Insulinoma and Rare Endocrine Tumors: What You'll See Once and Never Forget

Learning Objectives

• 1Apply Whipple's triad to evaluate episodic collapse in a middle-aged to older large-breed dog, prioritize glucose measurement before initiating anticonvulsant therapy, and interpret a concurrent insulin level drawn at the time of documented hypoglycemia
• 2Calculate the Amended Insulin-to-Glucose Ratio (AIGR) and explain its limitations, assign a WHO stage (I, II, or III) based on imaging findings, and select the appropriate treatment pathway — surgery versus medical management — for each stage
• 3Prescribe the complete medical management protocol for canine insulinoma including dietary modification, prednisone at 0.25-0.5 mg/kg PO q12h, diazoxide at 5-10 mg/kg PO q12h, and the in-clinic and home emergency hypoglycemia protocols
• 4Describe the key perioperative considerations for partial pancreatectomy in an insulinoma patient — including modified fasting, perioperative dextrose CRI, intraoperative glucose monitoring, and interpretation of post-operative transient hyperglycemia
• 5Recognize the clinical presentations of pheochromocytoma, feline hyperaldosteronism (Conn's syndrome), and feline acromegaly, and describe the critical management principles for each: alpha-blockade before beta-blockade for pheochromocytoma, the aldosterone:renin ratio for hyperaldosteronism, and IGF-1 measurement plus radiation therapy for feline acromegaly

Course Syllabus

1. 1
   Meet Rex: The Seizure That Isn't EpilepsyPreview

   module-1-meet-rex

   8 min
2. 2
   Insulinoma Biology and Diagnosis

   module-2-insulinoma-diagnosis

   9 min
3. 3
   Medical Management: Keeping Glucose Up

   module-3-medical-management

   9 min