Hypoglycemia and Diabetic Cats

Hypoglycemia, or low blood sugar, is a dangerous effect of overdosing insulin. Too much insulin triggers the body to continue processing glucose, ultimately sending blood glucose (BG) levels dangerously low. Also known as insulin shock, hypoglycemia can be a life-threatening and possibly fatal condition. First aid at home can be life saving.

Home testing the BG levels in your cat is highly recommended by many owners because of the increased certainty that comes with knowing a precise BG level, though many others find it unnecessary in a regulated cat. The choice is ultimately personal, and a topic of much contention on the Feline Diabetes Message Board.

These guidelines are not intended to replace the advice given by your veterinarian. It is very important that you discuss any and all treatment options with your cat’s physician BEFORE an event has occurred.

Symptoms of hypoglycemia: [in order of ascending severity]
abnormal hunger / complete disinterest in food
restlessness
weakness, lethargy
head tilting
shivering
staggering, uncoordinated movements
problems with eyesight
disorientation (yowling, walking in circles, hiding, etc.)
convulsions or seizures
coma

This list is by no means exhaustive; cats have also been known to be very sleepy, drool, vomit, or have glassy eyes. Be aware of behavior from your cat that is uncommon, but don't fret every time your pet gives you a single funny look.

Treating hypoglycemia:

During a hypoglycemic attack you must stay calm. You must work quickly, but carefully. Your goal is to bring the blood glucose back up to a safe level, continue to observe your pet, and contact the vet.

Immediate oral application of a glucose solution such as corn syrup (Karo), maple syrup, or honey will alleviate this condition. The pet doesn't need to actually swallow, glucose will be absorbed through the mucous membranes of the mouth.

To apply, rub the solution on the gums or place it underneath the tongue. In a comatose animal, this is important so to prevent obstruction of the airway in the impaired animal. Additionally, watch your fingers!

The blood glucose-raising effects of the syrup will last only for a short time. Therefore, following this emergency measure, food should be provided. If the insulin is long lasting or if the hypoglycemia is severe, the effects of the syrup will wear off and the the hypoglycemia may return. Continue observing your pet, and give syrup or syrup and food as needed.

Guidelines for Treatment

Mild hypoglycemia: If your pet's bg is only slightly low, you may often be able to treat the hypoglycemia by feeding your cat some of its normal food. Should your cat refuse, try offering some treats.

Moderate hypoglycemia: Syrup should be given, either alone, or combined with food. Syrup can be mixed in with wet food or drizzled over dry food. The syrup will help bring the bg up quickly, and the food will help keep the bg elevated for a longer period of time. Most cats need about one tablespoon of syrup. If your cat won't eat it, rub it on the gums and inside of the cheeks. You need to observe your pet for several hours to make sure the hypoglycemia does not happen again.

Severe hypoglycemia: If your pet is severely hypoglycemic, especially if it is having seizures or unconscious, you must give corn syrup immediately. Carefully rub small amounts of syrup on the cheeks and gums. Do not put a lot of liquid in the pet's mouth, and be sure the pet does not choke. Do not stick your fingers inside the teeth of a seizuring pet - you may get bitten. Then, call the vet.

After the episode: Whenever a pet has a hypoglycemic attack, you should contact your veterinarian. Future doses of insulin may need to be reduced until a proper insulin dose adjustment can be made. Making the proper adjustment will probably be based on the results of a blood glucose curve.

Be Prepared:

A cat could be fine one moment, and hypo the next. In an emergency, you don't want to be searching for this information, or searching for sugar. Print the emergency treatment information and keep a supply of glucose available where ever you pet is, and especially be thoughtful on trips or when leaving the house. When leaving your pet with a sitter, be especially concientious to go over these rules, and leave the glucose available on the counter.

How to keep a glucose supply:
Packets of honey can be slipped inside a purse, in the car, in a drawer
Glucose solutions can be purchased at the pharmacist
Tubes of cake decorating gel
Syringes filled with corn syrup

Trust your instincts: If you are at all concerned that your cat is hypoglycemic, especially if the cat is shivering or worse, give sugar! Temporary hyperglycemia (high blood sugar) will not harm your cat. Hypoglycemia KILLS.

Always ask your vet for information that is specific to your pet.