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Gastrinoma

By: Dr. Bari Spielman

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Management of gastrinomas center on treatment of the tumor, inhibition of acid secretion, and, if necessary, control of hemorrhage. In cases of GI ulceration secondary to gastrinomas, initial symptomatic therapy might be of benefit. These treatments may reduce severity of symptoms or provide relief for your pet. However, conservative, symptomatic therapy is not a substitute for definitive treatment of gastrinomas.

  • Withholding food and water for several hours allows the GI tract to rest, and is important in treating the patient with GI ulceration secondary to any cause. Complete dietary restriction allows the lining of the GI tract to heal. Gradual reintroduction of small amounts of bland food should be instituted after the fast, and the pet should be maintained on a similar diet for weeks to months after the ulcer has been successfully treated.

  • Drugs that decrease or inhibit acid production by the stomach such as Tagamet (cimetidine), Pepcid (famotidine), Zantac (ranitidine), Cytotec (misoprostol) and Prilosec (omeprazole) encourage and expedite the resolution of GI ulcers.

  • Fluid and electrolyte therapy may be necessary in some patients with gastrointestinal ulceration, and is directed toward correcting dehydration, acid-base and electrolyte abnormalities. Additionally, blood transfusions may be indicated in the severely anemic patients.

  • Antiemetics, or drugs that stop vomiting, should be used with caution. Examples include Reglan (metoclopramide) or Thorazine (chlorpromazine). In selected cases their use may be recommended.

  • Gastrointestinal protectants and adsorbents are medications that protect or soothe and are felt to coat an irritated GI lining and bind "noxious" (harmful) agents. Examples include Carafate (sucralfate) and Pepto-Bismol (bismuth subsalicylate).

  • Ultimately, surgery may be indicated to remove the gastrinoma if it is operable and possibly to remove an area of continual hemorrhage associated with some bleeding ulcers that are not responsive to medical management.

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