Feline increased insulin help please.

RE: Feline increased insulin help please.

Hannah Wynne Richards — Wed, 30 Mar 2016 15:35:48 GMT

Martin I expect you're right, but I am a bit of a coward. This is one I'd have been twisting the owner's arms to refer.

Wynne

RE: Feline increased insulin help please.

Andrew Kent — Wed, 30 Mar 2016 15:05:01 GMT

[quote user="Robin Grimmer"]

With insulinoma would the blood glucose not have been lower? The cases I have seen in dogs were all profoundly hypoglycaemic, closer to 1 mmol/l.

[/quote]

Agree that the glucose is not that low, I think its difficult to interpret isolated blood glucose levels.

I also think the insulin is difficult to interpret without knowing the concurrent glucose and could be spurious due to feeding.

I guess you have to see what happens to the clinical signs as the cat recovers.

Andy

RE: Feline increased insulin help please.

Robin Grimmer — Wed, 30 Mar 2016 10:43:18 GMT

With insulinoma would the blood glucose not have been lower? The cases I have seen in dogs were all profoundly hypoglycaemic, closer to 1 mmol/l.

RE: Feline increased insulin help please.

Claire Godfrey — Wed, 30 Mar 2016 09:20:01 GMT

Sorry I didn't think to take the glucose at the time of bloods for insulin. He had eaten that morning but bloods were taken about 11am.

I had found a couple of reports of insulinoma in cats, didn't really know what else it would be...

currently not hypoglycaemic but will keep monitoring.

Thanks

RE: Feline increased insulin help please.

Andrew Kent — Wed, 30 Mar 2016 09:10:40 GMT

Insulinoma is reported in cats but very rarely (a few case reports).

What was the blood glucose at the time the sample was taken for insulin? And was this after administration of glucose, or food or anything that might have caused insulin release?

If not then that is certainly suggestive of that disease - but obviously what was removed is not histologically consistent.

I think you have to see what happens to the cat now - if it remains persistently hypoglycaemic going forwards then you could consider further imaging (CT angiography is reported to have the highest sensitivity in canine insulinoma), further surgery or medical management.

Andy

RE: Feline increased insulin help please.

Martin Atkinson — Wed, 30 Mar 2016 08:48:25 GMT

[quote user="Hannah Wynne Richards"]That's surgery I'd have been terrified of attempting. [/quote]Probably because our generation was told that pancreatic surgery would lead to: a massive release of enzymes/auto-digestion/shock/horrible death etc etc not necessarily in that order. It is simply not true and so long as the area being resected doesn't involve a pancreatic duct then it is simpler than a cat spay.

RE: Feline increased insulin help please.

Robin Grimmer — Wed, 30 Mar 2016 00:00:43 GMT

Has insulinoma ever been recorded in cats?

RE: Feline increased insulin help please.

Claire Godfrey — Tue, 29 Mar 2016 13:16:34 GMT

Thank you,

The histology went to idexx. Will ring and check with them.

The cat is doing very well since surgery, not weakness so I suspect removing the larger nodule has allowed insulin levels to stabilise. It is just a worry as to when and how quickly the other nodules will join in.

RE: Feline increased insulin help please.

Hannah Wynne Richards — Tue, 29 Mar 2016 11:28:45 GMT

I take my hat off to you. That's surgery I'd have been terrified of attempting. Like Martin, I'm a bit suspicious of the histology, and wondering whether it was a carcinoma, and the smaller nodules 2ys. Hope not.

Wynne

RE: Feline increased insulin help please.

Martin Atkinson — Tue, 29 Mar 2016 10:48:13 GMT

What lab did you use? I would be inclined to ask them to re-visit the histology. Other than that just monitor I guess and if symptoms recur take a second look at the smaller nodules. However if there are multiple insulinomas surgery may be tricky.