Blood transfusions in domestic rabbits provide clinical benefit but are complicated by transfusion-associated dyspnea or cardiac overload: 21 cases.

Whole blood transfusion is feasible in critically ill rabbits but carries significant risk of dyspnea and cardiac overload.

This retrospective cohort study evaluated allogeneic whole blood transfusions in 21 domestic rabbits (Oryctolagus cuniculus) at a veterinary teaching hospital between 1993 and 2025. The most common transfusion indications were liver lobe torsion (48%) and intraoperative hemorrhage (29%). Crossmatching was performed in 62% of cases, with all results negative. Adverse reactions occurred in 10 of 21 rabbits (47.6%), with 14 total reactions documented. The predominant adverse reactions were transfusion-associated dyspnea (TAD) and transfusion-associated cardiac overload (TACO), each occurring in 24% of cases—a notably higher rate of acute respiratory complications than reported in dogs or cats. Reactions were classified using adapted canine and feline consensus guidelines; 64% were nonsevere and 36% were severe, with imputability scores of possibly (64%) or probably (36%) transfusion-related. No life-threatening complications were recorded. Overall survival to discharge was 57% (12/21), and all transfused rabbits demonstrated improved packed cell volume (PCV) post-transfusion. These findings support allogeneic whole blood transfusion as a clinically feasible and potentially lifesaving intervention in critically ill rabbits. However, the elevated incidence of respiratory and volume overload complications warrants heightened monitoring during and after transfusion in this species. The authors recommend prospective studies to better characterize transfusion reactions, refine dosing protocols, and optimize patient selection criteria in rabbits.

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