i took him to the vet this am and he fasted from 10pm last night til 8 am this morning and his bloodsugars were down to 1...so that pretty much confirms he has an insulinoma without an actual ultrasound. since this is the first time i have dealt with this, i will tell you what i just learned. first of all this type of cancer spreads to other parts of the body, very rapidly...usually before they even start to show symptoms. there is a difficult surgery available to remove the cancer in the pancreatis BUT in a 12 yr old rotti with a cancer that has probably already spread, it is just not worth the risk and recovery pain. sooo...palliative care with the goal being comfort and maintaining and improving his current quality of life...
treatment options as a palliative measure....steriods twice a day...preferably pred. i am not a fan of pred with dogs who live in a free fed communal shelter...too many food aggression issues as the pred dose starts to increase. but we will start with this and see how he does. plus he will need a high protein puppy canned food snack every couple of hours thru out the day (hint, hint...we will need lot's of donations of canned puppy food for oka please.) also, all of us have to ensure that he has a snack before and after he starts his utterly moronic rotti playing...he will burn off so many calories when he is having fun that we have to ensure he has a good supply and replacement of calories in him to prevent his blood sugars from dropping down.
if the food aggression develops or the pred does not bring his blood sugars under control, there is some hormone therapy options available...they may or may not work for him but right now we will wait and see.
POSSIBLY...with good and appropriate and successful medication regimes...we MIGHT be able to maintain him for 12-18 months but understanding that he is an elderly rotti whose cancer may have spread to some critical somewhere else. all bets are off with oka...we will just take him as far as we can each and every day.
signs and symptoms of insulinoma (of which today, oka is displaying the entire list)
rapid unexplained weight loss
fatique, and drowsiness
unable to keeps eyes open for very long
seizure activity due to hypoglycemia
ataxia.... generalized weakness and poor gross motor skills.
the appearence of over-sedation
oka may come home tonight or he may stay at the vets for another day...it all depends on how he does with his glucose curves and the pred adjustments that have to be made.
he is a very sick dog.