Hypoglycaemia in Canine and Feline Diabetes
If the insulin dose is too high, clinical signs of hypoglycaemia may be observed.
Hypoglycaemia may also be triggered by events causing a relative insulin overdose:
- loss of appetite
- vomiting
- excessive exercise
- remission of diabetes in cats - continuing treatment with the initial dose of insulin will result in hypoglycaemia
Clinical signs
The clinical signs of hypoglycaemia, in increasing order of severity, are:
- hunger
- restlessness
- shivering
- ataxia
- disorientation
- convulsions and coma
Some animals may just become very quiet and inappetent.
Treatment
Emergency Treatment of Hypoglycaemia
Immediate oral administration of glucose solution or honey (1 g per kg body weight).
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 honey onto the animal’s gums or under its tongue.
Intravenous dextrose solution (50%) can be administered in severe cases or if oral therapy has been ineffective.
Dose for hypoglycaemia 1-5 ml 50% dextrose by slow intravenous injection (over 10 minutes)* - not aimed to correct blood glucose concentration but to reverse clinical signs.
*(Ref: BSAVA Small Animal Formulary. Ed Tennant B. 4th Edition. BSAVA, UK. p 124)
Owners of diabetic pets need to 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.
If the insulin dose is too high, it should be reduced, e.g. by at least 10%. It may be necessary to construct a serial glucose curve to enable appropriate adjustment of the insulin dose.