Gastric neuroendocrine carcinomas, including somatostatinomas, are increasingly recognized in bearded dragons and present a significant clinical challenge due to their aggressive behavior, metastatic potential, and profound metabolic consequences. Among these, severe hyperglycemia—hypothesized as driven by somatostatin-mediated inhibition of insulin secretion—often becomes the most critical and life-limiting clinical abnormality. While medical options remain limited in reptile medicine, somatostatin analogues such as octreotide have been widely utilized in human and small animal oncology to manage hormone-secreting tumors and their systemic effects. This presentation will review the first known use of octreotide in a bearded dragon with suspected gastric neuroendocrine carcinoma, exploring drug rationale, dosing strategy, and the physiologic basis for its impact on glucose regulation. Attendees will gain a practical overview of the pathophysiology of somatostatinomas in reptiles, the diagnostic value of advanced imaging such as coelomic ultrasonography, and the considerations that guide medical management. A step-wise breakdown of the octreotide treatment protocol will be provided, including monitoring recommendations, expected clinical responses, and potential reasons for limited efficacy. Comparative discussion with human and canine literature will highlight parallels in disease behavior and therapeutic approach, offering clinicians a framework for extrapolating evidence-based strategies to exotic species. The goal of this session is to introduce reptile practitioners to an potential therapeutic option, deepen understanding of the endocrine and oncologic mechanisms at play, and equip attendees with practical guidance for managing complex metabolic derangements in patients with functional gastric neuroendocrine tumors.