GlucagonDose, contraindications and adverse effects for Cats, Cattle and Dogs.

Pancreatic hormone that raises blood glucose by stimulating hepatic glycogen breakdown; used for severe hypoglycemia (e.g. insulin overdose) and diagnostically. In small animals, the primary use for glucagon is to increase blood glucose in patients with excessive insulin levels, either endogenously produced (insulinoma) or exogenously administered (insulin overdose). There is significant interest in its potential SC use in emergency home treatment of hypoglycemia in small animals. In human medicine and potentially for veterinary patients, glucagon

Dogs/Cats: IV dosing for severe hypoglycemia (extra-label): There are 2 pri- mary recommended dosing regimens; the available evidence does not support one over the other: Regimen 1: Glucagon 1 mg (NOT mg/kg) is reconstituted per manufacturer directions and then added to 1000 mL of 0.9% sodium chloride; this results in a 1000 nanogram/mL solution.

Glucagon’s main pharmacologic activities are to increase blood glucose and relax smooth muscles of the GI tract. It primarily increases blood glucose by stimulating hepatic glycogenolysis but can also increase glucose via hepatic gluconeogenesis from available amino acid substrates. Glucagon does not stimulate the reactive release of insulin or cause rebound hypoglycemia.

Glucagon should usually not be given to patients with pheochromocytoma, as catecholamines may be released, leading to hypertension. When glucagon is used for insulinoma, it must be in a setting where blood glucose can be closely monitored. Although glucagon may be useful for blood glucose elevation in insulinoma patients, its use for this indication in humans is cautioned, as it can stimulate insulin production, leading to greater hypoglycemia once the drug is discontinued.

Glucagon is usually well tolerated, but sedation and injection site reactions may occur. Potentially, nausea, vomiting, and diarrhea soon after administration are possible, which is increased if doses greater than 1 mg are administered. Hypokalemia and hypersensitivity reactions (very rare) are unlikely but possible.

■ Blood glucose ■ Serum potassium if used other than for acute treatment