Nii Yasuyuki, Takahashi Emi, Tabata Miho, Furusato Shimon, Katsumata Masaya, Uechi Masami
JASMINE Veterinary Cardiovascular Medical Center, Yokohama 224-0001, Japan.
Laboratory of Nutrition of Veterinary Medicine, School of Veterinary Medicine, Azabu University, Sagamihara 252-5201, Japan.
Vet Sci. 2024 Feb 8;11(2):79. doi: 10.3390/vetsci11020079.
Hypoglycemia has not been previously reported as a postoperative complication of mitral valve repair (MVR) in dogs; however, the authors have encountered cases of hypoglycemia after MVR. This study aimed to determine the incidence of hypoglycemia in dogs after MVR and investigate its causes. Blood glucose levels were measured at multiple timepoints in dogs undergoing MVR. Simultaneously, insulin and glucagon blood concentrations in dogs with hypoglycemia preoperatively and postoperatively were compared to verify the physiological responses to hypoglycemia. Furthermore, risk factors for hypoglycemia, using variables selected based on the characteristics of MVR and dogs undergoing MVR, were examined prospectively. The incidence of hypoglycemia after MVR was 14.2%, and plasma glucagon concentrations increased in these dogs (mean: 260 pg/mL and 644 pg/mL pre- and postoperatively, < 0.001), whereas serum insulin concentrations decreased (median: 0.50 ng/mL and 0.29 ng/mL pre- and postoperatively, = 0.002). Therefore, hyperinsulinemia or hypoglucagonemia is unlikely to be the cause of postoperative hypoglycemia. The identified risk factors for hypoglycemia included low body weight and asymptomatic myxomatous mitral valve disease. Monitoring blood glucose levels after MVR should be included in the standard hospitalization plan to prevent hypoglycemic emergencies in dogs.
低血糖此前尚未被报道为犬二尖瓣修复术（MVR）的术后并发症；然而，作者遇到了MVR术后低血糖的病例。本研究旨在确定犬MVR术后低血糖的发生率并探究其原因。对接受MVR的犬在多个时间点测量血糖水平。同时，比较术前和术后低血糖犬的胰岛素和胰高血糖素血浓度，以验证对低血糖的生理反应。此外，前瞻性地研究了基于MVR和接受MVR犬的特征选择的变量作为低血糖的危险因素。MVR术后低血糖的发生率为14.2%，这些犬的血浆胰高血糖素浓度升高（术前和术后平均值分别为260 pg/mL和644 pg/mL，<0.001），而血清胰岛素浓度降低（术前和术后中位数分别为0.50 ng/mL和0.29 ng/mL，=0.002）。因此，高胰岛素血症或低胰高血糖素血症不太可能是术后低血糖的原因。已确定的低血糖危险因素包括体重低和无症状黏液瘤性二尖瓣疾病。MVR术后监测血糖水平应纳入标准住院计划，以预防犬的低血糖紧急情况。
