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:
- Paula Simons et al.
- Affiliation:
- Department of Emergency and Critical Care, Cornell University Veterinary Specialists, Stamford, CT, United States · CH
- 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 revealed 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 doctors decided to remove the affected kidney. After the surgery, her blood sugar levels returned to normal, and tests on the tumor confirmed it was a nephroblastoma, which is a type of kidney cancer. She then started chemotherapy with two medications, vincristine and doxorubicin, and this case is notable as it is the first report of treating severe low blood sugar caused by this type of tumor in a dog.
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://doi.org/10.3389/fvets.2023.1116846