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Hypoglycemia in Cats

By: Dr. Debra Primovic

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Other medical problems can lead to symptoms similar to those encountered in cats with hypoglycemia. It is important to rule out these conditions before establishing a definite diagnosis:

  • Hepatoencephalopathy. This is abnormal brain function caused by severe liver disease or shunting of blood around the liver

  • Hypocalcemia. This is blood calcium concentration that is lower than normal

  • Central nervous system disorders

  • Spinal cord disorders causing hind limb weakness

  • Syncope or fainting

    Diagnosis In-depth

    Diagnostic tests must be performed to confirm the diagnosis of hypoglycemia and exclude other diseases that may cause similar symptoms. Your veterinarian will probably recommend the following:

  • A complete medical history and physical examination. Your veterinarian will ask specific questions about you cat's appetite and eating habits.

  • Blood glucose concentration. Your pet's blood sugar will be measured, and if the reading is normal, it may be followed by a fasting blood sugar and repeated measurements during fasting.

    Your veterinarian may also recommend additional diagnostic tests to exclude other conditions or to better understand the impact of hypoglycemia on your cat. These tests ensure optimal medical care and are selected on a case-by-case basis. Examples include:

  • A complete blood count (CBC or hemogram) to identify anemia and evaluate for other problems such as infection or inflammation.

  • Serum biochemistry tests to identify underlying disease processes that may contribute to the development of hypoglycemia or to identify complicating disease processes.

  • Urinalysis to evaluate kidney function, identify glucose in the urine, and detect the presence of white blood cells in the urine, which would indicate urinary tract infection.

  • Fecal flotation to identify the presence of parasites that can cause hypoglycemia.

  • Blood concentration of bile acids to evaluate liver function since some animals with liver failure develop hypoglycemia.

  • Serum insulin concentration may be determined in conjunction with blood glucose concentration to identify an insulin-secreting tumor of the pancreas (insulinoma or beta cell tumor).

  • X-rays of the abdomen and chest may be performed to look for tumors that may be associated with hypoglycemia. X-rays of the chest often are performed to check for tumors that may have spread (metastasized) to the lungs. A small liver on abdominal X-rays may indicate chronic scarring (cirrhosis) or shunting of blood around the liver caused by an abnormal blood vessel (portosystemic shunt). A hazy appearance to the abdominal X-ray can be caused by peritonitis.

  • An abdominal ultrasound may be performed to evaluate your cat for the presence of tumors that could cause hypoglycemia. Insulin-producing tumors of the pancreas (insulinoma or beta cell tumor) often are very small and may not be evident on ultrasound examination. Fortunately, these tumors are very rare in cats.

  • Hypoglycemia that remains unexplained after complete diagnostic evaluation may necessitate referral to a specialist in veterinary internal medicine.

    Treatment In-depth

    Optimal therapy of any serious or persistent medical condition depends on establishing the correct diagnosis. There are several potential causes of hypoglycemia and the underlying cause of hypoglycemia must be determined before definitive treatment can be recommended.

    Initial therapy should be aimed at diagnosis and treatment of the underlying causes of hypoglycemia. Your veterinarian may recommend or perform the following treatment measures:

  • Supplemental dextrose by administration of corn syrup (Karo® syrup) on the cat's gums or a 50 percent solution of glucose administered orally. Special care should be taken to be certain the cat has a normal swallowing reflex so as to prevent aspiration of the glucose solution into the lungs. In some cats, it may be necessary to administer a sterile solution of dextrose by intravenous injection.

  • An intravenous catheter and administration of an electrolyte solution that also contains dextrose may be necessary.

  • Warming of patients with low body temperature and close monitoring of body temperature is important, especially in kittens.

    Your veterinarian will attempt to identify the underlying cause of hypoglycemia and treat it appropriately, such as removing the tumor associated with hypoglycemia, providing frequent small meals, and treating body wide infections. Treatment measures after emergency care may include:

  • The cat may be hospitalized for observation and treatment of hypoglycemia. Blood glucose concentrations may be checked frequently until the patient has been stabilized.

  • Your cat will be fed small meals frequently if possible. The diet should be high in protein, fat and complex carbohydrates. A combination of canned and dry foods fed 3 to 6 times per day is recommended.

  • Glucocorticoids may be recommended for cats with hypoglycemia caused by a tumor.

  • A drug called diazoxide (Proglycem®) also may be considered for cats with tumor-induced hypoglycemia.

    Prognosis

    Appropriate diagnosis and treatment of the underlying disorder will assure the best possible prognosis, which is dependent on the cause of hypoglycemia. In cases of juvenile hypoglycemia and insulin overdose hypoglycemia, prognosis is generally good.

    The prognosis for cats with hypoglycemia associated with body wide infection (sepsis) is dependent on the underlying cause of the systemic infection and how effectively it can be treated.

    Follow-up Care

    Optimal treatment for your cat requires a combination of home and professional veterinary care. Follow-up can be crucial and may include the following recommendations:

  • Administer any medications prescribed by your veterinarian. Inability to medicate properly can be a reason for treatment failure.

  • Feed your cat frequent small meals and observe your cat's general activity level and appetite. Monitor him for signs of recurrent hypoglycemia (lethargy, weakness, staggering, unusual behavior, apparent blindness, muscular twitching, seizures).

  • Have your veterinarian check your cat regularly for blood glucose determinations.

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