PRACTICAL MANUAL

OF
VETERINARY MEDICINE
(Unit I- GENERAL)

B.V.Sc. & A.H (MSVE 2016)

Compiled By:-
Prof.. R. K. Tanwar
(Head of Department)

Dr. D. B. Sarode
(Associate Professor)

Dr.Dhruba Das Dr. Leenu Tanwar Dr. Shivangi Pandey

(Assistant Professor) (Assistant Professor) (Assistant Professor)

Name :----------------------------------------------------------------

Roll no. :------------------------------------------------------------

:-----------------------------------------------------------------
DEPARTMENT OF VETERINARY MEDICINE
MJF COLLEGE OF VETERINARY & ANIMAL SCIENCE CHOMU, JAIPUR (RAJ.)
 CERTIFICATE

This is to be certify that Mr./Ms.………………

……………………..……………………Enrollment No……………
…… … ……………of Fourth year B.V.Sc. & A.H. has successfully
completed all practical‟s in the course entitled “Veterinary Medicine”
during the academic year …………………………

Date :
Place : CHOMU, JAIPUR

Head of Department Course In-charge

 FOREWORD

It seems interesting and delighted while going through the Practical Manual
entitled “Practical Manual of Veterinary Medicine” prepared by Dr. R. K.
Tanwar, Dr. D. B. Sarode, , Dr. Dhruba Das, Dr. Leenu Tanwar and
Dr. Shivangi Pandey faculty in the Department of Veterinary Medicine, MJF
College of Veterinary & Animal Sciences, Chomu, Jaipur (RAJ.) The Manual
covers the practical syllabus of undergraduate course Prescribed by veterinary
Council of India (MSVE 2016) for B.V.Sc. & A.H. programme.

This manual is written in simple language to help students to get

acquainted with an approach to the various activities like clinical and practical
approach to diagnose various general condition and status of body of animals
I hope this manual will make its own place in the libraries of Agricultural
Universities, Veterinary and Animal Science College in near future.
I congratulate the authors for the efforts put in bringing out his practical
manual.

Dean
MJF College of Veterinary &
Animal sciences, Chomu, Jaipur
 ACKNOWLEDGEMENT

Ever since the introduction of new course for professional B. V. Sc. &
A.H. degree under Veterinary Council of India pattern in Veterinary
Colleges/Universities in the country, there is a need to have a practical manual
on Veterinary Medicine subject which covers the practical syllabus of
undergraduate. These new course is nowdeveloped in most of the Veterinary
College/University after the introduction of Veterinary Council of India
programme. The present manual covers the practicaland clinical approach
towards investigation and differential diagnoses of various general and systemic
diseases in domestic, companion, zoo and wild animals and also includes
objectives, materials required, procedures and steps to be followed towards
diagnosing of diseases and organs. The main objective of this manual is to fulfill
need of students and teachers teaching this course. We hope that users will find
the manual immensely useful.

We look forward to receiving the valuable suggestions of readers for

improvement of this manual.

Prof.. R. K. Tanwar
(Head of Department)

Dr. D. B. Sarode
(Associate Professor)

Dr.Dhruba Das Dr. Leenu Tanwar Dr. Shivangi Pandey

(Assistant Professor) (Assistant Professor) (Assistant Professor)
Unit 1: General

CONTENT OF TABLE

Ex. Date Title Page Signature

No. No.
Collection of history and general clinical
1. examination
Collection, preservation, packing and
2. dispatch of samples from clinical cases
3. Nasogastric and orogastric intubation in
animals
4. Oxygen therapy in veterinary practice
5. Gastric and peritoneal lavage
6. Collection and examination of cerebrospinal
fluid
7. Blood transfusion
Exercise: 1 Date:

COLLECTION OF HISTORY AND GENERAL CLINICAL EXAMINATION

Clinical examination is a fundamental part of the process of veterinary diagnosis. It

provides the information required to determine the disease or diseases producing the clinical
abnormalities. In addition, the information derived from the clinical examination should assist in
determining the severity of the pathophysiological processes present. Without a proficient
clinical examination and an accurate diagnosis, it is unlikely that the treatment, control,
prognosis and welfare of animals will be optimized. The organs or systems involved, the
location, type of lesion present, the pathophysiological processes occurring and the severity of
the disease can be deduced from the information gained during the clinical examination. The
success of clinical examination relies heavily on the knowledge of the clinician. Many clinicians
begin their examination by performing a general examination which includes a broad search for
abnormalities. The system or region involved is identified and is then examined in greater detail
using either a complete or a problem oriented examination. For this sound knowledge of
Anatomy, Physiology, Pathology and Animal behavior, skills in the methods and techniques of
clinical examination, knowledge of etiology, clinical signs and pathogenesis of the diseases are
the basic requirements for clinician to make diagnosis.

Taking of patient history

History taking or anamnesis is the process of obtaining information on the animal patient
about its illness, onset of illness and feeding practice through careful questioning of the owner. In
Veterinary practice, the disease is presented indirectly in the form of a complaint by the owner or
the attendant. Thus, it is very necessary to have all the information from the owner. Most of the
time, the owner or attendant fails to provide pertinent and adequate history and inaccurate history
may lead to misdiagnosis. The clinician must substantiate these with rational questions utilizing
professional knowledge. The disease problem of animals is difficult to diagnose without
knowing the history of animals, the history should be taken from the owners of the patient and
recording the owner„s complaint. Disease information should include the group(s) affected, the
numbers of animal affected (morbidity) and the identities of the animals affected; the number of
animals that have died (mortality) should be established. In order to get the accurate and
complete history the following things should be focused; patient data, present history, past
history and environmental history.

1. Patient data

Patient data is essential to identify the patient and it includes: Owner„s name, Owner„s address:
postal address, telephone, peasant association, Species, breed, sex, age, name, ID No., body
weight, Description including color, marking, polledness, and other identification marks of
patient.

2. Present history

It comprises of recording the sequential events from the start of the patient chronic. Questions
about physiological functions such as appetite, urination, defecation, rumination, respiration,
sweating, milk production, gait, posture and also of the first symptoms shown by the animal
should be asked. All these information deal with the current problem of the animal and the
events associated with it. The point which going to be asked is that as follows:

a. Locations of the problems: Following up and attention at the complaint that a farmer
has to say and from there you can tentatively say the likely system involved in that
condition, for instance:

● Digestive system involvement will be shown as absence of rumination, appetite, bloat or

diarrhea.

● Respiratory system involvement will be indicated presence of nasal discharge, coughing,

dyspnea.

● Urinary system involvement will be manifested as frequent urination, passing red coloured or
cloudy urine.

a. Nature of illness: The clinician should be able to assess and find out the time of onset of
disease, any change in management practices and signs noticed by the farmers.
● To assess to know the duration of disease whether it is peracute, acute, subacute or chronic.

● To know number of animal diseased and morbidity rate and mortality rate of animals.

● Determine whether any drug has been given to animals, before it comes to clinic for assurance.

● And the following questions should be pointed:

● When did the farmer notice the disorder? (time) ?

➢ Did it occur suddenly/slowly? (acute /sub-acute / chronic nature)?

➢ What were the signs noticed? (anorexia/drop in milk yield/ others)?

➢ Are the animal fed / grazed in pasture / forest grazed? (getting information on management
practices e.g. ketosis seen in stall fed animals, while babesiosis seen in forest grazed animals).

➢ Is there any other animal affected with similar condition in the same herd / in other farmer„s
herd in the village (to find out if the disease is rapidly spreading)?

➢ Ask if there has been any introduction of new animal to the herd / village (sick animal may
have been bought from affected area and disease has started).

➢ Is the affected animal vaccinated against food-and mouth disease (FMD), anthrax,
hemorrhagic septicemia (HS), Black quarter (BQ) (to find out if the animal is protected against
common diseases).

3. Past history

Inquiring into the past history may help in arriving at a diagnosis. History of drenching a day or
two earlier may cause aspiration pneumonia. History of past disease may be correlated to the
present illness. Past history will also give idea if such condition prevailed previously in the area.

● Ask if such condition was reported previously too (reveal endemic nature of disease, or
occurrence of a new disease).

● Does this occur at certain period of time? (find out the seasonal occurrence of the disease).
● Was the disease reported form other places in the locality? (area of spread / occurrence can be
found out).

● Has any animal recovered from such a sickness? (to aid in prognosis).

● Is the disease restricted to certain age group / sex? (BQ is seen in animals between 1 – 3 years
of age in both sexes).

Physical examination

The main aims of physical examination is to apply general inspection, palpation, percussion and
auscultation methods used to detect clinical signs of abnormalities.

General inspection: It is done some distance away from the animal; sometimes go round the
animal or herd/flock, in order to get the general impression about the case. Attention should be
paid to the following items: (Behavior, Appetite, Defecation, Urination, Posture, Gait, Body
condition, Body conformation), Lesions on outer surface of the body can be observed: (Skin and
coat, Nose, Mouth, Eyes, Legs and hoofs, Anus).

Palpation: Palpation is used to detect the presence of pain in a tissue by noting increased
sensitivity by using fingers, palm, back of the hand, and fist, in order to get the information about
the variation in size, shape, consistency and temperature of body parts and lesions, e.g., the
superficial lymph nodes. The terms, which can be used to describe the consistency of parts
during palpation, are:

● Resilient, when a structure quickly resumes its normal shape after the application of pressure
has ceased (e.g., Normal rumen).

● Doughy, when pressure causes pitting as in edema.

● Firm, when the resistance to pressure is similar to that of the normal liver (e.g.,
neoplasia/tumor).

