Other Causes of Hypoglycemia

Occasionally neoplasms other than insulinomas result in hypoglycemia. Mechanisms may include secretion of an insulin-like product and excessive glucose utilization by the tumor. Examples are leiomyoma, leiomyosarcoma, hepatocellular adenoma, and hepatocellular carcinoma.

Hypoglycemia may be found in samples in which the serum is not promptly separated from the red blood cells following clotting of the blood because the erythrocytes utilize glucose in vitro. This is a common mechanism for hypoglycemia and needs to be ruled out prior to considering other causes.

Xylitol, a sugar substitute used in candy, chewing gum and some toothpastes can be toxic to dogs. Xylitol, in dogs, is a potent stimulator of insulin release, promoting increased glucose uptake and utilization, resulting in hypoglycemia. Sepsis, especially endotoxemia, may also cause hypoglycemia probably related to both increased utilization by tissue and decreased glucose production. A marked reduction in functional hepatic mass may result in hypoglycemia due to the fact that there are too few hepatocytes to maintain normal glucose production. Hypoadrenocorticism may be associated with hypoglycemia probably due to low cortisol concentrations and subsequent decreased gluconeogenesis. Juvenile hypoglycemia can occur in neonatal canine toy and miniature breeds and may be caused by hepatic immaturity and insufficient gluconeogenesis relative to metabolic rate and glucose consumption.

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Veterinary Clinical Pathology: An Introduction Copyright © by Marion Jackson; Beverly Kidney; and Nicole Fernandez is licensed under a Creative Commons Attribution-NonCommercial-NoDerivatives 4.0 International License, except where otherwise noted.

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