Incidence and risk factors for intra-anesthetic hyperglycemia in 400 nondiabetic dogs: a retrospective cohort study

Objective To determine the incidence of intra-anesthetic hyperglycemia and identify associated risk factors in non-diabetic dogs undergoing general anesthesia. Study design Retrospective, single-center cohort study. Animals Four hundred client-owned, non-diabetic dogs anesthetized for surgical or diagnostic procedures between May and December 2024. Methods Medical records were reviewed to collect data on patient characteristics, anesthetic management, and intra-anesthetic blood glucose concentrations measured via arterial blood gas analysis. Hyperglycemia was defined as blood glucose > 180 mg dL -1 (10 mmol L -1 ) and severe hyperglycemia as > 300 mg dL -1 (16.7 mmol L -1 ). Univariable and multivariable logistic regression analyses were performed to identify independent associated factors of hyperglycemia. Results Intra-anesthetic hyperglycemia occurred in 14.8% (59/400) of dogs, and severe hyperglycemia was observed in 4.3% (17/400). Multivariable logistic regression identified the following independent risk factors for hyperglycemia: preanesthetic fasting glucose ≥ 100 mg dL -1 (5.6 mmol L -1 ) [odds ratio (OR) 4.40, 95% confidence interval (CI): 1.98–9.79, p < 0.001], American Society of Anesthesiologists physical status classification (ASA status) ≥ 3 (OR 2.78, 95% CI: 1.18–6.54, p = 0.019), medetomidine use (OR 4.62, 95% CI: 1.03–20.75, p = 0.046), undergoing surgery (OR 3.09, 95% CI: 1.21–7.85, p = 0.018), intra-anesthetic hypothermia < 36 °C (OR 3.09, 95% CI: 1.29–7.38, p = 0.011), dopamine (OR 22.75, 95% CI: 9.36–55.33, p < 0.001) and norepinephrine use (OR 4.63, 95% CI: 1.76–12.20, p = 0.002), with dopamine showing the strongest association. Conclusions and clinical relevance Intra-anesthetic hyperglycemia occurred in non-diabetic dogs, with specific risk factors identified: elevated preanesthetic fasting glucose, ASA status ≥ 3, medetomidine use, surgery, intra-anesthetic hypothermia, dopamine and norepinephrine use. Patients with these risk factors may be predisposed to hyperglycemia, highlighting the importance of intra-anesthetic glucose monitoring.