● Hard, when the structure possesses bone-like consistency (e.g., Actinomycotic lesion).

Fluctuating, when a wave-like movement is produced in a structure by the application of

alternate pressure (e.g., hernia, hemorrhage/hematoma).
Emphysematous, when the structure is swollen and yields on pressure with the production of a
crepitating or crackling sound.

Percussion: Method of examination in which part of body to be examined is struck with sharp
blow using fingertips to produce audible sound. Sound thus emitted will indicate the nature of
the tissue / organ involved for example rumen when bloated will emit drum like sound. Some of
the organs that can be examined by percussion are: gastro-intestinal tract, abdomen and thorax,
frontal and nasal sinuses. The objectives of percussion are to obtain information about the
condition of the surrounding tissues and, more particularly, the deeper lying parts. Percussion
can examine the area of the subcutaneous emphysema, lungs, rumen and rump. Sounds produced
from various structures can be described as following list:

● Dull / flat – sound without resonance or echo, this type of sound can be heard on percussion of
thick muscles or bone.

● Full sound – sound heard is with resonance but not booming like drum. This type of sound is
heard from tissues like lungs that contain air inside.

● Tympanic sound – drum like sound can be heard and this type of sound is heard from bloated
rumen, abomasum and intestine.

Immediate percussion: Using fingers or hammer directly strike the parts being examined.

Mediate percussion: Finger-finger percussion; Pleximeter hammer percussion. The quality of

the sounds produced by percussion is classified as:

➢ Resonant: This is characteristic of the sound emitted by air containing organs, such as the
lungs.

➢ Tympanic: The sound produced by striking a hollow organ containing gas under pressure,
e.g., tympanitic rumen or caecum.

➢ Dull: Sound emitted by a solid organ like the liver or heart.

Modified percussion
Ballottement percussion: Tactile percussion or ballottement is method in which palpation and
percussion are combined together to feel structures that cannot be felt by either of these methods
applied singly. This is normally used for pregnancy diagnosis in cows when the foetus cannot be
palpated through per rectum. Here a firm-pushing stroke is applied on to the uterus and the hand
after pushing is kept in contact with uterus so that the foetus will bound and strike on it. While
firm pushing is done, this sets fluid in uterus into motion and foetus is made to bounce. This
modified percussion is used to detect late pregnancy in small ruminants, dogs and cats. And also,
used for detection rebound of floated material shows pregnancy.

Fluid percussion: Used to detect fluid in the abdomen

Procedure: Apply a push on one side of the abdomen, percussion on the other side. The presence
of wave-like fluid movement shows accumulation of fluid in the abdomen, e.g., ascites.

Auscultation

Word auscultation comes from ‗auscutona„ meaning ‗to listen„. This is a technique of listening to
the sounds produced from organs in the abdominal and thoracic cavities. In olden days listening
to these sounds were done with naked ears. This had certain limitations like the skin on animal
being dirty and infested by parasites it was not healthy for the clinicians and was difficult to keep
ears in contact on animal body due to constant movement. Therefore, an instrument was later
developed for this purpose and this is called stethoscope. The stethoscope was invented in France
in 1816 by Rene Laennec at the Necker-Enfants Malades Hospital. The main objective of
auscultation is listening to the sounds produced by the functional activity of an organ located
within a part of the body. This method used to examine the lung, trachea, heart and certain parts
of the alimentary tract.

Succussion (shaking)

It is the method used to determine the presence of fluid in the body cavities like thoracic and
abdominal cavity. Here the animal is shaken from side to side to set fluid into motion so that
audible fluid sound is produced. This is difficult in large animals and can be applied only in
small animals like dogs and cats.
Clinical Examination of the Patient

General physical examination

Physical examination can be carried out by taking vital signs such as; Temperature taking, Pulse
taking, Respiration taking, Capillary Refill Time (CRT), Physical body condition, Normal
demeanour, Abnormal demeanor.

Temperature taking: Temperature is the measure of how hot or cold the animal body is. On the
basis of the ability to regulate body temperature animals are divided into two groups via
homeotherms and poikilotherms. Homeotherms are those animals including man that can
regulate their temperature in relation to the environmental temperature. Poikilotherms are those
animals that are unable to regulate their body temperature in relation to the environmental
temperature (eg. Amphibians, Reptiles and Fishes). Heat is generated in the body via the
intracellular oxidation of food and the muscular activities. It is lost via the physical process of
conduction, convection, and radiation and through the evaporation, respiration and excretion.

Species Normal temp. in OC Normal temp. in OF

Cattle 37.5-39.5 99.5-101.5
Buffalo 37.5-39.0 99.5-102.2
Horse 37.5-38.5 99.5-100.4
Sheep/Goat 38.5-40.5 101.3-104.0
Pig 38.0-40.0 100.4-104.0
Dog 37.5-39.0 99.5-102.2
Cat 38-39.5 100.4-103.1
Camel 35.5-38.6 95.0-101.5
Chicken 40.5-43.0 104.9-109.4

Pulse taking: Pulse is defined as the regular expansion and contraction of the arterial wall
caused by the flow of blood through it at every heartbeat. Pulse gives information with regard to
the cardio-vascular abnormalities. It is influenced by exercise, excitement, annoyance, relative
humidity, environmental temperature. Pulse can be adapted from the number of heart beats per
minute by using stethoscope in less manageable animals. The rhythm of pulse should also be
noticed while taking pulse. The pulse rate can rise rapidly in nervous animals or those which
have undergone strenuous exercise. In such cases the pulse should be checked again after a
period of rest lasting 5 to 10 minutes.

Species Site
Cattle and Buffalo Middle coccygeal artery
Sheep, Goat, Dog and Cat Femoral artery
Equine External maxillary artery

Animals Rate/Min
Cattle 60-90
Horse 28-42
Sheep/Goat 68-90
Pig 60-90
Dog 90-130
Cat 110-130
Chicken 200-400

Respiration taking: Respiratory movements can be observed at the right flank. Any change in
the rate indicates respiratory involvement. Thoracic respiration is seen in animals suffering from
acute peritonitis and abdominal respiration in pleurisy. Double expiratory movements are seen in
emphysema in horses.

Types of respiration:

1. Costal respiration: In this type of respiration thoracic muscles are mainly involved and the
movement of the rib cage is more prominent. It is seen in dogs and cats.

2. Abdominal respiration: This type of respiration is seen in ruminants viz cattle, goat, sheep and
yak. Here the abdominal muscles are involved and movement of the abdominal wall is noticed.
3. Costo- abdominal respiration: This type of respiration is seen in horses and in this type of
respiration muscles of both thorax and abdomen are involved so the movement of the ribs and
the abdominal wall are noticed.

The respiration rate is measured through counting of either contraction or expansion of the
thorax and abdomen which can be observed during clinical examination.

Animals Per Minute

Horse 9-10
Cattle 27
Sheep/Goat 12-15
Pig 10-20
Cat 20-30
Dog 20-22
Chicken 15-30
Camel 5-12

Terms used in respiration

Eupnoea: Normal breathing

Polypnoea: Increase in respiration rate

Dyspnoea: Difficulty in respiration

Panting: Increased rate with reduced depth

Hyperpnoea: Increased rate with increase in depth

Oligopnea: Abnormally slow and shallow breathing

Apnoea: Cessation of respiration

Visible mucous membrane: The mucous membrane in the eyes, mouth and vagina (in the case
of females) can be examined to determine the health status of an animal. Examination of the
  Mucous membrane examination should be done in natural light (sunlight) not in the
lamplight. The abnormalities of color of mucous membrane are caused by different
factors like

 Pallor of the mucous membranes may indicate anaemia caused by direct blood loss or by
haemolysis,

 A blue tinge may indicate cyanosis caused by insufficient oxygen in

the blood, A yellow colour is a sign of jaundice,

 The mucosae may be bright red (sometimes described as being ‗injected mucous
membranes„) in febrile animals with septicaemia or viraemia,

 Bright red colouration of the conjunctiva is often seen, for example, in cases of bovine
respiratory syncitial virus infection.

 A cherry-red colouration may be a feature of carbon monoxide poisoning.

 A greyish tinge in the mucosae may be seen in some cases of toxaemia – such
membranes are sometimes said to be ‗dirty„.

 High levels of methaemoglobin, seen in cases of nitrate and/or nitrite poisoning, may
cause the mucosae to be brown coloured.

Anaemic mucous membranes.

➢ Blood loss anaemia.

➢ Parasitic infestations leading to haemolysis.

➢ Tumours or leucosis.

➢ Iron deficiency anemia.

➢ Long-standing infectious diseases.

➢ Exposure to X-rays and some medications.

Congested mucous membranes.

 High environmental temperatures and exercise.

 Any disease resulting in fever.
 Diseases of the heart, brain and its membranes.

Yellowish or icteric mucous membranes.

➢ Icterus of jaundice occurs due to increase of blood bilirubin concentration (blood parasites,
leptospirosis, hepatitis, cholangitis, cholecystitis and cholangiohepatitis).

➢ Infectious anaemia and contagious pleuropneumonia of horses.

➢ Chronic gastric dilatation.

Cyanosed mucous membranes.

➢ Bluish discoloration of visible mucous membranes resulting from presence of reduced

haemoglobin in blood capillaries.

➢ Myocarditis, pericarditis.

➢ Plant and mineral intoxications.

Swelling of mucous membranes: Inflammation of mucous membranes results in its swelling; in

which case the mucous membranes may also be hot and tender (i.e. showing cardinal signs of
inflammation). Marked swelling of conjunctival mucous membranes is characteristic of equine
influenza. A slight degree of swelling is noticed in contagious pleuropneumonia of horse and
cattle plague, anthrax and fowl diphtheria.

