OverviewHypoglycemia is often referred to as “low blood sugar.” When your cat’s body is deprived of sugar, its main source of energy, his ability to function declines and, in severe situations, loss of consciousness or even death can result. Low blood sugar is not a disease itself; rather, it is a symptom of an underlying disease or problem.
Kittens, especially those under 3 months of age, have not fully developed their ability to regulate their blood glucose (sugar) levels. TreatmentYour veterinarian will want to immediately treat the low blood sugar, as well as the underlying cause. PreventionKeeping a vigil eye on your pet, especially when she is a kitten, is an important factor in preventing hypoglycemia.
Not all cats with diabetes will need to be treated with insulin (some cats with mild diabetes may respond to and dietary change), but a majority of them will. In addition to treating the diabetes, any other concurrent diseases such as pancreatic exocrine insufficiency, hyperthyroidism, Cushing's disease, and infections need to be treated as well. Before treatment is started, it is important that the owner be well-informed and have the time necessary to make the correct decision since regulating a diabetic cat requires commitment.
The cat will need to be hospitalized for a number of days and one or more blood glucose profiles (described below) will need to be performed. Insulin must usually be given twice a day, every day at specific times, probably for the life of the cat. The type of insulin and insulin syringe that are used should not be changed unless under guidance by the veterinarian. The cat will need to be carefully monitored at home on a daily basis; when to seek veterinary advice and return for rechecks will depend on what signs the cat may be showing. Insulin requirements often change over time and the dose of insulin may need periodic adjustments based upon blood glucose monitoring. Emergency conditions of low blood sugar (hypoglycemia) can be seen if too much insulin is given in relation to food intake. Heat cycles can affect insulin requirements, so it is suggested that female diabetic cats be spayed. Cats, because of their size, generally need very small doses of insulin which can be difficult to measure accurately. Duration: Insulin preparations can be short-acting (regular insulin), intermediate (Lente, NPH), or long-acting (glargine, Ultralente, protamine zinc insulin - PZI).
There are corresponding syringes to use for the measurement of the three concentrations of insulin. Dose and frequency of administration: Based upon results of the blood glucose profile and the type of insulin which is used, the dose and frequency of administration of insulin will vary.
From this discussion, you can see there are many combinations of insulin, dose and frequencies of administration to be considered when attempting to regulate a cat with diabetes. Improper insulin administration: Inadequate mixing of insulin, improper measurement of the dose (misreading the syringe, using the wrong type of syringe), and errors in injecting the insulin can result in the cat not receiving the dose of insulin we think she is.
Inactive insulin: If insulin is improperly stored, used after the expiration date has lapsed, has been shaken or been exposed to higher temperatures, it may lose its potency. Changes in food or feeding schedule: If the feeding schedule, type of food, or access to food has changed, apparent insulin resistance could occur. Somogyi effect: The Somogyi effect, also called insulin-induced hyperglycemia, or rebound hyperglycemia, is somewhat difficult to understand. If the above causes of an inadequate response to insulin have been eliminated, true insulin resistance may be occurring.
Interference by medications: The long term administration of glucocorticoids such as dexamethasone, or progesterone-like hormones such as megestrol acetate can result in diabetes mellitus and insulin resistance.
Poor absorption of insulin: In some cats, even though active insulin is administered correctly, it is not well absorbed from the site of injection.
Other diseases: Infections, ketoacidosis, pancreatitis, liver disease such as hepatic lipidosis, kidney disease, or hormonal disorders such as Cushing's disease, hyperthyroidism, and acromegaly (condition resulting from an increased production of growth hormone) can affect the metabolism and effectiveness of insulin in the body.
Production of antibodies against insulin: Insulin and other components added during the manufacture of injectable insulin can be considered 'foreign' by the body and cause the body to produce antibodies to destroy them.
