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Home / Equine Research Bank / J Vet Intern Med / Presumed Neuroglycopenia Caused by Severe Hypoglycemia in Ho...
Journal of veterinary internal medicine2018; 32(5); 1731-1739; doi: 10.1111/jvim.15245

Presumed Neuroglycopenia Caused by Severe Hypoglycemia in Horses.

Abstract: Neuroglycopenia refers to a shortage of glucose in the brain resulting in neuronal dysfunction and death if left untreated. Presumed neuroglycopenia has not been described in horses. Objective: To report neurological signs in horses with presumed neuroglycopenia as the result of severe hypoglycemia. Methods: Ninety horses (hours to 28 years of age) diagnosed with hypoglycemia (blood glucose concentration < 75 mg/dL [< 4.2 mmol/L]). Methods: Retrospective study. Electronic medical records were searched. Signalment, history, complaint, clinical signs, laboratory findings including CSF analysis, electroencephalogram, clinical or definitive diagnosis, and outcome were recorded. Kruskal-Wallis analysis of variance and logistic regression were used to investigate association between blood glucose concentration and data extracted. Statistical significance was set at P < 0.05. Results: Thirty-eight and 52 horses had mild (50-74 mg/dL [2.8-4.1 mmol/L]), and severe hypoglycemia (< 50 mg/dL [< 2.8 mmol/L]), respectively. Most common causes of hypoglycemia included liver and gastrointestinal (40%) disease, sepsis (33%), neoplasia (7%), and insulin-induced (4%). Most common neurologic deficits included obtundation (100%), seizures (42%), and disorientation (22%). CSF-glucose was severely low (mean 2.5 mg/dL [0.1 mmol/L], median 0 mg/dL). Paroxysmal discharges in support of seizures were identified in the occipital (visual) and parietal (closest to temporal-auditory) cortical regions upon EEG examination (8/8 horses). Conclusions: Neuroglycopenia is presumed to occur in horses as the result of severe hypoglycemia. Subclinical seizures, and intermittent blindness and deafness of cortical origin can occur. Severe altered state of consciousness and seizures can be observed at a blood glucose cut-off value of < 42 mg/dL (< 2.3 mmol/L).
Copyright © 2018 The Authors. Journal of Veterinary Internal Medicine published by Wiley Periodicals, Inc. on behalf of the American College of Veterinary Internal Medicine.
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Publication Date: 2018-08-07 PubMed ID: 30084236PubMed Central: PMC6189342DOI: 10.1111/jvim.15245Google Scholar: Lookup
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  • Journal Article

Summary

This research summary has been generated with artificial intelligence and may contain errors and omissions. Refer to the original study to confirm details provided. Submit correction.

The study provides an inquiry into neuroglycopenia, a condition brought about by a lack of glucose in the brain, and its occurrence in horses due to severe hypoglycemia. It analyzes a range of neurological signs in these animals, including the frequency of various neurologic deficits and the common causes behind hypoglycemia.

Methodology

  • The study involved a retrospective examination of 90 horses, aged anywhere between a few hours and 28 years, which were diagnosed with hypoglycemia. The condition was signified by a blood glucose concentration of less than 75 mg/dL.
  • Included in the study’s methodology was an exploration of medical records and the use of the Kruskal-Wallis analysis of variance and logistic regression. This was to investigate the association between the level of blood glucose concentration and the extracted data.
  • Key factors considered throughout the study included signalment, history, complaint, clinical signs, laboratory findings among which were results from CSF analysis and electroencephalogram, and the clinical or definitive diagnosis. Also recorded were the outcomes.

Results

  • The study found that out of the 90 horses, 38 experienced mild hypoglycemia, while the remaining 52 suffered from severe hypoglycemia.
  • Most common causes of hypoglycemia were linked to liver and gastrointestinal (40%) disease, sepsis (33%), neoplasia (7%), and insulin-induced instances (4%).
  • Findings also revealed that among the most common neurologic deficits in horses with hypoglycemia were obtundation, seizures, and disorientation.
  • Severe levels of low CSF-glucose were noted, with paroxysmal discharges in support of seizures detected in certain regions of the brain according to EEG examinations.

Conclusions

  • The condition of neuroglycopenia is presumed to potentially occur in horses as a result of severe hypoglycemia, as the authors conclude.
  • Among the consequences of the condition can be subclinical seizures and intermittent loss of sight and hearing of cortical origin.
  • The study notes that an altered state of consciousness and seizures can possibly be observed when blood glucose levels fall below a certain value.

Cite This Article

APA
Aleman M, Costa LRR, Crowe C, Kass PH. (2018). Presumed Neuroglycopenia Caused by Severe Hypoglycemia in Horses. J Vet Intern Med, 32(5), 1731-1739. https://doi.org/10.1111/jvim.15245

Publication

Journal of veterinary internal medicine
ISSN: 1939-1676
NlmUniqueID: 8708660
Country: United States
Language: English
Volume: 32
Issue: 5
Pages: 1731-1739

Researcher Affiliations

Aleman, M
  • From the Departments of Medicine and Epidemiology (Aleman, Costa), Population Health and Reproduction (Kass), and The William R. Pritchard Veterinary Medical Teaching Hospital (Crowe); School of Veterinary Medicine, University of California, Davis.
Costa, L R R
  • From the Departments of Medicine and Epidemiology (Aleman, Costa), Population Health and Reproduction (Kass), and The William R. Pritchard Veterinary Medical Teaching Hospital (Crowe); School of Veterinary Medicine, University of California, Davis.
Crowe, C
  • From the Departments of Medicine and Epidemiology (Aleman, Costa), Population Health and Reproduction (Kass), and The William R. Pritchard Veterinary Medical Teaching Hospital (Crowe); School of Veterinary Medicine, University of California, Davis.
Kass, P H
  • From the Departments of Medicine and Epidemiology (Aleman, Costa), Population Health and Reproduction (Kass), and The William R. Pritchard Veterinary Medical Teaching Hospital (Crowe); School of Veterinary Medicine, University of California, Davis.

MeSH Terms

  • Aging
  • Animals
  • Animals, Newborn
  • Blood Glucose
  • Brain / metabolism
  • Central Nervous System Diseases / etiology
  • Central Nervous System Diseases / veterinary
  • Female
  • Glucose / metabolism
  • Horse Diseases / etiology
  • Horses
  • Hypoglycemia / complications
  • Hypoglycemia / veterinary
  • Male
  • Retrospective Studies

Grant Funding

  • Gifts from anonymous donors

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Citations

This article has been cited 4 times.
  1. Vinardell T, Elestwani S, Jamieson C, Karim E, Robin M, Glynn S, Benini R, Aleman M. Electroencephalographic evaluation under standing sedation using sublingual detomidine hydrochloride in Egyptian Arabian foals for investigation of epilepsy. J Vet Intern Med 2023 May-Jun;37(3):1209-1215.
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  2. Kinsella HM, Hostnik LD, Snyder HA, Mazur SE, Kamr AM, Burns TA, Mossbarger JC, Toribio RE. Comparison of insulin sensitivity between healthy neonatal foals and horses using minimal model analysis. PLoS One 2022;17(1):e0262584.
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  4. Easton-Jones C, Woolard K, Mohr FC, Roy MA, Aleman M. Ganglioglioma of the Right Cerebrothalamus in a 7-Year-Old Quarter Horse Cross Gelding. Front Vet Sci 2019;6:356.
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