# Clinical signs, management, and survival of 278 dogs diagnosed with insulinoma under primary veterinary care in the United Kingdom

## TL;DR

This study examines 278 dogs with insulinoma in the UK, finding that referral and surgery improve survival and outcomes.

## Contribution

The study provides new insights into clinical management and survival under primary veterinary care for canine insulinoma.

## Key findings

- Epileptiform seizures, weakness, and collapse were common clinical signs in dogs with insulinoma.
- Surgical treatment was associated with a 51% lower risk of death compared to medical treatment alone.
- Referred dogs had significantly longer median survival times than non-referred dogs.

## Abstract

Insulinoma is the most commonly diagnosed endocrine tumor of the pancreas in dogs. Current literature has predominately focused on referral management of insulinoma in dogs.

To describe clinical signs, management, and survival and to explore risk factors associated with clinical management undertaken for insulinoma in dogs under primary veterinary care in the United Kingdom.

Two hundred seventy-eight insulinoma cases identified from 225 0741 VetCompass study dogs within the United Kingdom in 2019.

Nested cohort study. Insulinoma cases were identified by manual review of electronic health records. Multivariable logistic regression was used to identify risk factors associated with clinical management. The Kaplan–Meier method with log rank test and multivariable Cox regression were used to identify risk factors associated with survival.

Epileptiform seizures, weakness, collapse/syncope, and muscle fasciculations were the most commonly reported clinical signs. Spaniel breed dogs (OR 2.43, 95% CI 1.02-5.79), dogs with epileptiform seizures (OR 2.15, 95% CI 1.15-4.02) and referred dogs (OR 4.85, 95% CI 2.42-9.72) had increased odds of undergoing surgery, compared to non-spaniel breed dogs, dogs without epileptiform seizures, and non-referred dogs. Compared to dogs treated solely medically, dogs treated surgically had a lower hazard (HR 0.49, 95% CI 0.32-0.77) of dying. Referred dogs had a longer median survival time (673 days, IQR 221-1139) than non-referred dogs (275 days, IQR 55-735) (P < .001).

This study identified that referral and surgical treatment are associated with improved clinical outcomes for dogs with insulinoma presenting to primary veterinary care.