit of your, your, your blood, basically your serum as the one that's going to receive it. And then I can take some of the blood from the donor, and do this sort of cross match scenario where I understand how's this blood going to behave in your body? Can you
just tell people what that looks like? Because look, he's making it sound super fancy, I take a drop of the, the serum from the one dog, I take some blood from the other dog, and I put them together and mix them up on a slide and look and see if they clump.
Pretty much. That's pretty accurate. We want to know if it's going to if it's going to cause immediate hemolysis or, you know, is the patient that needs the blood? Is their body going to destroy these red blood cells as soon as we give it to them? Or is it going to cause agglutination with the cell stick together like you're mentioning? So yes, we want to do that beforehand, so that we know what's going to be safe. Now, some people do still pre medicate. prior to giving blood they pre medicate the recipient, right with things like Benadryl and steroids, some do not, we just we start at a very closely calculated rate, and then may progressively increase the rate over time, but the whole time we're doing a transfusion, we monitor for signs of allergic reaction, we monitor for signs of fever, sometimes intestinal upset, and we monitor for signs of hemolysis. There's that word again, which means destroying of the red blood cells. So we monitor for all of that the whole time that transfusion is being given. Yeah,
I do all of that. Right? Like I started slow, you know, for the first 15 minutes staring at them, because everyone knows if you're staring at them, they won't have a problem. And
don't blink, right?
It's true. It's true in emergency medicine. That's why I wouldn't be able to see all the pets all the time. Because nothing dies while you're staring at it. And so, yeah, started slow. But I do give a little steroids. So is it wrong? If your vet it gives a little bit of steroids or Benadryl before the transfusion?
No, I don't think it's wrong at all. I think the scenario is, you know, we're in this place of Veterinary Medicine, where, over time, we're gathering evidence, we're gathering data, and we call that evidence based medicine. You know, what, what proof do I have that this is helpful? What proof do I have that this is harmful? And this is one of those areas where maybe there's more data to be collected. So people may take a different path there, some will pre medicate, some won't. I don't think either path is wrong. I think the important part is, if we see that a patient is reacting negatively to a blood transfusion, we're monitoring and we're prepared to intervene if we need to. Many patients do very, very well though, if they're, if they're in a position where they need a transfusion, we do our blood typing and cross matching, and then we administer it in an appropriate manner. It can be life saving for those patients.
So I have a question real quick for because you guys are just saying it's something that seriously, I relate everything to TV because everybody watches TV. I'm sorry. So hey, I got this blood type. I got that blood type blah, blah, blah. How is there a test? Like can you just do that in the clinic or they have a pretty like, pretty simple test, hey, you take a blood and this is going to be type A or do you just strictly do the crossmatch? Do you do both you are you able to blood type that the patient both of them like right in house. That's pretty cool,
right? You can there's some simple desktop kits that you can use to get what type and there's part of the reason why we want to do this is when we talk about blood transfusions when we talk about The Blood Banking, there's this concept of quote unquote universal donor blood, right? That's D A 1.1, negative 1.2. Negative. But there's a whole population of dogs that are D A 1.1. Positive. That could be donors, that could be donors, but their blood is only good to go to another dea 1.1. Positive dog. So there is a time where it's valuable to not only crossmatch, but blood type our recipients, because if it's a DEA 1.1 Positive dog, well, I might have dea 1.1 positive blood that I can give them. So it just expands my pool. Oh,
then you don't waste like the universal one that you may need for another dog. You know, at some point? Yeah. Yeah. Interesting. Interesting. Is there a universal donor for cats?
You know, cats are tricky. And you've got to you have to do your homework on that patient every time meaning we have to know what their blood type is. And ideally, we cross match as well, because cats are so reactive. Now, when we get into the topic of reactive, what we're talking about is those allo antibodies, the antibodies that are already there in circulation, ready to destroy a transfusion, if administered, type B cats, some of those, those type B breeds are far more sensitive to being given the wrong blood and will have an immediate and actually could be fatal reaction. Like it could be very, very serious. Yeah. So we always blood type cats, because we don't want to be surprised. Yeah. And find that we have a tight Be patient.
