Hypoglycaemia as a Paraneoplastic Syndrome Associated with Renal Adenocarcinoma in a Dog

Abstract

2005. Hypoglycaemia as a paraneoplastic syndrome associated with renal adenocarcinoma in a dog. Veterinary Research Communications, 29(8), 671^675

Pathology in Practice

“…In the study by Bryan et al 4 on primary renal neoplasia in 82 dogs, the most common hematologic abnormalities were neutrophilia (22/63), anemia (21/64), and thrombocytopenia (6/68). In addition to leukocytosis, there are other paraneoplastic syndromes reported for dogs with renal carcinomas, including hypertrophic osteopathy, 8,9 hypoglycemia, 10 and polycythemia, 11 although these were not observed in the dog of the present report. The cause of the dog’s resolved thrombocytopenia remains uncertain, although we favor disseminated intravascular coagulation or a paraneoplastic process as the leading differential diagnosis.…”

Paraneoplastic hypoglycemia in a diabetic dog with an insulin growth factor‐2–producing mammary carcinoma

“…Paraneoplastic hypoglycemia has been reported in animals in association with different tumor types, including non-b-cell neoplasms such as leiomyoma or leiomyosarcoma, 4-6 hepatocellular carcinoma, 7 and renal carcinoma. 8,9 To our knowledge, the association between paraneoplastic hypoglycemia and mammary carcinoma has not been reported in dogs. In people, carcinomas with ductal involvement frequently express IGF-2.…”

“…The most likely etiology of hypoglycemia was a paraneoplastic syndrome, as demonstrated by the inverse relationship between the presence of the mammary carcinoma and the serum glucose concentrations and the return of hyperglycemia following excision of the tumor. Paraneoplastic hypoglycemia has been reported in animals in association with different tumor types, including non‐β‐cell neoplasms such as leiomyoma or leiomyosarcoma, 4–6 hepatocellular carcinoma, 7 and renal carcinoma 8,9 . To our knowledge, the association between paraneoplastic hypoglycemia and mammary carcinoma has not been reported in dogs.…”

Hypoglycemia and its effect on the brain

“…When plasma glucose levels fall below 1 mmol/L (18 mg/dL), seizure activity, severe brain damage, coma, and death can occur as a result of neuronal dysfunction and cell death 4,6 . Neurological signs associated with hypoglycemia have been reported in critically ill dogs and cats with iatrogenic or endogenous hyperinsulinemia, septicemia, neonatal hepatopathy, portosystemic shunting, paraneoplastic syndrome, hypoadrenocorticism, and xylitol toxicicosis 31–43 …”

“…4,6 Neurological signs associated with hypoglycemia have been reported in critically ill dogs and cats with iatrogenic or endogenous hyperinsulinemia, septicemia, neonatal hepatopathy, portosystemic shunting, paraneoplastic syndrome, hypoadrenocorticism, and xylitol toxicicosis. [31][32][33][34][35][36][37][38][39][40][41][42][43] Hypoglycemia stimulates glucosensors, initiating compensatory mechanisms that increase plasma glucose concentrations, increase glucose delivery to and uptake by the brain, and alter glucose metabolic pathways ( Figure 1). These systemic and intracranial adaptive changes must be rapid and effective to prevent clinical signs of hypoglycemia and minimize brain cell damage.…”