A do and owner at the vets getting a diagnosis

Hypoglycemia in Dogs

Hypoglycemia - aka low blood sugar - is something talked about in terms of human health a great deal. But the fact is that this condition - hypoglycemia is a condition, not a disease in itself - can affect your pet dog too, and for many reasons.

What is hypoglycemia?

Hypoglycemia is the medical term used to describe low levels of sugar in the blood.

What is the difference between hyperglycemia and hypoglycemia?

Hyperglycemia occurs when blood sugar levels are too high. Hypoglycemia sets in when blood sugar levels are too low.

Some people confuse it with diabetes, but while the two are often associated with each other they aren't the same thing. In diabetic dogs, low blood sugar is usually a sign that something is off with their medication.

The reason low blood sugar in dogs - and other mammals including humans - is a problem is that the body needs sugar to create the energy to 'power' all kinds of critical bodily functions.

But low blood sugar is about more than just feeling tired and lethargic.

The brain needs sugar, converted into the form of glucose, to function. It cannot produce it by itself and so it needs to be carried there in the blood. 

Without adequate amounts of glucose (min. 70 milligrams per deciliter (mg/dL) the brain can rapidly lose its ability to function as it should, and brain damage and even death can occur, both in dogs and humans.

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What causes hypoglycemia in dogs?

Dog obesity

Obesity in pets can lead to a variety of health problems including diabetes mellitus. Hypoglycemia is most common in dogs with diabetes.

As previously mentioned, hypoglycemia is a condition or event, not a disease in itself. As such a number of underlying health problems can cause it occur. In dogs, these include liver and kidney disease, inadequate diet, malnutrition, hormone deficiencies and, in rare cases, pancreatic tumors

In particular, if a small breed dog does not have a high enough caloric intake they can develop hypoglycemia which can lead to lethargy, seizures, shaking and tremors.

One note: studies have recently been able to link excessive consumption of xylitol to canine hypoglycemia. That’s the stuff usually included in artificial sweetener and gum, so keeping your pup away from those is a must. Similarly, excess consumption of Sorbitol, which is used to make dog food more appealing can also lead hypoglycemia.

By far the most common cause in dogs however is poorly managed diabetes and excessive insulin consumption.

Dogs with the highest risk of developing diabetes include:

Insulin is used in diabetic patients - humans and animals - to regulate the blood sugar. This has to be very carefully measured and monitored, as giving a diabetic dog too much insulin - when his blood sugar levels are already higher than normal perhaps - can cause his body to 'panic' and process glucose too quickly, depleting it from his blood which will lead to hypoglycemia.


There are a number of visible signs that a pup's blood sugar is too low indicating hypoglycemia, including the following:

  • Unusually increased hunger, or, conversely, unusually decreased appetite
  • Shaking and tremors
  • Lethargy
  • Apparent confusion
  • Apparent vision problems
  • Apparent anxiety
  • Loss of consciousness
  • Seizures

These symptoms can also be signs of other medical problems, especially in a pup that has not been diagnosed as diabetic, and should never be ignored, especially as prompt medical treatment may be the only way to prevent brain damage and save his life.


Diagnosing hypoglycemia is relatively straightforward on the face of things. Via bloodwork and urinalysis your pup's blood sugar levels will be determined, and, if they are indeed low hypoglycemia is likely to be diagnosed.

What is less straightforward is determining why the episode has occurred. In dogs who are not diabetic this can lead to lots of tests, including CT scans of the organs to try to determine the underlying cause.

In pups already diagnosed as diabetic the vet - along with you - will need to determine what was wrong, but at a later time, as the first order of business has to be restoring normal blood sugar levels as quickly as possible before brain damage occurs.


The initial treatment for hypoglycemia depends on what symptoms you dog is experiencing. (U.S. Air Force photo by Airman 1st Class Clayton Lenhardt/Released)

In the short term, to restore blood sugar levels treatment may be as simple as giving him sugar to eat, in some form. If the pup can't eat, he can be injected with a glucose solution that will have the same effect. If a pup is very sick that will often be the first choice as it is the fastest acting.