Accurate and consistent monitoring of a diabetic cat at home can sometimes provide more accurate information as to the response to therapy than attempting to perform blood glucose tests in the veterinarian's office. Store, handle, and administer insulin properly: The proper method of storing, handling, and administering insulin were discussed in detail above. Monitor for signs of hypoglycemia: Signs of hypoglycemia (discussed in detail below) include lethargy, depression, weakness, seizures, and coma. Maintain a proper feeding schedule and access to food: Provide your cat with her recommended diet at the scheduled feeding times.
Observe the cat for improvement of signs of diabetes: Attitude, water consumption, frequency and amount of urination, and appetite are all clues as to how well your cat is responding to therapy.
Accurately measure other parameters as advised: Depending on your cat's overall health, weight, difficulty in regulation or other factors, your veterinarian may also ask you to measure water intake or urine glucose (measured using paper strips and watching for a color change). Keep scheduled appointments and communicate!: Your veterinarian will advise you as to how often your cat will need to be examined and have her blood glucose monitored. Be patient: Regulating a cat with diabetes is much more difficult than regulating a dog or person. Keep the cat indoors or supervised outdoors: Outdoor cats are at much more of a risk of missing their scheduled insulin injections and feeding times. Monitor glucose levels at home: Many owners are able to monitor their cat's glucose levels at home using an instrument called a glucometer.
Causes of hypoglycemia: Most of the causes of hypoglycemia in diabetic cats can be prevented or predicted. Signs of hypoglycemia: Cats with hypoglycemia will act depressed and lethargic, may show weakness or incoordination, progress into a stupor or coma, and ultimately develop seizures and die. Treatment of hypoglycemia: Home management of hypoglycemia depends upon recognizing the signs of hypoglycemia early. Regulating a cat with diabetes requires an understanding of the disease process and the complexity of the regulation process, good communication between the owner and the veterinarian, good observational skills, attention to detail, and commitment.
A healthy diet is essential, and feeding your pet the same amount of food at the same time every day will help make blood sugar easiest to control. Even if you are following a consistent routine, a diabetic pet may occasionally experience an emergency. Hypoglycemia most often results from accidental overdosage of insulin, but it can also occur if a pet is not eating well, misses a meal or vomits after eating, or if the type and amount of food he is being fed changes.
You should not give another dosage of insulin after any hypoglycemic episode until you have spoken to your veterinarian. If an insulin overdose or missed meal is not to blame for your peta€™s hypoglycemia, your veterinarian will need a complete history from you and will perform a full examination to determine how to adjust his insulin in order to prevent a future hypoglycemic crisis. Most often, dogs and cats will recover from hypoglycemic episodes; however, these episodes can be life-threatening and should be treated as emergencies. It is always best to contact your veterinarian if you are concerned about any changes in your diabetic pet. Known as the gentleman of the Terrier group, the Dandie Dinmont Terrier has a self-confident attitude. Check out our collection of more than 250 videos about pet training, animal behavior, dog and cat breeds and more. Treatment for Hypoglycemia:If the person having these symptom is conscious, giving them something to eat or drink such as candy, milk, or orange juice will bring their glucose levels up and drive their insulin levels down.
Dog Hypoglycemia (Toy Breed): toy dog breeds are becoming more and more remarkably popular these days as people move into small apartments and condos and need small dogs that adapt well to city life.
The problem with toy breed dogs is that being so small they tend to have difficulties in maintaining their blood glucose levels normal.
While toy breed dogs may develop hypoglycemia simply because of their constitution, in some cases there may be other underlying causes that may need addressed.

A toy breed dog should be fed a minimum of three times a day, some requiring even up to six feedings a day to maintain normal levels of blood sugar. Owners should always have along some honey, karo syrup (works the best!) or pancake syrup to rub on these dog’s gums in order to prevent them from going into a low blood sugar crisis.
