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Insulinoma

By: Dr. Arnold Plotnick

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Diagnosis

Diagnostic tests are needed to identify insulinoma and exclude other diseases. Your veterinarian may recommend the following:

  • A complete blood count (CBC or hemogram) to identify infection, inflammation, anemia, or low platelet count

  • Serum biochemistry tests to identify hypoglycemia, evaluate your pet's general health and determine the effect of the insulinoma on other body systems

  • Urinalysis to evaluate kidney function and identify urinary infection

  • Serum insulin concentration paired with blood glucose concentration. The hallmark of insulinoma is the presence of a normal or high serum insulin concentration at the same time that the patient has a low blood glucose concentration. In patients with hypoglycemia from other causes, serum insulin concentrations usually are very low at the same time the patient is hypoglycemic.

  • Chest X-rays to determine if the insulinoma has spread to the lungs – a very rare occurrence

  • Abdominal X-rays to evaluate liver, spleen, and kidneys. Insulinomas are very small and cannot be identified on plain X-rays of the abdomen.

  • Abdominal ultrasound to evaluate the pancreas for presence of an insulinoma and the liver and abdominal lymph nodes for local spread of the insulinoma. Regional lymph nodes and liver are the most common sites for spread of insulinoma.

    Treatment for acute insulinoma may include the following:

  • Surgery to remove the tumor
  • Medical therapy
  • Emergency treatment with intravenous glucose to increase the patient's blood glucose concentration

    Long-term treatment:

  • Dietary therapy
  • Cortisone-like drugs like prednisone
  • Diazoxide, which is a drug that inhibits release of insulin from the insulinoma
  • Somatostatin
  • Chemotherapy, although it is not very effective for insulinoma

    Home Care and Prevention

    Administer as directed any medications prescribed by your veterinarian and follow any special dietary recommendations. Watch your dog carefully for signs of hypoglycemia and administer corn syrup orally if you see signs of hypoglycemia, such as seizures, weakness or muscle tremors.

    Observe your dog's general activity level, appetite and attitude. Watch for recurrence of clinical symptoms of hypoglycemia that may indicate recurrence of the tumor. Feed frequent small meals of a high carbohydrate diet to maintain adequate blood sugar concentration.

    Schedule regular follow-up visits with your veterinarian to monitor your dog's progress and promptly identify any recurrence of hypoglycemia and insulinoma.

    Keep your dog's exercise and activity level relatively constant. Avoid intensive exercise or provide high carbohydrate snacks before exercise.

    The cause of insulinomas is unknown, and consequently there is no way to prevent development. You can prevent a hypoglycemic crisis by following the dietary, exercise, and medical recommendations of your veterinarian.

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