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1240 Hypoglycemia: Causes Hypomagnesemia

Hypoglycemia: Causes
VetBooks.ir Artifact Hepatic insufficiency Idiopathic hypoglycemia

Glucometers (especially those designed for
humans) Portocaval shunts* Neonatal hypoglycemia
Chronic fibrosis, cirrhosis
Juvenile hypoglycemia (esp. toy breeds)*
Delayed serum/plasma separation* Acute hepatic failure Hunting dog hypoglycemia (exercise)
Laboratory error Hepatic enzyme deficiencies Infection
Beta-cell tumor (insulinoma)* von Gierke’s disease (type 1 glycogen storage Sepsis*
Chronic kidney disease (rarely) disease) Babesia canis
Erythrocytosis (severe) Cori’s disease (type 3 glycogen storage disease) Bartonellosis
Extrapancreatic neoplasia Hypoadrenocorticism Trypanoxoma congolense
Hepatocellular carcinoma, hepatoma Hypopituitarism Leukocytosis (severe)
Renal adenocarcinoma Iatrogenic Starvation (prolonged)
Leiomyosarcoma, leiomyoma Insulin therapy* Toxins
Hemangiosarcoma (rarely) Sulfonylurea therapy/accidental exposure Xylitol*
Others Ethanol Oleander
Exocrine pancreatic neoplasia Ethylene glycol Ethanol/ethylene-glycol
Alpha-lipoic acid
*Particularly important causes of hypoglycemia.

Hypokalemia*: Causes

Decreased Intake or Absorption Increased Loss Drugs and Toxins
Decreased intake (unlikely as sole factor) Vomiting of stomach contents Loop diuretics (e.g., furosemide, ethacrynic acid)
Administration of potassium-free (e.g., 0.9% Diarrhea Thiazide diuretics (e.g., chlorothiazide,
NaCl, 5% dextrose in water) or deficient Osmotic diuresis (e.g., uncontrolled diabetes hydrochlorothiazide)
fluids (e.g., lactated Ringer’s solution over mellitus) Insulin
several days) Chronic renal failure in cats Beta-2 agonists (e.g., albuterol, terbutaline,
Bentonite clay ingestion (e.g., cat litter) Diet-induced hypokalemic nephropathy in cats dobutamine)
Translocation (ECF → ICF) Distal (type I) renal tubular acidosis (RTA) Theophylline intoxication
Alkalemia Proximal (type II) RTA after NaHCO 3 treatment Amphotericin B
Insulin/glucose-containing fluids Fanconi syndrome Penicillins
Catecholamines Postobstructive diuresis Rattlesnake envenomation
Thyrotoxicosis Dialysis Pseudoephedrine, ephedrine
Hypothermia Plasmapheresis Granulocyte colony stimulating factor
Hypokalemic periodic paralysis (Burmese cats) Hyperadrenocorticism (mineralocorticoid excess) (pharmacologic dosage)
Total parenteral nutrition Primary hyperaldosteronism (adenoma, Licorice ingestion (natural licorice, not common
Refeeding syndrome adenocarcinoma, hyperplasia) candies)
Hereditary disorders as yet undescribed in dogs Sodium phosphate enemas
or cats (e.g., Bartter syndrome, Gitelman
syndrome, Liddle syndrome)
*Hypomagnesemia is a common concurrent electrolyte disturbance that can be caused by the same initiating factor as hypokalemia and that can itself increase urinary potassium loss.
Modified from DiBartola SP, De Morais HA: Disorders of potassium, hypokalemia and hyperkalemia. In DiBartola SP: Fluid, electrolyte, and acid-base disorders in small animal practice, ed 4, St. Louis,
2012, Saunders.

Hypomagnesemia

Gastrointestinal Intrinsic renal causes of diuresis Cyclosporin
Reduced intake/starvation/malnutrition Postobstructive Cisplatin
Chronic diarrhea Polyuric acute kidney injury/uremia Postrenal transplantation
Gastric suction Hyperaldosteronism Familial or inherited
Malabsorption syndromes Hyperthyroidism Miscellaneous
Short bowel syndrome Renal tubular acidosis Excessive loss from
Gastric bypass surgery Concurrent electrolyte disorders Sweat
Colonic neoplasia Hypokalemia Lactation
Familial or inherited Hypercalcemia/hyperparathyroidism Redistribution
Renal Hypophosphatemia Acute myocardial infarction
Diabetes mellitus/diabetic ketoacidosis Drugs Acute pancreatitis
Diuretics (except potassium-sparing agents) Gentamicin Insulin
Osmotic agents (including hyperglycemia) Carbenicillin Catecholamine excess
Ticarcillin Idiopathic
From DiBartola S: Fluid, electrolyte, and acid-base disorders in small animal practice, ed 4, St. Louis, 2012, Saunders.
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