Hypokalaemia is one of the most frequently encountered electrolyte disturbances of cats. Mildly hypokalaemic cats may appear normal or show non specific signs such as lethargy whilst cats with severe hypokalaemia can present with marked muscle weakness (including ventroflexion of the neck) due to hypokalaemic polymyopathy. Cats are vulnerable to hypokalaemia whenever their appetite is reduced so all anorexic cats should have potassium levels assessed, where possible. Other important causes of hypokalaemia include chronic kidney disease, hyperthyroidism and iatrogenic causes such as diuretics, insulin and overzealous intravenous fluid therapy. Measurement of potassium levels is recommended in all sick cats and the speaker routinely supplements intravenous fluids with potassium at levels according to serum potassium readings. Diagnosis and management of hypokalaemia associated with less common causes such as primary hyperaldosteronism and Familial Episodic Hypokalaemic Polymyopathy will be included. Potassium supplementation can be provided via fluid therapy or orally. Potassium gluconate is typically favoured for oral supplementation as it is less gastric irritant than other forms. Therapeutic renal diets contain high levels of potassium and this can be another route for support. Acidifying diets and those low in potassium should be avoided, especially in cats with CKD, as these diets tend to increase the risk of hypokalaemia.

Learning Objectives

  • Primary Hyperaldosteronism Focus: Recognise the signs and underdiagnosed nature of primary hyperaldosteronism in cats, understanding its management and the essential role of potassium supplementation.
  • Hypokalemia Management: Learn diagnostic and management strategies for hypokalemia through case studies, with a focus on chronic kidney disease and potassium supplementation.
  • Causes of Hypokalemia: Identify key causes of low potassium in cats, including chronic kidney disease, anorexia, diuretics, primary hyperaldosteronism, and genetic predispositions.
  • Interpretation Skills: Develop the ability to accurately interpret potassium test results, recognising the clinical implications of deviations.
  • Importance of Potassium Monitoring: Understand the crucial role of potassium in feline health and the reasons for regular monitoring.

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