Glucose Toxicity and Hypoglycemia
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Glucose toxicity occurs when insulin secretion is reduced by prolonged hyperglycemia. Prolonged hyperglycemia and diabetes mellitus can occur following prolonged and high-dose therapeutic use of glucocorticosteroids or exogenous progestogens. Progestogens have an antagonist effect on insulin, as they can lead to growth hormone excess and also have an affinity for glucocorticosteroid receptors.
Hypoglycemia in Feline Diabetes
Hypoglycemia occurs when the blood glucose level drops to 60 mg/dL or less. Hypoglycemia may be triggered by:
- Insulin dose too high
- Overlapping insulin dosage
- Loss of appetite
- Excessive exercise
This serious and potentially fatal condition can occur at any stage, even after stabilization has been achieved. In some instances no particular trigger is identified.
Clinical Signs of Feline Hypoglycemia
The clinical signs of hypoglycemia that cat owners should be able to recognize are (in order of severity):
- Convulsions and seizures
It’s important to alert your cat-owning clients that early signs of hypoglycemia may be subtle. Also, some cats will simply become very quiet and inappetent.
Coach your clients to watch for abnormal behaviors associated with hypoglycemia, and to contact you if they are concerned it is present.
Emergency Treatment of Hypoglycemia
- Immediate oral administration of glucose solution or corn syrup (1 g per kg body weight). An alert animal may be fed a small amount of food. Animals that are collapsed should not have large volumes of fluid forced into their mouths as this may result in aspiration pneumonia: here it is preferable to rub a small amount of the glucose solution or corn syrup onto the animal’s gums or under its tongue.
- Intravenous dextrose solution can be administered to effect in severe cases or if oral therapy has been ineffective.
Owners of pets with diabetes should always have a source of glucose readily available. Following the successful emergency administration of oral glucose, small amounts of food should be offered at intervals of 1–2 hours until the effects of the insulin overdose have been counteracted. Blood glucose monitoring should continue through entire duration of action of insulin (i.e. 12 hours for twice daily insulin and 24 hours for once daily insulin).
If the insulin dose is too high, reduce it by at least 10-50%. It may be necessary to construct a glucose curve to appropriately adjust the insulin dose.
Help Your Practice Manage Diabetes Mellitus
Check out these tools and resources to help manage feline diabetes.
Create a blood glucose curve to monitor and evaluate diabetes treatments.
Create a customized, printable form for clients about their new diagnosis.
Access online tools and more to support staff and pet parents.
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Read More About Feline Diabetes
Important Safety Information:
Vetsulin® should not be used in dogs known to have a systemic allergy to pork or pork products. Vetsulin is contraindicated during periods of hypoglycemia. Keep out of reach of children. As with all insulin products, careful patient monitoring for hypoglycemia and hyperglycemia is essential to attain and maintain adequate glycemic control and prevent associated complications. Overdosage can result in profound hypoglycemia and death. The safety and effectiveness of Vetsulin in puppies, breeding, pregnant, and lactating dogs has not been evaluated. See package insert for full information regarding contraindications, warnings, and precautions.
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