Skip to main content
menu sluit menu
Home Home
Login
Main navigation
  • Library
  • Calendar
  • e-Learning
  • News
    • Veterinary News In this section you find veterinary news
    • Recent Additions All content that was recently added to the IVIS library
  • Get involved
    • Donate Support IVIS, make a donation today
    • Media kit Promote your e-learning & events on IVIS
    • Add your e-learning & events to the IVIS calendar
    • Publish on IVIS Publish your work with us
  • About
    • Mission Our Mission Statement
    • What we do More info about IVIS and what we do
    • Who we are More info about the IVIS team
    • Authors See list of all IVIS authors and editors
  • Contact
User tools menu
User tools menu
Main navigation
  • Library
  • Calendar
  • e-Learning
  • News
    • Veterinary News In this section you find veterinary news
    • Recent Additions All content that was recently added to the IVIS library
  • Get involved
    • Donate Support IVIS, make a donation today
    • Media kit Promote your e-learning & events on IVIS
    • Add your e-learning & events to the IVIS calendar
    • Publish on IVIS Publish your work with us
  • About
    • Mission Our Mission Statement
    • What we do More info about IVIS and what we do
    • Who we are More info about the IVIS team
    • Authors See list of all IVIS authors and editors
  • Contact
Follow IVIS
  • Twitter
  • Facebook
Support IVIS

Breadcrumb

  1. Home
  2. Library
  3. Manual of Equine Neonatal Medicine
  4. Plasma Therapy
Manual of Equine Neonatal Medicine
Back to Table of Contents
Add to My Library
Close
Would you like to add this to your library?

Get access to all handy features included in the IVIS website

  • Get unlimited access to books, proceedings and journals.
  • Get access to a global catalogue of meetings, on-site and online courses, webinars and educational videos.
  • Bookmark your favorite articles in My Library for future reading.
  • Save future meetings and courses in My Calendar and My e-Learning.
  • Ask authors questions and read what others have to say.
Sign in Register
Comments
Print this article
Share:
  • Facebook
  • LinkedIn
  • Mail
  • Twitter

Plasma Therapy

Author(s):
Madigan J.E. and
Spensley M.
In: Manual of Equine Neonatal Medicine by Madigan J.E.
Updated:
FEB 25, 2014
Languages:
  • EN
Back to Table of Contents
Add to My Library
Close
Would you like to add this to your library?

Get access to all handy features included in the IVIS website

  • Get unlimited access to books, proceedings and journals.
  • Get access to a global catalogue of meetings, on-site and online courses, webinars and educational videos.
  • Bookmark your favorite articles in My Library for future reading.
  • Save future meetings and courses in My Calendar and My e-Learning.
  • Ask authors questions and read what others have to say.
Sign in Register
Print this article
SHARE:
  • Facebook
  • LinkedIn
  • Mail
  • Twitter
    Read

    Plasma has been used as preventive therapy for treatment of failure of passive transfer and therapeutically to raise antibody levels in ill foals less than 2 months of age. The majority of neonatal foals with infectious conditions such as septicemia have failure of passive transfer (IgG < 400 mg/dl). However, some studies indicate that, with good management, healthy foals with serum IgG of 200-400 mg/dl have only slight risk of acquiring illness [1].

    I. Indications

    Editor's Comment - The controversy of which foals should receive plasma transfusions will continue until more studies on the protective and therapeutic effects of plasma are conducted.

    1. Failure of Passive Trans
    1. At this time all foals with IgG at 18-24 hours of age < 200 should be treated with plasma
    2. Plasma transfusion is optional for healthy, low risk foals with IgG of 400-600 mg/dl at 24 hours and good post birth management.
    3. Benefit of raising the serum IgG with a plasma transfusion has limited evidence for healthy, low risk foals with IgG of 400 mg/dl at 24 hours of age and good post birth management.
    1. Infectious Conditions
    1. Foals with septicemia may benefit from plasma transfusions to raise serum IgG to the 600-800 mg/dl range.
    2. When infections are present always check IgG post plasma transfusion after 24 hrs. Levels of serum IgG post transfusion may be quite variable.
    1. For High-Risk Foals
    1. Some foal conditions result in poor colostrum absorption.
    1. Prematurity
    2. Decreased gastrointestinal motility (minimal gut sounds) occurs nonspecifically in many stressed, ill foals.
    1. Start plasma immediately following birth in premature foals, weak foals with poor gastrointestinal motility, and severely hypothermic and hypoglycemic foals.
    2. Additional IgG from plasma transfusion in high-risk foals may be beneficial.
    1. Raising levels to 600-800 mg/dl has been suggested. Editor's Comment - Higher levels of serum IgG increase the chances of providing specific antibodies to pathogens and may be beneficial.
    1. Severe disseminated intravascular coagulopathy (DIC) with life-threatening hemorrhage in conjunction with heparinization.
    1. Plasma supplies antithrombin III which is the mechanism whereby heparinization produces a reduction in the hypercoagulable state.
    2. Must treat the primary disorder causing the DIC.
    3. Plasma administered to patients in DIC may exacerbate organ dysfunction with ongoing thrombin activation. It is important to monitor liver and kidney function and fibrin split products if using plasma in DIC.

