Hypoglycemia in Cats

Hypoglycemia most commonly occurs in cats with diabetes. This is because a diabetic cat requires a diligent, daily routine of timed feedings, insulin injections and moderate exercise. Any upset to the routine or misapplication of insulin can lead to the cat going into a hypoglycemic state. A cat who has been previously diagnosed with diabetes can also go into diabetic remission within the first four months of treatment and may suddenly no longer need injections. This can easily lead to overdosing the cat with insulin. 

Rarely, a cat who does not have diabetes can become hypoglycemic. This is often due to problems with the liver or pancreas, and in some cases can be caused by an infection of the blood. If the cat becomes unconscious, the situation is a medical emergency. 

Sugar is naturally processed in the body by the hormone insulin, which is produced in the pancreas. If too much insulin exists in the body, either from insulin injections if a cat has diabetes or from the pancreas overproducing the hormone (due to e.g. an insulinoma), blood sugar levels can become too low for normal body function. While other organs can use fat or protein if sugar is scarce, the brain requires glucose to operate. When levels of glucose in the bloodstream drop below 60 milligrams per deciliter, a cat is referred to as being hypoglycemic. The brain then begins to rapidly lose function. This condition can be fatal if not addressed immediately.

In the early stages of low blood sugar, a cat may only display subtle symptoms. If you have a diabetic cat, be sure to learn the early signs of hypoglycemia. If blood sugar is not raised in time, certain damage to the brain may be permanent. Symptoms to watch for include:

• Increased appetite
• Vomiting a green/yellow bile (indication of pancreatitis)
• Dilated pupils
• Tachypnea (rapid breathing)
• Restlessness
• Anxiety
• Weakness
• Lethargy
• Staggering
• Shivering
• Twitching muscles
• Confusion
• Dizziness
• Head shaking
• Seizures
• Coma

Generally, the cause of hypoglycemia in cats is related to the cat having diabetes. Disruption of a diabetic routine or insulin administration errors are often responsible for dangerously low blood sugar. In cats who do not have diabetes, liver and pancreas issues are usually to blame. Rarely, no cause will be identified. Known causes include:

• Too high of insulin dose
• Multiple insulin dose administration
• Not enough food intake prior to a full insulin dose
• Excessive vomiting
• Lack of appropriate blood level monitoring in diabetic patients
• Diabetic remission and continuation of insulin administration
• Too much exercise in a diabetic cat
• Addison’s disease
• Pancreatitis
• Liver disease
• Insulinomas (tumors on the pancreas that secrete insulin)
• Sepsis (severe infection of the blood)
• Kittens are prone to low blood sugar if not eating enough and/or vomiting or having diarrhoea

If you know that too many insulin doses have been administered to your cat, bring the cat to a veterinary clinic or animal hospital at once to consult a veterinarian. All medications, insulin doses, and the cat’s full daily routine will need to be made known to the vet. If no routine disruption has occurred, the cat’s full medical history will have to be provided and a complete physical examination will be performed. Glucose levels of the blood will be checked to determine how severe the hypoglycemia is. 

If the cat is not diabetic, the underlying issue will need to be identified. This diagnosis will take place after the cat has already been stabilized with treatment. Full blood work including a complete blood count and a biochemical profile will need to be run. This can reveal signs of infection or the presence of cancer by determining how many white blood cells are in the blood. Urinalysis may be used to gauge the function of the kidneys. X-rays and scans can help locate any abnormalities or tumors on the organs. An ACTH stimulation test may be used to determine how the adrenal glands are responding. 

A hypoglycemic cat needs to have its blood sugar raised significantly to be able to have enough fuel within the body to perform basic functions. If the cat is not diabetic, the underlying issue may also need extensive treatment. 

Oral Glucose Administration 

If your cat has begun to exhibit symptoms of hypoglycemia, you may be advised to administer a form of glucose to the cat before you bring it in for emergency care. This may be needed for the cat to survive the trip to a veterinarian. The glucose solution should be applied to the cat’s lips and under its tongue. Corn syrup or honey may be used for this process, but not table sugar.

IV Fluids 

An intravenous administration of a dextrose solution may be needed to restore significantly low levels of blood sugar. Hospitalization is required for this process, and the cat will need to be monitored every one to two hours after IV treatment to be given a small portion of food. This must be done until insulin levels return to normal.

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Most cats recover from hypoglycemia after appropriate treatment has been given. If brain damage has occurred, it is permanent in most cases. Your veterinarian may determine that insulin doses should be reduced in some scenarios. It is best to have regular appointments to have a veterinarian monitor a diabetic cat’s blood levels. 

Keeping a daily log of a diabetic cat’s routine can prevent inconsistencies from developing. Only one person should be in charge of administering insulin injections to avoid overdose. Monitor blood and urine glucose levels daily to ensure there are no changes in the cat. Always keep corn syrup or honey easily accessible to prevent a diabetic emergency. If your cat is not diabetic, ongoing care may be needed to help restore normal liver or pancreas function. Sepsis treatment may involve antibiotic and other medication administration.