Journal of Veterinary Clinics (한국임상수의학회지)

The Korean Society of Veterinary Clinics (한국임상수의학회)
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Partial Pancreatectomy Using an Ultrasonic-Activated Scalpel in Two Spaniel Dogs with Canine Insulinoma

  • Park, Jiyoung (College of Veterinary Medicine, Chungnam National University) ;
  • Lee, Hae-Beom (College of Veterinary Medicine, Chungnam National University) ;
  • Jeong, Seong Mok (College of Veterinary Medicine, Chungnam National University)
  • Received : 2017.05.12
  • Accepted : 2017.08.11
  • Published : 2017.10.31
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Abstract

Two spaniel dogs were presented with a history of lethargy, weakness, refractory hypoglycemia, and episodic seizure. A pancreatic mass on the distal end of the left limb was identified through screening tests including dualphase CT angiography in each patient. Canine insulinoma was suspected with low blood glucose, low fructosamine, and normal to high serum insulin levels. Exploratory laparotomies were performed, and partial pancreatectomy using an ultrasonic-activated scalpel was achieved without enzyme leakage or fistula formation after surgery. The lesions were definitively diagnosed as insulinoma via histopathologic examination. One dog has been doing well until POD 870 with medication; in the other dog, diffuse hepatic nodules noted during surgery were confirmed as a liver metastasis. This dog died at POD 45. This case report addresses the utility of the ultrasonic scalpel in partial pancreatectomy for the treatment of canine insulinoma and differences in prognosis according to disease stage.