Capillary Refill Time (CRT): Capillary refill time (CRT) is defined as ―time required for return
of color after application of blanching pressure to a distal capillary bed. This is taken by
compressing the mucosa of the mouth or vulva to expel capillary blood, leaving a pale area, and
recording how long it takes for the normal pink colour to return. In healthy animals, the CRT
should be less than 2 seconds. A CRT of more than 5 seconds is abnormal, and between 2 and 5
seconds it may indicate a developing problem. An increase in CRT may indicate a poor or failing
circulation causing reduced peripheral perfusion of the tissues by the blood.

Physical body condition: Body condition scoring is an important management practice used by
producers as a tool to help optimize production, evaluate health, and assess nutritional status.
Different scores can be given for individual animal and can further classified as normal, fatty,
lean/thin, emaciation.

Condition Score 1: Very thin: This animal„s skeletal structure is very prominent. Notice the deep
depressions next to the spine, between the pelvis and rib cage, between the hooks and pins, and
around the tail head.

Condition Score 2: Thin: The animal„s skeleton is still very apparent. The individual spinous
processes are clearly visible, but there is a small amount of fat tissue over the spine, hooks, and
pins.

Condition Score 3: Medium (Normal body condition): The animal appears smooth over the
spine, ribs, and pelvis and the skeletal structure can be easily palpated. The hooks and pins are
still discernible, with a moderate, rather deep depression between the pelvis and rib cage, hooks
and pins, and around the tail-head.

Condition Score 4: Fat: There are no spinous processes detectable, and no depression in the loin
area, which gives the top-line of the animal a flat, tabletop appearance. The ribs can no longer be
felt, and the pelvis can only be felt with firm pressure. The hooks and pins have a rounded
appearance due to areas of fat covering.

Condition Score 5: Very Fat: The animal appears rounded and smooth with a square-shaped
appearance, because of the amount of fat filling in the loin. The skeletal structure is no longer
visible, and can only be palpated with excessive pressure.

Normal demeanour: When, on being approached, an animal makes a normal response to

external stimuli, such as movement and sound, the demeanour is said to be normal (bright).
Normal reaction under these circumstances may consist of elevating the head and ears, turning
towards and directing the attention at the source of stimuli, walking away and evincing signs of
attack or flight.
Abnormal demeanour: Behavioral change/ response to external stimuli. The Abnormal
demeanours in domestic animals are as follows:

● Decreased response (depression): dull (apathetic); dummy state; comma.

● Excitation or increased response: apprehension (mildly anxious); restlessness; mania; frenzy.

● Posture: It denotes the anatomical configuration when they remain in stationary situation. How
does it stand? How does it sit? How does it lie?

● Gait: It indicates about the locomotory process of an animal.

● Body conformation: shape and size of the different body regions relative to other regions.

Regional or systematic clinical examination

Clinical Examinations of the head and neck region:

Before handling the head a further visual inspection and observation of the head and neck is
advisable as whether the following questions are present:

● Movements of head and neck – normal or abnormal

● Carriage of head – normal or tilted,

● Can the animal see?

● Can the animal hear?

● Ocular or nasal discharge,

● Salivation – normal or excessive,

Ability to prehend, masticate and swallow food

● Mobility of the neck.

Clinical Examinations of the thorax:

Lungs, heart and other vital organs are situated in the thorax. Inspection of thorax is important to
know about respiration. Rate, rhythm, depth and type of respiration can be observed by
examining the thoracic region. Place the back of hand in front of nostrils or by closely examining
the movement of the thoracic cavity.

Clinical Examinations of the abdomen:

Variation in size of abdomen can be noticed. Decrease in size of abdomen is termed as gaunt.
Occurs due to starvation, severe diarrhea and chronic diseases with loss of appetite. Other
abnormalities of abdomen are ventral oedema, congestive heart failure, gangrenous mastitis,
protein deficiency.

Clinical Examinations of the external genitalia:

In males, examination may reveal inflammatory or neoplastic enlargements of preputial sheath or

scrotum, presence of abscess on prepuce or sheath and any abnormal discharges. In females,
swelling of vulva and vagina, prolpase, abscess and presence of pus and blood, or retained
placenta can be seen.

Clinical Examinations of the mammary glands:

Various affections of udder can be determined on the basis of palpation and examination.
Exercise: 2 Date:

VETERINARY LABORATORY SAMPLING TECHNIQUES

The starting point for the laboratory investigation of any animal disease is the taking of
samples. Samples may be taken from animals or the environment for a variety of purposes, such
as disease diagnosis, disease surveillance, health certification or monitoring the response to
treatment or vaccination. The samples collected should be appropriate for the intended purpose,
and adequate in number and amount to provide statistically valid results. Diagnostic laboratories
require the submission of appropriate samples that arrive at the laboratory in good condition. For
disease diagnosis, the tissues sampled should be representative of the condition being
investigated and the lesions observed. Samples should be taken with care, to avoid undue stress
or injury to the animal or danger to the operator. Where appropriate samples should be collected
aseptically, and care should be taken to avoid cross-contamination between samples.

The samples should be carefully packaged, labeled, and transmitted to the laboratory by
the fastest practicable method, with the appropriate temperature control. There are specific
requirements for the packaging and shipping of infectious substances, including diagnostic
specimens, which must be followed. If material is sent to a laboratory in another country, this
laboratory should be consulted in advance to ensure that it is willing to receive the material and
to obtain the appropriate import license. All samples should be accompanied by a letter or
submission form, which includes the name and address of the submitter, the origin of the
material, the relevant history, animal identification and corresponding specimens, and the tests
requested.

A. COLLECTION OF SAMPLES

Before taking samples, careful consideration should be given to the purpose for which they
are required. This will determine the type and number of samples needed to provide valid results.
When samples are taken from live animals, care should be taken to avoid injury or distress to the
animal or danger to the operator and attendants. It may be necessary to use mechanical restraint,
tranquillization or anaesthesia. Whenever handling biological material, from either live or dead
animals, the risk of zoonotic disease should be kept in mind and precautions taken to avoid
human infection. Post-mortem examinations should be carried out under aseptic conditions as is
practicable. Care should be taken to avoid environmental contamination, or risk of spread of
disease through insects or fomites. Arrangements should be made for appropriate safe disposal of
animals and tissues.

Considerable skill and care are required to decide on the correct samples to be sent to the
laboratory. The samples collected should be representative of the condition being investigated
and the lesions observed. Frequently, a combination of blood samples for serology and tissues
from dead or culled animals for microbiological culture will be required.

1. Sample collection from live animals

a) Blood

Blood samples may be taken for haematology or for culture and/or direct examination for
bacteria, viruses, or protozoa, in which case it is usual to use anticoagulants, such as
ethylene diamine tetra-acetic acid (EDTA) or heparin. They may also be taken for serology,
which requires a clotted sample. Blood plasma is also used for some procedures. A blood
sample is taken, as cleanly as possible, by venipuncture. In most large mammals, the jugular
vein or a caudal vein is selected, but brachial veins and mammary veins are also used. In
birds, a wing vein (brachial vein) is usually selected. In small laboratory animals, the vena
auricularis or vena retroorbitalis may be useful to obtain blood samples or it may be
obtained by heart puncture. Blood may be taken by syringe and needle or by needle and
vacuum tube (not easy in delicate veins but convenient in strong veins). Small quantities of
blood are conveniently obtained by pricking with a triangular, solid-pointed needle. Ideally
the skin at the site of venipuncture should first be shaved (plucked) and swabbed with 70%
alcohol and allowed to dry.

For samples that are collected with anticoagulant, thorough mixing, using gentle agitation
only, is necessary as soon as the sample has been taken. It may also be necessary to make a
smear of fresh blood on a microscopic slide; both thick and thin smears may be prepared.
 For serum samples, the blood should be left to stand at ambient temperature (but protected
from excessive heat or cold) for 1–2 hours until the clot begins to contract. The clot can then
be ringed round with a sterile rod and the bottles placed in a refrigerator at 4°C. After
several hours, or overnight, the sample can be centrifuged at about 1000 g for 10–15 minutes
and the serum can be decanted or removed with a pipette. In order to establish the
significance of antibody titres, paired serum samples will often need to be collected 14 days
apart. An alternative method for collecting and transporting blood that is to be used for
serology is to place a drop of blood on to filter paper, the blood is dried at room temperature
and the sample can then be shipped unrefrigerated.

b) Faeces

At least 10 g of freshly voided faeces should be selected. Faeces for parasitology should fill
the container and be sent refrigerated to prevent hatching of parasite eggs and should arrive
at the laboratory within 24 hours. Screw top containers or sterile plastic bags should be used
for shipment; avoid tubes with rubber stoppers as gas generated can result in blowing the
stopper off the tube, ruining the integrity of the sample and contaminating other samples in
the package. An alternative and sometimes preferable method is to take swabs from the
rectum (or cloaca), taking care to swab the mucosal surface. The swabs should be visibly
coated with faecal material; however, samples collected with a swab are inadequate for
parasitology. Care should be taken when collecting swabs from small, delicate animals or
birds to avoid injury to the animal; small swabs are commercially available that should be
used. Swabs should be transported in appropriate transport medium. Faeces are best stored
and transported at 4°C.

