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.
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May/June 2013
Case Reports|
May 01 2013
Prolonged Survival in an Aged Labrador Retriever with a Metastatic Insulinoma
Jessica Rychel, DVM;
Jessica Rychel, DVM
Fort Collins Veterinary Emergency and Rehabilitation Hospital, Fort Collins, CO (J.R.); Flint Animal Cancer Center (D.W., C.H.) and Department of Clinical Sciences (D.W.), Dean’s Office of the College of Veterinary Medicine and Biomedical Sciences (C.H.), and Department of Microbiology, Immunology & Pathology (B.W.), Colorado State University, Fort Collins, CO.
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Deanna R. Worley, DVM, DACVS;
Fort Collins Veterinary Emergency and Rehabilitation Hospital, Fort Collins, CO (J.R.); Flint Animal Cancer Center (D.W., C.H.) and Department of Clinical Sciences (D.W.), Dean’s Office of the College of Veterinary Medicine and Biomedical Sciences (C.H.), and Department of Microbiology, Immunology & Pathology (B.W.), Colorado State University, Fort Collins, CO.
Correspondence: [email protected] (D.W.)
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Christine S. Hardy, MBA, MPH, DVM;
Christine S. Hardy, MBA, MPH, DVM
Fort Collins Veterinary Emergency and Rehabilitation Hospital, Fort Collins, CO (J.R.); Flint Animal Cancer Center (D.W., C.H.) and Department of Clinical Sciences (D.W.), Dean’s Office of the College of Veterinary Medicine and Biomedical Sciences (C.H.), and Department of Microbiology, Immunology & Pathology (B.W.), Colorado State University, Fort Collins, CO.
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Brett T. Webb, DVM
Brett T. Webb, DVM
*
Fort Collins Veterinary Emergency and Rehabilitation Hospital, Fort Collins, CO (J.R.); Flint Animal Cancer Center (D.W., C.H.) and Department of Clinical Sciences (D.W.), Dean’s Office of the College of Veterinary Medicine and Biomedical Sciences (C.H.), and Department of Microbiology, Immunology & Pathology (B.W.), Colorado State University, Fort Collins, CO.
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J Am Anim Hosp Assoc (2013) 49 (3): 224–229.
Citation
Jessica Rychel, Deanna R. Worley, Christine S. Hardy, Brett T. Webb; Prolonged Survival in an Aged Labrador Retriever with a Metastatic Insulinoma. J Am Anim Hosp Assoc 1 May 2013; 49 (3): 224–229. doi: https://doi.org/10.5326/JAAHA-MS-5860
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