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Blood biochemistry: glucose
Overview
- Physiological plasma levels of glucose are maintained by glucagon (raises glucose) and insulin (lowers glucose) to ensure that a continuous supply of glucose is available as an energy source for cell metabolism.
- Absorbed via small intestine.
- Stored as glycogen in liver and muscle and liberated when plasma levels fall.
- Other hormones can raise plasma glucose by increasing gluconeogenesis or glycogenolysis or increasing/decreasing utilization.
- Any condition which affects these hormones will influence plasma glucose levels.
- Hypoinsulinism (diabetes mellitus) → hyperglycemia.
- Epinephrine (adrenaline), cortisol, growth hormone, progesterone → increase glucose levels.
Uses
Alone
- Diabetes mellitus (relatively rare in rabbits).
- Insulinoma.
- Iatrogenic overdose (Somogyi effect) in the diabetic animal.
In combination
- Fructosamine Serum fructosamine (not validated in rabbits) for differentiating stress induced increases from diabetes mellitus.
- Fructosamine or glycosylated hemoglobin to assess mean glucose concentration status over last 2-3 weeks, or 4-8 weeks, respectively.
- Insulin assay: for insulinoma (insulin-secreting tumor of pancreatic beta cells) and diabetes.
Other points
- Stress can raise blood glucose levels above normal range.
- Convulsions can elevate blood glucose
Sampling
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Tests
Methodologies
Screening- Dextrostix used with whole blood only, gives a semiquantitative indicator of gross changes in plasma glucose.
- In-house glucometers (calibrated for dogs and cats) may be used but are not calibrated for rabbits.
Specific assays
- Glucose oxidase reaction - results said to approach true glucose value under reliable laboratory conditions.
- Ortho-toluidine - also measures galactose and mannose, but these are considered insignificant; simple, fast test.
Non-specific assays
- Nelson-Somogyi and Folin-Wu - may give slightly higher than true levels, the former more specific than the latter.
- Ferricyanide - approaches true glucose level.
Technique intrinsic limitations
- Some laboratory methods affected by presence of enzyme inhibitors/activators.
Result Data
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Further Reading
Publications
Refereed papers
- Recent references from PubMed and VetMedResource.
- Harcourt-Brown F M & Harcourt-Brown S (2012) Clinical values of blood glucose measurement in pet rabbits. Vet Rec 170 (26), 674 PubMed.
- Benson K G & Paul-Murphy J (1999) Clinical pathology of the domestic rabbit: acquisition and interpretation of samples. Vet Clin North Am Exotic Anim Pract 2 (3), 539-552 PubMed.
Other sources of information
- Varga M (2014) Textbook of Rabbit Medicine. 2nd edn. Butterworth Heinemann Elsevier, USA.
- Wesche P (2014) Clinical Pathology. In: BSAVA Manual of Rabbit Medicine. Eds: Meredith A & Lord B. BSAVA, UK.
- Harcourt-Brown F M & Harcourt-Brown S (2012) Clinical Value of Blood Glucose Measurement in Pet Rabbits. Vet Rec 170, 26.
- Fudge A M (1999) Laboratory Medicine. Avian and Exotic Pets. W B Saunders Co. ISBN 0721 676 790.