c) Skin

In diseases producing vesicular lesions, collect, if possible, 2 g of affected epithelial tissue

aseptically as possible and place it in 5 ml phosphate buffered glycerin or Tris-buffered
tryptose broth virus transport medium at pH 7.6. Additionally, the vesicular fluid should be
sampled where unruptured vesicles are present; if possible, vesicular fluid should be
aspirated with a syringe and placed in a separate sterile tube. Plucked hair or wool samples
are useful for surface feeding mites, lice and fungal infections. Deep skin scrapings, using
 the edge of a scalpel blade, are useful for burrowing mites and, in birds, feather tips can be
taken for detection of viral antigen where Marek„s disease is suspected.

d) Genital tract and semen

Samples may be taken by vaginal or preputial washing, or by the use of suitable swabs. The
cervix or urethra may be sampled by swabbing. Samples of semen are best obtained using an
artificial vagina or by extrusion of the penis and artificial stimulation. The sperm-rich fraction
should be present in the sample and contamination by antiseptic washing solutions should be
avoided.

e) Eye

A sample from the conjunctiva can be taken by holding the palpebra apart and gently
swabbing the surface. The swab is then put into transport medium. Scrapings may also be
taken on to a microscopic slide. The handles of metal-handled swabs are useful for this, to
ensure that sufficient cells are removed for microscopic examination.

f) Nasal or ocular discharge (saliva, tears)

Samples may be taken with dacron, cotton or gauze swabs, preferably on wire handles as
wood is inflexible and may snap. It may be helpful if the swab is first moistened with
transport medium. The swab should be allowed to remain in contact with the secretions for
up to 1 minute, then placed in transport medium and sent to the laboratory without delay at
4°C. Long protected nasopharyngeal swabs should be used to collect samples for some
suspected viral infections.

g) Milk

Milk samples should be taken after cleansing and drying the tip of the teat, the use of
antiseptics should be avoided. The initial stream of milk should be discarded and a tube
filled with the next stream(s), a sample of bulk tank milk can be used for some tests. Milk
for serological tests should not have been frozen, heated or subjected to violent shaking.
2. Sample collection at post-mortem

Samples of tissue from a variety of organs can be taken at post-mortem. Animal health personnel
should be trained in the correct procedures for post-mortem examination of the species of
animals with which they work. The equipment required will depend on the size and species of
animal, but a knife, saw and cleaver will be required, and also scalpel, forceps and scissors,
including scissors with a rounded tip on one blade, for opening intestines. A plentiful supply of
containers appropriate to the nature of the sample required should be available, along with labels
and report forms. Containers should be fully labeled with the date, tissue and animal
identification. The operator should wear protective clothing: overalls, washable apron, rubber
gloves and rubber boots. Additionally, if potential zoonotic diseases are being investigated, the
post-mortem examination should be conducted in a biological safety cabinet; if this is not
possible, an efficient face mask and eye protection should be worn. If rabies or transmissible
spongiform encephalopathies (TSEs) are suspected, it is usual to detach the animal„s head.

Tissues may be collected for microbiological culture, parasitology, biochemistry, histopathology

and/or immuno-histochemistry, and for detection of proteins or genome nucleic acids. The
person conducting the post-mortem examination should have sufficient knowledge of anatomy
and pathology to select the most promising organs and lesions for sampling. Each piece of tissue
should be placed in a fully labeled separate plastic bag or sterile screw-capped jar. Sterile
instruments should be used for collecting specimens for microbiological culture and care should
be taken not to contaminate tissues with intestinal contents. Disinfectants should not be used on
or near tissues to be sampled for bacterial culture or virus isolation.

The tissues may be sent to the laboratory dry or in bacterial or virus transport medium,
depending on the examinations required. After collection, the samples for microbiological
examination should be refrigerated until shipped. If shipment cannot be made within 48 hours,
the samples should be frozen; however, prolonged storage at –20°C may be detrimental to virus
isolation. For histopathology, blocks of tissue not more than 0.5 cm thick and 1–2 cm long are
cut and placed in neutral buffered 4–10% formalin, which should be at least ten times the volume
of the tissue sample. For certain suspected diseases, larger portions of brain are required; the
brain is sectioned using a sagittal cut, half is submitted fresh, on ice, and the other half is
submitted in 10% buffered formalin. Store and pack formalin-fixed tissues separately from fresh
tissues, blood and smears. Care should be taken to insure that formalin-fixed tissues are not
frozen. Once fixed, tissues can be removed from formalin and, as long as they are kept moist and
protected (e.g. by wrapping in formalin-soaked paper towels, then sealed in screw-capped jars),
they can be forwarded to the laboratory without formalin.

3. Environmental and feed sampling

Samples may be taken to monitor hygiene or as part of a disease enquiry. Environmental samples
are commonly taken from litter or bedding and voided faeces or urine. Swabs may be taken from
the surface of ventilation ducts, feed troughs and drains. This kind of sampling is particularly
important in hatcheries, artificial insemination centers and slaughter houses in which specialized
equipment is maintained. Samples may also be taken from animal feed, in troughs or bulk
containers. Water may be sampled in troughs, drinkers, header tanks or from the natural or
artificial supply.

B. INFORMATION TO BE SENT ALONG WITH THE SAMPLES

It is essential that individual samples be clearly identified using appropriate methods. Marking
instruments should be able to withstand the condition of use, i.e. being wet or frozen. Pencil has
a tendency to rub off containers and labels attached to plastic will fall off when stored at –70°C.
Information and case history should always accompany the samples to the laboratory, and should
be placed in a plastic envelope on the outside of the shipping container. The following are
suggested items that should be addressed. It would be advisable to contact the receiving
laboratory to determine if it has a submission form that it would like to have submitted with the
samples or if it needs other information.

i) Name and address of owner/occupier where disease occurred, with telephone and fax numbers.

ii) Name, postal and e-mail address, telephone and fax numbers of the sender.

iii) Diseases suspected and tests requested.

iv) The species, breed, sex, age and identity of the animals sampled.

v) Date samples were collected and submitted.

vi) List of samples submitted with transport media used.

vii) A complete history would be beneficial for the laboratory and should be included if possible.
Some of the components of the history are:

a) A list and description of the animals examined and the findings of the post-mortem
examination.

b) The length of time sick animals has been on the farm; if they are recent arrivals, from
where did they originate.

c) The date of the first cases and of subsequent cases or losses, with any appropriate
previous submission reference numbers.

d) A description of the spread of infection in the herd or flock.

e) The number of animals on the farm, the number of animals dead, the number showing clinical
signs, and their age, sex and breed.

f) The clinical signs and their duration including the condition of mouth, eyes and feet, and
milk or egg production data.

g) The type and standard of husbandry, including the type of feed available, possible contact
with poison or poisonous plants.

h) Any medication given to the animals, and when given.

i) Any vaccination given, and when given.

j) Other observations about the disease and husbandry

C. PACKAGING AND TRANSPORT OF SAMPLES

1. Approval to ship specimens

The laboratory that is going to receive the samples should be contacted to ensure that it has the
capability to do the testing requested and to see if there are any special packaging or shipping
requirements. It is essential to contact the receiving laboratory when material is sent to another
country. A special import license will usually be required and must be obtained in advance for
any biological material. This license should be placed in an envelope on the outside of the parcel.

2. Transportation of specimens

The specimens should be forwarded to the laboratory by the fastest method available. If they can
reach the laboratory within 48 hours, samples should be sent refrigerated. If dry ice is used, the
additional packaging requirements must be met. Infectious substances, which can include
diagnostic specimens, are not permitted to be shipped as checked luggage or as carry on luggage
and must be shipped as cargo.

3. Packaging

The shipper should ensure that the specimens are packaged so they arrive at the laboratory in
good condition and there is no leakage during shipment. The International Air Transport
Association (IATA), Dangerous Goods Regulations (DGR) has explicit requirements for
packaging and shipment of diagnostic specimens, by all commercial means of air transport. In
many countries, similar requirements are applicable to ground shipments and the postal service.

The IATA lists the following exemption from the Dangerous Goods Regulations:

Substances which do not contain infectious substances or substances which are unlikely to cause
disease in humans or animals are not subject to these regulations unless they meet the criteria for
inclusion in another class.

There are also exceptions for some Biological Products and the shipper of these products is
referred to the IATA Regulations for these requirements as some Biological Products are not
exempted.
Exercise: 3 Date:

NASOGASTRIC INTUBATION

Nasogastric intubation, more commonly known as stomach tubing, involves passing a hollow
tube up the horse„s nose, down the oesophagus (gullet) into the horse„s stomach. It is used by a
vet to identify if there are any abnormal contents in the horse„s stomach, and to administer fluids
and some treatments directly into the stomach. It is the second most commonly used test to help
diagnose horses with colic (rectal examination being the most common). Horses may resent this
action being undertaken, but it can be an essential procedure to perform in some cases.

Why is it performed?

The anatomy of the horse„s gastrointestinal tract means that in theory, horses are unable to
vomit. Therefore, any blockages resulting in a build-up of food and fluid within the stomach or
small intestine can„t be relieved. Instead the stomach becomes more and more distended
(swollen), causing severe pain. If this distension is not relieved, the stomach can rupture with
fatal consequences. This is rare and only occurs with certain types of colic, but it is an important
reason why a vet may want to use a stomach tube. Nasogastric intubation is also the only method
of giving fluids directly into the intestinal tract. Fluids are used to relieve conditions such as
impactions, to provide electrolytes and administer other treatments as required. This can be an
important part of treatment as horses with colic are often reluctant to eat or drink.

