Peer-reviewed veterinary case report
Treating high potassium from blocked urethra in male cats
By Jones, Jessica M et al.·Published in Journal of feline medicine and surgery·2022·Veterinary Medical Teaching Hospital, United States·View original on PubMed →
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Original publication title: Treatment strategies for hyperkalemia secondary to urethral obstruction in 50 male cats: 2002-2017.
- Species:
- cat
Plain-English summary
A group of 50 male cats with urethral obstruction were treated for dangerously high potassium levels, which can be life-threatening. The average potassium level when they arrived was 8.9 mEq/l, and after treatment with intravenous fluids and a combination of dextrose and insulin, it dropped to 6.6 mEq/l within six hours. While most cats improved, some still experienced low blood sugar despite receiving the commonly recommended amount of dextrose. Overall, the severity of their potassium levels did not seem to affect their chances of survival.
People also search for: cat urethral obstruction treatment · high potassium in cats · cat insulin dextrose ratio · cat low blood sugar symptoms
Abstract
OBJECTIVES: The aims of this study were: to describe the potassium-lowering treatment strategies used to manage moderate-to-severe hyperkalemia in male cats with urethral obstruction (UO); to determine how much dextrose was required per unit of insulin to prevent hypoglycemia; to determine whether early initiation of a dextrose continuous rate infusion (CRI) prevented hypoglycemia; and to determine whether in-hospital mortality was associated with presenting plasma potassium concentration ([K]). METHODS: The medical records of male cats presenting with a [K] ⩾7.0 mEq/l due to UO that had another [K] measured within 6 h were reviewed retrospectively. All [K] values within the first 6 h, blood glucose concentrations, treatments for hyperkalemia and survival to discharge were recorded. Analyses were performed to test for associations between dextrose:insulin ratios or method of dextrose administration and the development of hypoglycemia; and for presenting [K] and mortality. Normally distributed groups of continuous data were compared with a-test and categorical data were compared with a Fisher's exact test. RESULTS: Fifty cats were included. Mean presenting [K] was 8.9 ± 1.0 mEq/l, while the mean final [K] within 6 h was 6.6 ± 1.4 mEq/l. Forty-two (84%) cats were treated with intravenous fluids and 40 (80%) were treated with dextrose and insulin. Median dextrose:insulin ratio was 2 g/u (range 0.4-100). No dextrose:insulin ratio was found to protect against hypoglycemia, and 3/8 cats that became hypoglycemic had received ⩾2 g dextrose per unit of insulin. There was no association between the early initiation of a dextrose-containing CRI and avoidance of hypoglycemia. No association was found between presenting [K] and mortality. CONCLUSIONS AND RELEVANCE: While no specific dextrose:insulin ratio was found to protect against hypoglycemia, there is evidence that the commonly recommended dextrose:insulin ratio of 2 g/u may be inadequate in preventing hypoglycemia in every cat. Severity of hyperkalemia was not associated with mortality.
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Search related cases →Original publication on PubMed: https://pubmed.ncbi.nlm.nih.gov/36350735/