Insulinoma

[hoochie1628]

Hi Guys,

just wondering if anyone has any advice for me. My dog is in the icu, and the specialist said he most likely has insulinoma with second degree brain damaged. first of all, this procedure is costing me a lot of money, and if it is confirmed on firday that he has insulinoma, I will perform surgury on him which will only prolong his life by 2 yrs max. I am so confused, and bothered by the issue, I don't know what to do...

[doglady]

My heart goes out to you. I never heard of Insulinoma before and did some research on it. It is hard knowing what to do when your friend is hurting. How old is he?

[sheplovr]

Oh honey, this is bad I pray your dog makes it and gets a few years left for you, this is costly also.



Insulinomas, the tumor of the pancreas that leads to low blood sugar and
high insulin production, will commonly metastasize (some people say this
tumor always metastasizes) and recurrences of the tumor after removal do
occur in most patients. It is a good idea to have chest X-rays taken prior
to making a surgical decision, since it would be much less likely to help
if there are already visible tumors in the chest. If there is a good
ultrasonagrapher in your area, an ultrasound exam can help to determine the
size of an insulinoma prior to surgery and help to determine if there is a
metastasis to the liver.

Surgery increases the lifespan of affected dogs because it helps to reduce
the amount of excessive insulin being produced by the tumors. This effect
is usually temporary because the tumor has usually spread. It isn't
possible to find all the tumors once this has happened and eventually there
will be a recurrence of the hypoglycemia. As an average, according to
information on the Veterinary Information Network, the interval before
return of clinical signs is about 8 months if there are already visible
metastases prior to surgery and about 14 months if there are no metastases
visible at the time of surgery. With a combination of medical and surgical
therapy, lifespans of about 2 years have been recorded for patients after
diagnosis of insulinoma.

It is risky to do surgery on patients who have low blood sugar. It is
probably best to have an experienced surgeon for this procedure. We have
removed insulinomas in our practice and the surgery itself is not all that
difficult but fluids with dextrose should be administered during surgery
and blood glucose monitored during surgery, as well. I am still more
comfortable referring these patients to a facility with twenty-four hour
care and board certified surgeons when possible.

After surgery, when hypoglycemia returns as a problem, medical therapy
works for a while to control clinical signs. Medical therapy includes
feeding many small meals, administration of prednisone and use of
diazoxide. There may be some addition information available to your vet by
calling a veterinary school, as there has been a small amount of work done
on specific chemotherapy agents for this condition and the use calcium
channel blockers (usually used to control blood pressure) as an aid in
controlling blood sugar since they sometimes lower it as a side effect to
their normal actions. It is possible to use medical therapy without doing surgery but surgical
removal of as much of the mass as possible helps more than anything else in
extending lifespan of patients with insulinomas. This is a temporary
effect, so you have to think about how important it is to you and your dog
to gain a year or so of time. There are a few dogs who actually seem to
recover completely post surgically but the percentage is probably less than
5% and may be even lower than that.

[Deb's Tiny Dogs]

Sheplover - I hope you are 100% sure that that dismal post reflects all current medical opinion.

I would contact a vet at a teaching university such as The Cumming's School of Veterinary Medicine at Tuft's University in North Grafton, MA. I trust them completely.

Contacting someone like them will help you make an informed decision.

Keep us updated!