    II. Types of Plasma

    1. Anti-endotoxin (J-5) Plasma
    1. Made by vaccination of donors with a modified E. coli (J5).
    2. Contains antibodies against the core lipopolysaccharide and should provide cross protection to a variety of Gram negative infections.
    1. Anti-endotoxin (Salmonella typhimurium) Plasma
    1. Plasma donors vaccinated with mutant S. typhimurium.
    2. Protection by similar mechanism as J-5. i.e. cross protection against Gram negative infection with core antibodies.
    3. Source - Endoserumtm - IMMVAC, Inc., Columbia, MO 65201. Telephone 800-944-7563. www.immvac.com/
    1. Anti-Rhodococcus equi hyperimmune plasma (See Rhodococcus equi Diagnosis, Prevention and Treatment)
    2. Botulism - (See Infections)
    3. Platelet rich plasma (PRP)
    1. This is used in foals with post foaling thrombocytopenia presumed associated with ingestion of antibody to the foal's thrombocytes.
    2. Frozen plasma not a source of platelets
    3. Fresh harvested plasma is best - Can order from plasma companies for next day delivery

    III. Sources of Plasma

    1. Commercial availability
    1. Use of commercial USDA approved plasma is desirable. Donors may be hyperimmunized, tested for disease conditions and plasma is free of red blood cells.
    2. Sources of plasma

    USA

    Plasmavacc Inc. (formerly: Veterinary Dynamics)
    All types of equine plasma available.
    1535 Templeton Road, Templeton, CA 93465;
    800-654-9743
    805-434-0321
    www.plasvaccusa.com

    Lake Immunogenics, Inc.,
    348 Berg Road, Ontario, New York, 14519,
    800-648-9990,
    716-265-1973.
    www.lakeimmunogenics.com

    MgBiologics - Ames, Iowa
    Tel: 515-769-2340.
    www.mgbiologics.com

    Europe

    Veterinary Immunogenics Ltd
    www.veterinaryimmunogenics.com

    Kraeber GmbH & Co.
    www.kraeber.de

    Australia and New Zealand

    Plasmavacc Inc
    www.plasvacc.com

    Canada

    Centaur Pharmaceuticals,
    503 Imperial Road Unit #3, Guelph, Ontario N1H 6T9,
    Phone 519-824-9570,
    FAX 519-824-3553.
    www.centaurva.com

    1. Make your own plasma.
      Editor's Comment - Be careful - Anaphylaxis risk is much higher with untested plasma! Plasma donors need to be tested.
    1. Pre-selection of suitable blood/plasma donors on a large breeding farm or in a large practice is possible using blood typing procedures.
    2. The preferred donor is negative for A, Q, and C erythrocyte antigens and contains high level of antibody to indigenous pathogens.
    1. Contains no common anti-erythrocyte antibodies (universal donor).
    2. Alternately, blood from the dam, a Shetland pony, or unrelated gelding with no history of transfusion, may be used if the situation warrants.
    1. Collection
    1. Plasma collected by plasmapheresis is preferred.
    2. Centrifugation can be used but plasma may not be RBC free.
    1. Plasma can be administered immediately after collection or frozen and subsequently thawed at the time of administration. Frozen storage should not exceed 3 years.
    1. Quantitate immunoglobulin content of plasma if possible.
    2. Assess for anti-RBC alloantibodies which could produce neonatal isoerythrolysis.
    1. Storage of non-frozen plasma increases the risk of contamination - Use immediately after collection or thawing. Do not refrigerate non-commercial harvested plasma longer than 12-24 hours.

    IV. How Much Plasma to Administer

    Editor's Comment - It is difficult to determine exactly how much plasma is needed to raise IgG by a specific amount in an individual foal. In general, septic foals need to have more plasma administered (2-3 times the amount) to raise the IgG by 200 mg/dl compared to a healthy foal being treated for FPT.

