6/8 Doodle 1ps = 112, 2ps = 50 (ultrasound & b/w results)

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1ps = 112, 2ps = 50 (yes I shot that)

Well I have good news and bad news.. and news.
the good news is that there wasn't anything horribly and obviously wrong on Doodle's ultrasound. No obvious sign of hyperaldosteronism, his kidneys and other organs looked normal, etc...
The bad news is that his potassium has taken yet another dive and is back down to his all time low of 2.6 - which is dangerously low. :sad:
The "news" is that he has what the vet believes is probably a cyst on his liver - but it is located in an area that makes her unable to aspirate to confim that belief.
So for now we're calling it a "cyst." She said it may explain his appetite being lowered and possibly the vomiting (which may contribute to his pottassium issue) ??
She said we could go to a specialist at UF and possibly get more information - but I have unfortunately depleted my funds at this point ... Doodle will need more bloodwork every ten days until I can resolve the potassium issue, so for now I will have to choose my battles.

The other "news" is that I realized yesterday that Doodle's numbers had been wonky ever since I started giving him a different potassium supplement. I had only intended it to be a temporary measure until I could get some more of the brand I like, and I could have sworn I got the right thing when I bought it... but I got the wrong brand and when I looked at the ingredients I saw that it contained something called hypromellose ( a carb) ohmygod_smile
As you can see by his numbers he was not liking that...

oh, his +2 = 88 :smile:

 

Cysts on the liver, can shrink, yes? I am just wondering but don't know.

 

ugh....ok at least we know (we hope) what we are dealing with.

could you give him a banana to boost the potassium? ;-) maybe a nip-nanner instead?

 

Congrats on the good news. No hyperaldosteronism! The low potassium thing is very puzzling. I hope they can get to the bottom of that. I think that when ultrasounds are done (human, cat, etc), there are often incidental findings like cysts lurking around that may not even be of any danger. Are his liver values all normal? I don't know anything about it, but this link says:

http://www.vin.com/vindbpub/searchpb/pr ... r00113.htm
"Hepatic cysts
Single or multiple hepatic cysts are very occasionally identified in cats but are rarely of clinical significance."

I agree that resolving the potassium issue is more pressing right now.

I hope your back is better today.

(((Michelle))) (((Doodle)))

 

uh-oh. welcome to the liver cyst club we're syringe-feeding meowzi b/c hers has grown so large it's displacing her stomach and we think it's making her feel full.

yikes on that potassium level. hey does he have GI issues? i wonder if he's even absorbing what you're giving him. i know there is potassium that can be injected into squids, but it doesn't feel good (stings? i forget) - just wondering out loud.

 

Well she said she can't rule Hyperaldosteronism out completely - but she didn't see anything obvious on the ultrasound.
But she said she wasn't familiar enough with the additional tests needed to be willing to do them and that if i wanted to pursue it any further I needed to go to UF (or another specialist) So...
I figure since even if he was diagnosed I would be doing the exact same thing - which is treating the hypertension and dealing with the potassium that I may as well focus on that.

As for the cyst - don't' both Bear Man and Meowzi have cysts on their liver?
I'm not too worried about it right now - I read that same link last night and several other things that said something similiar.
And his liver values are all normal.

My back feels a little better already today thanks Linda

 

I didn't see your post until after I posted CF. I knew I wasn't making that up in my head about Meowzi.
( DH was just gushing over her last night and how darn cute she is getting her syringe fed meals )

I honestly am just not sure what to think about his potassium levels -- I am almost to the point of admitting him to the hospital and letting them give it to him via IV -- but I wonder if he could retain it ... and if not WHY?

DH is supposed to be picking up some NOW potassium powder this evening.

eta -- the only thing I can think of is that he has thrown up quite a lot this last week ( hairballs mostly) and has lost lots of fluid and therefore potassium.

 

Bear has kidney cysts and assorted abdominal cysts, likely in lymph nodes.

I wonder if giving him the IV potassium would at least get him up to a good level and give the oral supplement a chance to maintain it there?

 

Nope, you didn't make it up in your head, Meowzi does have a big liver cyst. Her u/s report is here if you're curious. Cheryl's Wolfie has a liver cyst too.

Glad DH liked the syringe-feeding video That was on a good day, when she was very very good. Some days she's just good, instead of very very good, but overall, she's been very tolerant of us.

I would be tempted to try that, just to see if he can retain it - if he can, then you can rule out retention, and maybe it's an absorption problem? Or if he can't, while you can't rule out absorption, you'll know he also has a retention problem? I don't know. That's just the curious analyst in me wondering; the cat parent in me finds his persistent low potassium very worrying. I think Jess mentioned in Cali's thread on Health a couple of weeks ago that she would consider <3 to be true hypokalemia. It's true vomiting and excessive urination can deplete potassium, but does he really throw up that much over hairballs?

Did he switch back to eating lower-phos Friskies, and do you think it's related to this? I'm thinking if it were me, I'd take my chances with renal disease if it worsens, but I'd want to jump on this potassium thing. Potassium takes priority here, IMHO. Have you PMed Jess to see if she would look in on your thread?

Oh, and how's his sodium level?

 

hi michelle! i don't know diddley-squat about low potassium, but wanted to stop by to cheer about the unremarkable ultrasound!
sounds like you're in good hands. choy-foong and linda have some good ideas...

