diabetestalk.net

Insulinoma And Back Pain

Daisy Has An Insulinoma

Daisy Has An Insulinoma

It’s been a rough couple of weeks here at Casa del Mel. If you haven’t seen it on my Facebook page, Daisy had surgery to remove a tumor, called an Insulinoma, from her pancreas. A tumor, that up until February 6th, we knew nothing about. Now we know too much. An insulinoma is almost always a malignant tumor that appears on the pancreas and starts messing with the insulin levels in a dog (or human). It causes hypoglycemia (low blood sugar), tiredness after exercise, collapse, seizures and sometimes brain damage. It is a progressive disease and will spread throughout the body, as all cancers do. On February 6, I took Daisy in to our regular vet to have her teeth cleaned and a lump (an benign outgrowth of a sebaceous cyst) removed. I expected to receive a call later in the day to be told all went well and she was ready to go home but instead, I received a call a few hours after I dropped her off to tell me that they could not perform the procedures because her blood sugar was really low, abnormally low (hers was in the 40s, normal is 80). I knew it was serious, but I did not know how serious until Monday. That was when my vet informed me it was likely an insulinoma, and that she was referring Daisy to her teacher at the University of Minnesota. Within 30 minutes, I received a call from the U of M to schedule an appointment (yes, it really did happen that fast). This was the moment when I got scared. A call within 30 minutes? An appointment two weeks out was not soon enough? Oh my God. We went in on Thursday for a consult and a CT scan was scheduled for the next day. It would tell us whether or not it had spread and what course of action we would take. The hardest thing I had ever done up until that point was to leave Daisy at her regular vet, with people she knew, but Continue reading >>

What Is An Insulinoma?

What Is An Insulinoma?

An insulinoma is a tumor of the pancreas. That’s the organ that makes the hormone insulin, which controls your blood sugar. Normally, the pancreas makes more insulin when your blood sugar is high and less when those levels drop. But when you have an insulinoma, the tumor will keep making insulin even when your blood sugar gets too low. These tumors are usually small (less than an inch), and almost all of them are not cancer. In most cases, surgery can cure the problem. Symptoms Because these tumors make too much insulin, they can cause symptoms of low blood sugar, also known as hypoglycemia. You could have: Hypoglycemia can be dangerous. If your blood sugar drops very low, you could faint or go into a coma. Hypoglycemia is common in people with diabetes. It often happens because they took too much of their medicine, missed a meal, or got more exercise than usual, all of which can lower blood sugar. An insulinoma can also cause hypoglycemia when you haven’t eaten in a while, but it can happen at any time. What Causes an Insulinoma? It’s not clear why some people get these tumors. Women are slightly more likely to have them than men, and most people get them between ages 40 and 60. You’re also more likely to have an insulinoma if you have certain genetic diseases, including: Multiple endocrine neoplasia type 1 -- when tumors grow in glands that produce hormones Von Hippel-Lindau syndrome -- when tumors and cysts grow in many organs throughout the body Neurofibromatosis type 1 -- noncancerous tumors in the nerves and skin Tuberous sclerosis -- noncancerous tumors that grow in organs such as the brain, eyes, heart, kidneys, skin, and lungs Getting a Diagnosis It can be tough for doctors to diagnose an insulinoma. Its symptoms are the same as other common health prob Continue reading >>

