Retrospective study of 20 cats surgically treated for insulinoma

Stan Veytsman; Pierre Amsellem; Brian D. Husbands; Aaron K. Rendahl; Philip J. Bergman; Guillaume Chanoit; Colleen Hickey; Kristy R. Cash; Karl C. Maritato; Francesco Collivignarelli; Jolle Kirpensteijn

doi:10.1111/vsu.13892

Retrospective study of 20 cats surgically treated for insulinoma

Stan Veytsman, Pierre Amsellem, Brian D. Husbands, Aaron K. Rendahl, Philip J. Bergman, Guillaume Chanoit, Colleen Hickey, Kristy R. Cash, Karl C. Maritato, Francesco Collivignarelli, Jolle Kirpensteijn

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Abstract

Objective: To report the clinical signs, histopathology results, and prognostic factors for outcomes following excision for feline insulinoma (INS). Study design: Retrospective study. Sample population: Twenty client-owned cats. Methods: Medical records from 2006 to 2020 were reviewed by Veterinary Society of Surgical Oncology members for cats with hypoglycemia resulting from INS, with surgical excision and follow up. Clinical signs and histopathology results were summarized. Factors potentially related to disease-free interval (DFI), disease-related death (DRD), and overall survival time (OST) were analyzed with a Cox proportional hazards regression analysis. Results: All cats were hypoglycemic on presentation with neurologic signs in 18 out of 20 and inappropriate insulin levels in 12/13. Excision of insulinomas resulted in immediate euglycemia or hyperglycemia in 18 cats. Eighteen cats survived to hospital discharge. The median time to death or last postoperative follow up was 664 days (range: 2-1205 days). Prognostic factors included age at presentation (for DFI); time to postoperative euglycemia (for DRD); preoperative and postoperative serum blood glucose concentrations; metastasis at the time of surgery (DFI and DRD), and histopathologic tumor invasion (for OST). The median OST for all cats was 863 days. The 1-, 2- and 3-year survival rates were 75%, 51%, and 10%, respectively. Conclusion: Excision of insulinoma resulted in euglycemia or hyperglycemia in most cats. Negative prognostic factors included young age, low serum glucose concentrations, metastasis at time of surgery, tumor invasion, and shorter time to euglycemia. Clinical significance: Surgical excision resulted in survival times comparable to those of canine INS.

Original language	English (US)
Pages (from-to)	42-50
Number of pages	9
Journal	Veterinary Surgery
Volume	52
Issue number	1
DOIs	https://doi.org/10.1111/vsu.13892
State	Published - Jan 2023

Bibliographical note

Funding Information:
Author Contributions: Veytsman S, DVM: Contributed to the conception and design, analysis, data interpretation, and manuscript preparation, and approved the final version of the manuscript. Amsellem P, DVM, MS, DACVS-SA: Contributed to analysis, data interpretation and manuscript preparation, and approved the final version of the manuscript. Husbands BD, DVM, DACVIM: Contributed to analysis, data interpretation, and manuscript preparation, and approved the final version of the manuscript. Rendahl AK, BA, BS, PhD: Contributed to analysis, data interpretation, and manuscript preparation, and approved the final version of the manuscript. Bergman PJ, DVM, MS, PhD, DACVIM: Contributed to study conception and design, analysis, data interpretation, and manuscript preparation, and approved the final version of the manuscript. Chanoit G, DEDV, MSc, PhD, DECVS/DACVS-SA: Contributed to data collection and manuscript preparation, and approved the final version of the manuscript. Hickey C, DVM: Contributed to study conception and design, analysis and data interpretation, and manuscript preparation; Cash KR, DVM: Contributed to analysis and data interpretation, and approved the final version of the manuscript; Maritato KC, DVM, DACVS-SA: Contributed to analysis and data interpretation, and approved the final version of the manuscript. Collivignarelli F, MS, PhD: Contributed to analysis, data interpretation, and manuscript preparation, and approved the final version of the manuscript. Kirpensteijn J, DVM, PhD, DECVS/DACVS-SA: Contributed to study conception and design, analysis, data interpretation, and manuscript preparation, and approved the final version of the manuscript. The authors would like to thank Drs. DeWana Anderson, Daniel Balogh, Sabrina Barry, Rebecca Brueggeman, Bishoy Eskander, Emily Klosterman, Phillippe Chagnon Larose, Jenny Lenz, Matt Matiasovic, Emily Montes, Oliver Morgan, John O'Neill, Jim Perry, Sam Ristich, Renee Rucinsky, Tim Scase, Lisa Sepesy, Sebastian Schaub, Satoshi Takagi, Jason Tarricone, Sam Woods, and David Worth for case submissions; Dr. Valentina Mashnikova for imaging advice; and Matt Cash for image editing. We especially thank Dr. Christopher B. Thomson for being a catalyst for this study.

