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Hypoglycemia

MUHAMAD AKMAL B. NOOREZATD09A014

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DEFINITIONHypoglycemia, also called low

blood glucose or low bloodsugar, occurs when bloodglucose drops below the

normal levels

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PATHOPHYSIOLOGY

First defense is decrease in insulin secretion

Glucagon and epinephrine then stimulate hepatic

glucose production Glycogen reserve is limited and will be reduce in

number after 24-48 hours of fasting

With continued fasting, gluconeogenesis

becomes primary source of glucose

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Mechanisms responsible for hypoglycemia:

Excess insulin or insulinlike factors (e.g., insulinoma,extrapancreatic paraneoplasia, and iatrogenic insulin

overdose)

Reduction of hormones needed for maintenance of

normal serum glucose (e.g.,hypoadrenocorticism)

Reduced hepatic gluconeogenesis (e.g., hepaticdisease and glycogen storage diseases)

Excessive utilization (e.g., hunting dogs andpregnancy)

Reduced intake or underproduction (e.g., puppies

and kittens, and severe malnutrition or starvation)

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Systems Affected

Nervous- blood glucose levels that are way belowthe safety levels will cause the body to look foralternative sources of energy and brains starvingfrom sugar will shut down essential body

processes that it may deem the least important,resulting in abnormal responses and behaviorthat the patient cannot control or resist.

Musculoskeletal- Cells of the skeletal muscle relyheavily on a readily available and balancedsupply of this fuel (glucose) in order to producethe energy needed for many basic functions.

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Signs and symptoms of low blood sugarare: Convulsions or seizures

Coma

Lack of energy Weakness

Head tilting

Hunger Restlessness

Drowsiness

Shivering

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Weight gain

depression

Disorientation

Stupor- a state of near-unconsciousness

Ataxia - meaning the body is out of balance;wobbling when walking; usually lack of muscularcoordination, but maybe changes in head and

neck movements Some animals appear normal aside from findings

associated with underlying disease.

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Head tilting

Weight gain

depression

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stupor

ataxia

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Common causes of low blood sugar are:1. Meal spacing (not eating often enough)

2. Lack of protein

3. Reduced glucose formation or storage

4. Seizures

5. Exercise

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6. Insulinoma: Insulinomas are tumors of theinsulin producing cells in the pancreas.

7. Insulin overdose: An excess of insulin canalso occur in diabetic animals on insulin

injections if the dose is inappropriate.8. Hormone function: Abnormal functioningof the hormones can cause low blood sugar,as can the inability of the body to store

adequate amounts of blood sugar. It may alsobe caused by the reduced ability of the liver toproduce glucose or store glycogen.

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TREATMENT Animals with clinical hypoglycemia andwhose underlying disease needs supportshould be treated as inpatients. If able to eat (i.e., responsive, no vomiting),

feeding should be part or all of initial treatmentfor hypoglycemia.

Surgery is indicated if a portosystemic shuntor insulinoma is the cause of hypoglycemia.

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The following nutrients have been shown to help

normalize blood glucose levels:

Chromium. It has multiple effects on insulinlevels. Its also have ability to lower blood sugar

levels at higher doses by increasing insulinsensitivity. Chromium also can help enhanceglucagon secretion

N-acetylcysteine. N-acetylcysteine (NAC) is aprotein amino acid that has antioxidantproperties. It act by preventing the rapid loss ofglucose.

oral consumption of glucose or sucrose

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MEDICATIONSDRUGS AND FLUIDS

Emergency/Acute Treatment In hospital-administer 50% dextrose At home-do not attempt to have the owner

administer medication orally during a seizure; If ashort seizure has occurred and ceased or other signsof a hypoglycemic crisis are present, recommendrubbing corn syrup or 50% dextrose on the buccal

mucosa followed by 2 ml/kg of the same solutionorally once the patient can swallow. Then, seekimmediate attention. Frequent feeding of a diet low in simple sugars or, if

unable to eat, continuous fluid therapy with 2.5%

dextrose should be initiated.

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Long-TermTreatment Hunting dog hypoglycemia-feed moderate mealof fat, protein, and complex carbohydrates a fewhours before hunting. Snacks (e.g., dog biscuits)

can be fed during the hunt every 3-5 hours. Toy breed hypoglycemia-increase the frequencyof feeding

Puppy and kitten hypoglycemia-increase the

frequency of feeding (i.e., nursing or handfeeding)

Other causes of hypoglycemia require treatment

of the underlying disease and do not usually need

long-term treatment.

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Lifestyle Changes for

Hypoglycemics Foods high in rapidly absorbed sugars should be

avoided.

Alcohol, caffeine, tobacco, and other stimulants

should be avoided because they are capable ofprecipitating a hypoglycemic attack.

Small meals taken often during the day are

recommended to control the amount ofcarbohydrates entering the system and to preventrapid declines in blood glucose levels.

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REFERENCES

http://www.canine-epilepsy-guardian-angels.com/hypoglycemia

https://www.vetconnect.com http://www.lef.org/metabolic_health

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Thankyou