||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)
- head tilting
- "drunkedness" - wobbling when walking, unbalanced
- ataxia - usually lack of muscular coordination, but maybe changes in
head and neck movements
- convulsions or seizures
The occurrence of signs depends on how far the bg drops and on how
fast the blood glucose drops.
Owners of diabetic cats have also reported observing these signs
- unable to wake the cat easily when it is sleeping.
- glassy eyes - it may look like it is staring into space
- laying, sleeping, or curled up in an unusual location of the house
- meowing, crying, yowling, or vocalizing in a way that is unusual for
- some cats get aggressive
Owners of diabetic dogs have also reported observing these signs
- sweating - check the nose and the paw pads.
- lip smacking or licking
- getting physically "stuck" in a place
where the pet normally could get itself out (for example, behind a
partially closed door that a pet would usually nudge open.)
Some animals are asymptomatic
at very low bg values. This
means they do not show any of the usual signs of hypoglycemia even though their bg is very
low. Read experiences of three
pets who have had episodes of asymptomatic hypoglycemia.
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.
- Another person filled a 1mL syringe (no needle) with
corn syrup, and
carried it on trips in case she needed to get it into her cat's 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.
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. As part of your
introduction to diabetes, your vet should have explained the classic signs of hypoglycemia
and how to treat it. If he didn't, or if you forgot, you should discuss it with the vet
again. There is a lot to learn in the beginning, and sometimes it all doesn't sink in the
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 the hypo depends on many factors. If your pet shows clear signs of hypo, if
you have a good idea of how the insulin effects your pet, or if you are doing home bg
testing, you can be more precise in your treatment and maybe avoid giving too much food or
sugar. But again, it is better to give too much food or sugar than not enough.
Here are some questions you can
ask your vet to help you prepare for a hypo attack.
These are general guidelines for treating hypoglycemia. Ask
your vet for information that is specific to your pet.
- 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
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 seizuring pet - you may get bitten.
Then, Call the vet. If you can not 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.
Future doses of insulin should be reduced until a proper insulin dose adjustment can be
made. Making the proper adjustment will probably be based on the results of a blood
cause hypoglycemia. If it is out of the ordinary, even a small amount of exercise
can cause hypoglycemia. Read some personal experiences from owners who have learned
this the scary way.
Nigel Goes Hypo. A well-written account of a
hypoglycemia episode, and the suspected cause.
there any humor in this? Not really -- hypoglycemia is a very serious condition. But Bobbi was
kind enough to write a song that helps
relieve the stress of being an owner of a diabetic pet. Sometimes laughter can go a
long way to help lift your spirits.
Pocket Companion to the Fourth Edition of Textbook
of Veterinary Internal Medicine. Stephen J. Ettinger, D.V.M, Editor. 1995. W.B. Saunders
The 5 Minute Veterinary Consult: Canine and Feline. Larry P. Tilly, Francis W.K. Smith,
Jr. 1997. Williams & Wilkins.
The Cornell Book of Cats. Mordecai Siegal, Editor. Second edition. 1997. Random House.
Updated August 2001
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