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© 2022 The Authors. Veterinary Surgery published by Wiley Periodicals LLC on behalf of American College of Veterinary Surgeons.

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@article{773b3f49112045a0b03d8705caca8da5,

title = "Retrospective study of 20 cats surgically treated for insulinoma",

abstract = "Objective: To report the clinical signs, histopathology results, and prognostic factors for outcomes following excision for feline insulinoma (INS). Study design: Retrospective study. Sample population: Twenty client-owned cats. Methods: Medical records from 2006 to 2020 were reviewed by Veterinary Society of Surgical Oncology members for cats with hypoglycemia resulting from INS, with surgical excision and follow up. Clinical signs and histopathology results were summarized. Factors potentially related to disease-free interval (DFI), disease-related death (DRD), and overall survival time (OST) were analyzed with a Cox proportional hazards regression analysis. Results: All cats were hypoglycemic on presentation with neurologic signs in 18 out of 20 and inappropriate insulin levels in 12/13. Excision of insulinomas resulted in immediate euglycemia or hyperglycemia in 18 cats. Eighteen cats survived to hospital discharge. The median time to death or last postoperative follow up was 664 days (range: 2-1205 days). Prognostic factors included age at presentation (for DFI); time to postoperative euglycemia (for DRD); preoperative and postoperative serum blood glucose concentrations; metastasis at the time of surgery (DFI and DRD), and histopathologic tumor invasion (for OST). The median OST for all cats was 863 days. The 1-, 2- and 3-year survival rates were 75%, 51%, and 10%, respectively. Conclusion: Excision of insulinoma resulted in euglycemia or hyperglycemia in most cats. Negative prognostic factors included young age, low serum glucose concentrations, metastasis at time of surgery, tumor invasion, and shorter time to euglycemia. Clinical significance: Surgical excision resulted in survival times comparable to those of canine INS.",

author = "Stan Veytsman and Pierre Amsellem and Husbands, {Brian D.} and Rendahl, {Aaron K.} and Bergman, {Philip J.} and Guillaume Chanoit and Colleen Hickey and Cash, {Kristy R.} and Maritato, {Karl C.} and Francesco Collivignarelli and Jolle Kirpensteijn",

