Current Trends in Diagnosis, Treatment and Prognosis of Canine Insulinoma.

Abstract

Simple SummaryDogs can develop a tumour of the pancreas that produces too much insulin, which is called an ‘insulinoma’. These tumours cause signs such as collapse at exercise and very low blood sugar. Insulinomas are difficult to cure because they spread to other tissues very commonly. The diagnosis of an insulinoma requires the demonstration of the simultaneous occurrence of low blood glucose levels and either normal or elevated blood insulin levels. The diagnostic imaging of insulinomas in dogs is preferably conducted by taking computed tomography scans. In general, the surgical treatment of insulinomas is the preferred therapy because it results in the best survival times, but many dogs also require medical treatment at some point. The prognosis of dogs with insulinomas is guarded, because clinical symptoms relating to low blood sugar almost always return due to tumour regrowth or spread. This review paper aims to provide a summary and update the current recommendations in the veterinary literature for the diagnosis, treatment and clinical outcome of insulinomas in dogs. The contents of this review are comprehensive and relevant to veterinarians that work at all levels and will inform and advance our understanding of insulinomas in dogs.The most common pancreatic tumour in dogs is the insulinoma. Canine insulinomas are considered to be malignant in more than 95% of the cases because they almost always tend to metastasise. The diagnosis of an insulinoma requires the demonstration of the simultaneous occurrence of hypoglycaemia and blood insulin levels that are within or above the high end of the reference interval. The staging of canine insulinomas is preferably conducted by contrast-enhanced computed tomography. In general, surgical treatment is the most effective because of it results in long survival times, but many dogs also require medical treatment at some point. The prognosis of canine insulinomas is guarded as clinical hypoglycaemia almost always returns due to metastasis or tumour regrowth. This review aims to provide a summary and update the current recommendations in the veterinary literature for the diagnosis, treatment and prognostication of canine insulinomas.