Retrospective study of 20 cats surgically treated for insulinoma

Abstract

To report the clinical signs, histopathology results, and prognostic factors for outcomes following excision for feline insulinoma (INS). Study design: Retrospective study. Sample population: Twenty client-owned cats. Methods: Medical records from 2006 to 2020 were reviewed by Veterinary Society of Surgical Oncology members for cats with hypoglycemia resulting from INS, with surgical excision and follow up. Clinical signs and histopathology results were summarized. Factors potentially related to disease-free interval (DFI), disease-related death (DRD), and overall survival time (OST) were analyzed with a Cox proportional hazards regression analysis. Results: All cats were hypoglycemic on presentation with neurologic signs in 18 out of 20 and inappropriate insulin levels in 12/13. Excision of insulinomas resulted in immediate euglycemia or hyperglycemia in 18 cats. Eighteen cats survived to hospital discharge. The median time to death or last postoperative

Laparoscopic partial pancreatectomy of the left limb using a harmonic scalpel in nine cats

“…Postoperative pancreatitis is a known complication of feline pancreatic surgery. 6 In a recent report of partial pancreatectomy in cats with insulinoma, a complication rate of 25% was reported with pancreatitis developing in at least one of the cats. 6 Pancreatitis might have contributed to postoperative morbidity in the one cat in the present study that developed abdominal discomfort, hyporexia and a sterile peritoneal exudate.…”

“…6 In a recent report of partial pancreatectomy in cats with insulinoma, a complication rate of 25% was reported with pancreatitis developing in at least one of the cats. 6 Pancreatitis might have contributed to postoperative morbidity in the one cat in the present study that developed abdominal discomfort, hyporexia and a sterile peritoneal exudate. However, none of the other cats developed clinical evidence of acute necrotizing pancreatitis and all cats had PLI values within the normal range, which did not differ from preoperative levels.…”

“…First, the left limb appears to be the most common location for neoplastic disease in cats with 16 of 20 insulinomas occurring in the left limb in one study. 6 Second, the left limb may be challenging to access via laparoscopy as it is contained within the omental bursa and is positioned dorsal to the stomach and spleen. Additionally, a laparoscopic approach for biopsy of the right limb has been described previously.…”

“…[1][2][3][4][5] A recent report describing the clinical outcome following open pancreatic resection for insulinoma in 20 cats suggests that there is a population of cats that would benefit from having a minimally invasive surgical option for partial pancreatectomy. 6 In this report, most cats underwent partial pancreatectomy using a suture guillotine technique, but one cat was reported to have undergone partial pancreatectomy using a harmonic scalpel. Currently, no technical descriptions of laparoscopic partial pancreatectomy (LPP), using an ultrasonic energy device exist in the veterinary literature.…”

“…This may be due to the rare nature of pancreatic neoplasia 4 or possibly because only limited technical descriptions exist in the veterinary literature 1–5 . A recent report describing the clinical outcome following open pancreatic resection for insulinoma in 20 cats suggests that there is a population of cats that would benefit from having a minimally invasive surgical option for partial pancreatectomy 6 . In this report, most cats underwent partial pancreatectomy using a suture guillotine technique, but one cat was reported to have undergone partial pancreatectomy using a harmonic scalpel.…”