Sometimes it’s good to go back to basic diabetes topics. Many of our readers are very educated in diabetic pet care, but I need to remind myself that we get new readers all the time. One of the greater concerns of treating diabetes, as we aim to achieve the proper insulin dosage, is hypoglycemia. If we accidentally expose the pet to too much insulin because a pet doesn’t eat as much as usual, or perhaps even vomits, then we could end up with a low blood glucose. Or, if we start at too high of an insulin dosage we could cause the blood glucose to go too low. I like to “sneak up” on the insulin dosage when we start a pet on insulin for this very reason. It’s good for pet owners to know how hypoglycemia might look and what to do in this event.

Before we talk about what is low blood glucose, let’s first discuss what a normal blood glucose level is.

The normal range for blood glucose in dogs and cats depends on several things. If the pet is at home, where white coat syndrome doesn’t play a role, a pet’s blood glucose is usually around 100 mg/dl, give or take a 30 points or so, for NON-diabetic pets. I think reference labs take stress hyperglycemia, anxiety while at the vet clinic, into account when they make their “normal range” for dogs and cats. One of the largest reference laboratories in veterinary medicine in America is Antech Labs. For dogs, the reference range for blood glucose at Antech is 70 to 138. For cats the normal reference range for blood glucose at Antech is 64 to 170. Cats are a bit more prone to stress hyperglycemia than dogs but it can happen for both species.

What Does Hypoglycemia Look Like?

I’m sure everyone has experienced feeling just downright ravenously hungry. That is how hypoglycemic humans feel. We can assume that is also how hypoglycemic pets feel. I remember years ago, before I opened my hospital, when my neighbors called me over to their house to check out their cat. Their diabetic kitty seemed disoriented and was walking funny. I ran right over with my glucose meter and checked the cat’s blood glucose. His blood glucose was in the mid 30’s as I recall. That’s very low! I had 2 choices… I could tell them to get to the nearby pet ER for an IV catheter and IV dextrose to increase the blood glucose. Or, what I did, was ask for a can of cat food which I set in front of him. He scarfed it down. He was ravenously hungry. If you are wondering how that turned out, I checked another blood glucose about 15 or 20 minutes later and it had risen up to the low normal range. He had gone into diabetes remission and no longer needed insulin. It truly was a matter of 15 to 20 minutes for his blood glucose to improve. Of course had he been seizing or tremoring or unaware he would have needed IV dextrose right away. He was stable and alert enough to eat. The point here is that hypoglycemic pets are hungry!

How Else Might Hypoglycemia Manifest?

If the blood glucose is just a bit low, say in the 50’s or 60’s you might just think your pet is sleepy. If the blood glucose is below 30 mg/dl the pet might seizure. There is no exact clinical sign for a particular level of low blood glucose. Some pets act drunk. Some pets seem blind. Some pets twitch. The scariest thought is that some pets act fine with mild hypoglycemia. Some owners may not even know as the hypoglycemia isn’t severe enough to cause dramatic I signs. It’s important for diabetic pet owners to be able to monitor blood glucose and run curves.

Hypoglycemia Treatment

If you notice any of the aforementioned clinical signs, put some food in front of your pet! If your pet is seizing then rub some honey or Karo syrup on the gums and get to a veterinary clinic ASAP! If your pet still has its wits about it, give it food. If time allows, get out your blood glucose meter and check the blood glucose. This is a number your vet will want to know.

Each veterinarian handles after hours emergencies a bit differently. I’m truly blessed that I have 2 fantastic vet emergency hospitals within 6 miles of my small animal practice. My clients know if they can’t reach me to go to one of them. I tell them to text me as like most veterinarians, when I see my phone ringing from a number I don’t recognize my heart skips a beat. I don’t usually answer any calls from an unknown number. I may even circle and eye the phone for a few minutes before I eventually listen to the voicemail, but text messages don’t elicit such fear and dread. Be sure to get a contingency plan in place should you need to reach your vet after hours. The clients at my vet clinic with diabetic pets get my cell phone number to text me.

What About Insulin Shots After a Hypoglycemic Episode?

What do you do when the next dose of insulin comes due? Do not give another dose of insulin until you’ve spoken with your vet or know that the blood glucose has risen sufficiently to warrant another, likely lessened, dose of insulin. This is a perfect time to run a spot check blood glucose level to help assess how much if any insulin should be given for the next dose. Without knowing the blood glucose level it would be difficult to know what to do.

Have a question or comment? Post below or email me at joi.suttondvm@adwdiabetes.com. I always enjoy hearing from my readers!


NOTE: Consult your veterinarian first to make sure my recommendations fit your pets special health needs.

Dr . Joi Sutton

Dr . Joi Sutton

Dr. Joi Sutton is a 1993 graduate from Oregon State University. She has practiced both in emergency medicine and general practice. Dr. Sutton has done extensive international volunteer work though Veterinary Ventures, a nonprofit organization that takes teams of veterinarians to undeveloped countries for humane medical care. She also runs a small animal practice in South Florida.
Dr . Joi Sutton

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