    1. Volume Determination (1 liter/45 Kg foal)
    1. A dose of 20 ml/Kg of average IgG concentration plasma results in an increase of 50-200 mg/dl serum IgG. Consequently, always check the serum IgG of the foal post treatment.
    2. Greater than 2 (4-6) liters of plasma may be needed to elevate IgG to 600-800 mg/dl in septicemic foals.
    1. Milligram Amount Determination [2].
    1. A dose of 200 mg/kg of IgG in normal foals raised the serum IgG by 450 mg IgG/dl.
    2. A dose of 400 mg/Kg of IgG in normal foals raised the serum IgG by 575 mg/dl.
    3. Serum IgG decreased by 30% from day 1 to day 7 of age, post plasma transfusion.
    4. A dose of 500 mg/kg IgG has been recommended for infected patients.
    1. Administration (I.V.)
    1. Experience suggests 1 liter/45 Kg healthy foal can be administered over a 15-minute period; slower if giving other fluids (maximum 2 L/hr).
    2. In sick foals or when giving greater than 2 liters, rate should not exceed 2 liters/hour. 20 ml/kg/hr delivers 1 liter/hour.
    3. Warm plasma to body temperature before administration. Editor's Comment - Must protect plasma by placing the plasma bag in a protective-sterile bag to thaw. Otherwise contamination at ports may occur.
    1. Do not thaw in very hot water or in a microwave oven; use tepid water.
    2. Use within 12-24 hours of thawing.
    1. Oral administration of plasma
    1. In foals still capable of absorbing IgG (less than 16 hours of age). Editor's Comment - This is very inefficient - Better to give intravenously.
    2. In foals with severe gastroenteritis may protect the bowel.

    V. Complications

    1. Plasma transfusion is believed to be generally safe. Infrequent complications include:
    1. Mild reactions of tachypnea and trembling.
    2. Anaphylaxis.
    3. RBC destruction if the plasma has sufficient amount of antibodies to foal's erythrocytes.
    4. Volume overload with subsequent hypertension
    1. If a transfusion reaction develops, i.e., tachypnea, dyspnea, shaking, sweating:
    1. Slow the rate of administration or stop for 5-10 minutes and restart.
    2. Discontinue the administration of plasma if signs persist.
    3. Epinephrine IV - 1 cc/45 kg foal of the 1:1000 for severe reactions and shock.
    4. Antihistamine - IV (May produce anaphylaxis itself).
    5. Prednisolone sodium succinate - 100 mg - 200 mg IV
    1. Sensitization of the foal with red blood cell contamination using non-commercial plasma is a potential concern although no documentation of it developing has been reported to date.
    2. Serum hepatitis has not occurred in horses less than 18 months of age and does not appear to be a risk of plasma therapy in neonatal foals.
    Back to Table of Contents
    Add to My Library
    Close
    Would you like to add this to your library?

    Get access to all handy features included in the IVIS website

    • Get unlimited access to books, proceedings and journals.
    • Get access to a global catalogue of meetings, on-site and online courses, webinars and educational videos.
    • Bookmark your favorite articles in My Library for future reading.
    • Save future meetings and courses in My Calendar and My e-Learning.
    • Ask authors questions and read what others have to say.
    Sign in Register
    Print this article
    References

    1. Baldwin JL, Cooper WL, Vanderwall DK, et al. Prevalence (treatment days) and severity of illness in hypogammaglobulinemic and normogammaglobulinemic foals. J Am Vet Med Assoc 198:423-428, 1991. - PubMed -

    ...
    Show all
    Comments (0)

    Ask the author

    0 comments
    Submit
    Close
    Would to like to further discuss this item?

    Get access to all handy features included in the IVIS website

    • Get unlimited access to books, proceedings and journals.
    • Get access to a global catalogue of meetings, on-site and online courses, webinars and educational videos.
    • Bookmark your favorite articles in My Library for future reading.
    • Save future meetings and courses in My Calendar and My e-Learning.
    • Ask authors questions and read what others have to say.
    Sign in Register
    About

    How to reference this publication (Harvard system)?

    Madigan, J. E. and Spensley, M. (2014) “Plasma Therapy”, Manual of Equine Neonatal Medicine. Available at: https://www.ivis.org/library/manual-of-equine-neonatal-medicine/plasma-therapy (Accessed: 08 June 2023).

    Affiliation of the authors at the time of publication

    School of Veterinary Medicine, University of California-Davis, CA, USA.

    Author(s)

    • John Madigan

      Madigan J.E.

      Professor of Medicine and Epidemiology
      MS DVM Dipl. ACVIM ACAW
      Department of Medicine and Epidemiology, School of Veterinary Medicine, University of California
      Read more about this author
    • Michael Spensley

      Spensley M.