Chilled dogs should be warmed up using a warm water bottle covered in a blanket to avoid the dog from getting burned. If the dog is not getting better after rubbing the sources of sugar on the gums or giving a treat (usually they should improve within 10-20 minutes), it will need prompt veterinary attention. Toy dog breeds may be mistakenly thought to be low maintenance, however the opposite is true. A condition of low levels of sugar in the blood that causes muscle weakness, uncoordination, mental confusion, and sweating. When blood sugars drop too low, the brain cannot get the glucose it needs to function properly. While severe symptoms are easy to spot, mild to moderate low blood sugar is not always easy to recognize. The more lows a child has, the greater the risk for lows that go unrecognized in the future, because fewer warning signs actually appear.
To treat low blood sugar during the day, the child should immediately take 15 grams of glucose or a sugar source such as three or four glucose tablets, four ounces (half a cup) of 100-percent fruit juice, four ounces (half a cup) of regular (not diet) soda, or one tablespoon of sugar or honey.
If the symptoms do not go away in 10 to 15 minutes, the blood sugar test should be repeated. In the case of severe low blood sugar reading, the child should be given glucagon as prescribed.
While exercise is important, extra physical activity can cause blood glucose levels to drop lower than usual, either during the exercises or much later (particularly during the night). To help prevent nighttime lows, a child’s blood sugar should be checked at bedtime and then followed with a snack.
It is also important that everyone who cares for a child with diabetes (even school bus drivers) should know that the child has diabetes and takes insulin.
High intensity interval training (HIIT) has been growing in popularity in the past few years. Hypoglycemia can be brought on when kittens are introduced to other stress factors, such as poor nutrition, cold environments, and intestinal parasites. Treatment may include oral or intravenous glucose supplements; other treatments will depend on the underlying cause.
The goal of treatment is to resolve the signs of the disease, maintain proper body weight, eliminate or reduce the likelihood of any complications, and provide the cat with a good quality of life. The owner must be aware of when this could occur, the signs of the condition, and how to manage it. Diabetic cats should not be bred, since pregnancy and lactation will greatly affect blood glucose levels and insulin requirements. If they do not eat consistently from day to day, their insulin needs will vary from day to day.
In addition, some cats develop transient diabetes, which may only last for several months and then have spontaneous remission in which it appears to be 'cured,' only to come back months later (in some cats). The insulin doses per pound of body weight vary much more between cats than between dogs or between humans.
The characteristics differ as to source, duration of action, concentration, and the frequency of administration. Generally, insulins which are short- or intermediate-acting are given twice daily; long-acting insulins may need to be given once or twice a day depending upon the response. Successful regulation is determined by the results of a blood glucose profile, glucose level monitoring, and the response of the cat (eating well, alert, normal water consumption, and urine production, etc.). The easiest way to determine if inactive insulin is the problem is to use a new bottle of insulin. An example: A dog we were trying to regulate on insulin was needing increasingly larger doses of insulin to keep the blood glucose level in a somewhat normal range. Basically, if too much insulin is given, the blood glucose level goes so low it stimulates the production of other hormones in the body such as epinephrine, which promote the breakdown of glycogen (the chemical compound which the body uses to store glucose) and increases the blood glucose level above normal.
It is sometimes difficult to determine the cause and it may require multiple laboratory tests to make the determination.
Many of these diseases can change the levels of other hormones in the body which affect the glucose level such as glucocorticoids.
This is generally quite rare and more likely to occur in cats if pork or human recombinant insulin are used, since when compared to beef insulin, they are less like cat insulin.
It is best to have one family member responsible for administration, so missed doses and 'double' doses do not occur as a result of miscommunication.
Establishing and maintaining your cat's weight is one of the major goals of insulin therapy, and an excellent means to monitor the effectiveness of the therapy. Be sure to keep these appointments; the time of day these appointments are scheduled is often critical.
You may be doing everything perfectly at home, but still have difficulty in regulating your cat. Their exercise may vary tremendously from day to day, which can greatly affect their insulin needs.
