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potassium high- heart problem?
Hi,
A few days ago I posted about my kitty Meetoo-20 yrs. old. She has crf w/ 100ml of sub-Q fluid every day. She's been in hospital since Friday. The original info I had was that her potassium level was low, and was the reason for her lethargy and small appetite. My updated info, straight from the vet's mouth is that her potassium is *high* at 6.4 5.5 is normal. Now that she's in the hospital, they have her on IV fluids and have added some dextrose to draw the potassium out of the blood stream and into the cells. The vet said with her potassium that high, her heart could stop. The vet is calling me later this evening to tell me the results of the most recent blood test. We wanted to bring Meetoo home tonight as she's been in hospital since Friday. Has anyone had experience with high potassium readings? Susan |
#2
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"SPillus" wrote in message ... Hi, A few days ago I posted about my kitty Meetoo-20 yrs. old. She has crf w/ 100ml of sub-Q fluid every day. She's been in hospital since Friday. The original info I had was that her potassium level was low, and was the reason for her lethargy and small appetite. My updated info, straight from the vet's mouth is that her potassium is *high* at 6.4 5.5 is normal. Now that she's in the hospital, they have her on IV fluids and have added some dextrose to draw the potassium out of the blood stream and into the cells. The vet said with her potassium that high, her heart could stop. The vet is calling me later this evening to tell me the results of the most recent blood test. We wanted to bring Meetoo home tonight as she's been in hospital since Friday. Has anyone had experience with high potassium readings? Susan When hyperkalemia occurs in CRF cats, its usually because the cat is either oliguric, over-supplemented with K, or in the terminal state of the disease. Since your cat was initially hypokalemic, my guess is your vet over-supplemented potassium (K) - since its unlikely your cat went from hypokalemia to hyperkalemia that fast - hyperkalemia usually doesn't occur that quickly. If I were you, I'd speak to your vet about a diuretic (Furosemide). Diuretics stimulate urinary output, which facilitates the excretion of excessive K and renal toxins. Furosemide should increase urine output within 30 mins. If it doesn't, the dose should be doubled, and then tripled at hourly intervals - although I don't think doses above 2 mg/lb are any more effective. That's, of course, only if your cat is oliguric. The only advantages of dextrose over flurosemide is its cheaper, provides some non-protein calories for energy and is readily detectable in the urine when its effects begin. However, there is a real risk of overhydration if your cat severely oliguric. I think Furosemide is much safer and should begin to work in about 30 mins. The problem with potassium levels is that most (90%) of the total body stores of K are contained in the tissue where it can't be measured by routine tests and not in the blood - so blood tests don't represent the true body stores of K. My best wishes for your Golden Girl.and you. Phil |
#3
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"SPillus" wrote in message ... Hi, A few days ago I posted about my kitty Meetoo-20 yrs. old. She has crf w/ 100ml of sub-Q fluid every day. She's been in hospital since Friday. The original info I had was that her potassium level was low, and was the reason for her lethargy and small appetite. My updated info, straight from the vet's mouth is that her potassium is *high* at 6.4 5.5 is normal. Now that she's in the hospital, they have her on IV fluids and have added some dextrose to draw the potassium out of the blood stream and into the cells. The vet said with her potassium that high, her heart could stop. The vet is calling me later this evening to tell me the results of the most recent blood test. We wanted to bring Meetoo home tonight as she's been in hospital since Friday. Has anyone had experience with high potassium readings? Susan When hyperkalemia occurs in CRF cats, its usually because the cat is either oliguric, over-supplemented with K, or in the terminal state of the disease. Since your cat was initially hypokalemic, my guess is your vet over-supplemented potassium (K) - since its unlikely your cat went from hypokalemia to hyperkalemia that fast - hyperkalemia usually doesn't occur that quickly. If I were you, I'd speak to your vet about a diuretic (Furosemide). Diuretics stimulate urinary output, which facilitates the excretion of excessive K and renal toxins. Furosemide should increase urine output within 30 mins. If it doesn't, the dose should be doubled, and then tripled at hourly intervals - although I don't think doses above 2 mg/lb are any more effective. That's, of course, only if your cat is oliguric. The only advantages of dextrose over flurosemide is its cheaper, provides some non-protein calories for energy and is readily detectable in the urine when its effects begin. However, there is a real risk of overhydration if your cat severely oliguric. I think Furosemide is much safer and should begin to work in about 30 mins. The problem with potassium levels is that most (90%) of the total body stores of K are contained in the tissue where it can't be measured by routine tests and not in the blood - so blood tests don't represent the true body stores of K. My best wishes for your Golden Girl.and you. Phil |
#4
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"SPillus" wrote in message
... Hi, A few days ago I posted about my kitty Meetoo-20 yrs. old. She has crf w/ 100ml of sub-Q fluid every day. She's been in hospital since Friday. The original info I had was that her potassium level was low, and was the reason for her lethargy and small appetite. My updated info, straight from the vet's mouth is that her potassium is *high* at 6.4 5.5 is normal. Now that she's in the hospital, they have her on IV fluids and have added some dextrose to draw the potassium out of the blood stream and into the cells. The vet said with her potassium that high, her heart could stop. The vet is calling me later this evening to tell me the results of the most recent blood test. We wanted to bring Meetoo home tonight as she's been in hospital since Friday. Has anyone had experience with high potassium readings? Susan http://www.felinecrf.org/treatments....gh%20potassium HTH Helen |
#5
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"SPillus" wrote in message
... Hi, A few days ago I posted about my kitty Meetoo-20 yrs. old. She has crf w/ 100ml of sub-Q fluid every day. She's been in hospital since Friday. The original info I had was that her potassium level was low, and was the reason for her lethargy and small appetite. My updated info, straight from the vet's mouth is that her potassium is *high* at 6.4 5.5 is normal. Now that she's in the hospital, they have her on IV fluids and have added some dextrose to draw the potassium out of the blood stream and into the cells. The vet said with her potassium that high, her heart could stop. The vet is calling me later this evening to tell me the results of the most recent blood test. We wanted to bring Meetoo home tonight as she's been in hospital since Friday. Has anyone had experience with high potassium readings? Susan http://www.felinecrf.org/treatments....gh%20potassium HTH Helen |
#6
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In , "Phil P."
