---
title: "Insulinoma Case Study: Winston"
description: With a combination approach that included FidoCure®, Winston survived two years following his initial diagnosis of metastatic insulinoma.
image: https://blog.fidocure.com/hubfs/winston.jpg
---
[](https://www.fidocure.com/)
- [Veterinarians](https://fidocure.com/for-veterinarians/)
- [Portal Login](https://dvm.fidocure.com/)
- [Veterinary Blog](https://blog.fidocure.com/fidocure-blog/tag/vet)
- [Case Studies](https://blog.fidocure.com/fidocure-blog/tag/case-studies)
- [Webinars](https://blog.fidocure.com/fidocure-blog/tag/webinars)
- [Pet Parents](https://fidocure.com/pet-parents/)
- [About Us](https://fidocure.com/about-us/)
- [How it works](https://fidocure.com/how-it-works/)
- [Find a Clinic](https://fidocure.com/find-a-clinic/)
- [Contact Us](https://fidocure.com/contact-us/)
[Case Studies](https://blog.fidocure.com/fidocure-blog/tag/case-studies)
# Insulinoma Case Study: Winston
[Dr. Dorothy Jackson Girimonte](https://blog.fidocure.com/fidocure-blog/author/dr-dorothy-jackson-girimonte)
[Share this blog post on Twitter](https://twitter.com/intent/tweet?text=I+found+this+interesting+blog+post&url=https://blog.fidocure.com/fidocure-blog/metastic-insulinoma) [Share this blog post on Facebook](http://www.facebook.com/share.php?u=https://blog.fidocure.com/fidocure-blog/metastic-insulinoma) [Share this blog post on LinkedIn](http://www.linkedin.com/shareArticle?mini=true&url=https://blog.fidocure.com/fidocure-blog/metastic-insulinoma)
#### With a combination approach that included FidoCure®, Winston survived two years following his initial diagnosis of metastatic insulinoma.
#### History and Initial Therapy
Winston Ford, an 11-year-old male neutered Maltipoo, despite being non symptomatic, was found to be hypoglycemic after undergoing pre-anesthetic bloodwork. Winston was then seen by the Department of Internal Medicine at Veterinary Specialty & Emergency Center of Thousand Oaks. An ultrasound revealed a left pancreatic mass, however no evidence of metastasis was found in the abdomen or on thoracic radiographs.
Winston was then taken to surgery to have the pancreatic mass removed. During surgery, an enlarged pancreatic lymph node was discovered and removed. Liver nodules were also noted, so the liver was biopsied as well. Biopsy confirmed an insulinoma which had spread to the local lymph node and liver. Winston was referred to the Department of Oncology at VSEC Thousand Oaks for continued therapy.
Enrollment in FidoCureⓇ was recommended to Winston’s parents in order to slow down the progression of the disease. As tissue was not submitted, a Data-Based Report with information about the diagnosis and recommended therapies was generated. Based on these recommendations, Winston began FidoCure enabled targeted therapy.
#### FidoCure® Analysis
Potential therapeutic approaches for Winston's diagnosis were ARID1A, SETD2, and mTOR. ARID1A encodes a member of the SWI/SNF family that has activities to regulate transcription of certain genes and plays a role in altering chromatin structure for various cellular functions.
SETD2 is a gene that encodes a lysine methyltransferase which has been described for tumor suppressor properties in human cancer literature. Mutations in SETD2 contribute to epigenetic regulation and interact with or modify the activity of histone deacetylases (HDAC).
mTOR is a downstream component of the PI3K cellular signaling pathway. The activity of mTOR has been connected to both human and canine cancer because of potentiating signals for neovascularization and cell growth. A number of studies have looked at mTOR expression in dogs including the potential benefits of therapies that target mTOR and other PI3K active proteins for inhibition.
#### FidoCure® Treatment
Based on the FidoCure Data-Based Report, Winston began Vorinostat (30 mg/kg every other day) in July of 2020. At his recheck in August, his glucose was normal on bloodwork. In September, his glucose remained normal and he had gained weight. At his three month recheck in October, re-staging diagnostics showed no pulmonary metastasis or recurrence of his pancreatic disease. The liver nodules found during surgery were noted on ultrasound.
In April of 2022, re-staging diagnostics were performed. Thoracic radiographs showed no evidence of metastasis. An abdominal ultrasound showed recurrent disease in his pancreas and lymph node; his liver disease was found to be stable. His therapy was continued given he was doing so well and his rechecks were continued every three months. Diagnostics were repeated in October of 2021, and his pancreatic and liver disease was considered to be stable if not improved. Again, there was no evidence of pulmonary metastasis on radiographs.
At his visit in January of 2022, Winston was still doing well at home. His glucose was low, and there was mild abdominal disease progression. However, neither of these were considered enough to warrant a change in therapy. In early June of 2022, Winston was euthanized due to poor mobility and arthritis.
#### Conclusion
On a combined treatment plan of surgery and FidoCure enabled targeted therapy, Winston survived two years following his initial diagnosis of metastatic insulinoma.
