Plasma for Neonates.. and Management of Viral Diseases

The following is an excerpt from an article, "Medical Indications and Use of Fresh- Frozen Plasma" which appeared in the April, 1993 issue of DVM Magazine. The article is from HEMOPET in Irvine, CA (a national non-profit animal blood bank program) and is reprinted by permission of Dr. W. Jean Dodds

Passive Immunity for Neonates and Management of Viral Diseases

Fresh-frozen plasma provides a source of globulins to protect orphaned neonates against the more common environmental pathogens to which they are exposed. Similar treatment is used in foals to protect them against failure of passive transfer from the dam, and equine plasma is available commercially for this purpose. In small animal neonates, plasma treatment for or- phaned puppies, kittens, or for those receiving minimal colostrum after birth should be given within the first 24-48 hours of life. Treatment for healthy neonates is repeated at about 10 days to 2 weeks of age and then again at 3-4 weeks of age. For sick neonates, more frequent transfusions may be necessary. These transfusions are usually given intraperitoneally.

Another important use of fresh-frozen plasma is for animals needing protection following exposure to acute viral diseases (e.g. canine parvovirus disease) and to assist in the treatment of these same diseases. A remarkable improvement in the morbidity and reduction in the mortality of canine parvovirus and herpes virus disease has been achieved with this approach. The length of hospital stay has also been shortened. While no documented clinical trials have determined the content of specific viral antibodies in these plasma products or their capacity to transfer measurable antibody levels to patients, clinical efficacy has been dem- onstrated as judged by improvement in the patient's overall condition. The standard dose of plasma (3-5ml/lb) given once or twice daily is most often applied, although some clinicians have reported giving doses as low as 1 ml/lb to less severely affected individuals. While the optimum dosages need to be determined by a properly controlled trial, the clinical efficacy demonstrated to date warrants alerting the profession to this use of plasma in the interim.

Justification for this approach is based on the fact that donors are immunized regularly or hyperimmunized against the viral agents of concern, and presumes that the plasma has a minimum degree of hemolysis (unless the donors have a "universal blood" type such as canine DEA-4). If the blood donors have not been blood typed, the plasma should be free of significant amounts of red blood cell fragments because these could transmit antigens that sensitize recipients of a different blood type against exposure to a subsequent incompatible transfusion.

A second reason for using fresh-frozen plasma in viral disease situations comes from experience with human parvovirus infections. There is currently no way to destroy the parvoviral agent in human blood or blood products. Its activity remains even after plasma is frozen or extracted. However, in human patients with chronic latent parvovirus infection which seeds the bone marrow, effective treatment and cure has been achieved with commercial intravenous gamma globulin. Thus, providing antibodies against circulating parvovirus is an effective means of neutralizing the virus in clinical patients. A parallel experience occurs in the dog whereby transfer of maternal parvovirus antibodies to puppies via the colostrum will effectively inactivate subsequent parvovirus vaccination.

Fresh-frozen plasma has also been used for herpes virus infected breeding females to enable them to produce a healthy litter. The puppies are taken by cesarian section at term, raised away from the mother, and given fresh-frozen plasma intraperitonally at the dose of 1 ml/ounce. This treatment is repeated at 7 and 14 days. Alternatively, with active herpes viral exposure in a kennel situation, fresh-frozen plasma is prepared from the blood of healthy adult dogs on the premises. Herpes virus antibody titers are determined beforehand on potential plasma donors. Plasma is harvested from those with measurable titers and given at the above doses to the puppies after their delivery by cesarian section.

Use of plasma is recommended by Dr. Stockner's office for healthy neonates as well as potential problem situations. It is provided frozen in 5/6cc syringes which are kept frozen until bitch starts whelp. Using one syringe per five pups (refrigerate between use), warming to body temperature, give orally by several drops at a time every two hours up to 1cc per 1 pound of body weight over the first 24 hours following whelp.