Blog6

If Rose Madore looks a little punky in this picture she can be easily forgiven, because she had come out of major abdominal surgery just 4 hours before this picture was taken. Her best pal Heather was very happy that she could even stand given the severity of her problem and the duration of the surgery to try to fix it.
Rose had been having episodes of weakness /tremoring/ collapse over about a month, with the major finding on initial tests being low blood sugar and not much else. Tracking down the exact cause of low blood sugar can be difficult, but finally we were able to pin down that it was being driven down by a tumor of the pancreas called an insulinoma.

Having an insulinoma is like a diabetic constantly giving herself an overdose of insulin - it drives down the blood sugar to the point where the brain especially cannot function very well. Rose's symptoms were getting worse rapidly, too, and the only option that offers much in terms of long term survival is to remove the tumor. After an ultrasound verified the location in the pancreas, Heather decided to have us perform the risky surgery. The pancreas is very delicate and can be traumatized easily, so the picture at right shows me actually using a Q-tip to gently dissect through the pancreatic tissue around the tumor.

Rose was solid as a rock during the entire 2 hours of the surgery. We took blood sugar readings every 15 minutes or so because just handling the tumor results in even more insulin release that can cause permanent brain damage while under the anesthesia. We gave her dextrose throughout the procedure and her blood sugar readings stayed within normal limits for the whole surgery. She woke up routinely and was able to walk outside on her own by the evening. By the next morning she was eating and showing no signs of the low blood sugar that was slowly killing her. Heather picked her up and took her home that very day, with Rose wagging her tail the whole way out the door.

We are waiting for biopsies to come back on the tumor itself and on a mesenteric lymph node that may be involved with the cancer as well. We knew that the node was large and probably involved based on the ultrasound, but were able to remove it cleanly and there was no other evidence of spread in the abdomen. I was particularly happy to see that Rose's liver was not involved, because the most advanced forms of insulinomas involve spread to the liver and carry a much more guarded prognosis.

The best indicator that we had removed the tumor successfully, though, was that she recovered quickly and showed no signs of the low blood sugar that had made her life so miserable before the surgery. A day after the surgery she looked like a normal dog, and that made all of us, but especially Heather, feel very good about the outcome.