Civvie Cali has low-ish potassium

[WCF and Meowzi]

Am stumped and concerned. Cali's postassium came back at 3.6 (3.4-5.6).
Seems like there's been a spate of low-potassium kitties lately? What are other low-K kitties eating and drinking?

Civvie Cali is 5 y.o., no known health issues. Went in on Wednesday for her annual and we did her first full bloodwork ever (had in-house pre-op for spay in 2005, and rabies titer last year), and I just got it back this afternoon. Creatinine is normal but looks a little higher than I expected: 2.0 (0.6-2.4) but everything else except potassium looks good.

I went over possibilities with Dr S: she drinks only distilled water - not likely cause, he said. Increased urination (more and larger pee balls) - can be cause, but we haven't found the reason. Been trying to get her USG for almost a week but she's extremely skittish and takes off each time I stick my hand under her. BG is fine, in the 70s tested this week. T4 is 1.7 (0.8-4). When I said we seem to have seen quite a few kitties with low K lately, he thought maybe lab error? But Doodle and Abby use in-house and Idexx, and we use Antech. (Jess, are there any reagents or special materials used in getting a K level?)

Cali eats canned Natures Variety, Wellness and Merricks. All poultry flavours, she doesn't like fish. She snacks on raw hearts (1-2 a day) and gizzards (1 a day) and sometimes gets a spoonful of baby food for bedtime snack. The only supplements she gets are taurine and fish oil (half capsule a day). Treats are freeze-dried chicken, baked crunch chicken and temptations. She's a healthy weight, 10.88 lbs, and seems fine in every other way; curious, bright, mischievous, a real little imp.

Dr S says we can retest her K in a month when she goes in for her FVRCP booster (her third ever: first was in 2005, then 2006). She also has a cardio appt coming up in June, but that's just precautionary because I'm a paranoid mom.

eta: link to her labs

 

[Jayne & Sweety]

When Sweety's potassium was low I also got paranoid. Found some human foods that are high in potassium - yogurt, and I looked on some baby food labels and started to give her some of that - just a little at a time, some are high in carbs. I think cottage cheese has some too. Sorry I don't have any links but try searching "high potassium foods" and see what comes up.
When the bloodwork results came back really low - the vet gave me Tumil-K - turned out their machine was wrong, but her level were always on the low end and I gave her the Tumil-K once in a while, just a little. Gotta be careful, too much is no good.

 

[Jess & Earl]

hi Choy Foong.

That potassium level is in range, did you mean a lower value? I wouldn't worry about it if it's really 3.6. Remember that every blood test is a snapshot of a particular moment in the body; sometimes you'll get a 3.6, tomorrow you could get a 4.2, the next day 3.8 or 5.3, etc. As long as she is healthy and on a normal diet, I wouldn't worry about it, truly.

 

[WCF and Meowzi]

Jayne - we do have potassium gluconate powder, because Cali's big sister Meowzi requires supplementation, so that's not a problem if we ever need to. Just not keen to start supplementing yet until we get a re-test and also figure out why it's low-ish. Supplementing is easy once we decide to do it, but I'd really like to know the cause given that she's perfectly healthy.

Jess - it is indeed 3.6, and yes, within normal range. But I remember both Dr Lisa and Dr G (back-up vet) telling me something along the lines of how if potassium is within normal range but borderline, that it's almost always depleted internally in the cells, because potassium resides in the cells and only a little is in the serum. And to start thinking of supplementing if the serum level is lower than mid- or low-4's (I forget which, it's in my notes somewhere). Of course, that was for Meowzi, who's both diabetic and has CKD and excretes lots of potassium through her urine. Perhaps it is a more pertinent concern when those two conditions exist?

We think Cali is healthy, which is why this value really surprised me. The rest of her bloodwork looks great except for creatinine (2.0, normal), but I've seen Meowzi in her healthier days (albeit older) at 2.1 only to come down to the high 1's, so I'm watchful but not alarmed about creatinine yet. Cali eats a normal low-carb canned diet. She gets only 3 oz a day of canned food, but maintains a nice healthy weight on it, so it can't be insufficient food. And she gets some snacks and treats too. The other concern I have is I started noticing a little less than a month ago that she's urinating more (pee balls are larger and have gone from 2 to 3, or even sometimes 4, a day) although I haven't observed her drinking more. The little imp hopped out of the litterbox as soon as I walked into the room this morning, but I'm going to keep trying to get a USG.

