Ultrasound-aided diagnosis of an insulinoma in a cat

Summary

A 15-year old, neutered female, domestic shorthaired cat was presented for evaluation of a 3-month history of paroxysmal falling over and trembling. In laboratory work the cat displayed a mild hypoglycemia. Ultrasound revealed a nodule in the left pancreatic lobe and surgical excision was performed. The histological diagnosis was an insulinoma. To the authors knowledge this is the first ultrasound description of an insulinoma in a cat. Up to date the cat has a survival time of 32 months without recurrence of symptoms.

Zusammenfassung

Eine 15 Jahre alte, weiblich-kastrierte Europäisch Kurzhaarkatze wurde wegen seit ca. 3 Monaten bestehenden paroxysmalen Umfallens und Zitterns vorgestellt. Die blutchemische Untersuchung ergab eine mittelgradige Hypoglykämie. Sonographisch stellte sich eine Zubildung im linken Pankreaslappen dar. Bei der histopathologischen Untersuchung der chirurgisch entfernten Umfangsvermehrung wurde ein Insulinom diagnostiziert. Nach Kenntnis der Autoren stellt dieser Fall die erste Beschreibung eines sonographisch dargestellten Insulinoms bei einer Katze dar. Bis heute hat die Katze eine Überlebenszeit von 32 Monaten, ohne dass erneut entsprechende Symptome auftraten.

Key words

Endocrine neoplasia - pancreas - ultrasonography - surgery - feline insulinoma

Schlüsselwörter

Endokrine Neoplasie - Pankreas - Ultraschall - Chirurgie - felines Insulinom

• References

• 1 Baudoin M. Les troubles endocriniens du furet (Mustela putorius furo). Doctorate thesis, Université de Toulouse; FR: 2004
• 2 Chatziioannou A, Kehagias D, Mourikis D. et al. Imaging and localization of pancreatic insulinomas. J Clin Imaging 2001; 25: 275-283.
• 3 Gaschen L, Kircher P, Lang J. Endoscopic ultrasound instrumentation, applications in humans, and potential veterinary applications. Vet Radiol Ultrasound 2003; 46: 665-680.
• 4 Goutal CM, Brugmann BL, Ryan KA. Insulinoma in dogs: A review. J Am Anim Hosp Assoc 2012; 48: 151-163.
• 5 Greene SN, Bright RM. Insulinoma in a cat. J Small Anim Pract 2008; 49: 38-40.
• 6 Hawks D, Peterson ME, Hawkins KL, Rosebury WS. Insulin-secreting pancreatic (islet cell) carcinoma in a cat. J Vet Intern Med 1992; 06: 193-196.
• 7 Hecht S, Penninck DG, Keating JH. Imaging findings in pancreatic neoplasia and nodular hyperplasia in 19 cats. Vet Radiol Ultrasound 2007; 48: 47-50.
• 8 Jackson T, Debey B, Lindbloom-Hawley S. et al. Cellular and molecular characterization of a feline insulinoma. J Vet Intern Med 2009; 23: 383-387.
• 9 Kraje AC. Hypoglycemia and irreversible neurologic complications in a cat with insulinoma. J Am Vet Med Assoc 2003; 223 810, 812-814.
• 10 Kyles AE. Endocrine Pancreas. In: Textbook of Small Animal Surgery. 3rd ed. Slatter AE. ed. Philadelphia: Saunders; 2003: 1724-1736.
• 11 Lamb CR, Simpson KW, Boswood A, Matthewman LA. Ultrasonography of pancreatic neoplasia in the dog: A retrospective review of 16 cases. Vet Rec 1995; 137: 65-68.
• 12 Lu CH, Hua SC, Wu CJ. Pancreatic insulinoma presenting with episodes of hypoinsulinemic hypoglycemia in elderly – A case report. J Intern Med Taiwan 2008; 19: 432-436.
• 13 Mahoney P. The Adrenal Glands. In: BSAVA Manual of Canine and Feline Abdominal Imaging. O’Brien R, Barr F. eds. Gloucester: British Small Animal Veterinary Association; 2009: 177-184.
• 14 MaiI W, Cáceres AV. Dual-phase computed tomographic angiography in three dogs with pancreatic insulinoma. Vet Radiol Ultrasound 2008; 49: 141-148.
• 15 McMillan FD, Barr B, Feldman EC. Functional pancreatic islet cell tumor in a cat. J Am Anim Hosp Assoc 1985; 21: 741-746.
• 16 Mellanby RJ, Herrtage ME. Insulinoma in a normoglycaemic dog with low serum fructosamine. J Small Anim Pract 2002; 43: 506-508.
• 17 Morandi F. The Pancreas. In: BSAVA Manual of Canine and Feline Abdominal Imaging. O’Brien R, Barr F. eds. Gloucester: British Small Animal Veterinary Association; 2009: 157-165.
• 18 Nola VL. Scintigraphic diagnosis of insulinoma in a dog. Vet Radiol Ultrasound 1999; 40: 174-178.
• 19 O’Brien TD, Norton F, Turner TM. et al. Pancreatic Endocrine Tumor in a Cat: Clinical, Pathological, and Immunohistochemical Evaluation. J Am Anim Hosp Assoc 1990; 26: 453-457.
• 20 Polton GA, White RN, Brearley MJ, Eastwood JM. Improved survival in a retrospective cohort of 28 dogs with insulinoma. J Small Anim Pract 2007; 48: 151-156.
• 21 Priester WA. Data from Eleven United States and Canadian Colleges of Veterinary Medicine on Pancreatic Carcinoma in Domestic Animals. Cancer Res 1974; 34: 1372-1375.
• 22 Rickea KK. Imaging procedures in neuroendocrine tumours. Digestion 2000; 62: 39-44.
• 23 Robben J, Pollak W. et al. Comparison of ultrasonography, computed tomography, and single-photon emission computed tomography for the detection and localization of canine insulinoma. J Vet Intern Med 2005; 19: 15-22.