Hyperinsulinemic Hypoglycemia Secondary to Multiple β cell Adenomas in a Boxer Bitch

Background: The most frequent pancreatic tumours are derived from insulin-secreting β cells, commonly called insulinomas; these are characterised by high insulin secretion causing hypoglycaemia and clinical signs such as seizures, tremors, weakness, and polyphagia, among others. In dogs, this tumour...

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Autores: Barajas-López, Ignacio Netzahualcoyotl, Medina-Flores, Jesús Aurelio, Arnaud-Pérez, Gabriela, Mendoza-Rivera, Marco Antonio, López-Garcia, Yurixhi, Beristain-Ruiz, Diana Marcela, Rodríguez-Alarcón, Carlos Arturo
Tipo de recurso: artículo
Estado:Versión publicada
Fecha de publicación:2019
País:Brasil
Institución:Universidade Federal do Rio Grande do Sul (UFRGS)
Repositorio:Revista Acta Scientiae Veterinariae (Online)
Idioma:inglés
OAI Identifier:oai:seer.ufrgs.br:article/94820
Acceso en línea:https://seer.ufrgs.br/index.php/ActaScientiaeVeterinariae/article/view/94820
Access Level:acceso abierto
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dc.title.none.fl_str_mv Hyperinsulinemic Hypoglycemia Secondary to Multiple β cell Adenomas in a Boxer Bitch
title Hyperinsulinemic Hypoglycemia Secondary to Multiple β cell Adenomas in a Boxer Bitch
spellingShingle Hyperinsulinemic Hypoglycemia Secondary to Multiple β cell Adenomas in a Boxer Bitch
Barajas-López, Ignacio Netzahualcoyotl
title_short Hyperinsulinemic Hypoglycemia Secondary to Multiple β cell Adenomas in a Boxer Bitch
title_full Hyperinsulinemic Hypoglycemia Secondary to Multiple β cell Adenomas in a Boxer Bitch
title_fullStr Hyperinsulinemic Hypoglycemia Secondary to Multiple β cell Adenomas in a Boxer Bitch
title_full_unstemmed Hyperinsulinemic Hypoglycemia Secondary to Multiple β cell Adenomas in a Boxer Bitch
title_sort Hyperinsulinemic Hypoglycemia Secondary to Multiple β cell Adenomas in a Boxer Bitch
dc.creator.none.fl_str_mv Barajas-López, Ignacio Netzahualcoyotl
Medina-Flores, Jesús Aurelio
Arnaud-Pérez, Gabriela
Mendoza-Rivera, Marco Antonio
López-Garcia, Yurixhi
Beristain-Ruiz, Diana Marcela
Rodríguez-Alarcón, Carlos Arturo
author Barajas-López, Ignacio Netzahualcoyotl
author_facet Barajas-López, Ignacio Netzahualcoyotl
Medina-Flores, Jesús Aurelio
Arnaud-Pérez, Gabriela
Mendoza-Rivera, Marco Antonio
López-Garcia, Yurixhi
Beristain-Ruiz, Diana Marcela
Rodríguez-Alarcón, Carlos Arturo
author_role author
author2 Medina-Flores, Jesús Aurelio
Arnaud-Pérez, Gabriela
Mendoza-Rivera, Marco Antonio
López-Garcia, Yurixhi
Beristain-Ruiz, Diana Marcela
Rodríguez-Alarcón, Carlos Arturo
author2_role author
author
author
author
author
author
description Background: The most frequent pancreatic tumours are derived from insulin-secreting β cells, commonly called insulinomas; these are characterised by high insulin secretion causing hypoglycaemia and clinical signs such as seizures, tremors, weakness, and polyphagia, among others. In dogs, this tumour represents <0.5% of neoplasias; the majority are solitary carcinoma masses and rarely adenomas. Insulin-secreting tumours are usually diagnosed in middle-aged or older dogs. There is no apparent sex predilection for the disease and it has been mainly reported in medium to large breeds. Independently of whether they are adenomas or carcinomas, dogs have the same disease-free time and survival time and the prognosis is poor.Case: An 8-year-old female Boxer was brought to the University Veterinary Hospital with a history of weakness, tremors, and generalised convulsions. Physical examination, CBC and urinalysis revealed no abnormalities. In the blood chemistry profile, hypoglycaemia was detected along with hyperinsulinemia. An abdominal ultrasound revealed the presence of two abnormal masses located in the pancreas. The insulin:glucose ratio was 59.8. Exploratory celiotomy was performed and two masses were located in the mesentery, adjacent to the left pancreatic lobe, and a third was in the pancreatic tissue of the same lobule. All masses were resected during the same surgery. Cytology of the masses coincided with apparently malignant insulinoma, however, the histopathological and immunohistochemically report indicated an insulin-secreting adenoma. The patient improved clinically and remained stable