Limitations and possible complications

There are some potential complications of nasogastric intubation; the most common resulting in
the horse having a nose bleed. There is a highly vascular (lots of blood vessels) structure called
the ethmoturbinates at the back of the horse„s nasal cavity which the stomach tube passes next to.
As a result it is not uncommon for this to bleed during or after intubation. Nose bleeds in a horse
can look quite dramatic; it can look like a large amount of blood, even though it is a small
proportion of their total blood volume (for example, an average 500kg horse has over 50 litres of
blood in its body). The sensation of a nosebleed will also make the horse blow out through their
nose, spreading the blood over their surrounding area. Although nose bleeds in the horse can
look dramatic, they are not painful to the horse, and should stop without any problems given
enough time. In some horses it can be difficult to pass the tube into the oesophagus and repeated
attempts may be required. Horses that are sedated or are very sick may have a reduced swallow
response making it harder to pass the tube. It is very important that the tube is passed into the
oesophagus and not the airway and therefore your vet will take extra time to check the position
of the tube.

GASTRIC INTUBATION, GAVAGE, LAVAGE

Synonyms

Gastric decompression, orogastric feeding, orogastric intubation

Overview and Goals

Passage of a hollow tube into the mouth and through the oropharynx into the stomach to
facilitate decompression of gas, removal of stomach contents (lavage), or administration of large
volumes of liquid, food, or medication (gavage)

Indications

• Gastric intubation:

○ Preoperative stabilization of gastric dilatation/volvulus (GDV); allows evacuation of gas and

fluid, resulting in an improved hemodynamic state

○ Relief of discomfort associated with gaseous dilatation (without torsion) of the stomach

• Gavage:

● Administration of large volumes of liquid medication, including:

▪ Activated charcoal after toxin ingestion

▪ Barium for gastrointestinal (GI) contrast radiography

▪ Hyperosmotic laxative agent prior to colonoscopy

● Administration of formula to neonatal animals that are not nursing on their own
• Lavage:

● Preoperative stabilization of GDV. Removal of stomach contents may help decrease the speed
of gas reaccumulation while the animal is being prepared for surgery, thus slowing or preventing
cardiovascular deterioration.

● Removal of stomach contents with suspected intoxications

Note: Gastric lavage may not be indicated in all cases of toxin ingestion. Substance ingested,
consistency, time since ingestion, and animal status will influence whether gastric lavage is
appropriate.

Contraindications

• Esophageal disease that could lead to tube-induced trauma or perforation. Conditions of

concern include esophageal stricture, neoplasia, ulceration, megaesophagus, and recent
esophageal surgery.

• Gastric disease that could lead to tube-induced trauma or perforation.

• Any swallowing disorder (megaesophagus, esophageal motility disorder, etc.), pharyngeal

disorder, or laryngeal disorder (paralysis, previous tie-back surgery, etc.) that could predispose a
nonendotracheally intubated animal to aspiration.

• If even one of these conditions is present, the risk of the procedure versus its benefits must be
considered (and will vary from case to case) before deciding whether to perform the procedure.

Equipment, Anesthesia

Gastric intubation:

• Two assistants (minimum)

• Flexible plastic tubing of various length and diameter. The distal end must be smooth and
atraumatic; smoothing may be achieved by brief heating of the end of the tube over a flame,
cooling, and trimming edges with a scalpel blade. One to three side holes may facilitate
evacuation of stomach contents by minimizing obstruction of a single distal hole with gastric
mucosa or ingesta.

• A roll of clinic-type white cloth tape

• Water-soluble lubrication jelly

• Mouth gag/speculum

If gastric lavage, all of the above, plus:

• Funnel or stomach pump

• Container (e.g., bucket) to collect stomach contents and lavage fluid

• Lavage fluid: usually warm (body temperature) water

Anticipated Time

Dependent on cooperation of animal; additional time may be needed for sedation or general
anesthesia:

• Gastric intubation: 2-5 minutes

• Gavage: 3-10 minutes

• Lavage: 10-60 minutes

Preparation: Important Checkpoints

• Ensure that adequate manual or chemical restraint for the procedure is planned. Personal
preference and animal stability may dictate the degree of sedation or anesthesia chosen. Note:
Some clinicians prefer to ensure a patent and protected airway to minimize the potential for
aspiration pneumonia through the use of general anesthesia and a cuffed endotracheal (ET) tube
when gastric lavage is performed.

● Maximize cardiovascular stability prior to the procedure.

Possible Complications and Common Errors To Avoid

● Inadvertent passage of the orogastric tube into the trachea can result in mild to severe
complications:

● Tracheal irritation leading to transient coughing or mucosal bleeding is possible.

● Tracheal or bronchial placement of the gastric tube can result in airway obstruction until the
tube is repositioned.

● Tracheal or bronchial tearing can result in pneumomediastinum, pneumothorax, and death.

● Tracheal or bronchial administration of gavage or lavage fluids can result in severe aspiration
pneumonia and death.

• Oral, pharyngeal, laryngeal, esophageal, or gastric trauma can result if excessive force is used
for passing the gastric tube. Full-thickness tearing is possible, especially with a preexisting
underlying disease.

• Inability to pass the tube into the stomach may be due to the choice of a tube with a diameter
that is too large, esophageal obstruction (foreign body, stricture, neoplasia), torsion of the
stomach, or excessive lower esophageal sphincter (LES) tone. Discontinuation of
metoclopramide prior to elective gastric intubation is recommended to minimize LES tone.

• Inadequate sedation of an uncooperative animal will lead to longer procedure times and
increased risk of injury to the animal and veterinary staff.

• Inability to effectively remove gastric contents through lavage may be related to excessive size
or adhesive nature of gastric contents, gastric compartmentalization, or other factors.

• Regurgitation during lavage, gastric overfilling, or esophageal administration of large volumes

of lavage fluid can result in aspiration if a cuffed ET tube is not in place.

• Excessive tube advancement can cause occlusion of the distal end of the tube against stomach
mucosa. Palpation of the tube pressing against the stomach wall may indicate a need for partial
retraction.
Materials and equipment used for gastric intubation and lavage. A, Orogastric tube. B, Metal
speculum or roll of tape to be used as a mouth gag. C, Stomach pump for lavage.

Procedure

• Manual restraint, sedation, or general anesthesia as indicated

• Position animal in sternal recumbency. If animal is uncomfortable, alternate positions may be

better tolerated (sitting, standing, lateral, etc.).

○ Placement of the animal on an elevated surface will allow gravity-assisted efflux of stomach
contents and lavage fluid once the tube is in place.

• Choose appropriate tube diameter for esophageal size and procedure planned. Example: A tube
with an outer diameter of 1.5 inches (3.5 cm) is appropriate for most medium-sized dogs (45 lb
[20 kg]). A larger tube size may be necessary for effective lavage versus gas decompression.

• Measure the length of tube necessary to pass from the nose to the xiphoid. Mark this distance
on the tube with a piece of tape or nontoxic marker.

• Place a mouth gag (speculum) to prevent the animal from chewing on the tube.

○ A roll of 2-inch (5 cm)-wide clinic-type white cloth tape works well in many animals. The tube
will pass through the hole in the tape roll. Place tape roll on top of the tongue and behind all 4
canine teeth.
○ Have an assistant hold the mouth closed around the mouth gag.

○ Avoid using a gag that will damage the teeth.

• Generously lubricate the distal portion of the stomach tube.

• Pass the tube into the mouth through the mouth gag.
Exercise: 4 Date:

OXYGEN THERAPY IN VETERINARY PRACTICE

Oxygen therapy denotes the delivery of high concentrations of oxygen into the respiratory
system to increase the oxygen levels in the blood so that more oxygen reaches at tissues level. It
is a key component in respiratory care. The body constantly takes oxygen and releases carbon
dioxide and when this process is inadequate, oxygen levels in the blood falls and the patient may
need supplemental oxygen. The purpose is to increase oxygen saturation in tissues where the
saturation levels are too low due to illness or injury.

Indications of Oxygen Therapy

Hypoxia

Hypoxia, which constitutes the most important indication for oxygen therapy, is defined as lack
of oxygen at the tissue level. Hypoxaemia, on the other hand, is low arterial oxygen tension
(PaO2) below the normal levels. There are numerous clinical conditions which could cause
hypoxemia, as discussed in the following conditions-

Decreased fraction of inspired oxygen: Conditions like central nervous system weakness,
neuromuscular weakness and diseases of thorax like pneumothorax/hydrothorax etc. interferes
with the normal ventilation.

Alveolar hypoventilation: Pathological conditions like pneumonia and fibrosis of lungs results
thickening of alveolar membrane which causes oxygen to be displaced by carbon dioxide in
poorly ventilated alveoli.

Impairment of diffusion, due to pneumonia or fluid/pus in alveoli also results hypoxemia.

In ventricular septal defect, there is mixing of oxygenated and non-oxygenated blood in the heart
which results hypoxemia.

Anaemic Hypoxia

This occurs when inadequate haemoglobin is available to transport oxygen. Conditions like
haemorrhages, chronic tick infestation, blood protozoan diseases, epistaxis, nutritional deficiency
etc. results anaemic hypoxia.

Stagnant Hypoxia

Stagnant hypoxia is caused by low blood flow, inadequate oxygen delivery to the tissues,
dehydration, haemorrhage, low cardiac output and CHF.

When to Institute Oxygen Supplementation

Clinical signs like nasal flaring, pallor of mucus membrane, cyanosis, panting, irregular chest
wall movements etc., require immediate supplementation of oxygen. Quantitatively, oxygen
should be provided to any patient with saturation of oxygen (SaO2) or pulse oximetry reading
(SpO2) of <93% or with an arterial partial pressure of oxygen (PaO2) of <80 mm Hg.