Yeah. And I guess it's so so when I when I remember learning about transfusions was because, you know, I just remember broad things. Dr. Stone, you remember details, and I get the broad strokes, and the broad strokes where you can get away with a single transfusion and a dog, and you'll probably be okay. Like, yeah, your second transfusion gotta be little gotta be a little more more heads up. Yeah. But with a cat, you cannot, they could die on the first transfusion if you don't do it, right.
That's right. That's right. Dogs tend to not have high titer allo antibodies mean, they don't have a ton of antibodies already in existence. So if I had if my own pet, if Chuck was involved in a traumatic event, no Chuck, if he got hurt, and he was anemic, and I had to give him a transfusion, but there was no time. Yeah, if I had no time to do typing and cross matching, I would confidently give him dea 1.1 negative blood, we call it universal donor blood. And I would be confident that he wouldn't have a reaction. Now, the key here is, when we have rescues, we don't always know if they've had a transfusion before or not,
right? 100% Unknown history, unknown,
That's yeah, so that's true. So it's another reason to be very upfront and honest with veterinary staff about your pet and what you know, and what you don't know about them, even though you've had them for 10 years, didn't have them for the first two or three. And so who knows what they may have gone through. So that's a great point about history.
You live in this world, more than more, certainly more than I do. That's for sure. So I'm just curious how often, you know, do you do cat transfers? And we keep bringing it up? But is it? Is it pretty rare? Or is it like half and half or? Or what it I would say, Do you have any kind of idea? Really, I mean, I don't know. It would be a
rough estimate just based on my anecdotal experience, but I would say it's, it happens far less frequently than in dogs, but it happens with regularity. You know, to give you kind of detail of things, just even in our own hospitals, we give somewhere on the order of 10,000 transfusions annually. To dogs and cats combined. A vast majority of those go to dogs probably nine out of 10 plus but it happens with enough frequency in cats that in that kind of environment where if you're in an emergency room or specialty hospital you often will have cat blood on him from you know that you obtained from from Lubbock so that you're ready in the event that a Cantonese
So speaking of blood banks, I told you guys that that I found that very interesting, because I remember not to bring up too much past but I worked at a clinic while before I was in vet school.
Wait a minute. Wait a minute. Did you and Dr. Stone maybe work at the same clinic before vet school?
Yeah, we did. It was actually an interesting story we don't have probably time for but we're different shifts. Like we didn't really know each other. Right? I was like a guy. He's like, Oh, there's that guy. And then turns out we got into the same. I mean, seriously the same clinic I would walk in, in a mortgage and would walk out you would know pretty much but at lunch I would walk out here walk it was just didn't really, really talk much. It was a crazy thing and Invesco ended up somehow sitting next to each other like Aren't you that guy from? Yup, that's me. I'm like dude. Anyways,
we have to give a shout out to Van Saverne to Dr.
Van Van Stiver. Neil Benz tavern events divers Farm Animal Hospital was fantastic for me and I'm assuming for richer but yeah, big shout out and we'll send them a copy of this right?
