Insulin‐secreting tumours of the canine pancreas: Clinical and pathological features of 11 cases

Abstract

This paper describes the clinical and pathological features of 11 dogs with insulin‐secreting tumours of the pancreas. All the dogs showed episodic weakness or collapse. The diagnosis was made on fasting plasma glucose and serum insulin concentrations, the insulimglucose ratio, and the results of an intravenous glucose tolerance test. Ten of the dogs had exploratory laparotomy, and partial pancreatectomy was performed in nine of the cases. One case was euthanased at surgery because of widespread metastases. The tumours were graded histologically and the results compared with the time to recurrence of clinical signs and postoperative survival time. Postoperative survival time for dogs which died or were euthanased as a direct result of tumour recurrence, and time to recurrence of clinical signs were calculated from actuarial survival curves. The median time to recurrence of clinical signs after surgery was 12 months (range from four to 16 months; mean time to recurrence of clinical signs 12 months). Two cases died of unrelated disease, without recurrence of hypoglycaemic signs. The median postoperative survival time was 14 months (range 10 to 33 months; mean survival time 15 months). There is a suggestion that tumours with a high mitotic count carried a worse prognosis.

Improved survival in a retrospective cohort of 28 dogs with insulinoma

“…This involves exercise limitation and feeding of multiple small meals low in simple carbohydrates, corticosteroid therapy (0·25 to 2 mg/kg prednisolone twice daily, initially) and 5 mg/kg diazoxide therapy, twice daily, initially, introduced in a stepwise fashion according to response (Lurye and Behrend 2001, Feldman and Nelson 2004). Medical management of canine insulinoma is associated with a poor outcome (Tobin and others 1999) although isolated positive responses are described from within other published cohorts (Leifer and others 1986, Dunn and others 1993).…”

Hypoglycemia

“…[10][11][12][13][14][15][16][17][18][19] Patients often exhibit weakness or collapse, and severe hypoglycemia is an isolated finding. They are described more commonly in middle-aged to older dogs but have also been seen in cats.…”

"Utilização da ultra-sonografia em cães com suspeitas de neoplasias do sistema digestório (fígado, intestinos e pâncreas)"

“…Seus sinais clínicos são convulsões, fraqueza ou desmaios decorrentes da hipoglicemia (DUNN et al, 1993). O diagnóstico não cirúrgico desse tumor é difícil, mas os sintomas causados pela hipoglicemia, associados à hiperinsulinemia orgânica, fornecem o diagnóstico (DUNN et al, 1993).…”

“…Seus sinais clínicos são convulsões, fraqueza ou desmaios decorrentes da hipoglicemia (DUNN et al, 1993). O diagnóstico não cirúrgico desse tumor é difícil, mas os sintomas causados pela hipoglicemia, associados à hiperinsulinemia orgânica, fornecem o diagnóstico (DUNN et al, 1993). Como citado anteriormente, o insulinoma pode aparecer ultrasonograficamente como nódulos redondos ou lobulares, mas pode ser muito difícil detectar esses nódulos no lobo pancreático esquerdo, pois a sensibilidade do ultrasom é muito baixa nesse diagnóstico (LAMB et al, 1995).…”

“…Os sinais clínicos são convulsões, fraqueza ou desmaios decorrentes da hipoglicemia (DUNN et al, 1993), como verificado no único caso de insulinoma da amostra aqui estudada. Os sintomas causados pela hipoglicemia, em conjunto com a hiperinsulinemia orgânica, fornecem o diagnóstico não cirúrgico da neoplasia.…”