Insulinoma is most commonly treated with surgery and supportive care for any secondary hypoglycemia. Reported survival times for metastatic insulinoma average about 6 months. A case report from [JAAHA 2019](https://pubmed.ncbi.nlm.nih.gov/30427714/) reported a 24 month survival time for a dog with metastatic insulinoma treated with Palladia (Toceranib) and Prednisone. To our knowledge, this is the first report of a metastatic insulinoma case treated with Vorinostat.
#### What Winston’s Parents Say:
> “Our experience has been fantastic and as our oncologist, Dr. Rodriguez, said during our check up, the medications have extended Winston’s life. The pharmacists are always pleasant when I call for refills and the process is really easy.”
#### Dr. Dorothy Jackson Girimonte
Dr. Dorothy Jackson Girimonte DVM, Diplomate ACVIM (Oncology), CVA Board certified in Medical Oncology 2015
## Related Articles
[-1.png)](https://blog.fidocure.com/fidocure-blog/veterinaryoptimistpodcast)
### [Vet Optimist Podcast: Interview with CEO Christina K. Lopes and Jennifer Evans](https://blog.fidocure.com/fidocure-blog/veterinaryoptimistpodcast)
We are excited to share an inspiring and insightful episode of "The Veterinary Optimist" podcast, featuring our very own Christina Lopes, CEO and Co-Founder of The One...
[Christina K. Lopes](https://blog.fidocure.com/fidocure-blog/author/christina-k-lopes)
[Read More](https://blog.fidocure.com/fidocure-blog/veterinaryoptimistpodcast)
[%20(5).png)](https://blog.fidocure.com/fidocure-blog/interview-with-dr.-len-lichtenfeld-former-chief-medical-officer-of-american-cancer-society)
[Webinars](https://blog.fidocure.com/fidocure-blog/tag/webinars)
### [Fireside Chat with Dr. Len Lichtenfeld - Former Deputy Chief Medical Officer of American Cancer Society](https://blog.fidocure.com/fidocure-blog/interview-with-dr.-len-lichtenfeld-former-chief-medical-officer-of-american-cancer-society)
###### Exclusive fireside chat with a distinguished trio of cancer experts: Dr. Len Lichtenfeld former Deputy Chief Medical Officer for the American Cancer Society (and...
[Christina K. Lopes](https://blog.fidocure.com/fidocure-blog/author/christina-k-lopes)
[Read More](https://blog.fidocure.com/fidocure-blog/interview-with-dr.-len-lichtenfeld-former-chief-medical-officer-of-american-cancer-society)
- [How it Works](https://fidocure.com/how-it-works/)
- [FAQ](https://fidocure.com/faq/)
- [Contact Us](https://fidocurestg.wpengine.com/contact-us/)
- [For Vets](https://fidocure.com/for-veterinarians/)
- [About Us](https://fidocure.com/about-us/)
- [Terms of Service](https://fidocure.com/terms-of-service/)
- [Blog](https://blog.fidocure.com/fidocure-blog)
- [Careers](https://fidocure.com/careers/)
- [Privacy Policy](https://fidocure.com/privacy-policy/)
-
-
-
-
**FidoCure® is an advanced cancer-care service for dogs, developed by One Health Company**. DISCLAIMER: All patients are enrolled in FidoCure® by a veterinarian with a valid veterinarian-client-patient relationship (VCPR). We use best efforts to inform the veterinarian on available targeted therapy options for patients. FidoCure® does not prescribe therapy. The targeted therapies that veterinarians may prescribe and order from compounding pharmacies, after receiving genetic test results from FidoCure®, may constitute extra-label uses of those drugs. FidoCure® makes no claims that every patient will have genetic test results that lead to targeted therapy options. FidoCure® makes no claims or guarantees about the effectiveness of the diagnostic and targeted therapy selected by the veterinarian for an individual patient. Like most cancer care approaches, the services provided by FidoCure® are not a guarantee of a cure. FidoCure® is not a pharmacy and does not supply drugs directly. By ordering any medication via one of our pharmacy partners, you agree that the pharmacy, not FidoCure®, is solely responsible and liable for any and all issues relating to the preparation, dispensation and fulfillment of the medication. The lifetime offer is subject to the commercially reasonable availability of any medication(s) and/or active pharmaceutical ingredient(s) necessary for the selected therapy.
© Copyright 2018-2026 One Health Company, All rights reserved
```json
{
"@context" : "https://schema.org",
"@type" : "BlogPosting",
"author" : {
"@type" : "Person",
"name" : "Dr. Dorothy Jackson Girimonte",
"url" : "https://blog.fidocure.com/fidocure-blog/author/dr-dorothy-jackson-girimonte"
},
"dateModified" : "2023-05-06T12:59:08.521Z",
"datePublished" : "2023-04-25T19:07:21.000Z",
"headline" : "Insulinoma Case Study: Winston",
"image" : [ "https://blog.fidocure.com/hubfs/winston.jpg" ],
"mainEntityOfPage" : {
"@id" : "https://blog.fidocure.com/fidocure-blog/metastic-insulinoma",
"@type" : "WebPage"
},
"publisher" : {
"@type" : "Organization",
"logo" : {
"@type" : "ImageObject",
"url" : "https://blog.fidocure.com/hubfs/fidocure_logo.png"
},
"name" : "FidoCure"
}
}
```