Shanna Hillsman, LVMT, University of Tennessee
M. Katherine Tolbert, DVM, PhD, DACVIM (SAIM), Texas A&M University
Following are differential diagnoses, listed in order of likeliness, for patients presented with hypoglycemia.
- Spurious (eg, storage artifact)
- Neonates (typically <6 weeks of age; normal finding or related to another condition [eg, portosystemic shunt])
- Toy-breed puppy (can occur in healthy puppies when fasting or if no access to nursing)
- Exogenous insulin overdose
- Hepatic failure
- Portosystemic shunt
- Hypoadrenocorticism
- Sepsis
- Systemic inflammatory response syndrome
- Insulinoma
- Xylitol toxicity
- Paraneoplastic syndrome (eg, leiomyoma/leiomyosarcoma, hepatoma)
- High-intensity exercise
- Pituitary dwarfism
- Glycogen storage disease
- Renal glucosuria
- Polycythemia
- Oleander toxicity
- Amphetamine-dextroamphetamine toxicity
- Trypanosoma congolense infection (only in specific geographic regions)
- Beaudry D, Knapp DW, Montgomery T, Sandusky GS, Morrison WB, Nelson RW. Hypoglycemia in four dogs with smooth muscle tumors. J Vet Intern Med. 1995;9(6):415-418.
- Deschamps JY, Desquesnes M, Dorso L, et al. Refractory hypoglycaemia in a dog infected with Trypanosoma congolense. Parasite. 2016;23:1.
- DuHadway MR, Sharp CR, Meyers KE, Koenigshof AM. Retrospective evaluation of xylitol ingestion in dogs: 192 cases (2007-2012). J Vet Emerg Crit Care (San Antonio). 2015;25(5):646-654.
- Fitzgerald KT, Bronstein AC. Adderall (amphetamine-dextroamphetamine) toxicity. Top Companion Anim Med. 2013;28(1):2-7.
- Forcada Y. Hypoglycemia, hyperglycemia. In: Ettinger SJ, Feldman EC, Côté E, eds. Textbook of Veterinary Internal Medicine. 8th ed. St. Louis, MO: Elsevier; 2017:247-249.
- Goutal CM, Brugmann BL, Ryan KA. Insulinoma in dogs: a review. J Am Anim Hosp Assoc. 2012;48(3):151-163.
- Kornhauser D, Adam PA, Schwartz R. Glucose production and utilization in the newborn puppy. Pediatr Res. 1970;4(2):120-128.
- Murphy LA, Coleman AE. Xylitol toxicosis in dogs. Vet Clin North Am Small Anim Pract. 2012;42(2):307-312.
- Page C, Murtaugh RJ. Hypoglycemia associated with oleander toxicity in a dog. J Med Toxicol. 2015;11(1):141-143.
For global readers, a calculator to convert laboratory values, dosages, and other measurements to SI units can be found here.
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