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Hypoglycemia in Dogs | How to Housebreak Your Puppy (PDF) | Letter to Owner

Hypoglycemia in Dogs

The most serious side effect of too much insulin is hypoglycemia, or low blood glucose. Hypoglycemia can be a life-threatening, even fatal condition.

Classic signs of hypoglycemia

• lethargy (lack of energy)
  
• glassy eyes - it may look like it is staring into space
  
• weakness
  
• head tilting
  
• "drunkenness" - wobbling when walking, unbalanced
  
• hunger
  
• restlessness
  
• sleepiness
  
• shivering
  
• unable to wake easily when it is sleeping
  
• laying, sleeping, or curled up in an unusual location of the house
  
• vomiting
  
• ataxia - usually lack of muscular coordination, but maybe changes in head and neck movements
  
• disorientation
  
• stupor
  
• convulsions or seizures
  
• coma
  
• death

Be Prepared
Always have corn syrup or sugar available. Corn syrup works well because it is a very pure sugar, and it is liquid. In the U.S. "Karo" is a brand name of corn syrup and you'll often see this word used. Karo is not available in Canada, but similar corn syrup products are available. Pancake syrup, honey, or table sugar dissolved in some water will also work. Wherever your pet is, there should be an emergency supply of sugar. You should carry sugar with you when you take your pet out of the house, even for a short walk.

How to Carry a Sugar Supply -- purse, doggie pack, car, or pocket

• Use small screw-top plastic bottles (Nalgene) from a sporting goods store or "travel-size" plastic bottles from the drug store.
  
• Packets of honey.
  
• Liquid glucose packets can be purchased at the pharmacy. The tablets might work if your pet is just beginning to show signs of hypo, but a liquid sugar is better - faster acting and easy to use.
  
• A tube of cake decorating gel, which is mostly sugar (if your in a pinch).
  
• Another person filled a 10mL syringe (no needle) with corn syrup, and carried it on trips in case she needed to get it into her pets mouth. With a syringe, it is easy to get the syrup in the mouth without being bitten.
  
• One owner connects a small pouch with a plastic bottle filled with corn syrup onto her dog's harness. This way sugar is always with them on their walks.
  In an emergency, you don't want to be searching for sugar. Many dog owners have been caught completely unprepared for their dog's hypo attack. At an obedience class, all one owner could find to feed her dog was powdered donuts. Another owner had her dog in the car and the dog started convulsing. She pulled into a gas station and purchase pancake syrup. It is better to be prepared than to have to search for something that might work, so put corn syrup on your grocery list and buy it. Then put a small container anywhere it will be needed and is easy to get to.

Treating Hypoglycemia
During a hypo attack, your goal is to stay calm, bring the blood glucose back to a safe level, continue to observe your pet, and contact the vet.

If your pet is acting strangely, you should assume it is due to hypoglycemia and treat it accordingly. This is a situation where it is better to be safe than sorry. If your pet is not hypoglycemic, your treatment may have raised the blood glucose for a few hours. But if your pet is hypoglycemic, you have just saved its life.

How you treat hypoglycemia depends on many factors. It is better to give too much food or sugar than not enough.

Ask your vet for information that is specific to your pet.

These are general guidelines for treating hypoglycemia.

• Mild hypoglycemia If your pet's bg is only slightly low or if it is showing only mild signs of hypoglycemia, you can often treat it by immediately feeding the pet some of its regular food. The blood glucose raising effects of the food may be enough to counteract the hypoglycemia. If your pet refuses its regular food, try offering a food it really enjoys or some treats. Any food is probably ok in this situation. Your main concern is to get the blood glucose up and to eliminate the signs of hypoglycemia. You need to observe your pet for several hours to make sure the hypoglycemia does not happen again.
  
• Moderate hypoglycemia Corn syrup should be given, either alone, or combined with food. Syrup can be mixed in with wet food or drizzled over dry food. The syrup will help bring the bg up quickly, and the food will help keep the bg elevated for a longer period of time. Cats should be fed about one tablespoon of syrup. If the cat won't eat it, rub it on the gums and inside of the cheeks. Small dogs should be given about 1-2 tablespoons, or larger dogs should get 0.25-0.5 mL per pound of body weight. You need to observe your pet for several hours to make sure the hypoglycemia does not happen again.
  
  The blood glucose raising effects of the syrup will last only for a short time. If the insulin is long lasting or if the hypoglycemia is severe, the effects of the syrup will wear off and the the hypoglycemia may come back. Continue observing your pet, and give syrup or syrup and food as needed.

• Severe hypoglycemia If your pet is severely hypoglycemic, especially if it is having seizures or unconscious, you must give corn syrup immediately. Carefully rub small amounts of syrup on the cheeks and gums. Do not put a lot of liquid in the pet's mouth, and be sure the pet does not choke. Do not stick your fingers inside the teeth of a pet having a seizure - you may get bitten. Then, Call the vet. If you cannot contact your vet, call any vet - and get additional instructions. Your pet will probably have to go to the vet immediately.
  
• Follow up Whenever a pet has a hypoglycemic attack, you should contact your veterinarian. Exercise can cause hypoglycemia. If it is out of the ordinary, even a small amount of exercise can cause hypoglycemia.

References
Pocket Companion to the Fourth Edition of Textbook of Veterinary Internal Medicine. Stephen J. Ettinger, D.V.M, Editor. 1995. W.B. Saunders Co.

The 5 Minute Veterinary Consult: Canine and Feline. Larry P. Tilly, Francis W.K. Smith, Jr. 1997. Williams & Wilkins.