Once blood sugar levels have been restored to normal, the underlying cause of the episode has to be addressed. In non-diabetic dogs this can be complicated and may call for weeks of testing and treatments. It's hard to generalize however as the causes and treatments vary widely.

In diabetic dogs the reasons for the episode of hypoglycemia will need to be discussed, and their treatment plan reviewed. Pet parents may also need to become better educated about how best to monitor and manage their pup's diabetes and in some cases medications may need to be changed. However, as every dog's experience of diabetes is unique it will be up to your vet to make those decisions.

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Costs of treating canine hypoglycemia and diabetes

In the case of dogs whose hypoglycemia episode is not caused by diabetes management issues then it is hard to estimate just how much the treatment of it might cost. You can expect to pay for an urgent vet visit, as well as for the cost of blood work and urinalysis, something that will cost somewhere between $200 and $500. Any further costs for treatment will depend on how an underlying cause is to be treated.

Pet parents of diabetic dogs already know that there are monthly costs to be met for their pup to keep them healthy. They need to see the vet more often than some other pups as their condition, and their medication, need to be monitored. If they take their pup to the vet to treat a hypoglycemic episode then they can expect to pay somewhere between $150 and $200, depending on their vet's fee schedule and any other treatment needed.

Recovery and prevention

Hypoglycemia itself can only be managed with proper diet and, in the case of diabetic dogs, the proper management of their medications. Diabetes itself in dogs is primarily a genetic disorder, and unlike is the case in humans, obesity has yet to be established as a major cause. However, research is still ongoing, and an obese dog is at risk of other health problems, so weight management is a must in general anyway.

Here are a few tips to help your pet lose the extra weight.

  • Keep track of the weight by regularly checking it.
  • Always use a measuring cup, don't free feed.
  • Feed at specific meal times
  • To reduce weight, eliminate treats.
  • Consider interactive toys, especially for dogs that stay indoors most of the time.
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Taking care of a diabetic pup, and preventing hypoglycemia, does take education, time and money on the part of pet parents, and a commitment to that is one that they must be willing to make. However, the good news is that with careful diet and medication management lots of pups live healthy, happy lives with diabetes, as long as they have lots of help from their humans and their vet.

In the case of diabetic dogs, the optimal diet is either a high complex carbohydratelow protein diet or a high protein–low carbohydrate diet. Here are the basic considerations when choosing a diet for a diabetic dog.

  • Choose complex carbs over simple carbs and keep it to <55% dry matter
  • Fiber should be kept between: 7% to 18% 
  • Protein should be highly-digestible and a high-quality protein is recommended. Keep proteins between <15% to 35% dry matter.
  • Fats should be <25% dry matter

Here are some of the best diabetic dog foods:

  • Royal Canin Veterinary Diet Glycobalance Formula Dry Dog Food [High levels of soluble and insoluble fiber and reduced fat levels] - available online at Chewy.
  • Zignature Lamb Limited Ingredient Formula Grain-Free Dry Dog Food [Another great kibble] - available online on Amazon.
  • Nulo Freestyle Limited+ Salmon Recipe Grain-Free [For both puppies & adults] - available online at Chewy.

Before making changes to your dog’s diet, it's important to consult your vet to make sure they are getting the appropriate nutrition for the stage of diabetes they are at.

Share Your Experience: Have a story about a hypoglycemia in your dog? What caused it and what were your experiences? Anything you can tell us to watch out for or advice you can give is very welcome. 

If you are concerned about your pet, visit or call your veterinarian – he/she is your best resource to ensure the health and well-being of your dog. This information is for informational purposes only and is not meant as a substitute for the professional advice of, or diagnosis or treatment by, your veterinarian with respect to your pet.

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