Insulinoma in a dog ( Canis lupus familiaris ) with concurrent non‐cardiogenic pulmonary oedema

Abstract

A 12‐year‐old, female, neutered beagle presented with hypoglycaemia, sudden‐onset non‐ambulatory tetraparesis and a single tonic‐clonic seizure. Computed tomography revealed a pancreatic nodule, consistent with an insulinoma, an enlarged hepatic lymph node and ground‐glass attenuation of the lung parenchyma, most consistent with non‐cardiogenic pulmonary oedema. The dog became markedly dyspnoeic secondary to non‐cardiogenic pulmonary oedema and had abnormal mentation, presumed secondary to hypoglycaemic neuropathy. Following medical stabilisation, the dog's mentation and dyspnoea greatly improved and ambulatory function returned. The patient subsequently underwent exploratory celiotomy for enucleation of a discrete lesion within the right limb of the pancreas and hepatic lymphadenectomy. Histopathology was consistent with a malignant insulinoma and concurrent hepatic lymph node metastasis. Post‐operative recovery was rapid with no clinical signs of hypoglycaemia 2 weeks later. Here, we describe a complex case of insulinoma with concurrent non‐cardiogenic pulmonary oedema, which was successfully treated with both medical and surgical interventions