Читать книгу Canine and Feline Epilepsy - Luisa De Risio - Страница 78

The diagnosis of hypoglycaemic encephalopathy is based on documenting hypoglycaemia in an animal with neurological signs that improve or resolve following normalization of blood glucose concentration. Specific diagnosis of the underlying disorder requires additional investigations. The reader is referred to internal medicine textbooks for further details on diagnosis and treatment of underlying aetiologies of hypoglycaemia. When hypoglycaemia is suspected in animals presenting with seizures or other neurological signs a blood sample should be taken. Falsely low glucose concentrations may result from use of human point-of-care glucometers in haemo-concentrated animals or from delayed separation of serum from blood cells (which continue to consume glucose).

Box 4.1. Underlying causes of hypoglycaemia.

Overproduction of endogenous insulin or insulin-like substances (e.g. insulin-like growth factor):

• Pancreatic insulinoma;

• Islet cell hyperplasia;

• Extrapancreatic neoplasms including intestinal smooth-muscle tumours, hepatic tumours, or lymphoma.

Exogenous insulin overdose in animals with diabetes mellitus (especially in cats).

Decreased glucose production:

• Severe hypoadrenocorticism;

• Hypopituitarism;

• Growth hormone deficiency;

• Hepatic failure;

• Glycogen storage disease;

• Glycogen depletion in young puppies (usually of toy or miniature breeds) and kittens.

Excess glucose consumption:

• Sepsis;

• Hunting dog hypoglycaemia syndrome associated with inadequate caloric intake and strenuous exercise.

Drug associated:

• Xylitol toxicity