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References

  1. Balcom JH 4th, Keck T, Warshaw AL, Graeme-Cook F, Fernandez-del Castillo C. Prevention of pancreatic fistula with a new synthetic, absorbable sealant: evaluation in a dog model. J Am Coll Surg 2002; 195: 490-496. https://doi.org/10.1016/S1072-7515(02)01313-3
  2. Bell R, Mooney CT, Mansfield CS, Jones BR. Treatment of insulinoma in a springer spaniel with streptozotocin. J Small Anim Pract 2005; 46: 247-250. https://doi.org/10.1111/j.1748-5827.2005.tb00318.x
  3. Buishand FO, Kik M, Kirpensteijn J. Evaluation of clinicopathological criteria and the Ki67 index as prognostic indicators in canine insulinoma. Vet J 2010; 185: 62-67. https://doi.org/10.1016/j.tvjl.2010.04.015
  4. Chijiwa K, Nishimura R, Matsuki N, Sasaki N. Relationship between treatment and prognosis of canine insulinoma: 22 cases (1997-2006). Jpn J Vet Anesth Surg 2007; 38: 19-24. https://doi.org/10.2327/jvas.38.19
  5. Cox D. Pancreatic insulin-secreting neoplasm (insulinoma) in a West Highland white terrier. Can Vet J 1999; 40: 343-345.
  6. de Herder WW, van Schaik E, Kwekkeboom D, Feelders RA. New therapeutic options for metastatic malignant insulinomas. Clin Endocrinol 2011; 75: 277-284. https://doi.org/10.1111/j.1365-2265.2011.04145.x
  7. Goutal CM, Brugmann BL, Ryan KA. Insulinoma in dogs: a review. J Am Anim Hosp Assoc 2012; 48: 151-163. https://doi.org/10.5326/JAAHA-MS-5745
  8. Hanly EJ, Mendoza-Sagaon M, Hardacre JM, Murata K, Bunton TE, Herreman-Suquet K, Poulose BK, Talamini MA. New tools for laparoscopic division of the pancreas: a comparative animal study. Surg Laparosc Endosc Percutan Tech 2004; 14: 53-60. https://doi.org/10.1097/00129689-200404000-00002
  9. Iseri T, Yamada K, Chijiwa K, Nishimura R, Matsunaga S, Fujiwara R, Sasaki N. Dynamic computed tomography of the pancreas in normal dogs and in a dog with pancreatic insulinoma. Vet Radiol Ultrasound 2007; 48: 328-331. https://doi.org/10.1111/j.1740-8261.2007.00251.x
  10. Jon B, Cecka F, Subrt Z, Ferko A, Neoral C, Nikolov DH, Tycova V. A novel approach for reinforcing the pancreatic remnant in laparoscopic distal pancreatectomy: an experimental study on a porcine model. Surg Laparosc Endosc Percutan Tech 2010; 20: 50-53. https://doi.org/10.1097/SLE.0b013e3181d8764c
  11. Kuroki T, Tajima Y, Kanematsu T. Surgical management for the prevention of pancreatic fistula following distal pancreatectomy. J Hepatobiliary Pancreat Surg 2005; 12: 283-285. https://doi.org/10.1007/s00534-005-0990-3
  12. Lunn KF, Page RL. Tumors of the Endocrine System. In: Withrow and MacEwen's Small Animal Clinical Oncology. Missouri: Elsevier. 2013: 504-531.
  13. Madarame H, Kayanuma H, Shida T, Tsuchiya R. Retrospective study of canine insulinomas: eight cases (2005-2008). J Vet Med Sci 2009; 71: 905-911. https://doi.org/10.1292/jvms.71.905
  14. Mai W, Caceres AV. Dual-phase computed tomographic angiography in three dogs with pancreatic insulinoma. Vet Radiol Ultrasound 2008; 49: 141-148. https://doi.org/10.1111/j.1740-8261.2008.00340.x
  15. Moore AS, Nelson RW, Henry CJ, Rassnick KM, Kristal O, Ogilvie GK, Kintzer P. Streptozocin for treatment of pancreatic islet cell tumors in dogs: 17 cases (1989-1999). J Am Vet Med Assoc 2002; 221: 811-818. https://doi.org/10.2460/javma.2002.221.811
  16. Nagakawa Y, Tsuchida A, Saito H, Tohyama Y, Matsudo T, Kawakita H, Ikeda T, Kasuya K, Ozawa T, Aoki T. The VIO soft-coagulation system can prevent pancreatic fistula following pancreatectomy. J Hepatobiliary Pancreat Surg 2008; 15: 359-365. https://doi.org/10.1007/s00534-008-1329-7
  17. Northrup NC, Rassnick KM, Gieger TL, Kosarek CE, McFadden CW, Rosenberg MP. Prospective evaluation of biweekly streptozotocin in 19 dogs with insulinoma. J Vet Intern Med 2013; 27: 483-490. https://doi.org/10.1111/jvim.12086
  18. Peng M, Meng Z, Yang ZH, Wang XH. The ultrasonic harmonic scalpel for circumcision: experimental evaluation using dogs. Asian J Androl 2013; 15: 93-96. https://doi.org/10.1038/aja.2012.67
  19. Polton GA, White RN, Brearley MJ, Eastwood JM. Improved survival in a retrospective cohort of 28 dogs with insulinoma. J Small Anim Pract 2007; 48: 151-156. https://doi.org/10.1111/j.1748-5827.2006.00187.x
  20. Robben JH, Pollak YW, Kirpensteijn J, Boroffka SA, van den Ingh TS, Teske E, Voorhout G. Comparison of ultrasonography, computed tomography, and single-photon emission computed tomography for the detection and localization of canine insulinoma. J Vet Intern Med 2005; 19: 15-22. https://doi.org/10.1111/j.1939-1676.2005.tb02652.x
  21. Royals SR, Ellison GW, Adin CA, Wheeler JL, Sereda CW, Krotscheck U. Use of an ultrasonically activated scalpel for splenectomy in 10 dogs with naturally occurring splenic disease. Vet Surg 2005; 34: 174-178. https://doi.org/10.1111/j.1532-950X.2005.00027.x
  22. Safi F, Bakathir S, Taha M, Lange T, El Salhat H, Branicki F. The value of postoperative measurement of amylase in abdominal drainage fluid after pancreatic surgery. Hepatobiliary Pancreat Dis Int 2012; 2: 31-37.
  23. Sugo H, Mikami Y, Matsumoto F, Tsumura H, Watanabe Y, Futagawa S. Comparison of ultrasonically activated scalpel versus conventional division for the pancreas in distal pancreatectomy. J Hepatobiliary Pancreat Surg 2001; 8: 349-352. https://doi.org/10.1007/s005340170007
  24. Takao S, Shinchi H, Maemura K, Aikou T. Ultrasonically activated scalpel is an effective tool for cutting the pancreas in biliary-pancreatic surgery: experimental and clinical studies. J Hepatobiliary Pancreat Surg 2000; 7: 58-62. https://doi.org/10.1007/s005340050155
  25. Takeuchi K, Tsuzuki Y, Ando T, Sekihara M, Hara T, Kori T, Nakajima H, Kuwano H. Distal pancreatectomy: is staple closure beneficial? ANZ J Surg 2003; 73: 922-925. https://doi.org/10.1046/j.1445-2197.2003.02821.x
  26. Tobin RL, Nelson RW, Lucroy MD, Wooldridge JD, Feldman EC. Outcome of surgical versus medical treatment of dogs with beta cell neoplasia: 39 cases (1990-1997). J Am Vet Med Assoc 1999; 215: 226-230.
  27. Trifonidou MA, Kirpensteijn J, Robben JH. A retrospective evaluation of 51 dogs with insulinoma. Vet Q 1998; 20: S114-S115. https://doi.org/10.1080/01652176.1998.9694853
  28. Truty MJ, Sawyer MD, Que FG. Decreasing pancreatic leak after distal pancreatectomy: saline-coupled radiofrequency ablation in a porcine model. J Gastrointest Surg 2007; 11: 998-1007. https://doi.org/10.1007/s11605-007-0180-5
  29. Wouters EG, Buishand FO, Kik M, Kirpensteijn J. Use of a bipolar vessel-sealing device in resection of canine insulinoma. J Small Anim Pract 2011; 52: 139-45. https://doi.org/10.1111/j.1748-5827.2011.01040.x
  30. Yuki M, Suzuki K, Tanahashi S, Katoh M, Hirano T, Takahashi M, Murai A, Sakaguchi T. Long-term management of plasma glucose concentration by a single administration of streptozocin in a dog with insulinoma. J Vet Med Sci 2007; 60: 867-871.