Although exocrine or endocrine pancreatic tumors are rare in dogs, canine insulinomas are highly metastatic. This case report describes a rare instance of insulinoma metastasis to the lungs and muscles rather than to common metastatic sites such as the liver and pancreatic lymph nodes, making it a unique presentation in veterinary oncology. A 12-year-old spayed female Japanese Spitz was referred for the evaluation of recurrent hypoglycemic episodes characterized by lethargy, weakness, and seizures. The initial diagnostic workup, including blood glucose measurements, confirmed severe hypoglycemia, which prompted further diagnostic imaging. Computed tomography (CT) identified additional lesions in the right caudal lung lobe, right sartorius, and left serratus muscle, suggesting widespread metastatic lesions. Based on imaging and laboratory examinations, surgical excision of the multiple lesions was performed. The procedure included a left pancreatectomy, right caudal lung lobectomy, excision of the affected portion of the sartorius muscle, and splenectomy. Histopathological examination of the pancreatic tumor confirmed the diagnosis of islet cell carcinoma. The resected pulmonary and sartorius muscle masses were diagnosed as metastatic carcinoma. Follow-up CT revealed an additional liver lesion and an increased nodule size in the serratus muscle. This is the first reported case of canine insulinoma with metastasis to the lungs and multiple skeletal muscles, making it a unique presentation in veterinary oncology. In conclusion, the present case suggests that insulinoma metastasis should be included in the differential diagnosis when muscular or pulmonary lesions are observed in dogs diagnosed with insulinoma.

A 7-year-old spayed female Shih Tzu dog was presented for evaluation of recurrent hypoglycemia. Serum insulin levels during hypoglycemia were 35.3 μIU/mL. Ultrasonography and computed tomography showed a mesenteric nodule between the kidney and the portal vein, but no pancreatic mass was observed. During surgery, the nodule had neither anatomical adhesions nor vascular connections to the pancreas. Pancreatic inspection and palpation revealed no abnormalities. Hypoglycemia improved after resection of the nodule.Histopathological examination confirmed the nodule to be an islet cell carcinoma. Although extremely rare, ectopic insulinoma should be considered as a possible cause of insulininduced hypoglycemia in dogs.

Background: Heartworm infection in dogs is caused by Dirofilaria immitis and common in shelter animals and outdoors dogs. Caval syndrome can develop with severe infection and physical heartworm removal is essential with heartworm burdens. In this study, we used an improved transvenous heartworm extraction brush, which was expected to cause less cardiovascular damage and allow easier manipulation. Objectives: This study aims to evaluate efficacy of this improved transvenous heartworm extraction brush. Methods: The brush was designed to improve upon the limitations of the previous brushtype devices. The brush was made of a polyvinyl chloride tube and threads of polyamides or polyglyconates. Metal material was inserted at the front tip for easy visualization under fluoroscopy. The eight dogs diagnosed with caval syndrome with large numbers of heartworms and pulmonary hypertension were used in this study. The removal procedure began with the dissection of the subcutaneous tissue around the right jugular vein. The device was inserted through the jugular vein. After insertion, the tube was rotated to catch the heartworms and extracted with the heartworms hanging on the threads. The procedure was repeated several times. Lastly, jugular vein and skin sutures were made. Adulticidal therapy was administered after heartworm removal. Results: The mean number of removed heartworms was 10.5 ± 4.24 and mean number of remaining heartworms was 0.63 ± 1.06. Total procedure time was 72.63 ± 51.36. Except for three cases, heartworms were not detected on ultrasonography after the procedure. No procedure-related side effects were observed within the 1- to 2-mon. Conclusions An improved transvenous heartworm extraction brush is efficient for heartworm removal in dogs with caval syndrome.