Insulinoma And Hypoglycemia

[greyhndz]

My greyhound "niece" (Miz Susie's sister Miz Mandy, almost 12) may have an insulinoma -- a pancreatic tumor which secretes insulin and causes profound hypoglycemia. Her glucose (taken about 2 hrs after a meal) was 39 and 37, respectively, over 3 days, and she has had the classic symptoms (PU/PD, collapse episodes after excitement or exertion, etc.) The complete workup still has to be done (insulin/glucose ratio, abdominal u/s) and her owner already has a call/e-mail in to Dr. Couto and is ready to drive to OSU if that's the best thing for Mandy.

 

We've done a lot of research on treatment options once the diagnosis is confirmed, but in the interim, Miz Mandy's mum could use some advice on hypoglycemic diets. She does know that small meals every 2-3 hrs, complex carbs, high in protein, is the way to go, but can anyone give her specific suggestions for a diet she can start using right now?

 

Also, Mandy needs to avoid excitement or overactivity (they cause a precipitous decline in blood sugar, and collapse) - if Mandy does need to travel to OSU, can anyone recommend a safe means of sedating her for travel?

 

TIA, and I'm sure Miz Mandy's mum would like to hear from anyone who has had a dog diagnosed with insulinoma. Hopefully she'll be posting here soon.

 

Thanks, from worried auntie.

[BrentsMom]

Thank you for posting here....

 

Today was the first day since Thursday that Mandy hasn't had any episodes of collapsing or wobbly legs. She is starting to get smaller more frequent feedings. One concern is that she is already FAT!!!! The last thing she needs is extra poundage!!!

Edited March 18, 2009 by BrentsMom

[Guest greylovinpair]

Our first greyhound Anna had an insulinoma. These are pretty rare tumors to begin with, and even more uncommon in greyhounds. My very first suggestion is to keep in contact with Dr. Couto. He had some great advice for us and was a really good resource. We lived in Utah at the time, so ultimately went to Colorado State for surgery, etc., and they were pretty good, but Dr. Couto is the greyhound guru.

 

The single most important thing is the frequent feedings. We still used regular dog food for two to three meals a day but then supplemented with snacks in between. I know you're worried about Mandy's weight, but it is a balance and to keep her blood sugars up she has to eat often. Essentially you want snacks for her that have complex carbohydrates and protein...these help to keep the blood sugar at a more consistent place. Snacks that we tried with her--cottage cheese with oats (i.e. Quaker oats) mixed in (this was probably her favorite and was fairly healthy option), whole grain pastas, cheese and whole grain crackers, and even regular oatmeal. We also tried pouring some "Boost" or "Ensure" over her food, but she didn't really like this.

 

I know you mentioned that an abdominal ultrasound would be done. As Dr. Couto told us, the ultrasound can often be normal even in the presence of an actual insulinoma and this was indeed the case with Anna. The ultrasound never did show her tumor, although at surgery the tumor was readily apparent.

 

We chose to be fairly aggressive with Anna since she was only 7 at the time of diagnosis. We watched for a couple months doing the dietary approaches and started her on low doses of prednisone. We ultimately had surgery done and the insulinoma was found and removed. She was symptom-free for about four months and we had our happy and playful girl back, but her symptoms then recurred and indeed the tumor had returned. We spent another month or so of doing higher doses of Prednisone and trying to get ahold of a medication called Diazoxide which can also help. We ultimately did get the Diazoxide, but it turned out to be too little too late.

 

Feel free to pm me if you have any questions, I'd be happy to help.