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Huerta Y, Lenz J, Flesner B, Abrams B, Amerman H, Griffin M. Resolution of paraneoplastic hypoglycemia following nephroureterectomy for treatment of canine renal cell carcinoma: Case report. Front Vet Sci 2023; 10:1134098. [PMID: 37065226 PMCID: PMC10102469 DOI: 10.3389/fvets.2023.1134098] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/29/2022] [Accepted: 03/14/2023] [Indexed: 04/03/2023] Open
Abstract
ObjectivesTo describe the clinicopathologic findings, imaging results, surgical treatment, and outcome of a dog with renal cell carcinoma (RCC) and paraneoplastic hypoglycemia.AnimalsA 13-year-old female spayed mixed breed dog that was presented for facial twitching and neurologic decline and diagnosed with a renal mass and paraneoplastic hypoglycemia.Study designCase report.MethodsSerum chemistry revealed severe hypoglycemia and normal renal values. Abdominal ultrasonography showed a large, heterogeneous, cavitated mass associated with the left kidney and no evidence of abdominal metastatic disease. Thoracic radiographs revealed no evidence of pulmonary metastatic disease. Fasted serum insulin was low concurrently with severe hypoglycemia. No other causes of hypoglycemia were detected, and paraneoplastic hypoglycemia was suspected.ResultsAfter initial medical management of the dog's hypoglycemia, left nephroureterectomy was performed. Histopathology was consistent with RCC. Postoperatively, the dog's hypoglycemia resolved, and supplementation was discontinued. The dog remained stable and was discharged from the hospital 3 days after surgery. At 2-week, 3-month, and 5-month follow up evaluations, the dog remained euglycemic, and no definitive evidence of disease progression was detected. Eight months postoperatively, the dog was euthanized due to decline in mobility. Necropsy and histopathology revealed cerebral and spinal cord multifocal myelin sheath dilation and two primary pulmonary carcinomas with no evidence of recurrence or metastasis of the RCC.ConclusionSurgical treatment of RCC with subsequent resolution of paraneoplastic hypoglycemia has not previously been reported in veterinary medicine. In this dog, nephroureterectomy for RCC resulted in immediate and sustained resolution of paraneoplastic hypoglycemia.
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Affiliation(s)
- Yael Huerta
- Department of Clinical Sciences and Advanced Medicine, University of Pennsylvania School of Veterinary Medicine, Philadelphia, PA, United States
| | - Jennifer Lenz
- Department of Clinical Sciences and Advanced Medicine, University of Pennsylvania School of Veterinary Medicine, Philadelphia, PA, United States
| | - Brian Flesner
- Department of Clinical Sciences and Advanced Medicine, University of Pennsylvania School of Veterinary Medicine, Philadelphia, PA, United States
| | - Brittany Abrams
- Department of Clinical Sciences and Advanced Medicine, University of Pennsylvania School of Veterinary Medicine, Philadelphia, PA, United States
| | - Hayley Amerman
- Department of Pathobiology, University of Pennsylvania School of Veterinary Medicine, Philadelphia, PA, United States
| | - Maureen Griffin
- Department of Clinical Sciences and Advanced Medicine, University of Pennsylvania School of Veterinary Medicine, Philadelphia, PA, United States
- *Correspondence: Maureen Griffin
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Kornya M, Abrams-Ogg A, Comeau D, Caswell J. Juvenile hyperinsulinism in a Maine Coon kitten. JFMS Open Rep 2022; 8:20551169221136473. [DOI: 10.1177/20551169221136473] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022] Open
Abstract
Case summary A 5.5 month-old intact male Maine Coon cat was presented to a referral hospital for a history of muscle fasciculations, lethargy and seizures associated with refractory hypoglycemia. Diagnostic testing for hypothyroidism, hyposomatotropism or hypoadrenocorticism, inborn errors of metabolism (ie, storage diseases and urea cycle disorders), infection or iatrogenic hypoglycemia were negative. An inappropriately high serum insulin level was noted in the face of marked hypoglycemia. The insulin:glucose ratio was 0.44 (<0.3) and the amended insulin:glucose ratio was 1268 (<30). Thoracic radiography and abdominal ultrasonography did not identify a cause for this elevated insulin level. Stabilization with a low, but adequate, blood glucose occurred with corticosteroid therapy, with further significant improvement with the addition of diazoxide. Peripheral neuropathy developed several months later, and concerns for quality of life led to humane euthanasia approximately 1 year after the initial diagnosis. Insulin levels remained high at the time of euthanasia. Necropsy found no gross lesions, though microscopic degeneration of the sciatic nerve and subjectively mildly increased size and number of pancreatic islets was noted. These findings were consistent with a diagnosis of congenital hyperinsulinism. Relevance and novel information This is the first reported case of congenital hyperinsulinism in a cat and may parallel the diffuse form of hypoglycemic hyperinsulinism reported in humans and a single dog. It should be considered a differential diagnosis in kittens presenting for refractory hypoglycemia.