for approximately 545 days, after which seizures relapsed and a new treatment was not approved. The patient died 575 days after surgery. Discussion: In dogs, pancreatic islet cell tumours correspond to endocrinologically active neoplasm that secrete hormones and are associated with functional disorders (hyperinsulinemia) in relation to hypoglycemia. Hypoglycemia causes episodic signs that are generally observed for a few seconds to several minutes, because of regulatory compensatory mechanisms. In animals, rapid hypoglycemia activates the sympathetic nervous system via hypothalamic glucoreceptors, producing signs such as tachycardia, tremors, nervousness, irritability, and intense hunger. Other clinical signs are related to neuroglycopenia by a decrease in blood glucose, which stimulates the autonomic nervous system, causing hypothermia, lethargy, weakness, ataxia, collapse, muscular fasciculation, convulsions, and coma. The diagnosis of an insulin-secreting tumour requires confirmation of hypoglycemia with evidence of elevated insulin secretion and the identification of a pancreatic mass by ultrasonography or exploratory celiotomy. An insulin:glucose ratio >30 is indicative of insulinoma. Unfortunately, the specificity of the amended insulin:glucose ratio is poor. In the past, there has been confusion with respect to their biological nature, because, based on histological and electron microscopic evaluations, 60% of these neoplasms are carcinomas and 40% are adenomas. Nevertheless, these claims were not substantiated and most insulinomas are currently considered to be malignant (carcinomas). The objective of this paper was to present a rare case of a Boxer dog that had three β cell tumours of the pancreas, which produced hyperinsulinemia and hypoglycemia. Although this is not a malignant tumour, we demonstrated, as described in the literature, that regardless of the histopathological classification, insulin-producing tumours have a poor prognosis in dogs.
publishDate 2019
dc.date.none.fl_str_mv 2019-01-01
dc.type.driver.fl_str_mv info:eu-repo/semantics/article
info:eu-repo/semantics/publishedVersion
format article
status_str publishedVersion
dc.identifier.uri.fl_str_mv https://seer.ufrgs.br/index.php/ActaScientiaeVeterinariae/article/view/94820
10.22456/1679-9216.94820
url https://seer.ufrgs.br/index.php/ActaScientiaeVeterinariae/article/view/94820
identifier_str_mv 10.22456/1679-9216.94820
dc.language.iso.fl_str_mv eng
language eng
dc.relation.none.fl_str_mv https://seer.ufrgs.br/index.php/ActaScientiaeVeterinariae/article/view/94820/53627
dc.rights.driver.fl_str_mv info:eu-repo/semantics/openAccess
eu_rights_str_mv openAccess
dc.format.none.fl_str_mv application/pdf
dc.publisher.none.fl_str_mv Universidade Federal do Rio Grande do Sul
publisher.none.fl_str_mv Universidade Federal do Rio Grande do Sul
dc.source.none.fl_str_mv Acta Scientiae Veterinariae; Vol. 47 (2019): CASE REPORTS (SUPPLEMENT)
Acta Scientiae Veterinariae; v. 47 (2019): CASE REPORTS (SUPPLEMENT)
1679-9216
reponame:Revista Acta Scientiae Veterinariae (Online)
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reponame_str Revista Acta Scientiae Veterinariae (Online)
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repository.name.fl_str_mv Revista Acta Scientiae Veterinariae (Online) - Universidade Federal do Rio Grande do Sul (UFRGS)
repository.mail.fl_str_mv questions-acta@ufrgs.br
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spelling Hyperinsulinemic Hypoglycemia Secondary to Multiple β cell Adenomas in a Boxer BitchBackground: The most frequent pancreatic tumours are derived from insulin-secreting β cells, commonly called insulinomas; these are characterised by high insulin secretion causing hypoglycaemia and clinical signs such as seizures, tremors, weakness, and polyphagia, among others. In dogs, this tumour represents <0.5% of neoplasias; the majority are solitary carcinoma masses and rarely adenomas. Insulin-secreting tumours are usually diagnosed in middle-aged or older dogs. There is no apparent sex predilection for the disease and it has been mainly reported in medium to large breeds. Independently of whether they are adenomas or carcinomas, dogs have the same disease-free time and survival time and the prognosis is poor.Case: An 8-year-old