We will be definitely sending a link to the vans. They can put it on the loop
and I'm sure he's got TVs everywhere because I used to watch the Golf Channel every day. Yeah, yeah. Anyways, back in the day right back there's a long time ago now they just have a clinic, dog. I don't know. I mean he would just use I think his dog from home but basically a lot of the boxers. Yeah, exactly. Could that like okay, I got a transfusion, I'm gonna go drop blood from this dog do my testing and then give it to the next dog. And you guys are saying that's there's so much more involved and so much more with blood transfusions are actually blood banks? Are you can I order it? Is that the right word? Right? In house? So you just have it right? That is that's super cool actually asked me,
you know, there's there's, so all of the above you mentioned could be appropriate, right? You could have as the the veterinarian or the staff could have large breed dogs that have been screened, that are healthy, that are not anemic, right, that would be appropriate donors. And that's, that's actually fine, you can actually do the collection in a veterinary hospital. And depending upon how you're going to utilize that blood, it can be stored for a while as well refrigerated. Okay. Now, the other scenario that we run into is in some of our specialty hospitals, we will have a local sort of blood banking operation that we utilize so that we can have a larger quantity of blood. And then if you look at it on a national level, there are national blood banks that do just this that have donors that come in, they collect. And then they can do different things with the blood, which is really interesting it can be you can have fresh whole blood, you can have packed red blood cells, you can have plasma, you can have very specific plasma type products. So you can divide that blood out based on what the liquid is and what the red blood cells are to treat different types of patients. Yeah, so
blood component therapy is, so it's a little bit more sophisticated, right? Because if you don't need everything that's in blood, all of the pieces, white blood cells, red blood cells, the proteins, the serum, if you just need red blood cells, then you you can just transfuse with red blood cells. And that's called. Super awesome. Yeah, because you're super stoked. Yeah. Now it doesn't make it wrong to do a whole blood transfusion. And I'm going to add them waiting to ask this question, Dr. Stone? Because well, because because he's a specialist, and I'm not. And so I think I remember hearing this, and I don't know if it's true. While it's not necessarily wrong to provide whole blood transfusion in the face of simple anemia. Is it true that there's very few true indications for whole blood? Rather, the indication is more distinctly for blood components?
It's a great question. So in a scenario where let's say I had a patient that had anemia, from blood loss, okay, there was some sort of trauma event, hit by car, hit by car, right, and they've got wounds, and they've been bleeding from the wounds, they both have anemia. So their total revenue and cell count in their body is low now, because they live, but they're also hypovolemic, meaning just the total volume of fluid in circulation is down. In that scenario, fresh whole blood could be very appropriate, right? Because it's, it's a loss everything.
The vein was opened, and it was bleeding out on the ground, right? That's what people think of,
right? Typically, yeah.
So it could be appropriate there. But then there's a lot of anemia scenarios, where we don't need the whole blood, maybe just need those pack cells, as you described. And in that scenario, that's preferable for me, because some of the patients I treat with anemia, they may actually not tolerate a large fluid load, right? It might be an advantage for me to have that more concentrated blood product,
just give them what they need, instead of giving them the whole blast, right?
Could it could it be considered more risky to give like, oh, okay, I think of stuff is less is more. And so if I don't have to give, so I'm okay, we're putting stuff into the body. Like, that's always it's always a risk. And it's always it's always, you know, I got to worry about some stuff. Right? So I guess, is it right to say it's a less risky to give? You know, less is more? I mean, is it is it a little a little bit less of a risk to give just what you need rather than everything, you know, this sort of reactions,
it's the way I think about it from the standpoint of the major reaction that's going to happen, it's how the the recipients body, the sick patient, how their body is going to respond to those red blood cells, are they going to let the red blood cells survive? Are they going to attack them? I think that's a risk with either right threshold blood or packed red blood cells. But the less is more question really comes down to when we're giving a blood transfusion, what is our goal, our goal in that moment is to stabilize our patient, right? Not necessarily to get all the way back to normal, but to get our red blood cell count to a safer place while we treat whatever the underlying problem is.
Yeah, and I think that's a good point because there's so many variables, right? Because there's so many things that can happen that can cause you to arrive at that point where you're standing there and they're saying your pet needs a transfusion. And nothing happens in a vacuum. We're like we're focused on the transfusion piece of it, but maybe they have heart disease that you've been managing. So they can't handle a lot of fluid load. Maybe they've got kidney involvement. Maybe there's a toxin on board that's causing all sorts of weird arrangements, including the anemia. And so you have to be careful. Right?