note = "Funding Information: Author Contributions: Veytsman S, DVM: Contributed to the conception and design, analysis, data interpretation, and manuscript preparation, and approved the final version of the manuscript. Amsellem P, DVM, MS, DACVS-SA: Contributed to analysis, data interpretation and manuscript preparation, and approved the final version of the manuscript. Husbands BD, DVM, DACVIM: Contributed to analysis, data interpretation, and manuscript preparation, and approved the final version of the manuscript. Rendahl AK, BA, BS, PhD: Contributed to analysis, data interpretation, and manuscript preparation, and approved the final version of the manuscript. Bergman PJ, DVM, MS, PhD, DACVIM: Contributed to study conception and design, analysis, data interpretation, and manuscript preparation, and approved the final version of the manuscript. Chanoit G, DEDV, MSc, PhD, DECVS/DACVS-SA: Contributed to data collection and manuscript preparation, and approved the final version of the manuscript. Hickey C, DVM: Contributed to study conception and design, analysis and data interpretation, and manuscript preparation; Cash KR, DVM: Contributed to analysis and data interpretation, and approved the final version of the manuscript; Maritato KC, DVM, DACVS-SA: Contributed to analysis and data interpretation, and approved the final version of the manuscript. Collivignarelli F, MS, PhD: Contributed to analysis, data interpretation, and manuscript preparation, and approved the final version of the manuscript. Kirpensteijn J, DVM, PhD, DECVS/DACVS-SA: Contributed to study conception and design, analysis, data interpretation, and manuscript preparation, and approved the final version of the manuscript. The authors would like to thank Drs. DeWana Anderson, Daniel Balogh, Sabrina Barry, Rebecca Brueggeman, Bishoy Eskander, Emily Klosterman, Phillippe Chagnon Larose, Jenny Lenz, Matt Matiasovic, Emily Montes, Oliver Morgan, John O'Neill, Jim Perry, Sam Ristich, Renee Rucinsky, Tim Scase, Lisa Sepesy, Sebastian Schaub, Satoshi Takagi, Jason Tarricone, Sam Woods, and David Worth for case submissions; Dr. Valentina Mashnikova for imaging advice; and Matt Cash for image editing. We especially thank Dr. Christopher B. Thomson for being a catalyst for this study. Publisher Copyright: {\textcopyright} 2022 The Authors. Veterinary Surgery published by Wiley Periodicals LLC on behalf of American College of Veterinary Surgeons.",

year = "2023",

month = jan,

doi = "10.1111/vsu.13892",

language = "English (US)",

volume = "52",

pages = "42--50",

journal = "Veterinary Surgery",

issn = "0161-3499",

publisher = "Wiley-Blackwell",

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TY - JOUR

T1 - Retrospective study of 20 cats surgically treated for insulinoma

AU - Veytsman, Stan

AU - Amsellem, Pierre

AU - Husbands, Brian D.

AU - Rendahl, Aaron K.

AU - Bergman, Philip J.

AU - Chanoit, Guillaume

AU - Hickey, Colleen

AU - Cash, Kristy R.

AU - Maritato, Karl C.

AU - Collivignarelli, Francesco

AU - Kirpensteijn, Jolle

N1 - Funding Information: Author Contributions: Veytsman S, DVM: Contributed to the conception and design, analysis, data interpretation, and manuscript preparation, and approved the final version of the manuscript. Amsellem P, DVM, MS, DACVS-SA: Contributed to analysis, data interpretation and manuscript preparation, and approved the final version of the manuscript. Husbands BD, DVM, DACVIM: Contributed to analysis, data interpretation, and manuscript preparation, and approved the final version of the manuscript. Rendahl AK, BA, BS, PhD: Contributed to analysis, data interpretation, and manuscript preparation, and approved the final version of the manuscript. Bergman PJ, DVM, MS, PhD, DACVIM: Contributed to study conception and design, analysis, data interpretation, and manuscript preparation, and approved the final version of the manuscript. Chanoit G, DEDV, MSc, PhD, DECVS/DACVS-SA: Contributed to data collection and manuscript preparation, and approved the final version of the manuscript. Hickey C, DVM: Contributed to study conception and design, analysis and data interpretation, and manuscript preparation; Cash KR, DVM: Contributed to analysis and data interpretation, and approved the final version of the manuscript; Maritato KC, DVM, DACVS-SA: Contributed to analysis and data interpretation, and approved the final version of the manuscript. Collivignarelli F, MS, PhD: Contributed to analysis, data interpretation, and manuscript preparation, and approved the final version of the manuscript. Kirpensteijn J, DVM, PhD, DECVS/DACVS-SA: Contributed to study conception and design, analysis, data interpretation, and manuscript preparation, and approved the final version of the manuscript. The authors would like to thank Drs. DeWana Anderson, Daniel Balogh, Sabrina Barry, Rebecca Brueggeman, Bishoy Eskander, Emily Klosterman, Phillippe Chagnon Larose, Jenny Lenz, Matt Matiasovic, Emily Montes, Oliver Morgan, John O'Neill, Jim Perry, Sam Ristich, Renee Rucinsky, Tim Scase, Lisa Sepesy, Sebastian Schaub, Satoshi Takagi, Jason Tarricone, Sam Woods, and David Worth for case submissions; Dr. Valentina Mashnikova for imaging advice; and Matt Cash for image editing. We especially thank Dr. Christopher B. Thomson for being a catalyst for this study. Publisher Copyright: © 2022 The Authors. Veterinary Surgery published by Wiley Periodicals LLC on behalf of American College of Veterinary Surgeons.

