Who’s Somogyi and why should I care?

If you have a diabetic pet, you’ll want to know about Dr. Somogyi. He was a scientist who developed the first insulin treatment given to a (human) child. He also discovered the “Somogyi Effect.” Oh, and it’s pronounced so-MOH-gee. This phenomenon is what makes regulating insulin doses in dogs and cats extra challenging.

If a dog or cat is getting too much insulin, the blood sugar will drop too low. This is bad. The body knows this, and tries to fix it.

sleeping white catSo, if the blood sugar drops very very rapidly, the brain detects the problem and says “help!!!” Always to the rescue are the liver and the adrenal glands. Hey, it takes a team effort! They release glucose that may be stored, make more glucose, and release hormones to help with making and releasing even more! The result? We now have a bunch of over-achievers who have over-shot their goal. The blood sugar was low, and now it is super high! The body has been saved, because these organs did their job.

However, it can make monitoring very tricky.

Let’s say you give the insulin at 7am. The blood sugar crashes at 10am, and by 11am, we’re hyperglycemic, with a sky-high blood sugar over 500! If we check the blood sugar then, we have no idea that it actually got too low. So what do we think? If the pet’s blood sugar is high, increase the insulin dose!

In this case, that only makes the problem worse.

The glucose drops more, then the spike is even higher. Sometimes owners will notice their pet becoming lethargic for a period, then mysteriously rebounding. That gives us a huge clue! These animals are often drinking and urinating a LOT, almost as if they are not getting insulin at all. This is because they spend most of the time with a very high blood sugar, and the low point is very brief.

This is why glucose curves are so nice. (here’s my article on monitoring) We check the glucose every couple hours, and we will see that change. Animals who are “somogyi-ing” as we call it, actually need their insulin dose lowered! This will avoid the dramatic drop, but lead to a more gradual decline in the blood sugar. Dogs and cats who experience this are often on very high doses of insulin. We never start an pet out on high doses, but over time the dose can creep up, then we get surprised with a somogyi.

While this is not super common, it happens enough to mention. Owners watching for the symptoms of hypoglycemia that miraculously heals itself can be a huge help in decoding this syndrome!

Diabetes is complicated! Check out the rest of the series:

Check out our podcast episode about diabetes. In an hour, we couldn’t even cover every detail, but you’ll learn and laugh with us along the way!


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Posted in Diabetes, Internal Medicine.

3 Comments

  1. Hi ,
    My 5 pound Maltese has Somogyi . She has not been regulated for 1 year and 1:2 to day she is 750 and I have a wonderful doctor and I trust her but I still feel I am missing something. Do you do Skype phone calls. I am crying my eyes out that I can’t gix this. It is Somogyi . We just switched from humility n to vestin. we pulled back from 1.5 to 1.00 . She is up and down, she gets her insulin st 4:00 am and 4:00 pm should I think about giving it later. Also I give her carrots at night before sleep she is starving all the time. Could carrots have an effect with Somogyi? I appreciate your help.

  2. Hi Anne Marie did you get your information and questions answered? Have you done a blood glucose curve? Diabetes I know can be extremely stressful for both your pet and owner. First things first. Have you thought about taking your pet to an internist veterinarian? A year and a half seems to be a long time….. to really get down to what could possibly be making it more difficult. Initially, it takes a specialist and a vet working together to treat your precious animal. For us we are on our way after 6 months of doctor visits, blood work, cushings testing , and making sure we are on the correct dosage of insulin. You start very low and slowly increase insulin depending on her numbers. for us, working with an internist veterinarian who only treats the disease was a gods send. Your veterinarian will agree I believe. I wish you all the luck and I hope in some way we have helped in some way. If you need moral support we are here. God speed and praying all will be well.

    • Don’t feed your dog carrots in middle of night. That throws off her blood glucose which you are trying to control …. it’s hard to hear them whine for food but stick to morning feeding and night feedings. I promise you it will all start to get easier and better. Consistency and timing is key for feeding and injecting. Every single day and night at same time.

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