Canine Insulinoma: Managing Hypoglycaemia and Quality of Life

Insulinoma is a rare but serious pancreatic tumour in dogs that causes dangerous episodes of low blood sugar, requiring careful medical management and welfare monitoring.

Key Facts

Insulinomas are functional tumours of the pancreatic beta cells that secrete insulin autonomously.
They cause episodic hypoglycaemia, manifesting as weakness, ataxia, collapse, and seizures.
Middle-aged to older, medium-large breed dogs are most commonly affected.
Diagnosis involves demonstrating inappropriately elevated insulin alongside low blood glucose.
CT imaging helps identify tumour location and assess for metastasis before surgery.
Surgical resection of the primary tumour is the treatment of choice when feasible.
Medical management with frequent small meals, prednisolone, and diazoxide can control signs.
Median survival after surgery is around 12-18 months; some dogs live significantly longer.
Approximately 40-50% of cases have already metastasised at the time of diagnosis.

Welfare Considerations

Hypoglycaemic episodes in dogs with insulinoma range from transient weakness to life-threatening seizures, all of which are deeply distressing for both dog and owner. The unpredictability of episodes creates chronic anxiety. Post-operative hypoglycaemia can persist for weeks as the pancreas readjusts, requiring careful monitoring. Medical management demands strict feeding schedules and owner vigilance. Quality of life assessment must weigh the dog's inter-episode wellbeing against the frequency and severity of episodes. Dogs in good inter-episode condition with manageable episode frequency can maintain excellent quality of life for many months. Honest owner education about realistic prognosis and palliation options is essential from diagnosis.

What You Can Do

If your dog has unexplained collapse or seizures, request blood glucose measurement immediately.
Feed insulinoma dogs small frequent meals of a moderate-fat, moderate-protein, low-simple-carb diet.
Always carry Karo syrup or glucose gel to rub on the gums during a hypoglycaemic episode.
Discuss surgical options with a veterinary oncologist or surgeon early after diagnosis.
Monitor and record episode frequency, severity, and triggers to guide treatment adjustment.
Use quality-of-life scoring tools to inform end-of-life decision-making.