      DVM
      Pyxis Global Consulting,
      Read more about this author

    Copyright Statement

    © All text and images in this publication are copyright protected and cannot be reproduced or copied in any way.
    Related Content

    Readers also viewed these publications

    • Journal Issue

      Veterinary Evidence - Vol 8 N°2, Apr-Jun 2023

      In: Veterinary Evidence
      JUN 07, 2023
    • Proceeding

      NO Laminitis! Virtual Conference - 2021

      By: ECIR - Equine Cushing's and Insulin Resistance Group Inc.
      MAY 02, 2023
    • Proceeding

      BEVA - Annual Congress - Liverpool, 2022

      By: British Equine Veterinary Association
      MAR 20, 2023
    • Journal Issue

      Veterinary Evidence - Vol 8 N°1, Jan-Mar 2023

      In: Veterinary Evidence
      MAR 19, 2023
    • Proceeding

      AVEF - Conférence Annuelle - Reims, 2022

      By: Association des Vétérinaires Équins Français
      MAR 03, 2023
    • Proceeding

      EEHNC - Virtual Congress - 2021

      By: European Equine Health and Nutrition Congress
      FEB 09, 2023
    • Proceeding

      SFT - Theriogenology Annual Conference - Bellevue, 2022

      By: Society for Theriogenology
      JAN 10, 2023
    • Proceeding

      ACVIM & ECEIM - Consensus Statements

      By: American College of Veterinary Internal Medicine
      NOV 11, 2022
    • Journal Issue

      Veterinary Evidence - Vol 7 N°2, Apr-Jun 2022

      In: Veterinary Evidence
      OCT 07, 2022
    • Journal Issue

      Veterinary Evidence - Vol 7 N°3, Jul-Sep 2022

      In: Veterinary Evidence
      OCT 04, 2022
    • Journal Issue

      Veterinary Practice Management Articles - Veterinary Focus

      In: Veterinary Focus
      AUG 05, 2022
    • Chapter

      Nutrition

      In: The Clinical Companion of the Donkey (2nd Edition)
      JUL 09, 2022
    • Chapter

      Pharmacology and Therapeutics

      In: The Clinical Companion of the Donkey (2nd Edition)
      JUL 03, 2022
    • Chapter

      Sedation, Anaesthesia and Analgesia

      In: The Clinical Companion of the Donkey (2nd Edition)
      JUN 05, 2022
    • Chapter

      The Geriatric Donkey

      In: The Clinical Companion of the Donkey (2nd Edition)
      MAY 20, 2022
    • Chapter

      Euthanasia and the Post-Mortem Examination

      In: The Clinical Companion of the Donkey (2nd Edition)
      MAY 20, 2022
    • Chapter

      Appendix 7: Example Diets: for the mature, pregnant and lactating donkey

      In: The Clinical Companion of the Donkey (2nd Edition)
      MAY 12, 2022
    • Chapter

      Appendix 2: Donkey Weight Estimator

      In: The Clinical Companion of the Donkey (2nd Edition)
      MAY 12, 2022
    • Chapter

      Appendix 1: The Clinical Examination

      In: The Clinical Companion of the Donkey (2nd Edition)
      MAY 12, 2022
    • Chapter

      Appendix 5: Monitoring your Donkey’s Quality of Life

      In: The Clinical Companion of the Donkey (2nd Edition)
      MAY 12, 2022
    • Chapter

      Appendix 6: Professional record of Assessment for Quality of Life

      In: The Clinical Companion of the Donkey (2nd Edition)
      MAY 12, 2022
    • Chapter

      Appendix 3: Body Condition Scoring

      In: The Clinical Companion of the Donkey (2nd Edition)
      MAY 12, 2022
    • Chapter

      Appendix 4: Parameters: Biochemistry and Haematology

      In: The Clinical Companion of the Donkey (2nd Edition)
      MAY 12, 2022
    • Chapter

      The Care of the Foal

      In: The Clinical Companion of the Donkey (2nd Edition)
      MAY 12, 2022
    • Chapter

      Approach to the Dull Donkey

      In: The Clinical Companion of the Donkey (2nd Edition)
      MAY 07, 2022
    • Load more
    Buy this book

    Buy this book

    The Manual of Equine Neonatal Medicine can be purchased either directly from the Live Oak Publishing or via Amazon.

    Buy this book from one of the distributors listed below
    Amazon Logo
    Amazon
    https://www.amazon.com/s?k=manual%20of%20equine%20neonatal%20medicine&crid=2M7W…
    Back To Top
    Become a member of IVIS and get access to all our resources
    Create an account
    Sign in
    Leading the way in providing veterinary information
    About IVIS
    • Mission
    • What we do
    • Who we are
    Need help?
    • Contact
    Follow IVIS
    • Twitter
    • Facebook
    International Veterinary Information Service (IVIS) is a not-for-profit organization established to provide information to veterinarians, veterinary students, technicians and animal health professionals worldwide using Internet technology.
    Support IVIS
    © 2023 International Veterinary Information Service
    • Disclaimer
    • Privacy Policy