Any underlying cause of the hypoglycemia should be corrected if possible. Surgery is recommended in many cases of insulinoma. Medication is helpful in preventing low blood glucose in some patients. Dietary management usually entails frequent small meals consisting of food that is high in protein, fat, and complex carbohydrates. Paradoxically, frequent administration of smple sugars may be counterproductive as this often stimulates insulin production. This lowers blood glucose and may precipitate a hypoglycemic episode.
Primary skeletal tumors do not typically cause neurologic signs. Multilobular osteochondroma originates in the flat bones of the skull, usually in older medium- or large-breed dogs and appears as a firm, fixed mass. It may erode the cranium and compress, rather than infiltrate, underlying brain tissues. Radiographically, the tumor contains nodular or stippled areas of mineralization, resulting in a characteristic “popcorn ball” appearance. Local recurrence and metastasis are common. Vertebral osteochondroma is the spinal cord counterpart.
At University of Florida's Evelyn F. and William L. McKnight Brain Institute, a rather new radiation therapy is now available in which a 3-dimensional ultrasound guidance system is used to accurately pinpoint the tumor's location. Therefore, radiation beams can be targeted precisely at the tumor cells, leaving the surrounding tissues unharmed. Also, since high-dose, precisely targeted radiation treatment can be given in one session, the dog does not have to be treated repeatedly over a period of several weeks as is required in other radiation treatment protocols. This is especially good news for older dogs since radiation treatment requires anesthetic to keep the dog patients from moving, and the single treatment avoids repeated anesthesia.