female Boxer was brought to the University Veterinary Hospital with a history of weakness, tremors, and generalised convulsions. Physical examination, CBC and urinalysis revealed no abnormalities. In the blood chemistry profile, hypoglycaemia was detected along with hyperinsulinemia. An abdominal ultrasound revealed the presence of two abnormal masses located in the pancreas. The insulin:glucose ratio was 59.8. Exploratory celiotomy was performed and two masses were located in the mesentery, adjacent to the left pancreatic lobe, and a third was in the pancreatic tissue of the same lobule. All masses were resected during the same surgery. Cytology of the masses coincided with apparently malignant insulinoma, however, the histopathological and immunohistochemically report indicated an insulin-secreting adenoma. The patient improved clinically and remained stable for approximately 545 days, after which seizures relapsed and a new treatment was not approved. The patient died 575 days after surgery. Discussion: In dogs, pancreatic islet cell tumours correspond to endocrinologically active neoplasm that secrete hormones and are associated with functional disorders (hyperinsulinemia) in relation to hypoglycemia. Hypoglycemia causes episodic signs that are generally observed for a few seconds to several minutes, because of regulatory compensatory mechanisms. In animals, rapid hypoglycemia activates the sympathetic nervous system via hypothalamic glucoreceptors, producing signs such as tachycardia, tremors, nervousness, irritability, and intense hunger. Other clinical signs are related to neuroglycopenia by a decrease in blood glucose, which stimulates the autonomic nervous system, causing hypothermia, lethargy, weakness, ataxia, collapse, muscular fasciculation, convulsions, and coma. The diagnosis of an insulin-secreting tumour requires confirmation of hypoglycemia with evidence of elevated insulin secretion and the identification of a pancreatic mass by ultrasonography or exploratory celiotomy. An insulin:glucose ratio >30 is indicative of insulinoma. Unfortunately, the specificity of the amended insulin:glucose ratio is poor. In the past, there has been confusion with respect to their biological nature, because, based on histological and electron microscopic evaluations, 60% of these neoplasms are carcinomas and 40% are adenomas. Nevertheless, these claims were not substantiated and most insulinomas are currently considered to be malignant (carcinomas). The objective of this paper was to present a rare case of a Boxer dog that had three β cell tumours of the pancreas, which produced hyperinsulinemia and hypoglycemia. Although this is not a malignant tumour, we demonstrated, as described in the literature, that regardless of the histopathological classification, insulin-producing tumours have a poor prognosis in dogs.Universidade Federal do Rio Grande do Sul2019-01-01info:eu-repo/semantics/articleinfo:eu-repo/semantics/publishedVersionapplication/pdfhttps://seer.ufrgs.br/index.php/ActaScientiaeVeterinariae/article/view/9482010.22456/1679-9216.94820Acta Scientiae Veterinariae; Vol. 47 (2019): CASE REPORTS (SUPPLEMENT)Acta Scientiae Veterinariae; v. 47 (2019): CASE REPORTS (SUPPLEMENT)1679-9216reponame:Revista Acta Scientiae Veterinariae (Online)instname:Universidade Federal do Rio Grande do Sul (UFRGS)instacron:UFRGSenghttps://seer.ufrgs.br/index.php/ActaScientiaeVeterinariae/article/view/94820/53627Copyright (c) 2019 Ignacio Netzahualcoyotl Barajas-López, Jesús Aurelio Medina-Flores, Gabriela Arnaud-Pérez, Marco Antonio Mendoza-Rivera, Yurixhi López-Garcia, Diana Marcela Beristain-Ruiz, Carlos Arturo Rodríguez-Alarcóninfo:eu-repo/semantics/openAccessBarajas-López, Ignacio NetzahualcoyotlMedina-Flores, Jesús AurelioArnaud-Pérez, GabrielaMendoza-Rivera, Marco AntonioLópez-Garcia, YurixhiBeristain-Ruiz, Diana MarcelaRodríguez-Alarcón, Carlos Arturo2021-12-27T23:46:30Zoai:seer.ufrgs.br:article/94820Revistahttps://seer.ufrgs.br/index.php/ActaScientiaeVeterinariae/oaiPUBhttps://seer.ufrgs.br/index.php/ActaScientiaeVeterinariae/indexquestions-acta@ufrgs.br1679-92161678-0345opendoar:2021-12-27T23:46:30Revista Acta Scientiae Veterinariae (Online) - Universidade Federal do Rio Grande do Sul (UFRGS)false
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