Clinical Features

+ Superficial Necrolytic Dermatiti

  • glucagonoma is a rare endocrine tumor of the α pancreatic cells and has been reported in 8 dogs
  • Glucagonoma is associated with a characteristic dermatitis of the footpads = superficial necrolytic dermatitis
  • Synonyms: metabolic epidermal necrosis, necrolytic migratory erythema, and diabetic dermatitis
  • Skin lesions can also occur on the muzzle, mucocutaneous junctions, elbow, hocks, pinnae, and external genitalia
  • Skin lesions tend to wax and wane and can be pruritic with secondary bacterial infections
  • However, superficial necrolytic dermatitis is not pathognomonic for glucagonoma as 78 cases of superficial necrolytic dermatitis have been reported and only 7 of these were diagnosed with concurrent glucagonoma
  • Classification scheme has been proposed: superficial necrolytic dermatitis, superficial necrolytic dermatitis and hepatocutaneous syndrome, and suspected superficial necrolytic dermatitis, with glucagonoma reported in:
  • 9% of dogs with superficial necrolytic dermatitis
  • 60% of dogs with superficial necrolytic dermatitis and hepatocutaneous syndrome
  • 31% of dogs with suspected superficial necrolytic dermatitis
  • Superficial necrolytic dermatitis resolves following successful surgical resection of the pancreatic glucagonoma
  • DDx: pemphigus foliaceus, SLE, generic dog food dermatosis, and zinc-responsive dermatosis

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From: Withrow SJ & MacEwen EG (eds): Small Animal Clinical Oncology (3rd ed).

+ Diabetes Mellitus

  • Glucagon promotes gluconeogenesis and glycogenolysis
  • Hyperglycemia will result if there is an excess of glucagon relative to insulin
  • Diabetes mellitus will occur if insulin production cannot match the excessive secretion of glucagon

+ Other Clinical Signs

  • Other clinical signs include weight loss, polyuria, and polydipsia
  • Weight loss is caused by the catabolic effects of glucagon on fat and protein metabolism

+ Diagnosis

  • Hematologic and serum biochemical abnormalities include non-regenerative anemia and elevated liver enzymes ± hypoalbuminemia, decreased BUN, and persistent hyperglycemia
  • Skin biopsy: diffuse parakeratotic hyperkeratosis with high levels of confluent vacuolation of keratinocytes resulting in epidermal edema, with minimal dermal changes (i.e., perivascular accumulation of lymphocytes and plasma cells)
  • Chronic lesions may have superficial to lichenoid inflammatory infiltrates
  • Abdominal and thoracic imaging for detection of a pancreatic mass and metastatic disease
  • However, pancreatic mass was only detected in 13% (1/8) dogs with ultrasonographic examination
  • Multiple diffuse hypoechogenic foci in the liver (= honeycomb pattern) is present in 50% (4/8) dogs with glucagonoma and is consistent with hepatic metastases
  • Plasma glucagon levels in the absence of hypoglycemia strongly supports the diagnosis of glucagonoma


  • Exploratory celiotomy with partial pancreatectomy and clinical staging for metastatic disease
  • Tumor debulking can decrease the intensity of skin lesions in humans with glucagonoma
  • Octreotide is recommended for medical management of humans with glucagonoma
  • Other medical treatment options include decarbazine and streptozotocin with 5-fluoroucil


  • Prognosis is poor with metastasis common and widespread at diagnosis
  • Survival times range from 3 days to 9 months