Peer-reviewed veterinary case report
Severe low blood sugar from tonsil cancer in a Pomeranian dog
By Azuma, Kazushi et al.·Published in Veterinary clinical pathology·2019·Synergy Animal General Hospital, Japan·View original on PubMed →
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Original publication title: Hypoglycemia associated with disseminated metastatic tonsillar squamous cell carcinoma producing insulin-like growth factor-I in a Pomeranian dog.
- Species:
- dog
Plain-English summary
A 13-year-old spayed female Pomeranian was brought to the vet for severe low blood sugar (hypoglycemia) that was causing her to feel very unwell. Tests showed she also had low red blood cells and platelets, and imaging revealed multiple nodules in her spleen and liver. After a thorough examination, the vet found that the dog had squamous cell carcinoma (a type of cancer) in her tonsil, which was producing a substance that lowered her blood sugar. Unfortunately, despite the diagnosis, the prognosis was poor due to the cancer's spread to other organs.
People also search for: Pomeranian low blood sugar causes · dog tonsil cancer treatment · symptoms of cancer in dogs
Abstract
A 13-year-old spayed female Pomeranian dog was presented for persistent, severe hypoglycemia (37 mg/dL; reference interval [RI] 75-128 mg/dL). Progressive nonregenerative anemia (hematocrit 23.3%-15.9%; RI 37.0%-55.0%) and severe thrombocytopenia (36 000/µL; RI 200-500 000/µL) were also noted. The serum insulin concentration was low (0.24 ng/mL; RI 0.302-1.277 ng/mL). Computed tomography revealed multiple splenic nodules (1-6 mm in diameter) and several hepatic nodules (7.6, 12 mm in diameter). Ultrasound-guided fine-needle aspiration of the splenic and hepatic nodules revealed low numbers of epithelial cells with mild cellular atypia, suggestive of a metastatic epithelial tumor, but the primary site was unknown at that time. On careful oral examination under general anesthesia, an enlarged right tonsil was noted grossly, and histopathologic examination of the tonsil diagnosed squamous cell carcinoma. Bone marrow aspirates and biopsies of the splenic and hepatic nodules were performed; all samples were diagnosed as metastatic carcinoma on histopathologic examination. No nodules were present in the pancreas, despite careful palpation during exploratory laparotomy. On immunohistochemistry, the neoplastic cells were positive for cytokeratin AE1/3 and insulin-like growth factor (IGF)-I but were negative for chromogranin A, PGP9.5, insulin, and inconclusive for IGF-II. This is the first report of a primary IGF-I-producing squamous cell carcinoma in the tonsil of a dog with metastases to bone marrow, liver, and spleen, resulting in hypoglycemia.
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Search related cases →Original publication on PubMed: https://pubmed.ncbi.nlm.nih.gov/31280499/