Peer-reviewed veterinary case report
Treating high potassium in male cats with blocked urethras: fluids
By Maciorowski, Stephanie et al.·Published in Journal of the American Veterinary Medical Association·2025·View original on PubMed →
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Original publication title: Pharmacological therapy for hyperkalemia in feline urethral obstruction has no additional benefit over intravenous fluid and calcium gluconate therapy and prompt unobstruction.
- Species:
- cat
Plain-English summary
A male cat with a blocked urethra was brought to the vet due to dangerously high potassium levels, which can be life-threatening. The cat received intravenous fluids and calcium gluconate to help lower the potassium. While additional treatments like insulin, terbutaline, or sodium bicarbonate were tested, they didn't show any extra benefits compared to the initial treatment. The cat's potassium levels dropped significantly after treatment, and with prompt care, the prognosis was good.
People also search for: cat urethral obstruction treatment · high potassium in cats · male cat blocked urinary tract · cat hyperkalemia treatment options
Abstract
OBJECTIVE: Urethral obstruction (UO) in male cats is a potentially fatal condition due to hyperkalemia. The objective of this study was to compare the effect of IV fluids and calcium gluconate (IVF-Cg) alone or with insulin/dextrose, terbutaline, or sodium bicarbonate on hyperkalemia in male cats presenting with UO. METHODS: Male cats presenting to a university hospital with UO and a blood potassium > 7.5 mEq/L were prospectively enrolled in this experimental study from July 2019 to September 2024. All cats received a fluid bolus and calcium gluconate dose IV. Cats were randomized to receive IVF-Cg alone or with terbutaline, insulin-dextrose, or sodium bicarbonate. The relative reduction in blood potassium after 4 hours was compared between groups. RESULTS: The study enrolled 34 cats, with 8 cats in the bicarbonate and insulin/dextrose groups and 9 cats in the IVF-Cg and terbutaline groups. The median baseline and 4-hour potassium for all cats was 9.1 mEq/L (range, 7.5 to 11.8 mEq/L) and 5.4 mEq/L (range, 4 to 8 mEq/L) respectively. The median relative reduction in blood potassium was 29% (6% to 50%) for IVF-Cg, 37% (12% to 55%) for insulin-dextrose, 36% (8% to 45%) for sodium bicarbonate, and 52% (10% to 56%) for terbutaline. There was no significant difference in percentage change in potassium between groups. CONCLUSIONS: There is no significant difference between the various treatments for hyperkalemia in male cats with UO. CLINICAL RELEVANCE: There is no adjunctive therapy that is clearly beneficial for promoting resolution of hyperkalemia. Prompt relief of obstruction, calcium gluconate, and administration of IV fluids result in rapid reduction of hyperkalemia and a good prognosis.
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Search related cases →Original publication on PubMed: https://pubmed.ncbi.nlm.nih.gov/40562375/