Presumptive paraneoplastic syndrome in a Dalmatian

Abstract

This paper discusses the case of a 9 year old, spayed, female Dalmatian who presented with clinical signs consistent with lower motor neuron disease and was diagnosed with presumptive paraneoplastic syndrome secondary to insulinoma. The lower motor neuron clinical signs consisted of moderate to severe, generalized muscle wasting and rapidly progressive generalized weakness over the course of one month. Neurological examination revealed a short-strided gait in all four limbs, tetraparesis, decreased withdrawal reflexes in all four limbs, and collapse if forced to walk without assistance. The clinical signs and examination findings localized the lesion to the neuromuscular system. Initial labwork revealed a hypoglycemia (blood glucose 36 mg/dL), with the remainder of the bloodwork relatively unremarkable. An insulin level was performed, which revealed elevated levels over 200 uIU/mL (ref. 5-20). The clinical signs of lower motor neuron disease were presumptively due to a paraneoplastic syndrome secondary to the insulinoma, as other causes were not definitively ruled out with muscle/nerve biopsies.