Insulinoma in dogs: why surgery is the treatment of choice
9-year-old Golden Retriever with episodes of weakness and one fasting seizure. Insulinoma confirmed with paired glucose and insulin. CT shows a single mass in the left pancreatic lobe without visible metastases; the dog is stable and in good condition.
Which treatment do you recommend?
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A. Medical treatment with prednisolone only, because surgery does not improve survival
Dogs treated surgically live, overall, considerably longer than those treated with drugs alone. Medical therapy is reserved for when surgery is not possible or for relapses.
B. Streptozotocin as first-line treatment
It is a beta-cell cytotoxic chemotherapy agent with a risk of nephrotoxicity. It is reserved for metastatic or relapsing disease and does not replace surgery.
C. Partial pancreatectomy with abdominal exploration and removal of suspicious lymph nodes or liver lesions, with medical therapy if hypoglycaemia recurs
Correct. Surgery removes most of the secreting tissue and prolongs survival, even when metastases are present and can be debulked. Most insulinomas eventually recur, so medical therapy is added when signs return.
D. Waiting until metastases appear to plan surgery
Delaying surgery allows the tumour to progress and prolongs hypoglycaemic episodes, with a risk of neurological damage. If the dog is a good candidate, it should be operated on as soon as possible.
lightbulb Key takeaway
After surgery, monitor for pancreatitis and blood glucose: transient hyperglycaemia or diabetes may occur because normal beta cells are suppressed, whereas persistent hypoglycaemia suggests residual tumour or metastases. Plan regular glucose checks after discharge.
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Updated: October 31, 2026 · Educational content for veterinary professionals. It does not replace current clinical guidelines or the judgement of the attending veterinarian.