Insulinoma pancreático en canino raza Shetland.

Abstract

A 6-year-old Shetland dog patient was admitted for consultation for prostration, vomiting and seizures. The owners reported that the patient had previously been diagnosed with hip dysplasia, which was being managed with pregabalin, and he had never had a seizure; furthermore, he could not stand up by himself. On clinical examination bradycardia was observed, with no heart murmurs on auscultation, threat reflexes and facial reflexes present, diminished proprioception of the right pelvic limb and pain on palpation in the lumbosacral region. Acute stress syncope was initially suspected, for which the owner is recommended to perform diagnostic aids such as hemogram, echocardiography and abdominal ultrasound, as well as pre- and post-pandrial glycemias, given by prostration, vomiting, convulsions and the degree of overweight. The abdominal ultrasound examination showed a mass at the pancreatic level with abnormal ecogenicities and compatible with possible mass. Pre and post pandrial glycemias were taken, evidencing as result 46 mg/dl pre-pandrial and one post taken two hours after supplying the food of 25 mg/dl. It was arranged to make an exploratory coeliotomy with exeresis of the mass at pancreatic level, and later histopathological evaluation. The diagnosis thrown in the histopathology was a pancreatic insulinoma. The prognosis was reserved, and it was kept under observation and glycemia control. The patient was treated with cephradine, clindamycin, dipyrone, tramadol, omeprazole and silymarin to control and avoid adverse effects to the surgery. There was an improvement in his health condition under reserved prognosis, after this, a routine ultrasound control was performed, which showed as a result a pancreatitis product of the manipulation and, secondly, an abscess located in the pancreas' caudal lobe, reason why it was determined to admit the patient again to surgery in order to perform a drainage and omentalization of the pancreas. After the surgery, the patient was referred to the ICU for observation; however, due to the complications presented by the patient, he failed hours after the operation.