Refractory Hypoglycemia in a Dog With Severe Zinc Intoxication

Area of Science:

• Veterinary Medicine
• Toxicology
• Internal Medicine

Background:

• Hypoglycemia is a common clinical sign in dogs, with various potential causes.
• Zinc toxicosis is typically associated with gastrointestinal signs and hemolytic anemia, but its association with hypoglycemia is not well-documented.

Observation:

• A 3-year-old spayed female Pug presented with lethargy and labored breathing.
• Diagnostic workup revealed hypoglycemia, regenerative anemia, azotemia, elevated liver enzymes, and metallic foreign bodies in the stomach.
• The dog's hypoglycemia was refractory to initial intravenous dextrose therapy.

Findings:

• Serum zinc concentration was significantly elevated at 32.28 µg/mL (reference interval, 0.8-1.8 µg/mL).
• Endoscopic removal of metallic foreign bodies led to a rapid normalization of blood glucose levels.
• This case highlights a novel presentation of zinc toxicosis causing refractory hypoglycemia.

Implications:

• Zinc toxicosis should be considered in cases of unexplained refractory hypoglycemia in dogs, especially with a history of foreign body ingestion.
• Early diagnosis and removal of the zinc source are crucial for successful management.
• This report expands the known clinical spectrum of zinc toxicosis in veterinary medicine.