Prolonged survival in an aged Labrador retriever with a metastatic insulinoma

J Am Anim Hosp Assoc. 2013 May-Jun;49(3):224-9. doi: 10.5326/JAAHA-MS-5860. Epub 2013 Jan 16.

Abstract

This case report highlights an unusually prolonged, asymptomatic, disease-free interval in an aged male Labrador retriever that underwent partial pancreatectomy for a functionally active pancreatic insulinoma with histologically confirmed hepatic metastasis. The patient developed pancreatitis and nonseptic suppurative peritonitis 24 hr after surgical resection of the insulinoma and was managed medically until discharge. Three mo after surgery, the dog was diagnosed with exocrine pancreatic insufficiency (EPI) that was effectively managed with parenteral pancreatic enzymes. Due to normal glucose levels 3 mo postsurgically, liver samples from the initial surgery were resubmitted for immunohistochemistry. Results confirmed insulinoma metastasis with insulin expression. Ten mo postsurgically, the blood glucose was normal and serum insulin levels were slightly above the upper reference limit. The first hypoglycemic episode was documented 23 mo postoperatively, which was effectively managed with prednisone. The cause for the prolonged disease remission and survival was unknown, but was possibly a result of pancreatitis and peritonitis, partial spontaneous regression of metastatic lesions, or idiopathic. Despite life-threatening postoperative complications, this patient enjoyed a profoundly longer than expected survival. This case highlights the importance of removing the primary tumor (insulinoma) despite the presence of metastatic disease.

Publication types

  • Case Reports

MeSH terms

  • Animals
  • Blood Glucose / metabolism
  • Dog Diseases / mortality*
  • Dog Diseases / surgery
  • Dogs
  • Insulin / blood
  • Insulinoma / mortality
  • Insulinoma / secondary
  • Insulinoma / surgery
  • Insulinoma / veterinary*
  • Liver Neoplasms / pathology
  • Liver Neoplasms / veterinary*
  • Male
  • Pancreatectomy / adverse effects
  • Pancreatectomy / veterinary*
  • Pancreatic Neoplasms / mortality
  • Pancreatic Neoplasms / secondary
  • Pancreatic Neoplasms / surgery
  • Pancreatic Neoplasms / veterinary*
  • Treatment Outcome

Substances

  • Blood Glucose
  • Insulin