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Symptoms of Low Blood Sugar but Normal Labs
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Symptoms of Low Blood Sugar but Normal Labs

My dog has been having the symptoms of hypoglycemia for most of his life, which have started becoming severe lately. He has a serious food aversion from an illness he had as a puppy, so he tends to miss meals and be an extremely picky eater (an issue we are constantly working on). There are times he may go without eating much for nearly 24 hours and when this happens I give when Nutri-Cal or a product called Stat. But, he has started having seizures, which begin with odd behavior if he goes longer than 12 hours without food now. The behaviors are standing & staring at the corner of walls/doors, running crazy, & vomiting yellow-brown foam. His blood sugar tests are normal & all other tests were normal, so what might be causing these low blood sugar-like episodes and seizures?
(We have an appointment with our local vet per instructions of the specialist to get a prescription for Mirtazipine for his appetite).  
Type of Animal
:  
Dog
Age of Animal
:  
1 year
Sex of Animal
:  
Male
Breed of Animal
:  
Bolognese
Last date your pet was examined by a vet?
:  
July 31, 2012
City
:  
Martin
State/Province
:  
Tennessee
Country
:  
USA
Blood Test Results
:  
Non-fasting:
T4 - 4.0
Total  Protein - 6.0
Albumin - 3.6
AST (SGOT) - 28
BUN - 22
Phosphorus - 2.4
Magnesium - 1.8
Na/K Ratio - 38
Triglycerides - 41
Free T4 - 30
Globulin - 2.4
A/G Ratio - 1.5
ALT (SGPT) - 198
Creatinine - 0.7
Glucose - 118
Sodium - 150
Chloride - 115
Amylase - 400
Alk Phos - 40
GGTP - 10
Total Bilirubin - 0.1
BUN/CREATININE Ratio - 31
Calcium - 11.5
Potassium - 4.0
Cholesterol - 206
Lipase - 497
CPK - 114
WBC - 11.5
RBC - 6.39
Hemoglobin - 15.4
Hematocrit - 47.5
MCV - 74
MCH - 24.1
MCHC - 32.4
Platelet Count - 267
Platelet EST - Adequate
Neutrophils - 8395 (73%)
Bands - 0 (0%)
Lymphocytes - 2070 (18%)
Monocytes - 690 (6%)
Eosinophils - 345 (3%)
Basophils - 0 (0%)
Bile Acids: Fasting - <1.0
Bile Acids: Post - 15.0
X-Ray Results
:  
CT of Abdomen:
All organs normal, except dog has a Pelvic Bladder
Other pertinent test results
:  
(He has had an ongoing undetected UTI for most of his life. Urine is being cultured for proper medication to treat.)
UA:
WBC - Neg
Bilirubin - 2+
Urobilirubin - Norm
Absorbic Acid - 2+
Spec Grav - 1.021
Protein - 30
pH - 5.0
Nitrite - Neg
Blood - Neg
Ketones - Neg
Glucose - Neg
Sediment - Yes
Crystals - Positive
2054217_tn?1330542034
This is a very tricky case and I am not sure how much help I will be. Chronic hypoglycemia is often due to a hormonal imbalance or for older dogs a tumor attached to the pancreas (insulinoma). But in this case I wonder if your dog has epilepsy and is seizuring/hallucinating (staring at the wall) and the sympotms are being confused with a low blood sugar level. Hypoglycemia can cause seizures however primary epilepsy is more common. The neurologist will be able to help a lot.
Good luck.
2 Comments
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2154088_tn?1336595980
Thank you for your response. We have discovered that he has epilepsy and it was probably triggered by the first vaccine he received as a puppy. His brother had a severe reaction to the same vaccine, but my pup's reaction wasn't as noticeable at the time so it went undiagnosed. I'm told it is rather common in some toy breed puppies when they get their first vaccines. We are hoping it will not get any worse, as now he only has seizures a few times a month and the vet wants to take a wait and watch approach for now.
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