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

Abstract Background 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. Hypothesis/Objectives 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. Animals Two hundred seventy-eight insulinoma cases identified from 225 0741 VetCompass study dogs within the United Kingdom in 2019. Methods 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. Results 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). Conclusions and clinical importance This study identified that referral and surgical treatment are associated with improved clinical outcomes for dogs with insulinoma presenting to primary veterinary care.