Glucagonoma

From Dog
Superficial necrolytic dermatitis associated with a glucagonoma in a dog[1]

Glucagonoma is a rare metastatic neuroendocrine neoplasia of the canine pancreatic islet cells.

Glucagon levels are normally regulated by secretin, produced by the canine stomach in response to gastric filling. The glycogenolytic and gluconeogenic actions of glucagon result in mild hyperglycemia.

Extrapancreatic glucagonomas have also been reported, primarily associated with the duodenum[2] and metastases to the liver are common.

These tumors are characterized by slow-growing secretory tumors with circulatory glucagonemia and hypoaminoacidaemia[3], and may be associated with multiple endocrinopathies[4].

Clinical symptoms include anorexia, ataxia, superficial necrolytic dermatitis, mild diabetes mellitus, glossitis and diarrhea.

Diagnosis is usually by pancreatic biopsy and immunohistochemical staining.

A differential diagnosis would include insulinoma, somatostatinoma and liver disease[5] or diabetes mellitus[6] as a cause of superficial necrolytic dermatitis.

Treatment usually requires excisional resection.

The use of octreotide (a somatostatin analogue that inhibits glucagon release) has been reportedly successful in dogs[7], at doses of 1 - 3.7 μg/kg two to four times daily.

The prognosis is guarded due to the likelihood of metastasis at the time of diagnosis.

References

  1. VSSO
  2. Mizuno T et al (2009) Superficial necrolytic dermatitis associated with extrapancreatic glucagonoma in a dog. Vet Dermatol 20(1):72-79
  3. Allenspach K et al (2000) Glucagon-producing neuroendocrine tumour associated with hypoaminoacidaemia and skin lesions. J Small Anim Pract 41(9):402-406
  4. Lurye JC & Behrend EN (2001) Endocrine tumors. Vet Clin North Am Small Anim Pract 31(5):1083-1110
  5. Byrne KP (1999) Metabolic epidermal necrosis-hepatocutaneous syndrome. Vet Clin North Am Small Anim Pract 29(6):1337-1355
  6. Gross TL et al (1990) Glucagon-producing pancreatic endocrine tumors in two dogs with superficial necrolytic dermatitis. J Am Vet Med Assoc 197(12):1619-1622
  7. Oberkirchner U et al (2010) Successful treatment of canine necrolytic migratory erythema (superficial necrolytic dermatitis) due to metastatic glucagonoma with octreotide. Vet Dermatol 21(5):510-516