Insulinoma: Causes, Symptoms, Treatment, Diagnosis

Insulinoma: Causes, Symptoms, Treatment, Diagnosis

Insulinoma is the name that refers to a small tumor that develops in the pancreas which is responsible for producing high amounts of insulin. In majority of the cases, Insulinoma is a benign tumor but in some cases it can become malignant. Insulinoma tumors are extremely small and measure not more than 2 cm in diameter. The blood sugar levels in the body are controlled by the pancreas. The pancreas produces insulin which decreases the sugar levels in the body and stops producing it when the sugar levels become lower than normal. This is how normal blood sugar levels are maintained in the body. What happens in case of Insulinoma is that even if the pancreas stops producing insulin, the tumor which develops in pancreas continues to produce insulin thus the blood sugar levels keeps on decreasing which may result in some potentially serious complications like hypoglycemia which can cause dizziness, blurred vision, and in some cases unconsciousness. If not treated promptly, it may even become life threatening. Treatment for Insulinoma is normally surgical where the tumor is removed in its entirety. Once the tumor is removed the affected individual completely recovers from Insulinoma. The exact cause of Insulinoma is still not yet known and most of these tumors develop without any warning signs. Once an Insulinoma develops then the normal functioning of the pancreas is affected. Normally, the pancreas regulates sugar levels in the body through insulin. The greater the amount of insulin the lesser will be the blood sugar level. Once all of the sugar from the food is absorbed by the body for their functions the pancreas stops producing insulin and thus controls the levels of sugar in the body but with Insulinoma the tumor continues to produce insulin which may lead to severe co Continue reading >>

Avian & Exotic Animal Hospital

Avian & Exotic Animal Hospital

Insulinoma One of the most common and most devastating of ferret diseases is cancer of the insulin-producing cells called an insulinoma. Other names for this tumor are beta-cell carcinoma or pancreatic endocrine carcinoma. This cancer occurs when the cells of the pancreas that produce insulin (beta-cells) grow out of control. The disease in the ferret caused by this cancer is not caused by the cancer growing into a large tumor and thereby disrupting the surrounding tissues or organs (as is often the case with cancer), rather, it is due to the effects of the over production of the hormone insulin by the cancerous tissue. As with any major disease problem in the ferret, insulinoma is a problem that should be addressed by a veterinarian familiar with ferrets, their diseases and with significant experience performing surgery on ferrets. This common problem of ferrets is very rare in dogs, cats, or other small animals. Significant anatomy and physiology The pancreas is a large glandular organ located at the upper end of the digestive tract, where the stomach empties into the small intestine. This large gland has two functions, one, called “exocrine” (meaning the gland secretes material outward or out of the body), and the other called “endocrine” (meaning that the gland secretes into the body or into the blood stream). The exocrine function involves the production and secretion of the digestive enzymes used to digest food, primarily proteins and sugars in the diet. The endocrine function involves regulation of the level of sugar in the blood stream. Two substances, or hormones, are involved in this process, insulin and glucagon. After eating a meal that contains sugar or carbohydrates, blood sugar levels rise in the blood. This rise in blood sugar causes the pancreat Continue reading >>

Surgical Management Of Insulinomas

Surgical Management Of Insulinomas

Objective To analyze the characteristics and outcomes following enucleation and pancreatic resections of insulinomas. Design Retrospective cohort study; prospective database. Settings Academic, tertiary, and referral centers. Patients Consecutive patients with insulinomas (symptoms of hyperinsulinism and positive fasting glucose test) who underwent surgical treatment between January 1990 and December 2009. Main Outcome Measures Operative morbidity, tumor recurrence, and survival after treatment. Results A total of 198 patients (58.5% women; median age, 48 years) were identified. There were 175 (88%) neuroendocrine tumors grade G1 and 23 (12%) neuroendocrine tumors grade G2. Malignant insulinomas defined by lymph node/liver metastases were found in 7 patients (3.5%). Multiple insulinomas were found in 8% of patients, and 5.5% of patients had multiple endocrine neoplasia type 1. Surgical procedures included 106 enucleations (54%) and 92 pancreatic resections (46%). Mortality was nil. Rate of clinically significant pancreatic fistula was 18%. Enucleations had a higher reoperation rate compared with pancreatic resections (8.5% vs 1%; P = .02). Multiple endocrine neoplasia type 1 was significantly associated with younger age at onset (P < .005) and higher rates of malignancies and multiple lesions. Median follow-up was 65 months. Six patients (3%; 5 patients had neuroendocrine tumors grade G2) developed tumor recurrence. Four patients (2%) died of disease. New exocrine (1.5%) and endocrine (4%) insufficiencies were associated only with pancreatic resections. Conclusions Outcomes following surgical resection of insulinomas are satisfactory, with no mortality and good functional results. Recurrence is uncommon (3%), and it is more likely associated with neuroendocrine tumors g Continue reading >>

