Hypokalemia-low potassium
Hypokalemia-low potassium
"The most common cause of hypokalemia (low potassium) is chronic kidney disease, although cats that have other ailments such as diabetes mellitus, liver disease and lower urinary tract disease may suffer from potassium depletion as well. Cats that are fed a special diet or given a supplement to acidify their urine may be subject to potassium loss".. Potassium gluconate (TUMIL-K) is available in palatable powder, tablet or gel form.
Geriatic cats
". Potassium is probably most important for the cells which make up skeletal and cardiac muscle. Severe muscle weakness can result when the body becomes depleted of potassium...A mild form of hypokalemia (low blood potassium) has been identified in the older cat and is associated with lethargy and inactivity, a poor appetite and haircoat, and the development of a mild anemia... Now we know that this process can be reversed with supplementation of potassium. .. The second discovery about low blood potassium is related to the effect of potassium on the kidneys.The potassium wasting associated with increased urine production has a negative effect on the kidneys.
Am J Vet Res. 2004 May;65(5):620-7. : Effects of dietary sodium chloride intake on renal function and blood pressure in cats with normal and reduced renal function.
Buranakarl C, Mathur S, Brown SA.
Department of Physiology, Faculty of Veterinary Science, Chulalongkorn University, Bangkok, 10330, Thailand.

OBJECTIVE: To determine effects of variations in dietary intake of sodium chloride (NaCl) on systemic arterial blood pressure (ABP) in cats with normal and reduced renal function. ANIMALS: 21 adult cats (7 with intact kidneys [control cats; group C], 7 with unilateral renal infarction with contralateral nephrectomy [remnant-kidney model; group RK], and 7 with unilateral renal infarction and contralateral renal wrapping and concurrent oral administration of amlodipine [remnant-wrap model; group WA]). PROCEDURE: All cats were sequentially fed 3 diets that differed only in NaCl content (50, 100, or 200 mg of Na/kg); each diet was fed for 7 days. The ABP was recorded continuously by radiotelemetry, and renal function (glomerular filtration rate [GFR]) was determined on the sixth day of each feeding period. RESULTS: Dietary supplementation with NaCl did not affect ABP, but it increased GFR in groups C and WA. The renin-angiotensin-aldosterone axis was activated in groups RK and WA at the lowest NaCl intake, but supplementation with NaCl suppressed this activation in group WA. The lowest NaCl intake was associated with hypokalemia and a high fractional excretion of potassium that decreased in response to supplementation with NaCl. Arterial baroreceptor resetting was evident after chronic hypertension but was not modified by dietary supplementation with NaCl. CONCLUSIONS AND CLINICAL RELEVANCE: Low NaCl intake was associated with inappropriate kaliuresis, reduced GFR, and activation of the renin-angiotensin-aldosterone axis without evidence of a beneficial effect on ABP. Therefore, this common dietary maneuver could contribute to hypokalemic nephropathy and progressive renal injury in cats.
J Vet Intern Med. 2004 Jul-Aug;18(4):463-7. : Dietary NaCl does not affect blood pressure in healthy cats.
Luckschander N, Iben C, Hosgood G, Gabler C, Biourge V.
Division of Small Animal Internal Medicine, Department of Clinical Veterinary Medicine, University of Bern, Bern, Switzerland.
nicole.luckschander@kkh.unibe.ch