This can occur if the wrong insulin or wrong type of syringe is used, or a second dose of insulin is given due to miscommunication between family members or to try to make up for a first dose that was improperly given. If insulin was administered but the cat will not eat her meal, the excess insulin in relation to the amount of glucose available to the body will cause the blood glucose to go too low. If the body is using more glucose for energy, it may pull too much glucose out of the bloodstream.
If the cat is poorly regulated, is experiencing the Somogyi effect, or insulin changes are made too rapidly in the regulation process, low blood glucose can occur. Heat cycles and other hormonal diseases (or their treatment) can result in a change of the body's insulin requirements. Your pet will usually also need twice-daily insulin injections, which should be given at the same time every day. A number of different things can cause an emergency, but the most common is hypoglycemia, or low blood sugar. Hypoglycemia may become a problem with very vigorous exercise; for this reason, regular daily controlled exercise is best. This scenario is particularly common in cats who often return to a non-diabetic state once an appropriate diet and insulin therapy start.
If he is not alert, hand-feed him corn syrup or honey until he is alert enough to eat his normal food. If he regains consciousness, feed him and get him to your veterinarian for continued observation.
When you get to the vet's office, your peta€™s blood glucose will immediately be checked to determine if intravenous sugar solutions are necessary or if he is stable enough to be managed by withholding insulin and giving food. If an owner is not monitoring blood or urine glucose levels routinely, diabetic remission can go unnoticed, and if insulin injections are continued, hypoglycemia may occur. Make sure to see your veterinarian every three to four months even if your peta€™s diabetes is stable, and make sure you have a plan for how to handle any after-hours emergencies. Characteristically, diabetes is the result of too much sugar (hyperglycemia) in the blood, but in cases where gaining control of glucose (sugar) levels in the blood, hypoglycemia can result.In Type 1 diabetes, low blood sugar is as much of a concern as high blood sugar.
After an episode such as this a call to the physician for further instructions should be made as soon as possible. A toy dog breed may easily fit into a purse and can be easily carried around while shopping. This is due to the fact that they have a low body mass and therefore they have a tougher time in storing glucose properly.

For instance, stress, diarrhea, parasites, liver shunt, and bacterial infections may be triggering causes of a hypoglycemic attack.
If not treated the dog may get cold, listless and suffer from loss of consciousness and seizures.
At the veterinary hospital, the dog will likely be given injections of dextrose, will be warmed up and monitored until levels of blood glucose are normal and the dog is willing to eat.
They are pretty vulnerable creatures that get cold quickly and may suffer easily from dehydration if they have vomiting or diarrhea. The level at which low blood sugar gets serious depends on the child’s age, health, and whether or not the child has had hypoglycemia before.
If these symptoms appear, blood sugar should be checked around midnight and again at 3 A.M. This is called “hypoglycemia unawareness.” On the other hand, symptoms of hypoglycemia can increase if the number of lows is decreased. Although glucagon is rarely needed, it is vital to keep it on hand and to know how to use it if the blood sugar drops so low that the child cannot eat or drink. Children should not skip meals or snacks, but if a child does not eat appropriately or eats less than usual during the day, blood glucose should be checked more often than usual during the rest of the day. When a child exercises more than usual, more carbohydrates (such as peanut butter and crackers) should be given.
They must also understand what hypoglycemia is, how to lessen the risk, and how to recognize and treat the problem. Screening for hypoglycemia in situations where your cat must fast, such as before surgery or anesthetic events, can also prevent her from becoming hypoglycemic. Because of stress, a cat hospitalized for a blood glucose profile may have a much different result than if the profile was performed in the cat's own home. Once obese cats reach their ideal weight, they may lose their need for supplemental insulin. The number of units of insulin your cat receives depends upon the type of insulin used, and your cat's response. If this rebound hyperglycemia is suspected, the insulin dose is reduced 50-75%, and after three days, a blood glucose profile is performed. We do know that as obese cats lose weight, their need for insulin therapy decreases and sometimes is eliminated. A urine glucose test does not tell us what is going on at the time the urine sample was obtained; it is an average of the glucose level in the urine, which was formed since the cat last urinated - that could be 8 or more hours ago. You will not be able to accurately monitor food intake, water consumption, or urination if your cat is allowed to be unsupervised outside.
