Homologous whole blood transfusion for treatment of severe anemia in five Eastern box trurtles (Terrapene carolina carolina)

Abstract Background The Eastern box turtle (EBT) (Terrapene carolina carolina) is an iconic North American species and the state reptile of North Carolina. In recent decades its numbers have been threatened by various anthropogenic factors including habitat loss, vehicular trauma, domestic pet predation, climate change, and collection for both the legal and illegal pet trade. Since 1997 the NC State College of Veterinary Medicine Turtle Rescue Team (NC State TRT) has been treating and rehabilitating EBTs. In some cases, injury or disease result in extremely low packed cell volumes (PCVs). In such cases, and when an appropriate donor is available, a whole blood transfusion is performed. Methods Homologous whole blood transfusions were performed to treat severe anemia in four wild EBTs and one client-owned EBT. The PCV of each patient was measured at between 1% and 3% and the donor PCV\u0027s were over 15%. No more than 1% total body weight of blood was removed from each donor. This amounts to approximately 3.0 mL of whole blood from a donor. Prior to the transfusion, a macroagglutination cross-match was performed. Blood was either collected from the jugular vein or postoccipital sinus and administered via these same two routes with the exception of one case which received whole blood via the subcarapacial sinus. Results All wild turtles survived to release, and the client-owned turtle has survived at least 18 months post transfusion. None of the patients or donors were observed to have any reaction or problem with the procedure. Conclusions and case series relevance The jugular vein was the preferred route for both blood extraction and transfusion. A one-time homologous whole blood transfusion is likely a safe, emergency intervention to treat severe anemia in the EBT.