**2. Blood types in dogs and cats**

Blood types are classified according to specific antigens on the surface of erythrocytes. Platelets, leukocytes, and body tissues and fluids may also consists of erytrocyte antigens. [1]. In immunogenicity and clinical significance these antigens can differ. They can serve as markers of disease in some cases and taking part in recognition of self. The clinical significance of blood group antigens is generally noted in transfusion reactions and neonatal isoerythrolysis (NI) in veterinary medicine [2]. These antigens can characteristically trigger a reaction caused by circulating anti-erythrocyte antibodies in the opposite host or donor.

These antibodies can occur naturally. Also they can be induced by a previous transfusion. Interaction leads to the destruction by hemolysis of red blood cells (RBCs). This is one of the severe and potentially life-threatening situation. [3].

Principles of Blood Transfusion 323

possess a major transfusion reaction [4]. In Turkey, the most common blood types were DEA 1.1, 4 and 7. Because all Kangal dogs have DEA 4 positivity it does not seem to be important in respect to transfusion medicine. The prevalence and antigenic properties of DEA 1.1 and 7 are significantly important. If unmatched transfusion is performed in Turkish Kangal dogs they can constitute acute hemolytic transfusion reactions [6]. Dogs with DEA 1.1 or 1.2 are called group A positive. Adversely, dogs do not have DEA 1.1 or 1.2 are called

A blood group system described as N-acetylneuraminic acid and N-glycolylneuraminic acid present on gangliosides (hematosides) of the RBC membrane in Japan [18]. It is referred as the D system. This system is consist of two antigens, D1 and D2, with phenotypes, D1, D2, and D1D2. The D1 and D2 antigens are codominanat factors. Anti-D1 is identical to anti-DEA3. The importance of this system in transfusion medicine pointed out by transfusion of D2 type blood into a D1 type patient, or of D1 type blood into a D2 type patient consistently cause severe acute transfusion reactions [19, 20]. RBCs of some dogs designated as type C at titre sup to 128 are aglutinated rather than lectin extracted from seeds of Clerodendron tricotomum. Type C is completely negative for other dogs. C system was compared to the DEA system and determined to be different [10, 19, 21]. Specific IgG alloantibodies in previously sensitized Dalmatian dog by blood transfusion is described as the Dal blood type. The frequency is not known. Typing sera for this antigen also is commercially not

Three blood types are described in the feline AB blood group system and mik group system. In cats a new blood group defined as Mik. It is named after the alloantibody identified in the first blood donor cat, Mike. In three cats that had not previously received transfusions Mik antibodies were detected. They are defined as a cause of incompatibilities between donor

The phenotypes type A, type B, and type AB are occured. A null phenotype is not exist. The most common blood type is Type A. Type B is less common. Type AB is rare [2, 25]. Type B is indicated in Australia (26.3%), and Greece (20.3%) ([26] , [27] ). In large studies of both pedigree and non-pedigree cats in the USA distribution of type AB cats is demonstrated to be rare (0.14%) ([28] ). Type AB were 0.4% in Australia (([26]). In Scotland the incidence of

Type B is indicated in Australia (26.3%), and Greece (20.3%) ([26, 27]. In large studies of both pedigree and non-pedigree cats in the USA distribution of type AB cats is demonstrated to be rare (0.14%) [28]. Type AB were 0.4% in Australia [26]. In Scotland the incidence of AB

In Turkey, 60 % of Van cats and 46.4 % of Angora cats are type B [30]. And 220 (73.1%) nonpedigree domestic cats had type A blood, 74 (24.6%) had type B and seven (2.3%) had type AB [31] in Turkey. Except type AB group, cats have naturally occurring alloantibodies. It is known that cats have naturally occurring alloantibodies (isoantibodies) against the blood type they are lacking. Because of this to prevent blood incompatibility reactions in cats feline blood typing is important in clinical practice. Blood type incompatibility can

and recipient blood that are not related to the AB blood group system [24].

group A negative [1].

available [2, 22, 23].

AB cats is 4.4% ([29] ).

cats is 4.4% [29].

The dog erytrocyte antigen types or blood types are categorized by the DEA (Dog Erythrocyte Antigen) system. DEA 1.1, 1.2, and 1.3 are termed A system. There are also DEA 3, DEA 4, DEA 5, DEA 6, DEA 7 and DEA 8. [2]. In the United States the incidence of DEA 1.1 is approximately 45% and DEA 1.2 is 20% [4]. DEA 1.3 is common in German shepherd dogs and has been reported only in Australia [5]. Frequency of DEA 1.1 in Kangal Dog was found as 61.1% in Turkey [6]. In Croatia where the closest data studied the rate was 66.7% [7]. The rate was also 56.9% in Portugal [8] and 55% in Japan [9]. Approximately 60 % of the canine population is in DEAs 1.1 and 1.2 group. DEA 1.1 is the strongest antigen in the dog. Two membrane proteins of 50 and 200 kD has been identified by a monoclonal antibody to DEA 1.1 using immunoprecipitation techniques. [10]. Presenting in a single band DEA 1.2 has been found to be an 85-kD protein [11].