The purpose of this study was to assess the effects of dietary salt intake on systolic blood pressure, water intake, urine output, and urine concentration in cats. Ten healthy young adult cats (mean age 2.5 years) were randomly divided into 2 groups and fed either a control diet (0.46% Na and 1.33% Cl on a dry matter [DM] basis) or a diet with a moderately increased salt content (1.02% Na and 2.02% Cl on a DM basis) for 2 weeks. After a 1-week wash-out period, each group was switched to the opposite diet for 2 weeks. During each 2-week study period, food and water intake, urine volume, urine specific gravity, and urine osmolality were measured daily. Systolic blood pressure (calculated as the mean of 5 readings measured with a Doppler flow detector) was assessed twice daily. No significant effect of diet composition was found on systolic blood pressure, and blood pressure measurements remained within reference limits throughout the study in all 10 cats. However, animals fed the higher salt diet had significantly increased water intake and urine osmolality, and significantly decreased urine specific gravity in comparison to animals fed the control diet. Examination of results of this preliminary study suggests that feeding a diet with moderately increased salt content increases water intake and causes diuresis without increasing systolic blood pressure in healthy adult young cats.
vin website crf..pdf format "
canine and feline liver overview
"Hypokalemia may develop due to inadequate potassium intake, vomiting, polydipsia and polyuria, magnesium depletion, and concurrent chronic renal failure. Hypokalemia is present in about 30% of cats with severe hepatic lipidosis.9 Hypokalemia was significantly related to nonsurvival in this group of cats. Hypokalemia is dangerous because it may prolong anorexia and/or exacerbate expression of hepatic encephalopathy. See Tables 2 and 3 for recommended potassium levels for dogs and cats with liver disease. "
Vet Q 2001 Jan;23(1):38-43:Hyperaldosteronism in a cat with metastasised adrenocortical tumour.
Rijnberk A, Voorhout G, Kooistra HS, van der Waarden RJ, van Sluijs FJ, IJzer J, Boer P, Boer WH.
Department of Clinical Sciences of Companion Animals, Faculty of Veterinary
Medicine, Utrecht University. A.Rijnberk@vet.uu.nl
In a 12-year-old male shorthaired cat with attacks of hypokalaemic muscular weakness in spite of oral potassium supplementation, highly elevated plasma aldosterone concentrations in combination with low plasma renin activity pointed to primary hyperaldosteronism. Ultrasonography and computed tomography revealed a large left-sided adrenal tumour growing into the phrenicoabdominal vein and the caudal vena cava. The tumour and its intravascular extension were surgically removed, but the subsequent stenosis of the caudal vena cava caused congestion and renal failure. At autopsy pulmonary micrometastases of the aldosteronoma were found.

J Am Vet Med Assoc 2000 Jul 15;217(2):213-5, 197 : Use of abdominal ultrasonography in the diagnosis of primary hyperaldosteronism in a cat.
Moore LE, Biller DS, Smith TA.
Department of Clinical Sciences, College of Veterinary Medicine, Kansas
State University, Manhattan 66506, USA.
A 13-year-old castrated male cat was examined because of a 2-week history of weakness, cervical ventroflexion, and dysphagia. Clinicopathologic abnormalities included hypokalemia and high serum creatine kinase activity. Abdominal ultrasonography revealed a 15-mm spherical mass in the area of the left adrenal gland. Plasma aldosterone concentration was high, and plasma renin activity was low. Findings were diagnostic of primary hyperaldosteronism. The cat responded well to intravenous and oral potassium supplementation while in the hospital. The owner declined surgery; therefore, repeated follow-up abdominal ultrasonography was recommended. The cat did well clinically with medical management alone until day 334, when it was lost to follow-up.
Vet Clin North Am Small Anim Pract 1998 May;28(3):545-64 : Clinical disorders of potassium homeostasis. Hyperkalemia and hypokalemia.
Phillips SL, Polzin DJ.
Department of Medicine, Cornell University School of Veterinary Medicine, Ithaca, New York, USA.
Potassium plays an important role in cell metabolism and membrane excitability. Disorders of potassium balance can have profound clinical effects, particularly on the cardiovascular and neuromuscular systems. Chronic hyperkalemia invariably results from impaired renal potassium excretion. Hyperkalemia can be a potentially life-threatening disturbance requiring emergency intervention. Treatment is usually directed at correcting the defect in potassium excretion. Hypokalemia has become closely linked with in cats. Clinical signs include muscle weakness and renal dysfunction, which usually respond well to oral potassium supplementation.
Semin Vet Med Surg (Small Anim) 1997 Nov;12(4):263-7 : Complications and concurrent disease associated with diabetes mellitus.
Nichols R.
Antech Diagnostics, Farmingdale, NY 11735, USA.
Many animals with diabetes mellitus are severely ill on clinical presentation. The spectrum of disease is quite variable and includes diabetic ketoacidosis (DKA), ketosis without acidosis, hyperosmolar nonketotic syndrome (HNKS), and other nonketotic variants (negative urine ketones, serum osmolality < 340 mOsm/kg with or without acidosis). These more severe forms of diabetes are often precipitated by concurrent diseases such as pyelonephritis, pancreatitis, pyometra, hyperadrenocorticism, renal failure, and heart failure. To make matters worse, in-hospital treatment of diabetic dogs and cats is commonly associated with serious complications, including hypoglycemia, hypokalemia, and hypophosphatemia.