A small drop of blood is obtained, usually from the cat's ear margin, and tested using the glucometer.
It is important that owners of diabetic cats know how to prevent, recognize, and treat this condition. In this case, it is important that you be prepared in order to avoid a life-threatening situation.
If he remains unconscious, this is a medical emergency and you should seek veterinary help immediately! However, owners of toy breeds must be aware of the fact that some of them may suffer from bouts of hypoglycemia that may require prompt veterinary attention.
People considering a toy breed should be educated about these health aspects first before making a final decision. If your pet is exhibiting behavior problems please refer to a professional pet behaviorist. If a child is having lows during the night, the nighttime insulin dosage, type, or timing of the insulin injections may need to be adjusted. A child who is having too many episodes of low blood sugar on a regular basis (such as every day) needs to have an adjustment in the diabetes regimen. It is important to emphasize at school that a child who might be having a hypoglycemic episode should not be sent to the nurse’s office alone, even for a blood sugar check. Cats treated for diabetes mellitus are at risk, as well as those with severe liver disease, severe bacterial infections, tumors of the pancreas (rare in cats), or portosystemic shunts. There were no other disease processes that we could identify, yet the dog's insulin requirements continued to rise. Working as a team will greatly increase your probability of successfully regulating your cat. Do not be offended if your veterinarian asks to review your methods of measuring and administering insulin.
This information along with in-hospital glucose curves and the above home management techniques will provide the best regulation of the cat. This can easily happen when there is too much insulin in the body which leads to low amounts of blood glucose. While bouts of hypoglycemia mostly affect toy breed dogs as puppies, some of them may still suffer from this condition as adults.
Hypoglycemia can occur in any infant or child who takes insulin injections for diabetes, or in people with type 2 diabetes taking certain medications. If for some reason a test is not possible, it is safer to assume that the cause of the child’s behavior is low blood sugar and treat the suspected low with carbohydrates. Signs that it is needed include lethargy, unconsciousness, or the inability to swallow normally. A middle-of-the-night blood glucose reading should be done if a child has eaten less than usual during the day. Glargine is considered to be better than PZI or lente insulins in newly-diagnosed diabetic cats. One day the owner of the dog came into the veterinary hospital and happily told us the problem had been solved.
For cats accustomed to going outside, many will learn to walk on a leash or be happy to be outside on a harness and long lead while you are in the yard with them. Contact your veterinarian who can determine what other treatment or hospitalization may be necessary.
Eating a snack before bedtime can prevent blood sugars from dipping too low during sleep.Coordinate your eating times and physical activity with taking your insulin. It is safer to treat a child for low blood sugar when levels are normal, than to ignore a situation in which the blood sugar is actually low.
Teachers should also understand that low blood sugar can be triggered by an altered mealtime, a skipped meal or snack, or extra physical activity. In some cats, it can even result in remission when used in combination with a low-carbohydrate-high-protein diet.
For those cats that have been on long term therapy with other insulins, the results for remission are less likely, though better control is often achieved. When taking long trips or traveling, make sure you have enough insulin supplies with you to keep check on glucose levels and to give yourself the needed insulin to keep sugar levels in normal limits.Never skip meals.
A person suffering from low blood sugar may exhibit signs and symptoms of confusion, dizziness, increased hunger, and headache. When counting carbohydrates, you will know just how much insulin is needed to keep glucose values steady. Be sure that your doctor knows all the medications you are taking, including over the counter meds.

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    Close to normal as possible, in order to avoid these serious long-term levels.

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