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Affiliation(s)
- Matthew Kornya
- Ontario Veterinary College, University of Guelph, Guelph, ON, Canada
| | | | - Dominique Comeau
- Ontario Veterinary College, University of Guelph, Guelph, ON, Canada
| | - Jeff Caswell
- Ontario Veterinary College, University of Guelph, Guelph, ON, Canada
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Piroth AC, Urbanschitz T, Lederer KA, Lipnik K, Degasperi B. [Intrapelvic leiomyoma causing concurrent colonic and urethral obstruction in a dog]. TIERAERZTLICHE PRAXIS AUSGABE KLEINTIERE HEIMTIERE 2021; 49:134-141. [PMID: 33902122 DOI: 10.1055/a-1385-5047] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 10/21/2022]
Abstract
An 8-year-old female spayed dog was presented due to simultaneous inability to defecate and urinate. During digital rectal examination a smooth, rounded, firm-elastic mass was detected. Laboratory results showed a 6-fold elevation of serum lactate dehydrogenase activity. Ultrasonographic, radiographic and computed tomography findings raised the suspicion of a leiomyoma. An ultrasound-guided fine needle aspiration biopsy was performed under mild sedation but cytologic evaluation was inconclusive. During laparotomy the mass was located at the colorectal transition. It was completely removed while keeping the intestinal wall intact. The results of the histopathological examination and immunohistochemistry confirmed the initial tentative diagnosis of a leiomyoma. Postoperatively the patient was able to pass urine and feces spontaneously. Six months later the dog presented clinically unremarkable. Abdominal ultrasound and rectal examination exhibited no signs of recurrence. Lactate dehydrogenase activity was only marginally increased.
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Affiliation(s)
- Ana Cristina Piroth
- Klinische Abteilung für Kleintierchirurgie, Universitätsklinik für Kleintiere, Department für Kleintiere und Pferde, Vetmeduni Wien
| | - Tobias Urbanschitz
- Klinische Abteilung für Interne Medizin Kleintiere, Universitätsklinik für Kleintiere, Department für Kleintiere und Pferde, Vetmeduni Wien
| | - Kristina A Lederer
- Klinische Abteilung für Bildgebende Diagnostik, Universitätsklinik für Kleintiere, Department für Kleintiere und Pferde, Vetmeduni Wien
| | - Karoline Lipnik
- Institut für Pathologie, Department für Pathobiologie, Vetmeduni Wien
| | - Brigitte Degasperi
- Klinische Abteilung für Kleintierchirurgie, Universitätsklinik für Kleintiere, Department für Kleintiere und Pferde, Vetmeduni Wien
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Calesso JR, Araujo MCAD, Oliveira TESD, Garcia IG, Souza MCD, Santis GWD, Hilst CLS, Pereira PM, Cardoso MJL. Gastric Leiomyosarcoma Associated with Hypoglycemia in Dog—A Case Report. ACTA ACUST UNITED AC 2019. [DOI: 10.4236/ojvm.2019.98009] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022]
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Rossi G, Errico G, Perez P, Rossi G, Paltrinieri S. Paraneoplastic hypoglycemia in a diabetic dog with an insulin growth factor-2-producing mammary carcinoma. Vet Clin Pathol 2010; 39:480-4. [DOI: 10.1111/j.1939-165x.2010.00260.x] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/01/2022]
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Sakai M, Asano K, Nakata M, Takahashi T, Koie H, Yamaya Y, Watari T, Shibuya H, Sato T, Tokuriki M, Hasegawa A. Diabetes mellitus after resection of hepatocellular carcinoma with hypoglycemia in a dog. J Vet Med Sci 2006; 68:765-7. [PMID: 16891796 DOI: 10.1292/jvms.68.765] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/22/2022] Open
Abstract
A 10-year-old male beagle was referred to us with seizure related to hypoglycemia and a large intraabdominal mass. Based on various types of imaging and a laparoscopic biopsy, the intraabdominal mass was diagnosed as a hepatocellular carcinoma (HCC) of the quadrate lobe. The hypoglycemia was suspected to be associated with the HCC. After lobectomy of the quadrate lobe was performed, blood glucose levels continued to increase to higher than normal values and sugar was detected in the urine. The dog was diagnosed as diabetes mellitus (DM) and was treated with insulin for over two years after the surgery.
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Affiliation(s)
- Manabu Sakai
- Laboratory of Comprehensive Veterinary Clinical Studies, Department of Veterinary Medicine, College of Bioresouce Sciences, Nihon University, Kanagawa, Japan
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