Insulinoma

Insulinoma

What are the other Names for this Condition? (Also known as/Synonyms) Beta Cell Tumor of Pancreas Islet Cell Insulinoma Pancreatic Insulinoma What is Insulinoma? (Definition/Background Information) Insulinoma is a rare tumor of the beta cells of the pancreas, which secretes insulin. They are considered to be functionally-active tumors, because they secrete insulin. Due to this secretion, they cause low blood glucose levels, which is termed ‘clinical hypoglycemia’ About 90% of Insulinomas have a benign behavior, while 10% may turn malignant. These pancreatic tumors generally occur in adults, especially in women These tumors may be small and during the early stages may not cause any significant signs and symptoms, making it difficult to detect an Insulinoma. Malignant tumors have more severe signs and symptoms than benign tumors Insulinoma can cause sweating, vision abnormalities, confusion, etc. in the affected individuals, due to reduced glucose levels in blood. Malignant tumors may infiltrate into local tissue or even metastasize There are various treatment modalities available to address the condition; although, a complete surgical excision is the preferred mode of treatment. In cases of metastasis, a combination of chemotherapy, radiation therapy, and surgical procedures may be used The prognosis of Insulinoma depends upon many factors including the behavior of the tumor (if benign or malignant) and overall health of the individual. Generally, a benign Insulinoma has an excellent prognosis with appropriate treatment The pancreas is an important organ of the digestive system. Based on function of the pancreas, it can be functionally divided into 2 parts, namely: Exocrine pancreas, which produces digestive enzymes, and Endocrine pancreas that produces hormones such Continue reading >>

Pancreatic Neuroendocrine Tumors: Insulinoma

Pancreatic Neuroendocrine Tumors: Insulinoma

What is an insulinoma? An insulinoma is a tumor, usually benign (non-cancerous), made up of specialized beta islet cells (see below) that constantly secrete insulin, causing hypoglycemia (low blood glucose–sugar). Normally, as the glucose rises with eating, the pancreas responds by secreting more insulin, which in turn helps utilize or store the glucose and its blood level drops back down into a safe range. Subsequently, as the glucose level continues to fall toward the lower limit of normal (normal, 60-100mg/dL), the secretion of insulin (by the normal beta cells in the pancreas) stops, and this allows the glucose to remain in the normal range. This type of feedback regulation is the hallmark of endocrine organs (thyroid, parathyroid, endocrine part of the pancreas, pituitary, gonad, and adrenal glands that secrete specific hormones). When an insulinoma is present, insulin regulation is abnormal such that the tumor continues to secrete insulin even though the glucose level may fall to a dangerously low level. Even though insulinoma is the most common pancreatic islet cell tumor, it is very rare, occurring in only 3-4 per million people. Except in very rare familial (occurring in families, transmitted genetically from parent to child) situations, the exact cause is unknown. Figure 1: The average age to develop an insulinoma is the mid-40s (range, 10-82 years), and occurs slightly more frequently in females than males. Most are sporadic (occurring "out of the blue" with no known cause) with about 10% occurring as part of the Multiple Endocrine Neoplasia type 1 (MEN 1) syndrome. At least 90% have single, benign, small (less than 2 cm – 3/4 of an inch) tumors (Figure 1). Hypoglycemic symptoms are experienced by virtually all patients with insulinoma and can be grouped Continue reading >>

Insulinoma

Insulinoma

What is an insulinoma? The pancreas makes insulin, which helps keep your blood sugar level balanced. Tumors on your pancreas, called insulinomas, make extra insulin, more than your body can use. This causes blood sugar levels to drop too low. These tumors are rare and usually do not spread to other parts of your body. What causes an insulinoma? The cause of insulinomas is unknown. What are the risk factors for an insulinoma? There are few risk factors for insulinomas. But, women seem to be affected more often than men. Most often, it starts between ages 40 and 60. Some genetic diseases can raise your chance of getting an insulinoma. They are: Multiple endocrine neoplasia type 1, abnormal tissue growth in the endocrine system Von Hippel-Lindau syndrome, an inherited disease that causes tumors and cysts throughout your body Other genetic syndromes, such as neurofibromatosis type 1 and tuberous sclerosis What are the symptoms of an insulinoma? Insulinomas can cause these symptoms: Confusion Sweating Weakness Rapid heartbeat If your blood sugar gets too low, you can pass out and even go into a coma. How are insulinomas diagnosed? Insulinomas can be difficult to diagnose. The average time between the start of symptoms and a diagnosis is about 3 years. If your healthcare provider suspects an insulinoma, you may stay in the hospital for a few days. This is so your doctor can watch your blood sugar and other substances in your blood while you fast. You will not be able to eat or drink anything except water during this time. If you have an insulinoma, you will probably have very low blood sugar levels within 48 hours of starting this test. If your symptoms of low blood sugar have been after meals, you may also have a test of your blood sugar and insulin for several hours after a Continue reading >>