wrote: | When hyperkalemia occurs in CRF cats, its usually because the cat is | either oliguric, over-supplemented with K, or in the terminal state of | the disease. Leaving aside the oversupplementation possibility, can oliguria happen before the terminal stage? With adequate hydration, CRF cats usually pee tons (okay, that's an exaggeration, but my fella's softball sized clumps in the literbox are costing me a fortune in litter!), so wouldn't *less* than normal urine output - which I believe is the meaning of oliguria - mean that the kidneys are shutting down altogether? Or is it the case that oliguria in CRF cats can also be due to some kind of treatable blockage inside the kidneys? |
#7
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In , "Phil P."
wrote: | When hyperkalemia occurs in CRF cats, its usually because the cat is | either oliguric, over-supplemented with K, or in the terminal state of | the disease. Leaving aside the oversupplementation possibility, can oliguria happen before the terminal stage? With adequate hydration, CRF cats usually pee tons (okay, that's an exaggeration, but my fella's softball sized clumps in the literbox are costing me a fortune in litter!), so wouldn't *less* than normal urine output - which I believe is the meaning of oliguria - mean that the kidneys are shutting down altogether? Or is it the case that oliguria in CRF cats can also be due to some kind of treatable blockage inside the kidneys? |
#8
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In , "Phil P."
wrote: | "Arjun Ray" wrote in message | ... | With adequate hydration, CRF cats usually pee [a lot,] so wouldn't | *less* than normal urine output - which I believe is the meaning of | oliguria - mean that the kidneys are shutting down altogether? | | Not necessarily. Oliguria can be physiologic or pathologic and | reversible - depending on the cause. Oliguria could occur in a cat | with primary polyuric renal failĀ*ure if some prerenal abnormality | develops. What kind of pre-renal abnormalities might trigger this? E.g. severe azotemia, dehydration, low blood pressure? | Or is it the case that oliguria in CRF cats can also be due to some | kind of treatable blockage inside the kidneys? | | Renal pelvic stones (nephroliths) can certainly obstruct urine flow | to the ureters, urinary bladder, and urethra. I guess this was my main question: how susceptible are CRF cats to developing blockages inside the kidneys? (Or would this be due to causes not necessarily related to the CRF condition itself?) | Urinary obstruction can also occur in cats that have some disorder or | abnormality of innervation from any cause that result in diminished or | ineffective detrusor contractions or lack of relaxation of the | urethral sphincter mechanism. Okay, so it can be post-renal, in the bladder too. | As an aside, the bladder should *never* be expressed in a oliguric | or anuric cat. I believe the standard treatment is a diuretic - is that correct? |
#9
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In , "Phil P."
wrote: | "Arjun Ray" wrote in message | ... | With adequate hydration, CRF cats usually pee [a lot,] so wouldn't | *less* than normal urine output - which I believe is the meaning of | oliguria - mean that the kidneys are shutting down altogether? | | Not necessarily. Oliguria can be physiologic or pathologic and | reversible - depending on the cause. Oliguria could occur in a cat | with primary polyuric renal failĀ*ure if some prerenal abnormality | develops. What kind of pre-renal abnormalities might trigger this? E.g. severe azotemia, dehydration, low blood pressure? | Or is it the case that oliguria in CRF cats can also be due to some | kind of treatable blockage inside the kidneys? | | Renal pelvic stones (nephroliths) can certainly obstruct urine flow | to the ureters, urinary bladder, and urethra. I guess this was my main question: how susceptible are CRF cats to developing blockages inside the kidneys? (Or would this be due to causes not necessarily related to the CRF condition itself?) | Urinary obstruction can also occur in cats that have some disorder or | abnormality of innervation from any cause that result in diminished or | ineffective detrusor contractions or lack of relaxation of the | urethral sphincter mechanism. Okay, so it can be post-renal, in the bladder too. | As an aside, the bladder should *never* be expressed in a oliguric | or anuric cat. I believe the standard treatment is a diuretic - is that correct? |
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