Use of Pulse Oximetry for Detection of Level of Oxygen Deficiency

Pulse oximetry is the most non-invasive and stress-free method of monitoring oxygen delivery to
the tissues. It calculates the percent of oxygen saturation of haemoglobin in arterial blood using
spectrophotometry. The probe passes light through the tissues at two different wavelengths: a red
and infrared light absorption. Oxygenated haemoglobin absorbs more infrared light and allows
more red lights to pass through. Deoxygenated haemoglobin absorbs more red lights and allows
more infrared light to pass through. The difference in light absorption is calculated and the final
figure is displayed as a percentage (PO2%).

Methods of Oxygen Therapy

There are 2 methods of oxygen therapy used in small animals.

Non-invasive Method

Invasive Method

Non-Invasive Methods of Oxygen Therapy

Non-invasive ventilation (NIV) refers to the administration of ventilator support without using an
invasive artificial airway (endotracheal tube or tracheostomy tube). This method includes-
a) flow-by oxygen

b) face mask

c) oxygen hood/oxygen collar and

d) oxygen incubator/oxygen cage.

Flow-by Oxygen

This method is the simplest among all non-invasive methods. Here, oxygen pipe placed adjacent
to, or within 2cm of a patient„s nostril or mouth. In this method there is no need of humidifier
(overall fractional oxygen concentration being delivered to the lungs < 35). A flow rate of 2L to
3L/minute was maintained, which provides a FiO2 of 25 to 40 per cent.

Face Mask

Face mask of variable sizes are widely available. It can be comfortably placed over the patient„s
muzzle. A tight-fitting seal is required to allow for optimal oxygen delivery. While using a face
mask, attention should be made to ensure that there is a gap between the patient„s nares and the
oxygen delivery point and patient„s nares should not be squashed to the end of the mask. In this
method, flow rate of 2L/minute to 5L/minute can provide a FiO2 of up to 50 to 60 %. If a loose-
fitting mask is used, a much higher flow rate will be required.

Complications

Tight-fitting masks may results rebreathing of carbon dioxide and an increase in temperature and
humidity of intake air.

Oxygen Hood /Oxygen Collar

Oxygen hood /oxygen collar produces a very effective oxygen delivery method, using low flow
rates. Commercial oxygen hoods are available in markets. It can be made easily by using a rigid
Elizabethan collar and plastic wrap. An oxygen tube must be attached two inches from the base
of the collar. The plastic wrap is placed across the front of the collar, covering two-thirds of the
front and secured to the sides. Opening acts as a vent which releases excess oxygen and exhaled
carbon dioxide. As oxygen is heavier than air, it remains in the lower two-thirds of the collar,
acting as a reservoir. Here flow rates of 0.5L/minute to 1L/minute should maintained, will
deliver a FiO2 of 30 to 40 %. Heat and humidity within the hood/collar should be monitored.
Also ophthalmic ointments are applied on a regular basis to prevent drying.

Oxygen Incubator/Oxygen Cage

This provides an excellent means of supplying oxygen to smaller patients within a stress-free
environment. Medical pediatric incubators and commercially available portable oxygen
cages/tents can be used in veterinary practice. A flow rate- 2 to 10 L/minute (depending on the
size of the cage) should be maintained. It also has some disadvantages like the patients can
rapidly become hyperthermic, there is rapid increment of humidity within a short time limiting
its use for short periods and it restrict immediate access to the patient.

Invasive Methods of Oxygen Therapy

This technique is only possible when the animal is unconscious or under anaesthesia. It includes
a) nasal oxygen prongs, b) nasal oxygen catheters and c) trans-tracheal oxygenation.

Nasal Oxygen Prongs

Nasal prongs are widely used in human medicine. Size of prongs varies from new borne,
pediatrics to adults. A prong is placed at each nare and aligned with the opening of the nostril.
Prongs can slip out easily, which may require securing with a suture or surgical staples. Here the
flow rates ranges from 3L/minute to 6L/minute.

Nasal Oxygen Catheters

Application of nasal catheter for oxygen delivery is the best method among all the invasive
method as it is inexpensive, technically easy to place and also well tolerated by the patient.
Oxygen catheters are available in various diameters and lengths. Flow rates of 50ml/kg/minute to
150ml/kg/minute should be maintained (can provide a FiO2 of 30 to 70 per cent).

Transtracheal Oxygenation

This technique is used in patients intolerant to nasal oxygen delivery like patients suffering from
upper airway obstruction. Catheters made up of silicones are placed surgically between the
fourth and fifth tracheal cartilaginous rings and the end of the catheter can then be attached to the
oxygen source. Here the flow rate is 50ml/kg/minute, which provides 40 to 60 % FiO2.

Oxygen Toxicity

Oxygen toxicity occurs when oxygen administered in excessive amounts over a prolonged period
of time. It causes injuries like alveolar damage and decrease pulmonary function, which is fatal
to animals. To avoid pulmonary oxygen toxicity, small animals should not receive a FiO2 of
more than 60 per cent for longer than 24 to 72 hours.

Conclusion

Success of oxygen therapy varies from patients to patients and depends mostly on the severity of
the disease. As tolerance of each method varies from patient to patient, determining the most
suitable method can be a challenging task, which needs experience and skilled personnel. While
delivering oxygen to the patients care should be taken that oxygen administration should be
stress free and if the animal becomes anxious or frightened, and starts to struggle, an alternative
method should be initiated. Choosing the suitable method along with the flow rate of oxygen and
careful observation of patient is the key of successful oxygen therapy.
Exercise: 5 Date:

GASTRIC LAVAGE

Gastric lavage is the term used when referring to a procedure that involves removing contents
from the stomach. Gastric lavage in dogs is commonly called ―pumping the stomach,‖ as the
fluids are taken upward from the stomach organ. A gastric lavage procedure is commonly used in
situations when the option of inducing emesis (vomiting) in unobtainable. Unconscious patients,
ingestion of a large quantity of a toxic agent, or sometimes, in the case of gastric dilation
volvulus syndrome (twisted stomach), a gastric lavage procedure is helpful. Gastric lavage
procedures are often performed an emergency situation.

Gastric Lavage Procedure in Dogs

First perform a routine diagnostic examination of the canine. Routine testing will include a
physical exam, blood work, a urinalysis and possibly a fecal examination. Radiographs and/or an
ultrasound of the abdomen may also be taken to establish the presence of gastrointestinal
obstruction or abnormality prior to conducting the gastric lavage procedure. An IV catheter will
be placed, preferably in either the right or left front limbs of the dog. An intravenous catheter
will allow easy access for fluid therapy and intravenously administered drugs. The canine will
be given a sedative injection and will be intubated with an endotracheal tube, which will allow
the veterinary team to provide the dog with oxygen and an anesthetic gas. The cuff of the
endotracheal tube will be inflated to prevent gastrointestinal fluids that will be aspirated from the
stomach, from entering the lungs. The patient„s vital signs will be checked and monitored
throughout the procedure. An anti-emetic drug may be administered intravenously at this time to
prevent the dog from retching while the tube has been placed. The dog will be placed in sternal
(on the belly) or right lateral (on the side) recumbency. The orogastric tube will be pre-measured
to an appropriate size. Place the tube alongside the dog„s body, placing the end of the tube at the
last rib. The other end of the tube will then be marked with tape to ensure once the tube is
inserted, it will not pass deeper into the digestive system. The tube will be lubricated and
inserted into the dog„s mouth, passing down the esophagus, then into the stomach. Then confirm
that the orogastric tube is properly placed through palpation or simultaneous auscultation. Warm
water will be infused down a funnel and into the orogastric tube. Using the force of gravity, the
exposed end of the orogastric tube will be directed towards a bucket on the floor for the stomach
fluids to pour into. More fluids will be administered and allowed to pour out until it is felt that
stomach has been lavaged. (Usually no more than ten times.) Before the tube is removed,
activated charcoal will be passed through the tube. The activated charcoal will bind and ―trap‖ any
toxic substance left behind. The lavage process will once again take place to remove the captured
toxins and charcoal. The orogastric tube will be kinked and removed from the dog„s stomach.
The patient will be extubated (removal of endotracheal tube) when the gag reflex returns and
allowed to awaken in the recovery area.

Efficacy of Gastric Lavage in Dogs

Gastric lavage for dogs is a highly effective way to remove a toxin from the stomach before the
body ingests the element.

Gastric Lavage Recovery in Dogs

After the gastric lavage procedure has been completed, the dog should show signs of
improvement in the following hours. Additional motorization may be required.

Dog Gastric Lavage Considerations

The tracheal wash procedure does require the patient to undergo a brief period of anesthesia,
which is the primary concern for most dog owners. Gastric lavage also poses the risk for
respiratory effects (hypoxemia), mechanical injuries (mouth, throat, stomach irritation) and
aspiration pneumonia if the endotracheal cuff was not properly inflated.

PERITONEAL LAVAGE

Peritoneal lavage is a diagnostic, surgical procedure performed to establish whether there is any
free floating fluid (usually blood) in the abdominal cavity. A peritoneal lavage is used relatively
early on, as it is primarily a diagnostic tool. Despite it being a highly accurate test for evaluating
intraperitoneal hemorrhage, or ruptured hollow viscus, it is not performed frequently as
abdominal sonography is increasingly being used.

Peritoneal Lavage Procedure in Dogs

Give the dog a physical examination, followed by possible tests, including blood work. Once the
decision for a peritoneal lavage has been made, the procedure will take place promptly, often
within days. The procedure itself will go as follows: The dog will be intravenously anesthetized.
A vertical incision of the skin will be made one third of the distance from the umbilicus to the
pubic symphysis. The linea alba is then divided. The peritoneum is picked up to prevent bowel
perforation. The peritoneum is then entered. A catheter will be inserted towards the pelvis and an
attempt at aspiration of material using a syringe will be made. If no blood is aspirated, warm
saline is infused. After a few minutes this is drained and then sent for analysis.