PY - 2023/1

Y1 - 2023/1

N2 - Objective: To report the clinical signs, histopathology results, and prognostic factors for outcomes following excision for feline insulinoma (INS). Study design: Retrospective study. Sample population: Twenty client-owned cats. Methods: Medical records from 2006 to 2020 were reviewed by Veterinary Society of Surgical Oncology members for cats with hypoglycemia resulting from INS, with surgical excision and follow up. Clinical signs and histopathology results were summarized. Factors potentially related to disease-free interval (DFI), disease-related death (DRD), and overall survival time (OST) were analyzed with a Cox proportional hazards regression analysis. Results: All cats were hypoglycemic on presentation with neurologic signs in 18 out of 20 and inappropriate insulin levels in 12/13. Excision of insulinomas resulted in immediate euglycemia or hyperglycemia in 18 cats. Eighteen cats survived to hospital discharge. The median time to death or last postoperative follow up was 664 days (range: 2-1205 days). Prognostic factors included age at presentation (for DFI); time to postoperative euglycemia (for DRD); preoperative and postoperative serum blood glucose concentrations; metastasis at the time of surgery (DFI and DRD), and histopathologic tumor invasion (for OST). The median OST for all cats was 863 days. The 1-, 2- and 3-year survival rates were 75%, 51%, and 10%, respectively. Conclusion: Excision of insulinoma resulted in euglycemia or hyperglycemia in most cats. Negative prognostic factors included young age, low serum glucose concentrations, metastasis at time of surgery, tumor invasion, and shorter time to euglycemia. Clinical significance: Surgical excision resulted in survival times comparable to those of canine INS.

AB - Objective: To report the clinical signs, histopathology results, and prognostic factors for outcomes following excision for feline insulinoma (INS). Study design: Retrospective study. Sample population: Twenty client-owned cats. Methods: Medical records from 2006 to 2020 were reviewed by Veterinary Society of Surgical Oncology members for cats with hypoglycemia resulting from INS, with surgical excision and follow up. Clinical signs and histopathology results were summarized. Factors potentially related to disease-free interval (DFI), disease-related death (DRD), and overall survival time (OST) were analyzed with a Cox proportional hazards regression analysis. Results: All cats were hypoglycemic on presentation with neurologic signs in 18 out of 20 and inappropriate insulin levels in 12/13. Excision of insulinomas resulted in immediate euglycemia or hyperglycemia in 18 cats. Eighteen cats survived to hospital discharge. The median time to death or last postoperative follow up was 664 days (range: 2-1205 days). Prognostic factors included age at presentation (for DFI); time to postoperative euglycemia (for DRD); preoperative and postoperative serum blood glucose concentrations; metastasis at the time of surgery (DFI and DRD), and histopathologic tumor invasion (for OST). The median OST for all cats was 863 days. The 1-, 2- and 3-year survival rates were 75%, 51%, and 10%, respectively. Conclusion: Excision of insulinoma resulted in euglycemia or hyperglycemia in most cats. Negative prognostic factors included young age, low serum glucose concentrations, metastasis at time of surgery, tumor invasion, and shorter time to euglycemia. Clinical significance: Surgical excision resulted in survival times comparable to those of canine INS.

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Retrospective study of 20 cats surgically treated for insulinoma

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