Reassessing neonatal hypoglycemia in kittens: clinical relevance beyond the laboratory value

The underdeveloped metabolism in newborn kittens, along with the quick use of liver sugar reserves and the limited ability to produce glucose, makes them prone to low blood sugar levels during this time. This condition may be potentially fatal, although reduced blood glucose values do not necessarily manifest with clinical signs. Fifteen neonatal kittens born to three clinically healthy pregnant queens were evaluated during the first three days of life. Apgar scoring was done daily, and blood glucose measurements began within the first hour after birth (T1), followed by evaluations every 2 hours, with a total of six measurements each day from T2 to T6. Samples were obtained via capillary puncture with alternating digital pads and analyzed using a glucometer validated for cats. A total of 270 glycemic measurements were performed, demonstrating instability during the first hours of life. On the first day, there was a mean glucose concentration of 61.7± 22.2 mg/dL. On the second day, it dropped to 53.9± 16.5 mg/dL. On the third day, metabolic recovery occurred (68.5 ±14.7 mg/dL). All neonates maintained adequate Apgar scores and showed no clinical signs of hypoglycemia (< 50 mg/dL; weakness, apathy, or reduced suckling reflex). Marked fluctuations in blood glucose levels were observed during the first 48 hours, characterized by wide glycemic variability (22-165 mg/dL on day 1 and 21-86 mg/dL on day 2). A high frequency of hypoglycemic values was recorded, reaching 51.1% on the first day and 60% on the second, indicating initial metabolic instability despite intermediate mean glucose levels. Progressive stabilization was observed by the third day (range 26-95 mg/dL), with the rate of hypoglycemic events dropping to 22.2%, reflecting the maturation of neonatal metabolic homeostasis. Despite the laboratory diagnosis of hypoglycemia, none of the kittens exhibited clinical manifestations or required intervention.