The donor horse is confined to a stall or stock. A patch of hair is clipped over the jugular vein in the neck and the skin is disinfected with a surgical scrub such as hibiscrub or iodine. A large gauge catheter (10gauge) or needle (14gauge) is required so that the red blood cells are not physically damaged as they flow through into the collection tubing and container. The needle is inserted into the vein and the hub connected to blood collection tubing. This is a length of clear, flexible, sterile tubing through which the blood flows into a collecting container. The blood collection container contains a vacuum, so the negative pressure continues to suck the blood out of the donor horse's circulation. The bottle contains ACD preservative which stops the blood from clotting once it has been collected. As the blood is collecting, gently swirl or rock the bottle to mix it with the preservative. Never shake the bottle, as this could cause the red blood cells to become burst or damaged. The maximum volume of blood that can be collected from one horse is 15-18 ml/kg body weight, once a month. Thus a 500-600kg horse provides approximately 7.5 liters (2.0USgal) of blood per month, and it takes around 1.5 hours to harvest. Once obtained. a blood sample should be used within 4 hours. The recipient horse's jugular vein is prepared in the same way as for the donor horse, and a 10g catheter or 14 gauge needle inserted into the vein. The giving set on the blood container is attached to the needle or catheter and the blood is elevated above the horse's head to allow gravity to assist with the delivery. The recipient horse's heart and respiratory rate, body temperature, and the color of the mucus membranes of the mouth are recorded before the transfusion starts, and every 2 minutes thereafter for the first 10 minutes of the transfusion. For the first 10 minutes the transfusion is given slowly, at a rate of 0.1ml/kg body weight. This allows the veterinarian to check for the early signs of a transfusion reaction. If a transfusion reaction is detected, the transfusion will be stopped before the recipient receives a large volume of donor blood. If no signs of a reaction occur, then the flow rate is increased to 20-30ml/kg body weight per hour. Thus a transfusion involving a 500kg horse receiving 7.5 liters (2.0USgal) of whole blood takes half an hour to complete. A blood transfusion buys the horse enough time to manufacture new red blood cells in the bone marrow. The transfusion provides enough increase in circulatory volume to stop damage to the major organs and take the horse out of immediate danger. However, the horse will still be weak following the transfusion and a period of box rest to aid recovery is essential. This also enables the horse's food intake to be monitored, along with her water intake and urine output. Closely monitoring these things is very important, because if the hemorrhage was severe enough to cause organ damage, the early warning signs are increased thirst, and increased urine production. The recipient horse should be fed a highly nutritious, iron-rich diet following the blood transfusion, to ensure that they have all the nutrients necessary for red blood cell production. These diets usually consist of a highly palatable muesli formulation that is protein dense and provides a greater density of calories than regular foods. Thus, if the horse's appetite is reduced, they still take in energy. This muesli also has added B vitamins to help appetite, and is rich in antioxidants to encourage healing.

Summary: Prepare the donor horse for blood collection. Collect the required amount of blood. Prepare the recipient horse for the transfusion. Monitor the horse's vital signs as the transfusion is performed. Watch the horse closely following the transfusion. Feed the recipient horse a nutrient-rich diet following the transfusion.

Emotional or comfort eating gets in the way of nutritional eating. Think about healthy foods you like that can replace your past unhealthy comfort foods. Look up healthy recipe swaps for your favorite dishes so you won't feel so restricted. Eating something fried might taste good today, but it might not feel so good the next morning. Your stomach will start to feel full if you slow down as you eat. Have a conversation with someone, or put the fork down between bites, to allow your stomach to tell your brain you are getting full. Be aware of what you plan to eat, and read the nutrition labels to be sure you are eating what you planned. Some packaging can be misleading for marketing purposes, so looking at the nutrition label is essential. Some foods are more pleasant than others, no doubt. Take control of experiencing new foods by removing the words "I can't eat that", and instead say "I don't eat that". By changing how you talk about food, it puts you in control of choosing foods you do not routinely eat. Instead of talking about the foods you can no longer have, talk about all of the foods your are adding in like fruit, vegetables, lean proteins, etc. Shifting your mindset from restriction to addition can make a big difference. Eat breakfast, plan ahead so you know what you will eat when you get hungry, avoid over-eating which can happen when watching TV, and eat the healthy food choices first. Other routines that can help include eating smaller meals, or snacks, throughout the day instead of 3 larger meals. The scale can help you to tweak your plan if you need to, and to stay on track with meeting your goal. What you can see in your cabinet, or can easily reach for, may not always be the best choice. Keep fruit on the counter and chopped veggies in the fridge. Easy access to healthy choices can help avoid unhealthy snacking. Get rid of the cookies and ice cream. Having the tempting foods within reach can pull you away from your plan. Smaller plates can help with portion control, decreasing the number of calories you consume at mealtime. Always eat off a plate as opposed to out of a box, bag or carton. You can pre-portion out servings of snack foods and leave them in your pantry to prevent over eating from the container. Grocery stores also have a lot of pre-portioned options. People that get enough sleep burn up to 5% more calories at rest than people that do not get a good night's sleep. Plus, getting the sleep you need increases the amount of fat you lose compared to people that sleep less than 6 hours each night. Life happens. Weddings, covered dish dinners, birthday parties, game-day snacks, or a night out on the town can all involve eating, or drinking, calories that are not in your plan. Think about what you could have done differently, and plan ahead so you will be ready for those challenging events next time. Avoid the "all or nothing" mentality. Just because you messed up once, doesn't mean you can spiral out of control and have anything else you want. It happened, move on and don't be so hard on yourself. Talking to your friends and family about your weight loss plan can help you stay focused on your goal. You may have a friend that will want to join you in losing weight. Support groups are also available that can provide encouragement, as well as personal tips on struggles they encounter. Sharing your goals can also prevent others from being bad influences when know you are serious about losing weight.
Summary: Break your old food habits. Pay attention to how foods make you feel physically. Slow down as you eat. Read the labels. Talk about food differently. Practice healthier eating every day, and all day. Weigh yourself once a week. Set up your pantry and kitchen to help you. Reduce temptation. Use smaller plate sizes. Get plenty of sleep. Get back on track after a setback. Ask for help.