 

3ps = 90

3ps = 90

Thanks for the response Linda - I knew Bear had abdominal cysts but for some reason I thought also liver cysts (rather than kidney) - please apologize to him and tell him I was not trying to add to his list! And also a few smooshes would be appreciated.

Choy-Foong, Thanks for the link to Meowzi's ultrasound report - I should be able to pick up a copy of Doodle's next week.
Doodle hasn't been eating low phos Friskies for the last 2 weeks. I tried to find a good balance so I put him back on regular Friskies (Turkey and Giblets @ 260 phos & Country Dinner@ 233phos) and the occasional FF elegant medley.(241phos) I certainly hope that those aren't secretly low magnesium as well :roll:
I'm not sure if his vomiting is really enough to be causing this - it's hard to imagine...
It's also hard for me to wrap my head around the fact that he is so darn (and dangerously) low on potassium, yet continues to play at night like there is nothing wrong. He has been a bit more lethargic, but not horribly so.
I'm definitely worried about him and I think I will talk to the vet, next week at his recheck, about admitting him if his values aren't up - your logic about ruling out retention makes sense to me.

His sodium is still running high at 163.

 

Re: 3ps = 90

It's on my to-do list to go through some sites (if they're to be trusted!) and check on mag levels in foods. I wonder how long Wellness has been low-mag. When Jess asked me if Cali was on a low-mag diet, I said no - little did I know! ohmygod_smile

Hmm. I know you and Jojo have been talking about hyperaldosteronism for some time, so this may not be news to you:
http://felinecrf.org/diagnosis.htm#low_potassium
Cats with diabetes may also have low potassium levels. Very occasionally, low potassium levels may be caused by a condition known as hyperaldosteronism, but this is very rare in cats. If hyperaldosteronism is present, the cat will often also have high sodium levels, and will frequently develop hypertension. Less common feline endocrinopathies (2004) is a presentation by BR Jones to the World Small Animal Association World Congress 2004. Scroll to the last section for information on hyperaldosteronism.

Grasping at straws here - this is a general description - but does anything here ring a bell?
Potassium low - creatinine not high (not renal)
The potassium level is low. Potassium is an electrolyte that is very important for heart and muscle function. Common reasons to have a low potassium level include vomiting, diarrhea, chronic kidney disease or secondary to Dextrose fluid, insulin, diuretic or penicillin medications. Two rare hormonal diseases that can cause this are hyperadrenocorticism (Cushing’s Disease) and hyperaldosteronemia. Burmese cats can have a congenital paralytic paralysis due to low potassium. A potassium level below 2.5 mEq/L can be fatal to any animal. Immediate potassium replacement is indicated due to this low level.


Insulin ... wonder if TID dosing could be a factor? (really grasping at straws here!)

 

Re: 3ps = 90

Yes, I did know that high sodium was also a symptom of hyperaldosteronism - it's one of the reasons I really pushed for the ultrasound -- I just couldn't get that trifecta out of my mind... ( low potassium. high(ish) sodium and hypertension)

Strangely enough, my vet actually wondered out loud about the TID dosing of insulin as well -- I somewhat dismissed the idea because his overall dose is so darn small - but now that you are mentioning it as well, I suppose I shouldn't ignore the possibility.
hmmm....


"A potassium level below 2.5 mEq/L can be fatal to any animal. Immediate potassium replacement is indicated due to this low level."

I had not seen this number before, and it's frankly horrifying. I think I'll call my vet tomorrow and ask her why she isn't insisting on IV supplementation.

 

Re: 3ps = 90

no, don't put too much weight into my speculation. like i said, i was grasping at straws.

i don't know what to tell you. another site i looked up said "life-threatening," but that somehow has a less dire connotation than 'fatal', doesn't it? please don't panic yet, but do call your vet tomorrow and ask her thoughts on the statement. it is a general explanation after all; the page i pulled it from has this in big red letters: These documents describe in greater detail some of the "assessment" portions of the lab work that you received from your doctor. Please keep in mind that these are general explanations of specific laboratory findings and have not been tailored to your pet. i should have included this in the earlier post, i'm sorry if i alarmed you.

 

Seeing some good news is great, cyst news, well, we just go along & take the best care we can of them..
You are a diligent, caring, loving bean who makes every attempt to keep your kitties happy & healthy--
I just know Doodle will improve, and we are sending giant healing vines to him for away cyst & better potass. values--
Luv that Doodle boy--Get better soon--Hugs from us!!!

 

no no Choy-Foong -- no apology needed - not in the least!

You're just looking out for us - and I'm so so grateful that you even take the time!

besides, I can be "horrified" and not be in a panic ;-)
I'll call tomorrow.

 

Michelle I think it's time to supplement magnesium now. I have no idea why Doodle's magnesium would be low, but not 'holding' potassium that's being supplemented is a sign of hypomagnesemia. I would speak to your vet about it and start supplementing today. You can use mag oxide or mag sulfate. Start low and increase because it can act as a laxative if you give too much.

Did the ultrasonographer get a good look at the adrenal glands? ANd did your vet ever send out for aldosterone levels?

I agree with everyone else about the cyst. I'm waiting for one to show up on Dillon --seems to be an old cat thing. His liver values are normal, right?