Caplan E R, Peterson M E, Mullen H S, Quesenberry K E, Rosenthal K L, Hoefer H L, Moroff S D
Department of Surgery, Animal Medical Center, New York, NY 10021, USA.
J Am Vet Med Assoc. 1996 Nov 15;209(10):1741-5.
To evaluate clinical, laboratory, radiographic, ultrasonographic, surgical, and histologic findings in ferrets with insulinoma and to determine their long-term outcome.
Retrospective study.
57 ferrets with a histopathologic diagnosis of pancreatic islet cell tumor.
Medical records of ferrets with pancreatic islet cell tumors were reviewed.
Lethargy, weakness, and collapse were the most common clinical signs. All ferrets had hypoglycemia, and hyperinsulinemia was documented in 39 of 47 (83%) ferrets. Ultrasonographic examination of the abdomen revealed pancreatic nodules in 5 of 23 ferrets. Surgical treatment was performed in 50 ferrets, 3 were treated by medical management alone, and 4 did not have treatment. At the time of surgery, 1 pancreatic nodule was found in 13 (26%) ferrets and multiple nodules were found in 37 (74%) ferrets. Pancreatic carcinoma alone was found in 34 ferrets. Whereas a combination of carcinoma and either hyperplasia or adenoma was found in 23 ferrets; 4 ferrets had metastasis to regional lymph nodes or liver. In 26 (53%) ferrets, hypoglycemia persisted after surgery, necessitating medical treatment with prednisone, diazoxide, or both. Sixteen (33%) ferrets had redevelopment of hypoglycemia at 1 to 23.5 months (median, 10.6 months) after surgery. Only 7 of the 50 (14%) ferrets remained euglycemic after surgery.
In ferrets, surgical removal of insulin-secreting pancreatic islet cell tumors is recommended as definitive treatment; however, multiple pancreatic nodules are common, making complete excision of all tumor tissue difficult. Persistent hypoglycemia after surgical treatment indicates that lifelong medical management with prednisone or diazoxide or both may be necessary in many ferrets. Finally, because the insulin-secreting tumors are malignant, long-term cure and survival are not likely.
评估患有胰岛素瘤的雪貂的临床、实验室、影像学、超声、手术及组织学检查结果，并确定其长期预后。
回顾性研究。
57只经组织病理学诊断为胰岛细胞瘤的雪貂。
查阅患有胰岛细胞瘤雪貂的病历。
嗜睡、虚弱和虚脱是最常见的临床症状。所有雪貂均有低血糖，47只雪貂中有39只（83%）记录到高胰岛素血症。腹部超声检查发现23只雪貂中有5只存在胰腺结节。50只雪貂接受了手术治疗，3只仅接受药物治疗，4只未接受治疗。手术时，13只（26%）雪貂发现1个胰腺结节，37只（74%）雪貂发现多个结节。仅34只雪貂发现胰腺癌。23只雪貂发现癌合并增生或腺瘤；4只雪貂发生区域淋巴结或肝脏转移。26只（53%）雪貂术后仍有低血糖，需要用泼尼松、二氮嗪或两者进行药物治疗。16只（33%）雪貂在术后1至23.5个月（中位数为10.6个月）再次出现低血糖。50只雪貂中只有7只（14%）术后血糖正常。
对于雪貂，建议手术切除分泌胰岛素的胰岛细胞瘤作为确定性治疗；然而，胰腺多发结节很常见，难以完全切除所有肿瘤组织。手术治疗后持续低血糖表明许多雪貂可能需要终身用泼尼松或二氮嗪或两者进行药物治疗。最后，由于分泌胰岛素的肿瘤是恶性的，不太可能实现长期治愈和存活。
