A 7-year old male castrated French Bulldog presented to Cornell University Hospital for Animal’s Emergency Service on 7/5 for hypoglycemia of at least three days duration that had been refractory to medical management. Clinical signs included generalized weakness, circling, and lethargy, which were consistent with the documented hypoglycemia.

Results for abdominal ultrasound, thoracic radiographs, complete blood count, serum biochemical profile, urinalysis, and urine sensitivity were largely unremarkable. Blood submitted for the insulin:glucose ratio showed a marked hyperinsulinemia in the face of profound hypoglycemia providing definitive evidence for the interpretation of abnormal production of insulin. Computed tomography revealed a solitary, well-circumscribed spherical nodule, 0.9 cm in size, in the right limb of the pancreas. The collective findings were consistent with an insulin-producing pancreatic carcinoma (insulinoma).

The treatment for insulinoma can either be approached conservatively through medical management or aggressively through a combination of surgical resection and medical management. Although limited in time and medication options, the patient had already proven refractory to moderate efforts at medical management with prednisone and the owner remained concerned about an unmanageable hypoglycemic crisis. Thus, it was elected to perform a partial pancreatectomy followed by medical management.

This seminar will report on a partial pancreatectomy for an insulinoma as well as provide a discussion on glucose homeostasis and an overview of insulinoma.