insulinoma

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Ruthie - 08 Apr 2006 20:47 GMT

Hi all,
I've been reading this newsgroup for awhile and notice that there are a lot of knowledgable folks here. I hope you can help.

In December, my beloved 14-year old (female, spayed) fox terrier was diagnosed with hypoglycemia and in early January, with insulinoma with insulin ratio, x-rays and ultrasound. In mid-January, surgery was performed and the nodules removed were said to be 'consistent with insulinoma.' The pathology report said there was no metastasis to the liver; the surgeon found no other nodules.

After recovering from the surgery and about ten days of vomiting (pancreatitis) she was able to start keeping food down a little better. Her energy level increased and she seemed to feel really good - like a much younger dog. This went on for about two weeks, and then her energy level started to drop off again.

Long story short, two weeks ago she started having hypoglycemic episodes again - a blood test at my vet's was ~45, and one at the vet school where she had the surgery was 56.

From this blood test alone, they conclude that the insulinoma has grown back.

Is this reasonable? Should I insist on more testing?

They have me feeding her high protein/low carb cat food to avoid rebound hypoglycemia, and giving her 5 mg. predinisone twice a day. I think both of these things will do damage (kidneys and liver) while keeping her stable.

Any knowledge y'all are willing to share would be welcome.

Ruthie

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Ruthie - 08 Apr 2006 21:24 GMT

sorry: the values I mentioned are _glucose_ levels...

Ruthie

Hi all,
I've been reading this newsgroup for awhile and notice that there are a lot
of knowledgable folks here. I hope you can help.

In December, my beloved 14-year old (female, spayed) fox terrier was
diagnosed with hypoglycemia and in early January, with insulinoma with
insulin ratio, x-rays and ultrasound. In mid-January, surgery was performed
and the nodules removed were said to be 'consistent with insulinoma.' The
pathology report said there was no metastasis to the liver; the surgeon
found no other nodules.

After recovering from the surgery and about ten days of vomiting
(pancreatitis) she was able to start keeping food down a little better. Her
energy level increased and she seemed to feel really good - like a much
younger dog. This went on for about two weeks, and then her energy level
started to drop off again.

Long story short, two weeks ago she started having hypoglycemic episodes
again - a blood test at my vet's was ~45, and one at the vet school where
she had the surgery was 56.

From this blood test alone, they conclude that the insulinoma has grown
back.

Is this reasonable? Should I insist on more testing?

They have me feeding her high protein/low carb cat food to avoid rebound
hypoglycemia, and giving her 5 mg. predinisone twice a day. I think both of
these things will do damage (kidneys and liver) while keeping her stable.

Any knowledge y'all are willing to share would be welcome.

Ruthie

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josh - 08 Apr 2006 23:17 GMT

You could always repeat the insulin level to convince yourself.

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Ruthie - 09 Apr 2006 15:29 GMT

Hi, Josh -

Thanks for your response. Sorry I didn't answer sooner, but it seems that no
sooner did I get around to actually posting here, my news server went down.
I could _read_ your answer on a web site but didn't know how to post from
there...

You said insulin _level_ - I'm assuming that would measure just the insulin
in the blood, not as compared to glucose, which was the test she had before.

Would this still be accurate since she's taking prednisone?

Forgive me - I have no medical training - I have just tried very hard to
understand what is happening to my dear little fearless friend.

> You could always repeat the insulin level to convince yourself.

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josh - 09 Apr 2006 20:30 GMT

It's a valid question. Yes, insulin in the blood. Ideally, you'd do it
with no pred on board since pred causes insulin resistance, with a
subsequent rise in both blood glucose and insulin levels. However, and
perhaps one of the more experienced docs can correct me if I'm wrong, but in
my experience (two cases) of insulinoma, the insulin level in the blood is
so high that it can't really be caused by anything else. You additionally
would want to see elevated insulin in the presence of hypoglycemia to be
sure.

> Hi, Josh -
>
[quoted text clipped - 13 lines]
>
>> You could always repeat the insulin level to convince yourself.

Reply to this Message

Ruthie - 09 Apr 2006 22:10 GMT

Thanks, Josh. You are obviously a vet yourself, and I appreciate your
thoughts and your expertise. I'll ask the vet tomorrow.

I just worry that, if by some chance it's _not_ the tumor again, cat food
and prednisone can do a fair amount of harm themselves.

> It's a valid question. Yes, insulin in the blood. Ideally, you'd do it
> with no pred on board since pred causes insulin resistance, with a
[quoted text clipped - 22 lines]
>>
>>> You could always repeat the insulin level to convince yourself.

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josh - 09 Apr 2006 23:34 GMT

> Thanks, Josh. You are obviously a vet yourself,

Not quite yet. ONE...............MORE...............MONTH................

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buglady - 10 Apr 2006 00:20 GMT

> Not quite yet. ONE...............MORE...............MONTH................

.........got a job lined up?

buglady
take out the dog before replying

Reply to this Message

josh - 10 Apr 2006 02:27 GMT

>> Not quite yet.
>> ONE...............MORE...............MONTH................
>>
> .........got a job lined up?

Internship.