DEA 1.1 is the most antigenic group in respect to transfusion medicine. Little is investigated about DEA 3, 4, 5 and 7 in comparison to DEA 1.1. In literature, the frequency of DEA 3 is lower in comparison to DEA 1.1 blood type. In the United States it is determined that approximately 6% of the general dog population is DEA 3 positive [12]. This rate is reported as 13% in Brazil [13]. In Turkey, DEA 3 is most found blood type in the Kangal Dog [6]. In the canine blood groups DEA 4 is the most common type. In USA, it is indicated that overall 98% of the general dog population have DEA 4 blood [12]. In Brazil, all dogs blood type were positive for DEA 4 [13]. The molecular weight of DEA 4 present in a single band has been found to be 32 to 40 kD using immunoprecipitation techniques [11].

In the United States typing sera can be commercially obtained only for DEA 1.1, 1.2, 3, 4, 5, and 7 [4]. In Brazil a report studied on German shepherd dogs determined that 14% of the dogs were positive for DEA 5 and 8% were positive for DEA 7 [13]. The frequency of DEA 5 and 7 positive dogs was 55.5% and 71.7% respectively in Turkey [6]. Also, DEA 7 may cause an antibody response in dogs that lack it. A system of nomenclature about antigen Tr has described. The Tr antigen system is a 3-phenotype, 6-genotype system [14]. The molecular weight of DEA 7 present in 3 distinct bands has been found to be 53, 58, and 63 kD by using immunoprecipitation techniques [11].

An exact definition of a canine universal donor is not agreed among veterinary transfusion experts. Well excepted description of the universal donor is that a dog negative for DEA 1.1, 1.2, DEA 3, DEA 5, DEA 7, and positive for DEA 4. It is difficult to find DEA 4 negative dog because 98% of all dogs are positive for DEA 4. Thus there is a very little chance to influence donor selection. If the dog is DEA 7 positive, some other experts do not exclude it from the donor pool [15]. In most populations the incidence of DEA 4 blood type is more than 98% [16]. Because of this in transfusion medicine these dogs are the best candidate for being a donor. If other donors are known to be compatible with the recipient they can also be utilized [17]. DEA 3, 5 and 7 negative dogs have naturally occurring antibodies to DEA 3, 5 and 7 positive red cells. However during the first transfusion these blood groups do not possess a major transfusion reaction [4]. In Turkey, the most common blood types were DEA 1.1, 4 and 7. Because all Kangal dogs have DEA 4 positivity it does not seem to be important in respect to transfusion medicine. The prevalence and antigenic properties of DEA 1.1 and 7 are significantly important. If unmatched transfusion is performed in Turkish Kangal dogs they can constitute acute hemolytic transfusion reactions [6]. Dogs with DEA 1.1 or 1.2 are called group A positive. Adversely, dogs do not have DEA 1.1 or 1.2 are called group A negative [1].

322 Blood Cell – An Overview of Studies in Hematology

severe and potentially life-threatening situation. [3].

has been found to be an 85-kD protein [11].

immunoprecipitation techniques [11].

These antibodies can occur naturally. Also they can be induced by a previous transfusion. Interaction leads to the destruction by hemolysis of red blood cells (RBCs). This is one of the

The dog erytrocyte antigen types or blood types are categorized by the DEA (Dog Erythrocyte Antigen) system. DEA 1.1, 1.2, and 1.3 are termed A system. There are also DEA 3, DEA 4, DEA 5, DEA 6, DEA 7 and DEA 8. [2]. In the United States the incidence of DEA 1.1 is approximately 45% and DEA 1.2 is 20% [4]. DEA 1.3 is common in German shepherd dogs and has been reported only in Australia [5]. Frequency of DEA 1.1 in Kangal Dog was found as 61.1% in Turkey [6]. In Croatia where the closest data studied the rate was 66.7% [7]. The rate was also 56.9% in Portugal [8] and 55% in Japan [9]. Approximately 60 % of the canine population is in DEAs 1.1 and 1.2 group. DEA 1.1 is the strongest antigen in the dog. Two membrane proteins of 50 and 200 kD has been identified by a monoclonal antibody to DEA 1.1 using immunoprecipitation techniques. [10]. Presenting in a single band DEA 1.2