Efficacy of Peritoneal Lavage in Dogs

Peritoneal lavage is extremely effective in attaining its goal of allowing a thorough and accurate
evaluation of a hemorrhage. Due to the diagnostic nature of this procedure, plus the emphasis on
safety, long-term implications are unlikely. Despite minimal risks of complications, it is
extremely unlikely a dog will suffer from any permanent effects, as the procedure is used mainly
for diagnostic purposes. There are alternatives to having a peritoneal lavage. Abdominal
sonography is increasingly being used instead. This is due to the non-invasive nature of
sonography. A peritoneal lavage is an invasive procedure, that comes with greater associated
risks than a sonography. But, a sonography cannot provide as accurate results, as it does not
allow direct access to the problem area. As sonography is not as informative, it increases the
chance of missing vital information.

Dog Peritoneal Lavage Considerations

There are minimal risks associated with the procedure, just 0.8%-1.7% suffer from
complications. Those complications are all short term issues, such as injury to the iliac vessels,
inadequate fluid return, and bladder punctures. However, when the chances of these are around
1%, the benefits that the procedure offer far outweigh the risks. A peritoneal lavage can give a
detailed and accurate diagnosis of the abdominal problem, which then allows for the most
effective treatment to be administered. While there is the chance of the dog suffering from
peritonitis and bleeding again in the future, it will not be as a result of the procedure itself.
Exercise: 6 Date:

COLLECTION AND EXAMINATION OF CEREBROSPINAL FLUID

Collection of CSF

For collection of CSF the material required is 12.5 cms long 14G needle with a stylet, 3 inch 16
G spinal needle, cotton swab, BP handle with knife, rectified spirit, sterilized test tubes, sharp
razor etc in sterilized condition and aseptic precautions should be taken during collection.

Methods of collection

The CSF is collected from two sites,

A. Cisterna magna or atlanto-occipital puncture in horse, cat and dog.

B. Sub lumbar or lumbosacral puncture in cow, sheep and goat.

A. Atlanto occipital puncture: The collection can be done either in the standing position or in
the lateral recumbency with following steps,

1. Restrain the animal, casting with rope.

2. Sedation of the animal by giving local anesthesia such as 2% Xylocaine, Lignocaine and
tranquilization with Siquil or Largactil.

3. Flex the head by bending and stretching the neck, so that it forms a 900 angle with the
longitudinal axis of the neck and hold it in this position firmly.

4. Clip, clean and sterilize the selected area.

5. Use a 3-4‖ long and 16 G spinal needle with a stylet and insert it slowly at the cranial edge of
the wings of atlas. Direction of the needle should be parallel to the long axis of the head. When
the needle enters subarachnoidal space resistance is not felt.

6. Needle enters into atlanto-occipital joint, remove the stylet so that the CSF flows out and
collect approximately 1 to 2 ml of CSF.
B. Sub lumbar puncture: The collection is done in the standing position.

1. Presurgical and aseptic precautions are taken and the depression between the dorsal process of
last lumbar vertebra and cephalic end of median crest of sacrum is palpated. Needle is passed
and punctured at this site. Insert the needle vertically, then slightly oblique by applying gradual
pressure in forward and backward directions. As the needle enters in subarachnoid space
comparatively less resistance is felt.

2. Animal must be tied firmly to avoid damage to the spinal cord. CSF collection is done by
removing the stylet, apply a syringe and suck the fluid.

Examination of CSF

The CSF is examined for following tests,

I. The Physical examination is described in Table.

Parameters Observation Inference

Colour Clear, watery and transparent Normal

Red Puncture of blood vessel

during collection

Dull red / brownish Intracranial hemorrhage,

cranium fracture
Yellow (xanthochromic) Presence of bile pigments
(jaundice), hemorrhage.

Grayish or greenish Due to infection leading to

pus formation
Turbidity Clear, transparent Normal

Hazy, ground glass like Presence of cells/ white

 clots appearance
(pleocytosis)

Cloudy/purulent Encephalitis, bacterial

meningitis.

Red turbid Puncture of blood vessel

during collection

Coagulation No coagulation Normal

Coagulation Presence of abnormal

amount of proteins
especially fibrinogen in
cases of meningitis

Blood (in large quantities) Internal hemorrhage or

improper collection.

II. Chemical examination

a. Proteins: Normal protein content of CSF is 12-40 mg/100 ml and most of it is
albumin.
b. Glucose: The quantitative estimation of CSF glucose is done by the Folin – Wu
technique. The concentration of the glucose in CSF is approximately 60-70 % of
blood glucose level and ranges from 40-80 mg/100 ml in normal CSF.
The glucose level in CSF depends upon the
1. Blood glucose levels,
2. Selective permeability of the blood to CSF barrier,
3. Presence or absence of glycolytic barrier.
An increased glucose level in the CSF is termed as ―hyperglycorrhacia‖ and is seen in
association with any disease having a hyperglycemia (Diabetes mellitus),
encephalitis, spinal cord compression, brain tumors or brain abscess. A decreased
glucose level in the CSF is termed as ‗hypoglycorrhacia„ and is associated with
systemic hypoglycemia or acute pyogenic infection.
c. Chlorides: Normal CSF values in domestic animals ranges between 650-850
mg/100ml. Lower values are seen in pyogenic meningitis, protracted vomiting,
advanced pneumonia, hypochloremia, while normally higher values of chlorides in
CSF are recorded than in serum.
d. Sodium: Slightly higher in CSF than in blood in salt poisoning cases.
e. Cholesterol: Hemorrhages in the CNS, tumors, meningitis and brain abscess lead to
an increase in cholesterol content. Usually normal cholesterol level is very low and
values recorded in Horse: 0.36 - 0.55 mg/dl and Goat: 0.51 mg/dl.
f. Determination of enzymes: Increased levels of CSF GPT: 20.1(9-46 unit) and GOT:
13.7 (2-32 units) have been observed in dogs suffering from distemper with
involvement of CNS, purulent meningitis and cerebral infarction.
Lactic dehydrogenase enzyme level of CSF are also increased in bacterial meningitis,
metastatic carcinoma, lymphoid tumor, subarachnoid hemorrhage and cerebral
infarction. A marked elevation in the CPK (creatinine phosphokinase) is also seen in
certain neurological conditions.
g. Calcium: Normally the calcium is lower in CSF than in serum. Increased level of
protein bound calcium in CSF indicates disturbance in blood brain barrier.
Table. Chemical Examination of CSF:

Tests Observation Inference

Foam test Slight foam that disappears Normal Protein levels
Take CSF in test tube and after few minutes
shake the test tube at least for More foam that remains
5 minutes Protein level Increased
Sulfosalicylic acid test (SSA) Increase in the turbidity Presence of proteins
3 ml of 3% SSA + 1 ml CSF
Mix and allow to Stand
Nonne - Apelt test White to grayish ring at the Presence of increased amounts
1 ml saturated ammonia junction of two fluids of globulin in CSF which is
solution + 1 ml CSF seen in
Do not mix. Allow to stand 1. Encephalitis,
Pandy's test White cloudy or turbid 2. Meningitis,
1 ml saturated phenol or 3. Neoplasia,
Pandy's reagent, 1-2 drops of 4.Hemorrhage,
CSF Shake ( reagent is 5.Hydrocephalus,
prepared by dissolving 10 6.Tissue destruction,
grams of pure phenol in 150 7. Uremia,
ml of distilled water) 8.Toxoplasmosis,
9. Pneumonia

III. Cytological examination

The total cell counts of the CSF must be estimated within 20 minutes of collection,
since the cells degenerate rapidly. The estimation of the number of cells is done as for
the determination of WBC„s of the blood. The total number of cells which are
obtained are then multiplied by 0.6 to get number of cells in one cu mm of the CSF.
Normal counts:
Cattle, sheep and pig 0 - 15 cells/ cu mm
 Dog upto 25 cells/cu mm
Horse upto 23 cells/cu mm
Pleocytosis or increased number of WBC„s are seen in inflammatory conditions of
brain, spinal cord or meninges, abscess of brain or spinal cord, encephalitis, chronic
inflammatory conditions, toxic or degenerative conditions.
Differential Count: Prepare the smear from CSF, dry it and stain with leishmanns
stain, examine under microscope. Neutrophilia indicates pyogenic or bacterial
infection, abscesses in brain, bacterial meningitis, encephalitis and hemorrhage, while
lymphocytosis is observed in uremia, toxemia, chronic viral and fungal infection.
IV. Bacteriological examination
It is carried out when the CSF cell count and protein contents are high. The organisms
are isolated in CSF and identified by cultural methods.
Exercise: 7 Date:

BLOOD TRANSFUSION

Blood transfusion is being practiced for centuries for saving life of human beings and animals.
Richard Lower in 1665 transfused the blood in a dog for the first time in the history. With the
help of latest techniques and equipment developed after 1950, blood transfusion became more
popular in veterinary medicine. Blood transfusion has made considerable advancements in
veterinary medicine in recent times. Although, the information and availability of blood and its
products has increased, transfusion therapy has become more complex. Advanced screening
facilities, blood group testing and techniques for cross matching blood had made the process of
donor selection more complicated. Advancement in techniques of separating the components of
blood has given the clinician an opportunity to use the component as per the demand of the
patient.