How I Treat... Canine Insulinoma - Wsava2009 - Vin

How I Treat... Canine Insulinoma - Wsava2009 - Vin

World Small Animal Veterinary Association World Congress Proceedings, 2009 Michael E. Herrtage, MA, BVSc, DVSC, DVR, DVD, DSAM, DECVIM, DECVDI, MRCVS Department of Veterinary Medicine, University of Cambridge Functional islet cell tumours (insulinomas) are the most frequently occurring tumours of the endocrine pancreas in dogs. Most insulin-secreting tumours are malignant islet cell carcinomas which metastasize to regional lymph nodes and/or the liver. Early diagnosis is important as dogs with metastases have significantly reduced survival times. Insulinomas are composed of neoplastic -cells which continue to release insulin despite the presence of hypoglycaemia. Hypoglycaemia is normally the major inhibitory stimulus for insulin secretion. As a result of hyperinsulinism, tissue utilization of glucose continues, the hypoglycemia worsens, and ultimately clinical signs develop. The onset and severity of clinical signs is determined by the degree of hypoglycemia and the rate at which the plasma concentration of glucose falls. A rapid decline in plasma glucose concentration may occur with fasting, exercise, or excitement in dogs with insulinomas. The brain is an obligate consumer of glucose. Cerebral cells have limited stores of glycogen and a limited ability to utilize protein and amino acids for energy. These cells will be the first affected by hypoglycaemia. Prolonged and profound hypoglycaemia causes ischemic neuronal cell damage in a pattern similar to that caused by cerebral hypoxia. Hypoglycemia is a potent stimulus for the release of hormones which have an antagonistic action to insulin. These include glucagon, growth hormone, glucocorticoids, catecholamines, and possibly thyroid hormones. These hormones act in concert to raise the plasma glucose concentration. Som Continue reading >>

What Are Diseases Of The Pancreas?

What Are Diseases Of The Pancreas?

Pancreatic cancer is a disease of the pancreas. There are two main types of pancreatic cancer: Pancreatic cancer that arises from the ductal cells of the exocrine pancreas. This is called “pancreatic ductal adenocarcinoma”. This is the most common type. Pancreatic cancer that arises from the endocrine cells in the pancreas. This is called “termed pancreatic neuroendocrine tumors” or “islet cell tumors”. This disease of the pancreas has a wide spectrum of biologic activity ranging from benign to more aggressive endocrine carcinomas. Pancreatic Ductal Adenocarcinoma Pancreatic cancer is a lethal malignancy in which the anticipated mortality approaches the incidence of the disease. Although pancreatic cancer only represents 3% of new cancer cases each year among men and women, the disease is responsible for 6% (men) or 7% (women) of all cancer related deaths in the United States. Despite steady improvements in cancer related outcomes for many malignancies over the past several decades, the survival for patients with pancreatic cancer remains challenging. Pancreatic cancer has the ability to invade beyond the pancreas to surrounding structures (locally advanced) and to spread from the pancreas to distance sites (metastasis). The outcomes for patients are related to the extent of disease at presentation and the effectiveness of therapy, which may include surgery, chemotherapy and radiation therapy. Neuroendocrine (Islet Cell) Tumors of the Pancreas Neuroendocrine tumors of the pancreas are rare, comprising less than 5% of all pancreatic tumors. Although some of these tumors over-produce hormones that can be measured in the blood and produce a clinical syndrome (such as insulinomas, glucagonomas, or gastrinomas), most of these tumors are nonfunctional. Nonfunction Continue reading >>

