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.

So, 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: