Читать книгу Complications in Equine Surgery - Группа авторов - Страница 299

Definition

Hyperglycemia is an effect of alpha‐2 adrenergic agonist drugs, which increase blood glucose concentrations for variable durations following administration [128, 131]. On the other hand, hypoglycemia is also possible, especially in foals who are fasted or medically compromised.

Risk factors for hyperglycemia

Use of alpha‐2 adrenergic agonists

Risk factors for hypoglycemia

Neonatal or pediatric patients (especially fasted)

Pathogenesis

Alpha‐2 agonists cause hyperglycemia as a result of decreased insulin release from pancreatic beta cells [37].

Monitoring

Blood glucose concentrations are often provided by bench top blood gas analyzers. However, glucose can also be easily measured via the use of a hand‐held glucometer. Although specific brands of glucometers are not necessarily designed for use in equines, some glucometers have been evaluated in studies against bench top analyzers and laboratory standards using both equine whole blood and plasma [132, 133].

Treatment

While no untoward consequences of an alpha‐2 agonist related increase in blood glucose have been documented in horses, the anesthetist should be aware of its occurrence. While in other species hyperglycemia may result in diuresis, to date urine glucose data suggests that this is not the routine situation in the horse in this circumstance of drug induced hyperglycemia.

Blood glucose concentrations should be carefully monitored in foals during anesthesia, and hypoglycemia should be treated. Depending on the fluid administration rate, 1–5% dextrose in a balanced electrolyte solution will help correct hypoglycemia.