Daisy has an insulinoma
It’s been a rough couple of weeks here at Casa del Mel. If you haven’t seen it on my Facebook page, Daisy had surgery to remove a tumor, called an Insulinoma, from her pancreas. A tumor, that up until February 6th, we knew nothing about. Now we know too much.
An insulinoma is almost always a malignant tumor that appears on the pancreas and starts messing with the insulin levels in a dog (or human). It causes hypoglycemia (low blood sugar), tiredness after exercise, collapse, seizures and sometimes brain damage. It is a progressive disease and will spread throughout the body, as all cancers do.
On February 6, I took Daisy in to our regular vet to have her teeth cleaned and a lump (an benign outgrowth of a sebaceous cyst) removed. I expected to receive a call later in the day to be told all went well and she was ready to go home but instead, I received a call a few hours after I dropped her off to tell me that they could not perform the procedures because her blood sugar was really low, abnormally low (hers was in the 40s, normal is 80).
I knew it was serious, but I did not know how serious until Monday. That was when my vet informed me it was likely an insulinoma, and that she was referring Daisy to her teacher at the University of Minnesota. Within 30 minutes, I received a call from the U of M to schedule an appointment (yes, it really did happen that fast).
This was the moment when I got scared. A call within 30 minutes? An appointment two weeks out was not soon enough? Oh my God.
We went in on Thursday for a consult and a CT scan was scheduled for the next day. It would tell us whether or not it had spread and what course of action we would take.
The hardest thing I had ever done up until that point was to leave Daisy at her regular vet, with people she knew, but on that Friday, I had to drop her off with strangers (albeit, wonderfully nice strangers) and leave her there for the whole day. It killed me inside.
When I got the call that she was done, the vet also confirmed it was an insulinoma (just as we thought). I was also informed that it was a single tumor and had not spread to her chest or other organs. There was some concern over a slightly odd-looking lymph node nearby, but it was small (2mm) and not as concerning as the insulinoma. The recommendation was surgical removal.
As the vet and surgeon both told me at our post CT scan meeting, they almost never see a dog with an insulinoma who has not shown any major symptoms (collapsing, seizures, etc.), and who has not already found to have multiple tumors or to have it spread throughout their body. By the time they see dogs with this type of tumor, they are pretty far gone. They were both pretty excited that Daisy had been caught early. They wanted to schedule the surgery for Tuesday, February 17.
To say I was completely overwhelmed would be an understatement. I was scared and freaked out and not sure what to do. I needed time to think. Should I do the surgery and get the cancer while it was early? Should I let the cancer spread and just maintain Daisy’s glucose levels as long as I could with drugs? What was fair to Daisy? What was best for her?The decision was agonizing.
I could not bear the thought of willingly letting the cancer, this insidious, awful curse of a disease, spread through Daisy’s body, but, I was also filled with doubts. What if she died in surgery or due to complications from surgery? What if her quality of life was better without surgery, even though it might mean an earlier death? What if I lost her in surgery when I could have had her for a few more months without it? Was it fair to put Daisy, my fearful girl, through this?
In the end, I decided to go ahead with the surgery, partly because it was already scheduled and partly because Daisy was the anomaly, the cancer had been caught early, and I couldn’t bear the thought of letting the cancer spread. Not if we could remove it and give her a good quality of life for a year or so to come. I wanted her to have a quality life, not a life slowly seeping away as the cancer ate through her body.
The surgery went well. Daisy came out of to with the left half of her pancreas gone (due to the location of the tumor), but her glucose levels we’re closer to normal and she made it through. In addition to the tumor, Daisy had the lymph node removed and a biopsy of her liver done. Both the lymph node and the liver biopsy came back negative for cancer. The tumor was, of course, positive for cancer, but they got it all out. Luckily, she can still function with the remaining half of her pancreas and her glucose levels have been normal since the surgery. Her prognosis is good.
But, I am still plagued with doubts. Did I do the right thing?
On Friday, Daisy started drooling, drinking water excessively, pacing, seemed restless, and suddenly developed a bloated stomach. I thought I was going to lose her. I thought she had bloat. Only another surgery would save her and I did not have the money for another surgery.
However, after an X-ray and a radiologist consultation, it was determined Daisy had food bloat. A very different type of bloat and much less scary that the stomach-twisting kind. Supposedly, she got into something and ate a lot of it – they can see lots of particles of something like dog food in her stomach. Unfortunately, she had very little opportunity to get into anything and I cannot find any missing items that would explain what she might have eaten, unless it was poop. So, I worry and wait for her to poop out whatever she supposedly ate.
For me, it is concerning that her stomach is still bloated, but it appears to be less so than Friday evening. The good news is that she is still eating and drinking and she is also acting more like herself. She is more tired right now, but that is to be expected after major surgery (not to mention the visits to the ER).
Being a lifelong worrywart, I think I will continue to worry about Daisy, and my decision to put her through surgery, for some time to come. Maybe I will feel better when I see Daisy back at the dog park with her siblings, running through the woods and begging treats from her friends at the dog park. Until then, I wait and hope and pray that I made the right decision.
While I would not wish this experience on anyone (who wants their dog to have cancer or major surgery?), I have learned a lot.
What I have learned:
- No one can make the decision for your dog’s healthcare except you. Others will weigh in and may even scoff at your choices, but in the end, the decision is yours. Also keep in mind what your pet would want.
- Know how far you are willing to pursue saving your pet. Ask yourself: How much is too much? How long do I keep trying to save them? What kind of quality of life is my pet getting? Before the CT scan, I had already decided I would not do surgery of the tumor had spread, even a little bit.
- Having a great vet who knows your dog, and knows when to be concerned, is a blessing. Find a good one. We have and we love her.
- Blood work before surgery is a must for my vet, I am guessing it is for most medical procedures involving anesthesia, but ask your vet beforehand. If my vet had not run Daisy’s blood work, she could have had a seizure on the operating table and/or could have died.
- The University of Minnesota Veterinary Medical Center is a great place and filled with amazing people. They are responsive and kind and always willing to help.
- Be okay with saying “No” to a procedure if you feel it is not beneficial to your pet or will not extend their life. I had a hard time with this one at first. There is always one more procedure that can be performed, one more drug given, but in the end you have to decide if it is worth it.
- Get pet insurance. I wish I had. The costs add up quickly. My costs went above the estimated price, by a lot. Be prepared for it to do so.