Blood groups in various animals

Animals Blood groups

Dog 6
Cat 3
Horse and donkey 7
Cattle 11
Sheep and goat 7

Dog

The blood group system in dogs includes DEA 1.1, DEA 1.2, DEA 3, DEA 4, DEA 5 and DEA
7. DEA 1.1 and 1.2 are the most important blood groups and are found in 60% population of
canines. 15 ml of blood per kg BW can be collected from dog in every 6 weeks.

Cat
Three blood groups are reported in cats in AB blood group system. Type A blood group is the
most common group and found in 95% of the American cats. Majority of Indian and 30 % of
cats in UK belongs to blood group B. Blood group AB is extremely rare. Healthy adult cats can
donate 45-60mL every 6 weeks.

Horse and donkey

The seven blood groups in horses viz. A, C, D, K, P, Q and U are internationally recognized with
more than 30 erythrocyte antigens. Universal donor horse is not possible because of various
possible antigenic combinations. The cross matching must be performed although impractical to
minimize transfusion reactions. Adult horses can safely donate approximately 6-8 L of blood.
Whole blood can be collected every 15-30 days and plasma collected every 7 days if the
erythrocytes are returned to the donor.

Cattle

The internationally recognized blood groups in cattle are A, B, C, F, J, L, M, R, S, T and Z. Out

of these 11 groups, group B and J being the most clinically relevant. Cattle can donate 8-14 mL
of blood per kg of body weight.

Sheep and goat A, B, C, D, M, R, X are the seven blood groups identified in sheep.

Cross-matching technique

● Collect the blood from the donor as well as recipient in purple top and red top tubes i.e
EDTA tube and non-EDTA tubes respectively.
● Centrifuge the blood and allow separating plasma and serum from the RBCs.
● Remove the serum and save it in a separate sterile tube.
● Discard the plasma from the EDTA tube.
● Wash the RBCs collected from EDTA tube.
● Place the RBCs in a spate tube filled with normal saline and centrifuge for 1 minute.
● Repeat the process 5 times removing the supernatant every time.
● Resuspend the cells to make a 2% to 4% solution (0.2mL of blood in 4.8mL of saline
gives a 4% solution).
 ● Label the tubes to make the following mixtures as Major crossmatch (2 drops patient
serum with 1 drop donor RBC suspension), Minor crossmatch (1 drop patient RBC
suspension with 2 drops donor serum) and Control (1 drop patient RBC suspension with
1 drop patient serum). Incubate the mixtures for 15 to 30minutes at 37°C and then
centrifuge for 15seconds.
● If either hemolysis or hemagglutination is seen macroscopically, or if agglutination is
seen microscopically, the donor is not a good match.

Transfusion therapy: General principles and indications

● Blood transfusion should be practiced after proper blood grouping and cross matching the
donor„s group with the recipient„s to prevent the transfusion reactions.
● In addition to potential adverse reaction of mismatched blood transfusion, the shortened
lifespan of mismatched transfused cells result in ineffective therapy.
● Breeding females of all the species should be properly checked for bold group and cross
matched to dodge primary sensitization and risk of future offspring developing hemolytic
disease. In the past, cross matching was recommended in dogs that had previously been
pregnant. However, a recent study showed that pregnancy does not seem to sensitize dogs
to antigens on RBCs.42 Blood grouping for canine DEA 1.1 and for feline types A and B
generally practiced in veterinary medicine. Other groups and cross matching can be done
in research and reference laboratories.
● Blood transfusions are mostly risky, hence, they should be performed in only warranted
cases.
● History of previous transfusion therapy should be collected from clients, which
necessitates cross matching. Whole blood as well as component is transfused in
veterinary medicine depending upon availability and indications of transfusion.
● The primary indication for blood transfusion is the treatment of severe anemia caused by
hemorrhage, hemolysis, ineffective erythropoiesis, immune-mediated hemolytic anemia,
chronic inflammatory or infectious disease, or neoplasia. Animals must be clinically
evaluated on an individual basis.
● A thumb rule for the treatment of anemia is to transfuse when the packed cell volume
(PCV) is less than 10% to 15%. Animals with acute-onset anemia, however, usually
 require transfusion before their PCV decreases to 15%, which contrasts with the situation
in animals with chronic anemia.
● For cases of thrombocytopenia, the generally accepted trigger for platelet transfusion is
platelet counts of 10,000/μL.
● Additional indications for transfusion include hypovolemia, primary or secondary
clotting factor deficiency and hypoproteinemia.
● Collected blood should be labeled with all the details and record keeping is crucial in all
cases of blood collection and administration.

Selection of donor

● Blood grouping should be performed to select permanent blood donors. All donors
should be healthy young adults that have never been transfused.
● In addition, donors must have undergone routine physical, hematological and clinical
chemistry evaluations examinations.
● Proper clinical history of the expected donor should be collected by carefully
interviewing the owner to minimize the risk of disease transmission through blood.
● In the veterinary medicine, it is usually the cost that restricts to test individual units.
Therefore, a combination of careful interview and blood screening of the donor is
used to minimize the risk of infectious disease transmission.
● Donor should be properly vaccinated and should be tested free of blood parasites and
other infectious diseases.
● Donors should have normal baseline PCV and total protein concentrations prior to
any donation. Blood should be collected aseptically usually via jugular venipuncture.
To avoid interference with platelet function, donors should not be sedated with
acepromazine.

Anticoagulants used for storage

Two anticoagulants namely Citrate-phosphate-dextrose-adenine (CPDA-1) and Acid-citrate-

dextrose (ACD) are commonly used for storage of blood. CPDA-1 is considered better
anticoagulant because it maintains higher levels of 2,3-disphosphoglycerate (2,3-DPG) and
adenosine triphosphate (ATP) in collected blood. In CPDA-1 blood can be stored for
approximately 35days. Acid-citrate-dextrose (ACD) allows storage of blood for 21 days. Use
1mL of anticoagulant (CPDA-1/ACD) for every 7mL of blood. Blood should be refrigerated in
plastic blood collection bags. Heparin is not recommended for blood collection because it
activates platelets, but if still used 5 U per mL of blood is sufficient. Blood collected in heparin
as anticoagulant must be used immediately. Survival and functional usefulness of erythrocytes
decrease with increased storage temperature and time because of glucose consumption and
depletion of ATP and 2,3- DPG. Blood should be collected into latex free plastic bags or plastic
syringes to preserve platelets.

Transfusion process

Aseptic conditions should be maintained and perfect aseptic procedures should be followed
while collection of blood for transfusion. A separate aliquot from every donated unit of blood
should be stored for later testing when disease transmission following transfusion is suspected.
Blood should be filtered using 150-170μm pore nonlatex filters either prior to or during
administration. Blood should be warmed to 37°C before administration to prevent hypothermia.
Temperature should not be more than 37°C, because higher temperatures cause lysis of
erythrocytes and inactivation of clotting factors. Blood is administered intravenously through
commercially available administration I/V sets with filters. Fluid containing 0.9% saline should
be used when concurrent crystalloid fluid therapy is indicated or for reconstituting blood
components such as packed erythrocytes. Lactated Ringer„s solution causes calcium chelation
with citrate-containing anticoagulants and subsequent clot formation, 5% dextrose in water cause
swelling and lysis of erythrocytes and hypotonic saline fluids will lyse erythrocytes, so they are
contraindicated. Excessive and rapid injection of blood or plasma can result in circulatory
overload and heart failure. Generally, blood should be given intravenously at a rate not
exceeding 10mL/kg per hour (always begin the transfusion slowly then gradually increase flow
rate); however, each patient must be assessed individually to establish an appropriate infusion
rate. For example, hypovolemic patients may require an infusion rate of 20mL/kg per hour,
whereas patients with cardiac, renal, or hepatic disease or recumbent calves may require an
infusion rate of only 1mL/kg per hour. If blood is transfused too quickly, salivation, vomiting
and muscle fasciculations may occur. Warm blood should be transfused within 4 hours to avoid
contamination. The volume of blood to be transfused is determined according to the recipient„s
body weight, estimated blood volume, PCV of the recipient and of the donor and
the purpose of therapy. A simple guideline for small animals is that 10-15mL/kg of
packed erythrocytes or 20mL/kg of whole blood increases the PCV by 10% if the
donor has a PCV of approximately 40%. One report in horses demonstrated that
15mL/ kg of whole blood and 8-10mL/kg of packed erythrocytes resulted in a 4%
increase in PCV when the donor PCV was 35-40%. More specific calculations for
cattle are reported depending on the indication for transfusion for example, in
hemorrhagic shock a general volume rule is 7L of whole blood/600kg cow.21 For
cases of thrombocytopenia in dogs and cats for which fresh whole blood is used for
treatment, the general rule is to administer 10mL/kg to increase the recipient„s
platelet count by a maximum of about 10,000/μL. In dogs, the half-life of
erythrocytes transfused after matching is approximately 21days. In cats, the half-life
of erythrocytes transfused after matching is approximately 30- 38days. In horses
and cattle the survival time of compatible transfused erythrocytes is only 2-4 days.

Initial Infusion Rate

0.25 mL per kilogram (kg) of body weight over a 30 minute period
Caution: Dog should be watched carefully during this process for any allergic reactions
Infusion Rate
If no problems arise in the receiving patient after the initial 30 minutes, the rate
may be increased.
The recommended infusion rate is 22 mL/kg per day.

Total Blood Volume to be infused

Total mL donor dog blood in anticoagulant = 2.2 x receiving dog„s weight (kg) x
40 x packed cell volume (PCV) desired in receiving dog - PCV of receiving dog /
PCV of donor dog blood in anticoagulant.
Note: 2.2 mL/kg of whole blood will raise PCV by 1% when PCV of transfused blood is 40%.