Management of massive blood loss in a dog under general anaesthesia during a sternotomy

Abstract

A 2-year-old male neutered American Staffordshire Terrier was presented collapsed, with tachycardia, dyspnoea and pale mucous membranes. An emergency sternotomy and lateral thoracotomy was performed. Before surgery the dog's blood was typed and found to be DEA negative. The dog lost the equivalent of its entire blood volume (estimated) during the first hour of surgery. Cardiovascular parameters initially responded to boluses of crystalloids and colloids. He also received transfusions of DEA negative packed red blood cells and fresh frozen plasma. Due to ongoing haemorrhage, the dog's clinical condition, and a lack of availability of any more DEA negative blood products, the decision was made to give a unit of DEA positive packed red blood cells. The dog recovered uneventfully, although following diagnosis of an aggressive soft tissue sarcoma the dog was later euthanased. This report discusses the management of massive blood loss in veterinary medicine and the implications, potential options for management, and treatment of these cases perioperatively.