Incidence and risk factors for intra-anesthetic hyperglycemia in 400 nondiabetic dogs: a retrospective cohort study

To determine the incidence of intra-anesthetic hyperglycemia and identify associated risk factors in nondiabetic dogs undergoing general anesthesia.

Retrospective, single-center cohort study.

A total of 400 client-owned, nondiabetic dogs anesthetized for surgical or diagnostic procedures between May and December 2024.

Medical records were reviewed to collect data on patient characteristics, anesthetic management and intra-anesthetic blood glucose concentrations measured via arterial blood gas analysis. Hyperglycemia was defined as blood glucose > 180 mg dL^-1 (10 mmol L^-1) and severe hyperglycemia as > 300 mg dL^-1 (16.7 mmol L^-1). Univariable and multivariable logistic regression analyses were performed to identify independent associated factors of hyperglycemia.

Intra-anesthetic hyperglycemia occurred in 14.8% (59/400) of dogs, and severe hyperglycemia was observed in 4.3% (17/400). Multivariable logistic regression identified the following independent risk factors for hyperglycemia: preanesthetic fasting glucose ≥ 100 mg dL^-1 (5.6 mmol L^-1) [odds ratio (OR) 4.40, 95% confidence interval (CI): 1.98-9.79, p < 0.001], American Society of Anesthesiologists physical status classification (ASA status) ≥ 3 (OR 2.78, 95% CI: 1.18-6.54, p = 0.019), medetomidine use (OR 4.62, 95% CI: 1.03-20.75, p = 0.046), undergoing surgery (OR 3.09, 95% CI: 1.21-7.85, p = 0.018), intra-anesthetic hypothermia < 36 °C (OR 3.09, 95% CI: 1.29-7.38, p = 0.011), dopamine (OR 22.75, 95% CI: 9.36-55.33, p < 0.001) and norepinephrine use (OR 4.63, 95% CI: 1.76-12.20, p = 0.002), with dopamine showing the strongest association.

Intra-anesthetic hyperglycemia occurred in nondiabetic dogs, with specific risk factors identified: elevated preanesthetic fasting glucose, ASA status ≥ 3, medetomidine use, surgery, intra-anesthetic hypothermia, dopamine and norepinephrine use. Patients with these risk factors may be predisposed to hyperglycemia, highlighting the importance of intra-anesthetic glucose monitoring.