Traumatic Brain Injury And Blood Glucose

We're approaching the month of October - known for scary costumes and sugar overload. Why not look at a recent study about glucose to kick up our adrenaline? Okay, so this is a study in dogs and cats, specifically about traumatic brain injury and relationship between glucose and prognosis but don't shame me for trying to make a link to "current events"!


Background

This was a retrospective study (Cameron S, et al. JVECCs, 2021) looking at 131 dogs and 81 cats that were presented to one of two teaching hospitals following trauma and were diagnosed with traumatic brain injury (TBI). (TBI is the new term for head trauma, in case you're wondering.) At admission, glucose and a modified Glasgow Coma Scale, among other tests, were evaluated from the record and correlated to outcome. The animals were termed "survivors" if they lived to be discharged from the hospital and they were termed "non-survivors" if they, well, didn't.


Results

Here are the key points, and the interesting bits!

Dogs:

  • The MGCS was significantly lower in non-survivors compared to survivors.

  • Blood glucose concentration was significantly higher in non-survivors compared to survivors.

  • A cut off of 148 had a sensitivity of 73% and specificity of 76% for a poor outcome (non-survivor)

Cats:

  • The MGCS was the ONLY significant predictor of outcome

  • Glucose was not significantly related to outcome!


Take home message:
When presented with a post-traumatic patient, perform a serum blood glucose concentration and a neurologic examination (to get a MGCS). Both of those may be able to help you predict the outcome for a DOG (not cat) and guide the clients towards or away from referral if they are considering humane euthanasia. Naturally, we must account for co-morbidity, financial impact and prior medical conditions of the pet when faced with a post-traumatic patient but hopefully these two little points will further improve your ability to help the patient.

Thanks for reading! I hope you have a nice week and keep those consults coming!
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