Insulinoma

Insulinoma

What is Insulinoma? Insulinoma is a tumor of the insulin making cells of pancreas, which are called as beta cells or pancreatic islet cells or Islets of Langerhans. The insulinomas are located in the pancreas or are attached to the pancreas. Insulinoma is a type of neuroendocrine tumor (NET); neuro means nerve and endocrine mean hormone producing. It is also known as pancreatic neuroendocrine tumor (pNETs) or islet cell adenoma. Insulinoma leads to production of excessive insulin, which is a hormone controlling the levels of blood glucose. Excess amounts of insulin lead to hypoglycemia or low blood sugar. Under normal conditions, the glucose levels increase after eating and in response, pancreas secrete insulin which helps in utilizing the glucose or storing it, thereby reducing the blood sugar level to a safe level. Subsequently, when the glucose level falls to the lower limit, the secretion of insulin from pancreas stops. This cycle regulates the levels of glucose in body. In patients with insulinoma, this regulation is affected and the tumor continues to secrete insulin, in spite of reaching very low blood glucose levels. The pancreatic tumors are small in size and in most of the cases, they are benign or non-cancerous. Malignant insulinomas are very rare in occurrence. Facts on Insulinoma Occurence of insulinomas in the general population is 1-4 people per million Insulinomas can occur throughout the pancreas and are found either inside or attached directly to the organ Around ninety percent of insulinomas are benign, solitary, < 2 cm, and occur at intrapancreatic sites Extrahepatic insulinomas causing hypoglycemia are extremely rare with an incidence of < 2%; these are mostly found in the duodenal wall What are the Causes of Insulinoma? The exact cause of insulinom Continue reading >>

General Information About Pancreatic Neuroendocrine Tumors (islet Cell Tumors)

General Information About Pancreatic Neuroendocrine Tumors (islet Cell Tumors)

Pancreatic neuroendocrine tumors form in hormone-making cells (islet cells) of the pancreas. The pancreas is a gland about 6 inches long that is shaped like a thin pear lying on its side. The wider end of the pancreas is called the head, the middle section is called the body, and the narrow end is called the tail. The pancreas lies behind the stomach and in front of the spine. Enlarge There are two kinds of cells in the pancreas: Endocrine pancreas cells make several kinds of hormones (chemicals that control the actions of certain cells or organs in the body), such as insulin to control blood sugar. They cluster together in many small groups (islets) throughout the pancreas. Endocrine pancreas cells are also called islet cells or islets of Langerhans. Tumors that form in islet cells are called islet cell tumors, pancreatic endocrine tumors, or pancreatic neuroendocrine tumors (pancreatic NETs). Exocrine pancreas cells make enzymes that are released into the small intestine to help the body digest food. Most of the pancreas is made of ducts with small sacs at the end of the ducts, which are lined with exocrine cells. This summary discusses islet cell tumors of the endocrine pancreas. See the PDQ summary on Pancreatic Cancer Treatment for information on exocrine pancreatic cancer. Pancreatic neuroendocrine tumors (NETs) may be benign (not cancer) or malignant (cancer). When pancreatic NETs are malignant, they are called pancreatic endocrine cancer or islet cell carcinoma. Pancreatic NETs are much less common than pancreatic exocrine tumors and have a better prognosis. Pancreatic NETs may or may not cause signs or symptoms. Most pancreatic NETs are functional tumors. There are different kinds of functional pancreatic NETs. Pancreatic NETs make different kinds of hormones s Continue reading >>