DEA 1.1 is the most antigenic group in respect to transfusion medicine. Little is investigated about DEA 3, 4, 5 and 7 in comparison to DEA 1.1. In literature, the frequency of DEA 3 is lower in comparison to DEA 1.1 blood type. In the United States it is determined that approximately 6% of the general dog population is DEA 3 positive [12]. This rate is reported as 13% in Brazil [13]. In Turkey, DEA 3 is most found blood type in the Kangal Dog [6]. In the canine blood groups DEA 4 is the most common type. In USA, it is indicated that overall 98% of the general dog population have DEA 4 blood [12]. In Brazil, all dogs blood type were positive for DEA 4 [13]. The molecular weight of DEA 4 present in a single band has

In the United States typing sera can be commercially obtained only for DEA 1.1, 1.2, 3, 4, 5, and 7 [4]. In Brazil a report studied on German shepherd dogs determined that 14% of the dogs were positive for DEA 5 and 8% were positive for DEA 7 [13]. The frequency of DEA 5 and 7 positive dogs was 55.5% and 71.7% respectively in Turkey [6]. Also, DEA 7 may cause an antibody response in dogs that lack it. A system of nomenclature about antigen Tr has described. The Tr antigen system is a 3-phenotype, 6-genotype system [14]. The molecular weight of DEA 7 present in 3 distinct bands has been found to be 53, 58, and 63 kD by using

An exact definition of a canine universal donor is not agreed among veterinary transfusion experts. Well excepted description of the universal donor is that a dog negative for DEA 1.1, 1.2, DEA 3, DEA 5, DEA 7, and positive for DEA 4. It is difficult to find DEA 4 negative dog because 98% of all dogs are positive for DEA 4. Thus there is a very little chance to influence donor selection. If the dog is DEA 7 positive, some other experts do not exclude it from the donor pool [15]. In most populations the incidence of DEA 4 blood type is more than 98% [16]. Because of this in transfusion medicine these dogs are the best candidate for being a donor. If other donors are known to be compatible with the recipient they can also be utilized [17]. DEA 3, 5 and 7 negative dogs have naturally occurring antibodies to DEA 3, 5 and 7 positive red cells. However during the first transfusion these blood groups do not

been found to be 32 to 40 kD using immunoprecipitation techniques [11].

A blood group system described as N-acetylneuraminic acid and N-glycolylneuraminic acid present on gangliosides (hematosides) of the RBC membrane in Japan [18]. It is referred as the D system. This system is consist of two antigens, D1 and D2, with phenotypes, D1, D2, and D1D2. The D1 and D2 antigens are codominanat factors. Anti-D1 is identical to anti-DEA3. The importance of this system in transfusion medicine pointed out by transfusion of D2 type blood into a D1 type patient, or of D1 type blood into a D2 type patient consistently cause severe acute transfusion reactions [19, 20]. RBCs of some dogs designated as type C at titre sup to 128 are aglutinated rather than lectin extracted from seeds of Clerodendron tricotomum. Type C is completely negative for other dogs. C system was compared to the DEA system and determined to be different [10, 19, 21]. Specific IgG alloantibodies in previously sensitized Dalmatian dog by blood transfusion is described as the Dal blood type. The frequency is not known. Typing sera for this antigen also is commercially not available [2, 22, 23].

Three blood types are described in the feline AB blood group system and mik group system. In cats a new blood group defined as Mik. It is named after the alloantibody identified in the first blood donor cat, Mike. In three cats that had not previously received transfusions Mik antibodies were detected. They are defined as a cause of incompatibilities between donor and recipient blood that are not related to the AB blood group system [24].

The phenotypes type A, type B, and type AB are occured. A null phenotype is not exist. The most common blood type is Type A. Type B is less common. Type AB is rare [2, 25]. Type B is indicated in Australia (26.3%), and Greece (20.3%) ([26] , [27] ). In large studies of both pedigree and non-pedigree cats in the USA distribution of type AB cats is demonstrated to be rare (0.14%) ([28] ). Type AB were 0.4% in Australia (([26]). In Scotland the incidence of AB cats is 4.4% ([29] ).

Type B is indicated in Australia (26.3%), and Greece (20.3%) ([26, 27]. In large studies of both pedigree and non-pedigree cats in the USA distribution of type AB cats is demonstrated to be rare (0.14%) [28]. Type AB were 0.4% in Australia [26]. In Scotland the incidence of AB cats is 4.4% [29].

In Turkey, 60 % of Van cats and 46.4 % of Angora cats are type B [30]. And 220 (73.1%) nonpedigree domestic cats had type A blood, 74 (24.6%) had type B and seven (2.3%) had type AB [31] in Turkey. Except type AB group, cats have naturally occurring alloantibodies. It is known that cats have naturally occurring alloantibodies (isoantibodies) against the blood type they are lacking. Because of this to prevent blood incompatibility reactions in cats feline blood typing is important in clinical practice. Blood type incompatibility can

especially result in two fatal reactions. The first is acute haemolytic transfusion reactions, occur particularly in cat transfused with type A blood [32]. Feline neonatal isoerythrolysis (NI) is the second incompatibility reaction. It occurs when type A or AB kittens born to type B queens are nursing. Naturally occurring anti-A alloantibodies result in blood incompatibility reaction in the type B queen's colostrum and milk [25, 30].

