Peer-reviewed veterinary case report
Dog with type 1 diabetes survived fatal insulin overdose and seizures
By Park, Jun-Hyeong et al.·Published in Frontiers in veterinary science·2023·Department of Veterinary Clinical Science, South Korea·View original on PubMed →
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Original publication title: Case report: Fatal insulin overdose in a dog with type 1 diabetes mellitus-characteristics and successful management.
- Species:
- dog
Plain-English summary
A 15-year-old miniature poodle with diabetes was brought in after receiving an insulin overdose, which caused severe symptoms like confusion, unsteadiness, and seizures. Blood tests showed dangerously low blood sugar levels. The veterinarian treated the dog with intravenous dextrose to address the hypoglycemia and used anticonvulsants for the seizures. When the low blood sugar continued, glucagon was given, which eventually stabilized the dog's blood sugar levels after about 37 hours. This case highlights the effective use of glucagon in treating insulin overdose in dogs.
People also search for: dog insulin overdose treatment · miniature poodle seizures · low blood sugar in dogs · glucagon for dogs · diabetes management in dogs
Abstract
Administering more than 10 times the therapeutic dose of insulin is extremely rare in diabetic dogs and is life threatening with hypoglycemia and seizures if not accompanied by appropriate treatment. A 15-year-old, castrated male miniature poodle dog managed for diabetes presented with depression, disorientation, ataxia, and cluster seizures. The dog had been administered 11.1 U/kg of neutral protamine hegadorn (NPH) insulin (10 times the prescribed dose) 3 h before the onset of symptoms. Blood analysis revealed hypoglycemia, with a circulating glucose level of <50 mg/dL. To treat the hypoglycemia-induced seizures, dextrose was repeatedly administered intravenously. Repeated generalized seizures were treated with anticonvulsants and intermittent mannitol. Since refractory hypoglycemia persisted 24 h after the insulin overdose, it was decided to proceed with glucagon treatment (15-30 ng/kg/min titrated to the blood glucose level after a loading dose of 50 ng/kg intravenous bolus infusion). After 37 h of glucagon treatment, blood glucose levels stabilized. After entering a hyperglycemic state, NPH insulin was administered to manage insulin-dependent diabetes mellitus. This is the first case documented of successful treatment with glucagon, anticonvulsants and intermittent mannitol for refractory hypoglycemia and seizure caused by fatal insulin overdose. Thus, it has great clinical value in veterinary medicine.
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Search related cases →Original publication on PubMed: https://pubmed.ncbi.nlm.nih.gov/38026640/