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Gastrin-secreting Islet Cell Tumors in Dogs and Cats

By

David Bruyette

, DVM, DACVIM, Anivive Life Sciences, Woodland Hills, CA

Last full review/revision Jul 2019 | Content last modified Jul 2019

Gastrinomas are functional tumors of the pa s that secrete the hormone gastrin. They are rare but have been reported in people, dogs, and a cat. Hypersecretion of gastrin in people results in the Zollinger-Ellison syndrome, consisting of hypersecretion of gastric acid and recurrent peptic ulceration in the GI tract. The tumors, derived from ectopic amine precursor uptake decarboxylase (APUD) cells in the pancreas, produce an excess of the hormone gastrin, which normally is secreted by cells of the antral and duodenal mucosa.

Clinical Findings of Gastrin-secreting Islet Cell Tumors

Gastrin-secreting islet cell tumors occur less frequently than the insulin-secreting β-cell neoplasms. The prominent functional disturbances appear to result from multiple ulcerations of the GI mucosa that develop from gastrin hypersecretion.

Clinical signs include:

  • anorexia

  • hematemesis

  • intermittent diarrhea

  • weight loss

  • dehydration

Lesions

Animals studied with the Zollinger-Ellison-like syndrome have had single or multiple tumors of varying size in the pancreas. The tumors were firm on palpation because of an increase of fibrous connective tissue in the stroma, and all had evidence of metastasis before diagnosis.

Diagnosis of Gastrin-secreting Islet Cell Tumors

  • Blood testing

  • Possible exploratory surgery

Serum gastrin levels have been evaluated in a limited number of dogs with gastrinomas. Gastrin levels in a dog with a Zollinger-Ellison-like syndrome varied from 155 to 2,780 pg/mL, whereas the mean serum gastrin in clinically healthy (control) dogs was 70.9 pg/mL. Recurrent gastric or duodenal ulcers in dogs with no identified cause warrants exploratory surgery and careful inspection of the pancreas.

Treatment of Gastrin-secreting Islet Cell Tumors

  • Surgery

  • Medical management for signs if inoperable

Excision of the gastrin-secreting mass in the pancreas can be attempted. However, all such tumors that have been studied in dogs have had evidence of local invasion into adjacent parenchyma and had metastasized to regional lymph nodes and liver. The dogs had either single or multiple ulcerations in the gastric or duodenal mucosa associated with free blood in the lumen. Medical management with H2-receptor antagonists (famotidine or ranitidine) or the proton-pump inhibitor omeprazole may temporarily alleviate clinical signs in animals with inoperable disease.

Key Points

  • Gastrinomas are uncommon tumors of the endocrine pancreas.

  • The diagnosis should be considered in older animals with unexplained gastric ulceration.

  • Limited data are available on preferred treatments, though surgical removal should be considered in patients with a solitary pancreatic mass.

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