Glucagon infusion used to treat low blood sugar in 9 dogs

Abstract

OBJECTIVE: To describe the use of glucagon infusion for adjunctive treatment of hypoglycemia in dogs. DESIGN: Multicenter retrospective case series. SETTING: One university and 1 private veterinary referral hospital. ANIMALS: Dogs were included if they were hospitalized and received glucagon therapy for hypoglycemia, defined as blood glucose concentration (BG) <60 mg/dL. A total of 9 dogs were included from September 2005 to May 2014. INTERVENTIONS: None. MEASUREMENTS AND MAIN RESULTS: The medical record for each eligible case was reviewed. Data recorded included signalment, presenting complaint, underlying disease process, presenting BG, BG after dextrose supplementation, BG before glucagon administration, maximum BG while receiving glucagon, and BG after discontinuation of glucagon, if available. Adverse reactions to glucagon and outcome of case were recorded if available. The most common causative disease was insulinoma (n = 7). Median serum glucose concentration on presentation was 30 mg/dL (20-41 mg/dL). The median bolus of glucagon was 50 ng/kg followed by a median maximum dose of a glucagon CRI of 15 ng/kg/min. The mean time period on glucagon CRI until normoglycemia (defined as BG > 60 mg/dL) was 7 hours. All hypoglycemic patients had improvement of BGs when glucagon was added. Statistically significant differences (P < 0.05) were found between BG measurements on glucagon CRI compared to BG at presentation, BG after dextrose, and BG prior to glucagon with a Friedman statistic of 17.3. A CRI was found to effectively increase the BG without recurrence of hypoglycemia after weaning. The majority of patients (5/9) survived to discharge. CONCLUSION: Glucagon CRI was accompanied by an increase in BG in hypoglycemic dogs. Glucagon CRI appears to be a safe method and can be readily utilized in most practice settings.