ISSN 2398-2950      

Hypoglycemia

ffelis

Introduction

  • Plasma glucose less than 3.0 mmol/L (55 mg/dL) is significant.
  • In animals that have chronic low blood glucose concentrations may have to drop very low (less than 2.0 mmol/L (35 mg/dL)) before clinical signs are exhibited.
  • Signs: ataxia, weakness, disorientation, seizures.
  • Diagnosis: blood or plasma glucose concentration.
  • Treatment: glucose (oral or intravenous), and correct underlying cause. Note that consumption of food will not reliably increase blood glucose in cats.

Pathogenesis

Etiology

Physiological

  • Neonatal hypoglycemia - dystocia, hypothermia, hypoxia, failure to feed/maternal rejection/maternal agalactia, dehydration, diarrhea may be contributing causes.
  • Anorexia/malnourishment - especially in neonate/juvenile cats.

Primary disease

Exogenous agents

Predisposing factors

General

  • Neonatal/juvenile animals have immature mechanisms for regulating blood glucose.

Pathophysiology

  • Decrease of blood glucose towards the lower end of the physiological range stimulates secretion of counter-regulatory hormones (glucagon, adrenaline, noradrenaline, cortisol and growth hormone), which increase glycogenolysis and gluconeogenesis and so increase blood glucose concentration.
  • Hypoglycemia results from failure of these mechanisms due to excess insulin, deficiency of counter-regulatory hormones, and/or inadequate glucose production.
  • Hypoglycemia also → an increased appetite.
  • If these protective counter-regulatory mechanisms are overwhelmed, hypoglycemia → reduced glucose availability to central and peripheral nervous system → lethargy, weakness, ataxia, disorientation, seizures.
  • Prolonged severe hypoglycemia → reversible or irreversible brain damage, and rarely death.

Specific

  • Neonatal hypoglycemia - gluconeogenesis limited in neonate and limited glycogen stores rapidly deplete - relies upon regular feeding - may develop hypoglycemia after only 12 hour fast.
  • Starvation - severe malnutrition  →  decreased hepatic glycogen, decreased fat stores  →  decreased gluconeogenesis  →  hypoglycemia.
  • Exogenous agents: direct drug action  →  hypoglycemia.
  • Bacterial shock  →  depletion of glycogen stores, increased peripheral use of glucose, decreased gluconeogenesis + ?circulatory factors  →  hypoglycemia.
  • Extra-pancreatic tumors:
    • Secretion of Insulin/insulin-like/insulin precursor.
    • Accelerated glucose utilization.
    • Inhibited glucose release from liver  →  hypoglycemia.
  • Functional islet cell tumor or non-neoplastic beta cell hyperplasia →  insulin secretion →  hypoglycemia.
  • Insulin overdose, inappetence/starvation, and/or concurrent illness during treatment with insulin may →  hypoglycemia.

Diagnosis

This article is available in full to registered subscribers

Sign up now to obtain ten tokens to view any ten Vetlexicon articles, images, sounds or videos, or Login

Treatment

This article is available in full to registered subscribers

Sign up now to obtain ten tokens to view any ten Vetlexicon articles, images, sounds or videos, or Login

Outcomes

This article is available in full to registered subscribers

Sign up now to obtain ten tokens to view any ten Vetlexicon articles, images, sounds or videos, or Login

Further Reading

Publications

Refereed papers

  • Recent references from PubMed and VetMedResource.
  • Behrend E, Holford A, Lathan P et al (2018) 2018 AAHA Diabetes Management Guidelines for Dogs and Cats. JAAHA 54 (1), 1-21 PubMed.
  • Viebrock K A, Dennis J (2017) Hypoglycemia episodes in cats with diabetes mellitus: 30 cases (2013-2015). J Feline Med Surg 20 (6), 563-70 PubMed.
  • Hambrook L E, Ciavarella A A, Nimmo J S et al (2016) Hyperinsulinaemic, hypoglycaemic syndrome due to acquired nesidioblastosis in a cat. JSFM Open Rep (2), 2055116916657846 PubMed.
  • Greene S N, Bright R M (2008) Insulinoma in a cat. JSAP 49 (1), 38-40 PubMed.
  • Münnich A (2008) The pathological newborn in small animals: the neonate is not a small adult. Vet Res Commun 32 (Suppl 1), S81-5 PubMed.
  • Gabor L J, Canfield P J, Malik R (2000) Haematological and biochemical findings in cats in Austrlia with lymphosaroma. Aust Vet J 78 (7), 456-461 PubMed.

Can’t find what you’re looking for?

We have an ever growing content library on Vetlexicon so if you ever find we haven't covered something that you need please fill in the form below and let us know!

 
 
 
 

To show you are not a Bot please can you enter the number showing adjacent to this field

 Security code