Dr. Dan, you're telling us and Dr. Stone tell us we have to take the whole patient into consideration, right? Is that what you're saying? You can look at the whole patient, not just not just these numbers on a chart. Right. So that's a good point. So everybody has to be aware that the client has to be aware that obviously the veterinarians already aware of that, just so for everybody, why am I not getting whole blood? Why am I only getting a little bit or this is why? Because there's a lot of stuff goes involved. We're talking about just you know, this and that put him in if he's good, there's a whole bunch of little, little decisions that have to be made. So the point? Well, and
I think what's also interesting today, in in today's times, right? People know a whole lot about plasma transfusions and antibodies. Thanks, COVID. And so one of the other common things that I used to see in the emergency clinic was when we would have dogs that were severely ill with Parvo, right, they had the parvo virus and rightous. Occasionally, we would have veterinarians who would want to give a plasma transfusion. So that's when you have just the proteins from the blood. Because if you have plasma, and they do this on human medicine, if you have plasma that was collected from a dog that was vaccinated, or had survived Parvo, then they have the magic silver bullet in their blood, right, they have the antibodies to fight off the virus. And so you could transfuse them with the plasma, and there's a multitude of other things that happen to right, like you're giving them what is that? Called? orthostatic support? Or what am I looking for here? Dr. Stone COVID oncotic, supply adding support, right, which, which is not cancer support, it sounds like it, but it's not. But it helps, you know, hold the fluid in the in the vessels where it's supposed to be. And so, yeah, so there's a lot of reasons you might use components instead of whole blood doesn't make whole blood wrong. But
I just think it's awesome that we've progressed that far, that we're just moving forward with medicine, I think it's really good. So it's not just it's not just a tube to tube and you know, dog to dog or putting milk in their sheep or whatever, right? We're actually doing sophisticated stuff for is not like a shotgun, hey, just take some of my good stuff. And maybe you'll be better. It's like, we have very specific, you know, snipe for type things to kind of attack what we wanted. That's, that's really good for the for the industry. And now we have blood banks. I think that's really I didn't even know that. That's really, really cool. So wonder fish tavern uses blood banks, or if you still got, you know, I'm sure you're tired of you still got the dogs. So
I mean, he doesn't write obviously, but I'm sure clinics do right, West Texas. What are you going to do? It's the easiest, most simple thing and you always have something there, right? So
it can be very appropriate, right? Because in that situation, if you've got a healthy donor, it's been screened for all the diseases we want to rule out. And you've got a patient that needs blood right now, like
an emergency for sure. Appropriate?
Well, and that so like my emergency clinic, we had stuff on hand at all times. We had pack sales, and we had plasma, and but if we had a holiday weekend, you know, and yeah, and I ran through it, then then we would move to donors, right. And I had a cat, the fat one. You know, she would come up and give blood she didn't volunteer, but you know, she can. But yeah, the fat one she
was. If you name me, the fat one, I wouldn't volunteer for anything, either. I don't blame that kid.
You knew the fat one.
She didn't name it, though.
Even being called the fat one. Like, I wish I had an ounce of her confidence on her worst day. That would be like my best day. She was a very confident kitty. But anyway, so. Yeah. So I think that that's, I think all of the options are good to have available because you just never know. So yeah, so So we're not saying that, that any one is better than the other, but they are all definitely appropriate at the time,
right. And, you know, the challenge we run into typically is not being able to make the right decision with which products we want to use. Honestly, it comes down to availability. And you mentioned that before, like, what if I'm out in a location where I don't get my next shipment of blood? Well, they were plenty of times where hospitals go to order blood from, say, a National Blood Bank, and it's on backorder it's not available or may not be available for several weeks, right doesn't help you
not today. A write that in there. Okay, buddy, come back and get sick in a couple of weeks. We'll be ready for two weeks. Yeah, that doesn't work
out. Right. Yeah. So you know, there is there is an effort to increase awareness and the pedaling population peddling public that, hey, not only could your pet one day need a transfusion, if one of these anemia scenarios happen, but also, just like us, as people, we have the opportunity to be donors, our pets can actually be donors to get so usually larger breed dogs that are healthy. And depending upon your veterinarian and what they do, they may participate in this sort of activity and give your pet an opportunity to be a donor.
