Hypoglycemia and irreversible neurologic complications in a cat with insulinoma

Abstract

A 14-year-old spayed female domestic shorthair cat was evaluated for weakness, lethargy, decreased appetite, diarrhea, weight loss, and seizures. On physical examination, the cat appeared disoriented and had an inconsistent menace response. An insulinoma was diagnosed on the basis of normal serum insulin activity in conjunction with profound hypoglycemia and histologic examination (with immunohistochemical staining for chromogranin A and insulin) of a pancreatic mass that was removed surgically. Blood glucose concentration was within reference limits after surgery. However, neurologic abnormalities persisted, and the cat was euthanatized. Chronic hypoglycemia, associated with insulinomas, can cause irreversible neuronal changes in cats; therefore, rapid diagnosis and treatment of hypoglycemic conditions are of critical importance.

Beta-Cell Neoplasia: Insulinoma

“…Insulin-secreting beta-cell tumors are rare in cats with only a few single cat case reports in the literature (McMillan, 1985;O'Brien et al, 1990;Hawks et al, 1992;Kraje, 2003;Greene and Bright, 2008) and one additional report in which the beta-cell tumor was an incidental finding at necropsy in a cat with ductal pancreatic adenocarcinoma (Carpenter et al, 1987). We have seen only two cats with beta-cell neoplasia during the past three decades, in contrast to more than 150 dogs with the disease during the same time interval.…”

“…Immunohistochemical analysis of the beta-cell tumor in a few of these cats has revealed multihormonal productivity, with insulin and chromogranin A being the most common peptides demonstrated in the neoplastic cells (Kraje, 2003;Jackson et al, 2009). To date, the disorder has affected aged cats, 12 to 17 years old.…”

Cellular and Molecular Characterization of a Feline Insulinoma

“…Insulinomas in cats are rare, with fewer than a dozen well‐documented cases reported in the literature. In cats, the reported clinical signs usually are related to tumor functional capacity and include lethargy, weakness, and seizures 1–5 …”

Hypoglycemia

“…[10][11][12][13][14][15][16][17][18][19] Patients often exhibit weakness or collapse, and severe hypoglycemia is an isolated finding. They are described more commonly in middle-aged to older dogs but have also been seen in cats.…”