Improved survival in a retrospective cohort of 28 dogs with insulinoma.

OBJECTIVES: To determine the survival times for a cohort of dogs with insulinoma and to describe the impact of medical therapy both in non-surgical cases and in surgical cases following relapse. METHODS: A retrospective study of dogs with insulinoma is presented. The Kaplan-Meier method is used to evaluate the survival characteristics of this population. RESULTS: Twenty-eight dogs were included in the study. The median survival time for all dogs was 547 days. Nineteen patients underwent partial pancreatectomy. The median survival time for this group was 785 days and for those subsequently receiving prednisolone therapy on relapse it was 1316 days. Perioperative complications are discussed. CLINICAL SIGNIFICANCE: Survival times in this study exceed those in other studies published previously. In part, this is explained by an improved remission duration following surgery compared with previous reports. More striking though is the longevity of patients following institution of medical therapy. These data give strong objective support to the role of medical therapy in the management of canine insulinoma, including following relapse after surgically induced remission.

Caecal impaction and chronic intestinal pseudo-obstruction in a dog.

A 10-year-old female neutered cross-breed dog presented with a 4-month history of chronic intermittent diarrhoea and vomiting. Abdominal ultrasound showed dilated loops of small intestine and a suspected faecolith. Exploratory surgery revealed a caecal impaction and a typhlectomy was performed. Histopathological examination of caecal and full thickness small intestine sections demonstrated atrophy of smooth muscle fibres as well as an influx of plasma cells, lymphocytes and macrophages, and mild lymphoplasmacytic and eosinophilic enteritis. This combination of caecal impaction and chronic intestinal pseudo-obstruction has not been reported previously in the dog.

Assessment of an ECG event recorder in healthy dogs in a hospital environment.

Ambulatory electrocardiography techniques are superior to standard electrocardiography in evaluating rhythm disturbances in dogs with episodic weakness or collapse. Disadvantages include cumbersome equipment, short recording periods and an inherent delay in trace analysis. A small programmable cardiac event recorder with combined automatic and owner-triggered recording capability was evaluated in 13 healthy dogs in a hospital environment. The unit was well tolerated and produced diagnostic recordings directly to a personal computer, with useful information about continuous heart rate. It detects premature complexes, pauses and bradycardias according to programmed detection thresholds. These events were counted frequently but trace review revealed concerns regarding specificity. Recordings were often triggered by sinus arrhythmia, sinus tachycardia and unclassifiable rate changes rather than by clinically significant arrhythmias. Correct detection of ventricular ectopic complexes, a single supraventricular premature complex, sinus arrest and second-degree atrioventricular block occurred in individual dogs. Visual review of all automatically recorded events was essential and significantly increased the time required for event recording analysis. Manual recordings might be more useful and the overall results suggest that further studies are warranted to evaluate the system in clinical cases in the home environment.

Trilostane treatment of a dog with functional adrenocortical neoplasia.

A 13-year-old, crossbreed dog presented with a history of recent onset polydipsia, progressive lethargy, weakness and reduced appetite. Blood tests showed raised concentrations of alkaline phosphatase and alanine aminotransferase with marginally low serum potassium. There was a leucocytosis with a mature neutrophilia and no eosinophils. Endocrine tests showed a normal aldosterone concentration and an exaggerated adrenocorticotropic hormone (ACTH) stimulation test, consistent with a diagnosis of hyperadrenocorticism (HAC). A diagnosis of adrenal-dependent HAC was made, based on the presence of a calcified mass involving the left adrenal gland, and hepatomegaly, on radiography and ultrasonography. The owners declined surgical adrenalectomy. Medical management with trilostane rapidly improved the clinical signs and normalised the serum chemistry. ACTH stimulation tests showed an improvement in post-ACTH cortisol concentrations and were used to make dose adjustments where necessary. At the time of writing, no adverse side effects had been seen and the dog remained well after 80 weeks of treatment.