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

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.