Etiology and prognosis for dogs with abnormal blood glucose concentrations evaluated in an emergency room

Abstract

Objective To determine the prevalence of glucose abnormalities in nondiabetic dogs presenting to a veterinary emergency room (ER) and their association with underlying disease processes, previous glucocorticoid administration, and overall mortality. Design Single‐center, retrospective study from January 2013 to December 2014. Setting University Teaching Hospital. Animals A total of 660 dogs presenting to an ER with a blood glucose concentration measured within 6 hours of presentation. Interventions None. Measurements and main results Medical records from dogs with a blood glucose concentration measured within 6 hours of hospital admission were reviewed. Medications administered prior to blood sampling, the presence of shock, final clinical diagnosis, and survival were recorded. Hypoglycemia and hyperglycemia were defined as a blood glucose <4.4 mmol/L (80 mg/dL) and >6.7 mmol/L (120 mg/dL), respectively. Diabetic patients were removed from analysis. Hyperglycemia was found in 40.1% of dogs, whereas hypoglycemia was present in 9.0%. Hyperglycemia was most often associated with gastrointestinal disease, trauma, neoplasia, and respiratory disease. The most common diseases associated with hypoglycemia were sepsis, gastrointestinal disease, and neoplasia. Dogs in shock or with hyperlactatemia had higher blood glucose values than dogs with normal perfusion and plasma lactate concentrations (P = 0.016 and P < 0.0001, respectively). Mortality was higher in dogs with hyperglycemia (33.2%, P = 0.03) or hypoglycemia (44.6%, P = 0.0024) compared to those with normoglycemia (24.9%). Conclusion Dysglycemia in nondiabetic dogs evaluated in an ER was associated with a higher mortality rate than dogs in the same population with normoglycemia. Hyperglycemia in this population was common and may represent a stress response.

Association of point‐of‐care blood variables obtained from dogs and cats during cardiopulmonary resuscitation and following return of spontaneous circulation with patient outcomes

“…Dysglycemia is a common occurrence in CPA and ROSC patients and is influenced by the underlying disease process, decreased tissue perfusion, and by medications administered during resuscitative efforts. In dogs presented to an emergency room, dysglycemia is associated with a higher mortality compared to normoglycemic dogs, but information on its prevalence and association with outcomes in small animals undergoing CPR is limited 7,77 …”

The Effect of Different Opioids on Acid-Base Balance and Blood Gas Analysis in Hospitalized Dogs

“…Opioids are one of the most important drugs classes for the management of acute and chronic pain conditions and the management of postoperative pain. Besides the analgesic effects, they may interfere with the values of certain biochemical-clinical parameters, especially blood glucose and, in emergency room, the mortality is higher in dogs with hyperglycemia or hypoglycemia compared to those with normoglycemia ( 33 , 34 ).…”

Development of a requirement for exogenous insulin treatment in dogs with hyperglycemia

“…Medical records also were searched for conditions other than ITDM that have been reported to cause hyperglycemia in dogs. These conditions included current treatment with glucocorticoids, cyclosporine, or tramadol, hyperadrenocorticism, hepatocutaneous syndrome, bite wound injuries, blunt trauma, hypovolemic shock, pregnancy, and diestrus 4‐11 . Dogs were defined as receiving these drugs or having these conditions if these medications and diagnoses were clearly recorded in the medical record.…”

“…These conditions included current treatment with glucocorticoids, cyclosporine, or tramadol, hyperadrenocorticism, hepatocutaneous syndrome, bite wound injuries, blunt trauma, hypovolemic shock, pregnancy, and diestrus. 4 , 5 , 6 , 7 , 8 , 9 , 10 , 11 Dogs were defined as receiving these drugs or having these conditions if these medications and diagnoses were clearly recorded in the medical record. Dogs were defined as having hyperadrenocorticism if the medical record confirmed this diagnosis and they were treated with trilostane.…”