Yep. And I think that's a good thing to point out too. So ask your vet, what's going on with that? Good T shirts also? I don't think so. They get treats,
they get treated fairly good. Gotta work for something, right?
That's right, because that only works for treats. So the other thing we didn't mentioned either, is that there are some sometimes there's surgical reasons. So like if your dog is having a surgery, or dogs or cats having a surgery. And sometimes we know it's going to be one where they have a lot of blood loss, and they may have a transfusion, and they may let you know that that might happen. had already for sure it's right. Yeah. And so that in that way, you could put off a surgery potentially, until such time as you have the the support available, but yeah, so Okay, so I think we've hit on all the questions that I used to get all the time about transfusions from pet owners. Dr. Jason, did you have any other
Oh, man, I think we covered as per the norm, our expert, not you, Dr. Jin, but our expert covered a wide variety of topics. And, and also I learned a ton or relearned it or you know, probably for the first time, but it's it was really interesting. And and, you know, it was great. I don't have any other questions. I have any other questions. So just covered everything.
I know. I have another question, though.
I mean, I'm not sure. I asked you perhaps to pertain to blood stuff? No, it doesn't. Yes, it does this the rule?
No. Like, I just am wondering, Richard, I'm
going to remind you of the G O. TM loyalty here. I go ahead. Question I was
gonna ask about the group of the month. Oh,
what? What on earth? Were you going to ask about the group of the month?
There was a group of the month situation right? Was there there was you guys were a group of the month or
is completely sanctioned. It was legitimate.
It's not like we took a picture and just put it on a wall somewhere in the vet school. This photographic proof?
That's exactly yeah.
Okay. So friends, friends, they're not telling the story all the way.
Thanks. We Are we one group of the month, and there was a photo to prove it. And there were several voted, several people voted,
voted. And it was unanimous that y'all. So you know, at most universities, they have framed photos of people who've accomplished great things, or who were selected by their peers to receive awards. Exactly. And the same is true at Texas a&m at the vet school there. And so with Jason and Dr. Stone, another character that was a friend of theirs. Yeah, we can't call out Dr. Anders. Give me you're gonna I'm gonna call Dr. Cole havy out. All right, I'm gonna say cousin Anders was there. And yeah, and they took a photo matching the other photos of people who had been selected by their peers to receive awards, and dressed up in an appeared to be the same and just hung it on the wall in the school as the group of the month,
even though it was a janitor's closet. It was the door to the janitor's closet, but it still looked very official like
I think it's still there and which case we are by right group of the month. Why are all these nasty rumors go on disparaging our fantastic feet? All right, I think we won that award four or five times I don't try this for five different pictures.
So if you visit the anatomy lab in Texas at dibs, College of vet med and I think now biomedical sciences or something. You look closely at the group of the month photos hanging as you walk into the anatomy lab down that little hallway. And you may indeed see Dr. Stared and Dr. Chatfield is Dr. Anders Cole. havy Yeah,
he's a history. That's a little reason history. I love it well,
and while Dr. Stone went on to bigger and better things, that blue pearl, that is my one and only living. I was clean to the group of the month.
That's awesome. That's awesome. All right. So um, thank you so much. Dr. Stared vice president of medicine for Blue Pearl, specialty and emergency care pet hospitals. Right. Is that right? Pretty close.
Pretty close again. All right. Horseshoes, you get a point. All right.
Thank you so much for joining us. We really appreciate it and for learning us up on some transfusion that Listen, what was the links in the show notes? So for those of you listening, and hopefully we can wrangle dr. stone back into the chat room to talk about other topics and give us some more dirt on Dr. Jason. Would love
to give I don't know. I
don't know why you keep there is no dr. stone. It was fantastic. Thank you for coming on. I know you guys are busy. We do appreciate the time.
All right, so I'm Dr. Jenn the vet. And I'm Dr. Jason, and we'll catch you guys on the next episode.
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