Neonatal Hypoglycemia

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Neonatal Hypoglycemia

Neonatal Hypoglycemia is a common cause of death in newborn piglets. It can occur when piglets don’t get enough milk.

Neonatal Hypoglycemia in a piglet

Neonatal Hypoglycemia also known as baby pig disease.

Etiology

Insufficient milk ingestion by newborn piglets in their first few days of life or piglets affected with any disease which interferes with milk intake or that have enteropathy and are unable to digest milk.

Epidemiology

  • Most common in piglets under 3 days old.
  • Sows have insufficient milk.
  • Morbidity 30-70%
  • Mortality 100%.
  • Occurs in twin or triplet lambs exposed to hypothermia.
  • Occurs rarely in calves with diarrhea.
  • Occurs in premature foals

Pathogenesis

  • The piglet is born with liver glycogen levels which may be as high as 200 mg/g WW while muscle glycogen may reach 120 mg/g WW
  • The blood glucose level at birth is low at 30-60 mg/dL (1.66-3.33 mmol/L) and increases rapidly after feeding on colostrums to 95 mg/dL (5.25 mmol/L)
  • Satisfactory gluconeogenesis does not develop in piglets until the 7th day after birth, and during this period glycogen stores are likely to be rapidly exhausted if the intake of milk is restricted.
  • The blood glucose level is then extremely unstable and dependent entirely upon dietary sources. The first week of life is thus the danger period
  • Deprivation of food after this produces only loss of weight and has no effect on blood glucose levels.
  • Signs appear first when blood glucose levels fall to about 50 mg/dL (2.775 mmol/L), although further depression to levels as low as 7 mg/dL (0.388 mmol/L) has been observed.
  • The hypoglycemic comatose state induced in piglets by fasting occurs as blood glucose values fall below 40 mg/dL (2.2 mmol/L)

Clinical Signs

  • In coordination is apparent first and the piglet has progressive difficulty in maintaining balance until recumbency becomes permanent.
  • Shivering, dullness, and anorexia, and often a typical weak squeal.
  • Subnormal rectal temperature and the cold, clammy skin which also evidences marked pallor and ruffling of the hair.
  • The heart rate becomes increasingly feeble and slow and may fall as low as 80/min.
  • Aimless movements of the head and forelimbs to severe tetanic convulsions.
  • Violent galloping movements, particularly with the hind legs, opisthotonos, an champing of the jaws.
  • Tortuous movements and rigidity of the neck and trunk also occur.
  • Terminally, coma develops and death follows 24-36 h after the onset of signs.
  • The clinical findings are similar in other species with weakness, in coordination, hypothermia, eventual recumbency, and coma being characteristic. The nervous signs are most common in the piglet and not seen in the other species.

Clinical Pathology

  • Blood glucose levels of less than 50 mg/dL (2.8 mmol/L) in piglets are considered to indicate clinical hypoglycemia.
  • The hypoglycemic comatose state induced in piglets by fasting occurs as blood glucose values fall below 40 mg/dL (2.2 mmol/L).
  • Significant rises in blood non-protein nitrogen and urea nitrogen are often observed but appear to be related to catabolism rather than to renal dysfunction.

Differential Diagnosis

  • Piglets:
    • Coliform septicemia
    • Transmissible gastroenteritis
    • Viral encephalomyelitis
    • Other septicemias
  • Lambs:
    • Watery mouth disease
    • Hypothermia
  • Calves:
    • Coliform septicemia
    • Bacterial meningitis
    • Dehydration and acidosis associated with enterotoxigenic colibacillosis

Treatment

  • Piglets with primary hypoglycemia should be given glucose (15 mL of 20% solution) IP repeated every 4-6 h until the animal will suck a foster dam or drink an artificial diet.
  • Protection from cold.
  • Hypoglycemia and hypothermic lambs can be resuscitated by an IP injection of a 20% solution of glucose at a rate of 10 ml/ kg body weight followed by rewarming the air at 40°C (104°F).

Control

  • Piglets should be carefully observed during the first week of life for early signs of any disease and treatment instituted promptly.
  • Maintenance of a stable environmental temperature at 32°C (90°F may delay the onset of the disease, or in marginal circumstances prevent its occurrence.
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