Equis ISSN 2398-2977

Hypoglycemia

Contributor(s): Nicola Menzies-Gow

Introduction

  • Hypoglycemia is a decreased blood glucose concentration.
  • Cause: decreased food intake or utilization; decreased glycogenolysis or gluconeogenesis; increased utilization, eg sepsis.
  • Signs: weakness/collapse progressing to central nervous signs, signs associated with underlying cause.
  • Diagnosis: blood glucose concentration measurement, identification of cause.
  • Treatment: supportive therapy; specific therapy depending on cause.
  • Prognosis: depends on cause.

Pathogenesis

Etiology

  • Decreased food intake or assimilation:
    • Neonates.
    • Starvation.
    • Malabsorption.
    • Maldigestion.
  • Decreased production:
    • Hepatic insufficiency.
    • Adrenocortical insufficiency in neonates.
    • Sepsis.
  • Increased utilization:

Predisposing factors

General
  • Lack of dietary intake.
  • Excessive exercise.

Specific

  • Hepatic disease.
  • Sepsis.
  • Pregnancy.
  • Hyperthermia.

Pathophysiology

  • Decreased production and/or increased utilization   →   hypoglycemia.
  • Fasting   →   hepatic glycogenolysis maintains blood glucose until hepatic glycogen stores depleted   →   gluconeogenesis (hepatic and renal) utilizing body proteins and glycerol.
  • Insulin   →   inhibition of gluconeogenesis and uptake of glucose into cells   →   reduces blood glucose.
  • Hypoglycemia   →   glucagon increases, insulin decreases   →   glycogenolysis and/or gluconeogenesis   →   increased blood glucose.

Timecourse

  • Acute or chronic, depending on cause.

Diagnosis

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Treatment

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Prevention

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Outcomes

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Further Reading

Publications

Refereed papers

  • Recent references from PubMed and VetMedResource.
  • Wong D et al (2015) Hypoglycaemia associated with cholangiocarcinoma and peritoneal carcinomatosis in a horse. Vet radiol Ultrasound 56 (1), E9-E12 PubMed.
  • Lyle C H et al (2010) Retrospective evaluation of episodic collapse in the horse in a referred population: 25 cases (1995-2009). J Vet Intern Med 24 (6), 1498-1592 PubMed.
  • Hollis A R et al (2008) Blood glucose concentrations in critically ill neonatal foals. J Vet Intern Med 22 (5), 1223-1227 PubMed.
  • Alexander S L, Roud H K & Irvine C H (1997) Effect of insulin-induced hypoglycemia on secretion patterns and rate of corticotropin-releasing hormone, arginine vasopressin and adrenocorticotropin in horses. J Endocrinol 153 (3), 401-409 PubMed.


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