BASICS
- Hypoglycemia is a decreased concentration of glucose in blood, plasma, or serum
- Glucose is a major source of energy, especially for the central nervous system
- Glucose is acquired from the diet and stored as glycogen in liver and muscle
- Insulin moves glucose from plasma into cells
- Hypoglycemia results from decreased glycogen availability, excessive cellular use of glucose, decreased feed intake, or excessive insulin or IGFs
- Bacterial utilization of glucose can cause hypoglycemia, especially in neonates
- Systems affected—nervous, neuromuscular, cardiovascular, behavioral
Neonates are very susceptible to hypoglycemia from decreased intake because of limited energy reserves.
- Depression, weakness, tachycardia, muscle fasciculations, tremors, ataxia, collapse, and seizures
- Additional signs depending on the underlying cause
- Neonates—anorexia, sepsis/septicemia, ischemic hepatopathy (e.g. perinatal asphyxia)
- Sepsis/endotoxemia
- Exhaustion after prolonged exercise
- Hepatic failure—toxins (pyrrolizidine alkaloid-containing plants, Alsike clover, Panicum grasses, aflatoxins, Indigofera, iron, copper), infections (Clostridium, Fasciola, Parascaris), hepatic lipidosis, chronic active hepatitis, cholangiohepatitis, Theiler's disease, neoplasia, Tyzzer's disease in neonates
- Iatrogenic—e.g. treatment of hyperlipidemia/hyperlipemia
- Pancreatic islet B-cell neoplasia (rare)
- Renal or hepatic carcinomas that secrete IGF (rare)
DIAGNOSIS
TREATMENT
MEDICATIONS
FOLLOW-UP
MISCELLANEOUS