Hypoglycemia post-anaesthetic in a Chihuahua

Re: Hypoglycemia post-anaesthetic in a Chihuahua

Andrew Kent — Fri, 04 Apr 2014 14:36:57 GMT

[quote user="Torunn Beurling"]

Thanks for that! Unfortunately we do not have an endoscope... But I guess I could try with sucralfate and ranitidine, couldnt hurt :)

[/quote]

Perhaps consider referring the dog to a centre with the facility for endoscopy?

Re: Hypoglycemia post-anaesthetic in a Chihuahua

Torunn Beurling — Fri, 04 Apr 2014 07:44:55 GMT

Thanks for that! Unfortunately we do not have an endoscope... But I guess I could try with sucralfate and ranitidine, couldnt hurt :)

Re: Hypoglycemia post-anaesthetic in a Chihuahua

Torunn Beurling — Fri, 04 Apr 2014 07:43:13 GMT

I am pretty sure it is vomiting, I have seen it. It usually happens approx. 5 min after eating, but she brings up only mucous, not food. However, the owners say they have tried her with dry food at home, and she brings that up straight away.

Re: Hypoglycemia post-anaesthetic in a Chihuahua

Joyce Whitehead — Thu, 03 Apr 2014 22:28:12 GMT

I have no further comments on the hypoglycemia, but it did just occur to me to ask are you sure that this dog is vomiting and not regurgitating saliva? I had a similar sounding case a year or two back (without the possibly unrelated hypoglycemia admittedly) - lots of gulping , bringing up mucous etc. He turned out to have phenobarbitone responsive sialedinitis. He is well controlled now, but I spent ages trying to find a cause of his vomiting, only to find he wasn't actually vomiting at all.....

Re: Hypoglycemia post-anaesthetic in a Chihuahua

Andrew Kent — Thu, 03 Apr 2014 21:10:51 GMT

The nausea is certainly worth investigating, but I would be doubtful the hypoglycaemia is a part of the disease, just a sequel. It is very unlikely your dog has an Insulinoma as the majority of those will barely get the blood glucose into the normal range even with therapy - this controls clinical signs but doesn't get normal figures. Remember if you do an insulin glucose ratio it needs to be taken at the time the dog is hypoglycaemic and before any therapy to be useful and interpretable.

Andy

Re: Hypoglycemia post-anaesthetic in a Chihuahua

Robin Grimmer — Thu, 03 Apr 2014 18:45:39 GMT

I agree. Stop the preds/nsaids and put the dog on some gastric protectants eg ranitidine and sucralfate.

Re: Hypoglycemia post-anaesthetic in a Chihuahua

ruths — Thu, 03 Apr 2014 18:30:49 GMT

I would get the dog off steroids and NSAIDs at this stage tbh. I agree with the small dog/ post GA starving hypoglycaemia But I'm interested in the vomiting. I in e had an EBT who wrecked her I esophagus by eating a stick. Her presenting sign was vomiting mucus but keeping food down. She struggled a bit to eat and made exaggerated swallowing movements too. I think what was Halle ing is thst the upset and ulcerated oesophagus was oozing mucus into the stomach and the dog was thwoing this nasty mix of inflammatory juice and acid back up a few times a day and this was causing more damage. She was managing to keep food down as it was more solid somehow ( not really sure why!!) It took me a little bit to work it out - I couldn't work out why she kept food down and vomited mucus ( it was def a vomit and not regurg as it was active and no food came up) I anaesthetised her to scope her and it made me wince to see the mess that her was her oesophagus. During that GA, I put in a per cutaneous stomach tube and we rested her oesophagus for a while. I have the owner a very guarded outlook as I thought there were some really deep erosions in the oesophagus. Being a bull terrier, she looked dreadful for 48 hrs and then was back to normal! I have no idea if this is what is going on with your little dog, but maybe she had some reflux during the GA and recovery and the hypoglycaemia and is now suffering from oesophagitis It sounds frustrating and I wish you luck

Re: Hypoglycemia post-anaesthetic in a Chihuahua

Gillian Mostyn — Thu, 03 Apr 2014 15:23:57 GMT

Certainly, in people, the first signs of hypoglycaemia (such as during endurance events) is nausea!

Re: Hypoglycemia post-anaesthetic in a Chihuahua

Torunn Beurling — Thu, 03 Apr 2014 15:17:06 GMT

I considered toy breed hypoglycemia.. But as low as 0,64mmol/l?? Also the licking around the mouth, hard swallowing and vomiting just does not add up. This poor dog has been vomiting every day for almost 2 months now, usually only bringing up mucous.

I will definitely check the insulin/glucose ratio, thanks for the tip!

Re: Hypoglycemia post-anaesthetic in a Chihuahua

Andrew Kent — Thu, 03 Apr 2014 13:43:09 GMT

[quote user="Robin Grimmer"]

Toy breed hypoglycaemia? Toy breeds are more susceptible to hypoglycaemia, especially puppies but can be seen in adults as well. A GA could have triggered this, especially with the fasting required before a GA. I would do an insulin:glucose ratio to rule out insulinoma as Gillian suggests.

[/quote]

I would agree that this is most likely breed related - I assume you starve the dog for a GA each time? Toy breed dogs are very prone to becoming hypoglycaemic with even short periods of fasting. As it has only been present after a GA its most likely that.

Equally if she has vomiting/regurg then her calorie intake is likely to be reduced.

Andy

Re: Hypoglycemia post-anaesthetic in a Chihuahua

Robin Grimmer — Thu, 03 Apr 2014 12:41:38 GMT

Re: Hypoglycemia post-anaesthetic in a Chihuahua

Gillian Mostyn — Thu, 03 Apr 2014 10:58:03 GMT

Insulinoma? The relation to anaesthetic could be more related to the pre-op starving than the drugs themselves?