Management of insulinoma in a dog with subcutaneous diluted glucagon and a continuous glucose monitoring system

Abstract

Glucagon has been shown effective for the treatment of insulinoma-associated hypoglycemia. However, its use has been limited to preoperative supportive care and emergency treatment of hypoglycemic crisis because of the need of constant intravenous infusion administration. Here, we report a case of insulinoma in a dog managed with subcutaneous saline-diluted glucagon and a continuous glucose monitoring system (CGMS), which were effective in glycemic control allowing long-term home treatment.

A 14-year-old spayed female Lakeland terrier presented with hypoglycemic crisis, unresponsive to prednisolone and diet. The dog was diagnosed with insulinoma based on hyperinsulinemia and computed tomography findings. Treatment with subcutaneous diluted glucagon along with CGMS monitoring allowed the patient to remain at home with controlled glycemia for approximately 4 months. Therefore, a combination of subcutaneous diluted glucagon and CGMS might be an effective long-term supportive care of insulinoma in dogs.