As Fable, a 5-year-old Newfoundland, lies on a table at the Baltimore Humane Society in Reisterstown, she doesn't seem to notice the needle in her jugular vein.
Instead, the pooch blissfully licks peanut butter from the hand of her owner, Lauren Schneider, while a handler cradles her with his whole body.
Fable and her sister, Kenzie, are canine blood donors — and veterinarians and animal advocates say the world needs more of them. The dogs' blood was going to a major university and an emergency animal hospital in other states, where it's in high demand.
"Most people don't even know that it exists, and they certainly don't know the risks of not having enough blood," said Wendy Goldband, spokeswoman for the Baltimore Humane Society.
Spending on veterinary care for pets has jumped from $7.2 billion in 2002 to an estimated $13.6 billion in 2012, according to the American Pet Products Association. Technology has improved to allow for new surgical techniques, veterinarians say — which has increased the need for blood.
"Pets that wouldn't be able survive a certain injury or certain disease process now have a chance to do that," said Dr. Keisha Hayward of Falls Road Animal Hospital.
Jocelyn Pratt, manager of the Blue Ridge Veterinary Blood Bank in Loudoun County, Va., said there's an increased need for blood during the summer, when animals are more likely to play outside — and so more likely to suffer from car accidents and heat-related maladies.
Other conditions that could require transfutions include parvo and snake bites.
The Baltimore Humane Society and Blue Ridge recently put out a plea for help in replenishing Blue Ridge's canine blood supply. The groups warned that the blood bank was forced to ration blood to medical providers and put them on waiting lists.
The humane society in Reisterstown is one of the 13 sites in Maryland where donors can give to Blue Ridge. Schneider learned about dog blood donations from a flier.
"I was a little nervous the first time I brought them, I won't lie," the Catonsville resident said. "Especially when they told me the needle went in their jugular."
Now, her dogs seem to love their appointments, she said, where they get to feast on treats afterward.
Schneider said she was alarmed to learn that many animal blood banks keep colonies of pets whose only purpose is to give blood.
Blue Ridge bills itself as the largest all-volunteer bank in the country — meaning its collection of blood is solely dependent upon owners offering their pets as suppliers. The facility ships blood to veterinary hospitals throughout the nation.
To donate to Blue Ridge, Pratt said, dogs must be at least 35 pounds and a healthy weight for their size. They need to be current in their vaccinations for rabies and distemper and preventive treatment for heartworm.
Dr. Urs Giger, an animal transfusion expert at the University of Pennsylvania' School of Veterinary Medicine, said temperament is also important for dog blood donors.
"They should be well behaved, not aggressive," he said.
Like humans, dogs have blood types, but they're screened for only two, he said.
"It's a safe procedure, just like in humans, and it's altruistic," Giger said. "It's extraordinarily important to save the lives of various sick animals with anemia and bleeding disorders."
At Kenzie's and Fable's appointment, Blue Ridge employee Chris Oldt snuggled with the dogs to comfort them.
"So brave, so brave," he whispered to Fable as a tube held by vet Dr. Valerie Latchford filled with blood.
Cheryl Trudil learned about dog blood donors a few years ago from a friend with a greyhound. Although the Reisterstown resident is plugged into a network of dog rescuers, it was the first time she'd heard of it. Her dog Monty has been giving ever since.
Now she spreads the word to other dog owners, including her neighbors. She recruited Hazel, her neighbors' 140-pound English mastiff.
"These are hero dogs," Trudil said as Monty and Hazel played in her kitchen. "They're saving lives."
Hazel is a universal donor, said 14-year-old Ethan Rosman, whose family owns her.
"She's actually perfect — she's so calm, she can give to any dog, and she gives a ton," Ethan said.