Veterinary care should include diagnostic tests and subsequent treatment recommendations. Diagnosis In-depth
Diagnostic tests must be performed to confirm the diagnosis of hypoglycemia and exclude other diseases that may cause similar symptoms. Tests may include: A complete medical history and physical examination with specific questions about your dog's appetite and eating habits
Repeated fasting blood glucose concentration measurements to identify hypoglycemia if the initial blood glucose concentration is normal
Your veterinarian may recommend additional diagnostic tests to exclude other conditions or to understand the impact of hypoglycemia. These tests insure 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 the kidney function, identify glucose in the urine, and detect the presence of urinary tract infection based on the observation of white blood cells in the urine under the microscope
Fecal flotation to identify the presence of parasites that can cause hypoglycemia, especially in puppies.
ACTH stimulation test to identify hypoadrenocorticism or Addison's disease, an endocrine disorder that occasionally causes hypoglycemia.
Blood concentration of bile acids to evaluate liver function because some animals with liver failure develop hypoglycemia
Serum insulin concentration 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 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.
Abdominal ultrasound exam may be performed to evaluate for the presence of tumors that could cause hypoglycemia. Insulin-producing tumors of the pancreas often are very small and may not be evident on ultrasound examination.
Hypoglycemia that remains unexplained after complete diagnostic evaluation may necessitate referral to a specialist in veterinary internal medicine.
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:
Provide supplemental dextrose by giving corn syrup (Karo® Syrup) on the dog's gums or a 50 percent solution of glucose administered orally. Special care should be taken to be certain the dog has a normal swallowing reflex so as to prevent aspiration of the glucose solution into the lungs. In some dogs, it may be necessary to administer a sterile solution of dextrose by intravenous injection.
Placement of an intravenous catheter and administration of an electrolyte (salt) solution that also contains dextrose. Dogs that have hypoglycemia due to hypoadrenocorticism (Addison's disease) usually are treated with a 0.9 percent sodium chloride (salt) solution.
Patients with low body temperature should be warmed and body temperature should be monitored closely.
Treatment measures after emergency care may include:
Your veterinarian will attempt to identify the underlying cause of hypoglycemia and treat it appropriately. This may include removing the tumor associated with hypoglycemia, treating Addison's disease, feeding hunting dogs small meals before working, providing frequent small meals, and treating body wide infections.
The dog may be hospitalized for observation and treatment of hypoglycemia. Blood glucose concentrations may be checked frequently until the patient has been stabilized.
Feed 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.
Limit exercise to short walks.
Glucocorticoids may be recommended for dogs with hypoglycemia caused by a tumor.
A drug called diazoxide (Proglycem) also may be considered for pets with tumor-induced hypoglycemia.
A drug called Octreotide also can be used for medical treatment of dogs with insulinomas. This drug works by decreasing insulin secretion by the tumor.
Prognosis is dependent on the cause of hypoglycemia. Appropriate diagnosis and treatment of the underlying disorder will assure the best possible prognosis. The prognosis is good in cases of juvenile hypoglycemia, hunting dog hypoglycemia, and Addison's disease.
Dogs with hypoglycemia due to insulinoma generally have a poor prognosis because many of these tumors have metastasized by the time of surgery. With early diagnosis and surgical removal of the tumor however some dogs have lived up to 2 years.
The prognosis for pets 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.