Necrolytic migratory erythema (NME; also known as superficial necrolytic
dermatitis) is a syndrome most often associated with certain chronic
liver diseases or pancreatic
glucagonomas. In humans with
glucagonoma-associated NME, skin lesions usually respond to
octreotide, a
somatostatin analogue that inhibits
glucagon release. In this report an 11-year-old golden retriever dog with pancreatic
glucagonoma and
metastasis to the regional lymph nodes, spleen and liver was diagnosed with NME. The dog exhibited erosions,
ulcers and crusts on the paws, pressure points, muzzle, periocular area and prepuce. The dog was also anorexic and had
difficulty walking. Because
metastasis precluded surgery, treatment was initiated with subcutaneous
octreotide (2 μg/kg twice daily). Skin lesions and systemic clinical signs improved markedly within 5 days. The dosage was increased to nearly 3 μg/kg twice daily and signs almost completely resolved within 10 days.
Anorexia was the major adverse effect observed. During the following month, both dosage (1-3.7 μg/kg) and frequency (two to four times daily) of the
octreotide injections were adjusted to permit control of clinical signs while maintaining adequate appetite. Temporary cessation of
octreotide administration resulted in the rapid recurrence of skin lesions. Resuming
injections led to improvement of clinical signs within 48 h. The dog was later euthanized because of progressive metastatic disease. In conclusion, subcutaneous
octreotide injections were beneficial in this dog with
glucagonoma-associated NME. This
somatostatin analogue could be a valuable option to treat canine patients with non-resectable or relapsing pancreatic
glucagonoma-associated NME.