Peer-reviewed veterinary case report
Case report: Severe, refractory hypoglycemia in a 9-year-old Brittany Spaniel with renal nephroblastoma.
- Journal:
- Frontiers in veterinary science
- Year:
- 2023
- Authors:
- Simons, Paula et al.
- Affiliation:
- Department of Emergency and Critical Care · United States
- Species:
- dog
Plain-English summary
A 9-year-old female spayed Brittany Spaniel was brought in because she was weak and stumbling, and tests showed she had very low blood sugar (hypoglycemia). The usual causes of low blood sugar were ruled out, and imaging tests found a large tumor in her left kidney and a possible spread to the right kidney. Although she was given glucagon to help raise her blood sugar, it didn’t work, so the veterinarians decided to remove the affected kidney. After the surgery, her blood sugar levels returned to normal, and further tests confirmed the tumor was a type called nephroblastoma, which was producing a substance that contributed to her low blood sugar. She then started chemotherapy with two medications. Overall, the treatment was successful in resolving her hypoglycemia.
Abstract
A 9-year-old female spayed Brittany Spaniel presented for weakness and stumbling, and was diagnosed with severe hypoglycemia. An insulin to glucose ratio was not consistent with insulinoma as a cause for hypoglycemia. Diagnostic imaging (abdominal ultrasound and computed tomography) revealed a large left renal mass and a possible metastatic lesion in the right kidney. Glucagon therapy was initiated, but hypoglycemia was refractory to therapy. A left nephrectomy was performed and hypoglycemia subsequently resolved. Histopathology of the mass was consistent with nephroblastoma and immunohistochemistry for anti-insulin-like Growth Factor-2 (IGF-2) antibody revealed immunoreactivity in over 50% of the neoplastic cells. Chemotherapeutic treatment was initiated with a combined protocol of vincristine and doxorubicin. To the authors' knowledge, this is the first case report documenting the treatment of severe, refractory non-islet cell tumor-induced hypoglycemia in a dog, suspected to be secondary to an IGF-2 secreting nephroblastoma.
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Search related cases →Original publication: https://pubmed.ncbi.nlm.nih.gov/37143502/