Ferret Insulinoma

Ferret Insulinoma

Tumors of the pancreas (insulinoma) can cause excess secretion of insulin, thus lowering the blood glucose (sugar) level to a point that a ferret can become ill. Unfortunately, this is a relatively common problem in middle aged and older ferrets. Graphic photos on this page. The end of this page has a short video on surgery to remove nodules from the pancreas. Symptoms Some ferrets do not show any symptoms, while others exhibit lethargy and weakness. There might be a decrease in appetite and weight loss. These symptoms might even come and go over a period of months. Some ferrets will have increased salivation and even a glazed appearance to the eyes, and might even collapse or have seizures. Diagnosis Some ferrets are diagnosed as having an insulinoma when an abdominal surgery is being performed for other reasons (adrenal gland disease, spay, liver disease). This is especially true for the ferrets that are not showing any symptoms of this disease. For those ferrets that are symptomatic of insulinoma, the diagnosis is made based on history, examination findings, and diagnostic tests. Our laboratory has a special blood panel for ferrets that are exhibiting signs of insulinoma.The diagnosis of insulinoma is verified by a low blood glucose (sugar) level. We use a special instrument to check the blood glucose level that only requires a few drops of blood. If you have ever tried to get blood from a ferret you would understand the importance of being able to do this test with only a few drops of blood Medical Treatment Medical therapy can be effective at controlling symptoms, although it can not cure the disease. Food should be fed frequently, and should consist of cat food or ferret food. Stay away from high sugar foods that can stimulate the pancreas to secrete excess amount Continue reading >>

Pancreatic Neuroendocrine Neoplasms (pnens)

Pancreatic Neuroendocrine Neoplasms (pnens)

General Discussion The pancreas is a gland located between the stomach, spleen, duodenum and colon transversum. It contains specialized exocrine cells that secrete enzymes that travel to the intestines and aid in digestion as well as endocrine cells, so called islet cells. Pancreatic neuroendocrine neoplasms (pNENs) are an increasingly common group of malignancies that arise within the endocrine tissue of the pancreas. Endocrine tissue is specialized tissue that contains hormone-secreting cells (e.g. α-cells, ß-cells). These cells secrete several different hormones into the blood (endocrine) or to local cells (paracrine, autocrine). These hormones have a variety of functions within the body (e.g. glucose-metabolism). Neoplasms that arise from endocrine tissue may also secrete hormones, resulting in excessive levels of these hormones in the body and potentially a wide variety of symptoms. There are several different subtypes of functioning pNENs distinguished by the specific type of hormone that they secrete. Insulinomas and gastrinomas are the most common types of hormone secreting pNENs. Although there is no difference in diagnosis and therapy, pNENs can be differentiated as functioning or nonfunctioning. Functioning pNENs secrete hormones into the bloodstream, which cause special symptoms; nonfunctioning neoplasms may produce hormones, but no systemic symptoms. Nonfunctioning neuroendocrine neoplasms can still cause symptoms relating to tumor size and location such as obstruction or internal bleeding. They have some different differentiation (G1-3), but all of them have the potential for malignant transformation. Most pNENs occur sporadically, but in some cases, pNENs may occur as part of a larger genetic syndrome such as multiple endocrine neoplasia type 1 (MEN1) o Continue reading >>

Insulinoma

Insulinoma

An insulinoma is a rare type of tumor of the pancreas that secretes insulin, a hormone that lowers the levels of sugar (glucose) in the blood. Insulinomas are a type of pancreatic endocrine tumor. Only 10% of insulinomas are cancerous. The average age at diagnosis is 50. Symptoms Symptoms of insulinoma result from low levels of sugar (glucose) in the blood (hypoglycemia), which occur when the person does not eat for several hours (most often in the morning after an all-night fast). The symptoms include faintness, weakness, trembling, awareness of the heartbeat (palpitations), sweating, nervousness, and profound hunger. Other symptoms include headache, confusion, vision abnormalities, unsteadiness, and marked changes in personality. The low levels of sugar in the blood may even lead to a loss of consciousness, seizures, and coma. Diagnosis Diagnosing an insulinoma can be difficult. Doctors try to perform blood tests while the person has symptoms. Blood tests include measurements of blood glucose levels and insulin levels. Very low levels of glucose and high levels of insulin in the blood indicate the presence of an insulinoma. Because many people have symptoms only occasionally, doctors may admit them to the hospital. In the hospital, the person fasts for at least 48 hours, sometimes up to 72 hours, and is closely monitored. During that time, the symptoms usually appear, and blood tests are performed to measure the levels of glucose and insulin. If the blood tests suggest the person has an insulinoma, the location must then be pinpointed. Imaging tests, such as endoscopic ultrasonography (which shows the lining of the digestive tract more clearly because the ultrasound probe is placed on the tip of the endoscope) or positron emission tomography (PET) scans, can be used t Continue reading >>

More in insulin