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.

A 15-year-old neutered male domestic shorthair cat presented with a 2-month history of stridor, snoring, hoarseness, dysphagia and weight loss. Non- anesthetized contrast computed tomography of the head revealed a heterogeneous enhanced mass which was suspected as a malignant tumor the oropharynx, extending from the caudal soft palate. Fine needle aspiration under anesthesia was performed from deep tissue of the mass. Cytology revealed cells consistent with squamous cell carcinoma. The patient was treated with toceranib (10 mg/cat, p.o., EOD or thrice weekly) and meloxicam (0.025〜0.300 mg/kg, s.c. or p.o., SID, EOD or thrice weekly). Radiologically, the cancer resolved almost completely by day 8. The cancer recurred after 13 days of meloxicam suspension. Progression-free survival was 30 days. The range of creatinine was 1.83〜3.39 mg/dL during follow-up. This is the first reported case of an oropharyngeal squamous cell carcinoma in a cat treated with combinational therapy of toceranib and high dose meloxicam.