Principles of Blood Transfusion 325

The treatment of severe anemia caused by hemorrhage, hemolysis, ineffective erythropoiesis, auto-immune hemolytic anemia, or neoplasia is primary indication for blood transfusion. Lethargy and altered mentation, increased respiratory effort, pale mucous membranes and tachycardia are the clinical signs of anaemia. The body carry out a number of adaptive responses physiologically, to maintain carrying of oxygen to the tissues [42, 43]. The solution of oxygen in plasma is weak. Because of this hemoglobin (Hgb) carries approximately whole oxygen in blood [41]. The decision to conduct a RBC transfusion is generally based on a measurement of the patient's packed cell volume (PCV), hematocrit (Hct) or Hgb concentration (Hgb) and especially on clinical evaluation of the patient [41]. Clinically animals should be evaluated individually. Generally when the hematocrit is less than 10%, the treatment of anemia is transfusion. However, animals with acute-onset anemia usually require transfusion before their hematocrit decreases to 15%. This contrasts with the situation in animals with chronic anemia. Other indications for transfusion are hypovolemia, thrombocytopenia, clotting factor deficiency, and hypoproteinemia [1]. Electrocardiographic signs of myocardial ischaemia are similar to those identified in human

The usage of administration of FFP are for the treatment of a single or multiple clotting factor deficiency, vitamin K deficiency or antagonism, surgical bleeding or where a massive transfusion is required [45]. Hypoalbuminaemia and coagulopathies especially due to liver

Stored blood is more than 8 hours old. The length of storage depends on the anticoagulant/preservative solution used. It varies from 48 hours for 3.8% sodium citrate (no preservative) to 4 weeks for CPD-A1 (citrate, phosphate, dextrose, and adenine). Acid citrate dextrose (ACD), citrate phosphate dextrose (CPD and CP2D), and citrate phosphatedextrose-adenine (CPDA-1) are mostly used as preservatives. The viability of RBCs is provided by the added dextrose, phosphate, and adenine. Due to the preservative

In patients that are hypothermic or receiving large volumes of blood, refrigerated RBC products should be prewarmed to temperatures between 22°C and 37°C immediately before transfusion. In the routine practice of RBC products to normovolemic anemic patients, refrigerated blood components do not need warming before transfusion. Warming may accelerate the deterioration of stored RBCs and may cause rapid growth of contaminating

In clinical practice advances in safety of blood transfusion is important in preventing transfusion-transmitted infections (TTI). The most frequent severe infectious outcome of transfusion has been known as bacterial contamination of platelets, with resultant sepsis in the recipient recently. Using automated or semi-automated blood culture devices, apheresis

Generally, before a blood transfusion is given to animals, blood typing and/or crossmatching of the recipent and donor should be done to avoid the likelihood of a transfusion reaction. Also, ineffective therapy is caused by shortened survival of transfused mismatched

patients with myocardial infarction. It can ocur with anemia [44].

used, the storage can extend up to 3 to 5 week ([3, 41, 47].

platelets and prestorage pooled platelets are most often tested [49].

microorganisms [48].

disease are the main reported indications for FFP transfusions in cats [46].

Cats constitute non-self antibodies in contrast to dogs. As a result of this non-self antibodies potentially fatal antibody-mediated reactions can occur towards non-self red blood cells. Nearly 20% of type A cats have anti-B antibodies. These antibodies are usually weak. All type B cats have strong anti-A antibodies. In contrast AB cats do not have alloantibodies [32]. In previously unsensitized cats naturally occuring isoantibodies are responsible for transfusion reactions. Nearly all type B cats have highly titered anti-A agglutinins and hemolysins. RBCs can be destructed rapidly in type B cats taking type A blood. In type B cats the high titres of naturally occurring anti-A antibodies cause rapid intravascular destruction of transfused type A red blood cells [33]. This can be mediated by IgM, complement fixation and the release of potent vasoactive compounds. As a result of this shock can develop usually due to possessed antibodies towards the transfused RBCs [3, 34]. This can cause severe transfusion reaction and death even if as little as 1 ml of type A blood is administered to a type B-cat [2, 35]. Because of their endotheliochorial placenta newborn kittens have no alloantibodies. Nevertheless colostral transfer of immunoglobulin (Ig) G and a small amount of IgM occurs. Neonatal isoerythrolysis develops in cats. It is one of the cause of the fading kitten syndrome. Kittens that are type A or AB and those that are born to type B queens are at risk. In affected kittens Clinical sings can range from unapparent, to severe hemolytic anemia with hemoglobinuria, icterus, and death [1, 36, 37, 38].