I guess there really isn't much I can do except re-test in a month's time, and to try to get a USG. You know me, I'll keep worrying just a little till then :mrgreen:

It would be safe for her to go under anesthesia (buprenex + propofol + sevo) with a lower-but-within-range potassium, right? We haven't had her BP checked because she's so young, but she'll have that monitored (oscillometer) as well as the usual good stuff: pulse-oxi, IV fluids. We're just waiting for the result of her heartworm test (which Antech seems to have misplaced!) and the all-clear from the cardiologist before we schedule her first ever dental cleaning.

 

[Jess & Earl]

J
Perhaps it is a more pertinent concern when those two conditions exist?

Yes, I think that's the key.

Cali eats a normal low-carb canned diet. She gets only 3 oz a day of canned food, but maintains a nice healthy weight on it, so it can't be insufficient food.

Um, this seems like too little food. How much does she weigh? Is she very well muscled? She jumps, leaps, sustains activity, you don't feel her spine or pelvis, etc? If she is well muscled, energetic, and active, I guess it's ok. But this low food intake would be the first culprit in my mind if she did turn out to be truly hypokalemic. She is not on a urinary or low-magnesium diet?

The little imp hopped out of the litterbox as soon as I walked into the room this morning, but I'm going to keep trying to get a USG.

You'll send out for a regular urinalysis, right?

It would be safe for her to go under anesthesia (buprenex + propofol + sevo) with a lower-but-within-range potassium, right? We haven't had her BP checked because she's so young, but she'll have that monitored (oscillometer) as well as the usual good stuff: pulse-oxi, IV fluids.

There's no reason to use sevo unless it's the same price. True hypokalemia (<3) would be worrisome, but her level is fine. They should monitor ECG too.

 

[WCF and Meowzi]

J
Perhaps it is a more pertinent concern when those two conditions exist?

Yes, I think that's the key.

Ahh, ok.

Cali eats a normal low-carb canned diet. She gets only 3 oz a day of canned food, but maintains a nice healthy weight on it, so it can't be insufficient food.

Um, this seems like too little food. How much does she weigh? Is she very well muscled? She jumps, leaps, sustains activity, you don't feel her spine or pelvis, etc? If she is well muscled, energetic, and active, I guess it's ok. But this low food intake would be the first culprit in my mind if she did turn out to be truly hypokalemic. She is not on a urinary or low-magnesium diet?

Uh-oh. You think so? She was 10.88 lbs this week. Her range has been from 10.5 to 11.5 lbs. I can't really tell about muscle, but she's not fat. Just tried to feel her spine - can't feel - don't know how to feel pelvis. She's definitely not spiney like Meowzi is (yet Meowzi is overweight at 12.6 lbs). She does have a defined waist. She does jump and leap but not as much as when she was 2 y.o., but back then she would flop down and pant after vigorous leaping - part of the reason we want to do the cardio workup. She is very active, runs around the apt like a crazy kitten (bit me this morning because I was late in getting up), playful. And I just found her chart: 12/12/06, when she was 1.5 years old: "11 lb 5.5 oz, discussed weight management." So she's not underweight, I think? Gee. I hope I haven't been underfeeding her. Poor Cali She does love food, and will eat as much as we put out (she steals Meowzi's raw heart snack too, which Meowzi seldom eats). 3 oz canned food, one gizzard, one raw heart (and another stolen one, usually) daily. I can ask Dr S about her weight and food intake when we go back in for her FVRCP vax and potassium re-test.

Nope, not urinary diet. Or low-mag diet as far as I know. Wellness Turkey or Chicken, Merrick Turducken, and Natures Variety Chicken.

Hmm interesting. Chart has 5/2/06 note on "sometimes pants with exertion, sometimes resp distress, lungs clear, poss mild asthma? no tx at this time." I remember talking about the panting, but not about mild asthma.

The little imp hopped out of the litterbox as soon as I walked into the room this morning, but I'm going to keep trying to get a USG.

You'll send out for a regular urinalysis, right?

Umm no? I have a refractometer, was just going to use that. Do you think we should get a full urinalysis?

There's no reason to use sevo unless it's the same price. True hypokalemia (<3) would be worrisome, but her level is fine. They should monitor ECG too.

No more iso at our hospital, they switched to sevo several years ago. ECG, got it. I think they do, but I'll confirm.

No dental rads, but this is just grade 1 dental, mild gingivitis, no extractions expected, so I think it's ok for no rads?

 

[Jess & Earl]

3 oz canned food, one gizzard, one raw heart (and another stolen one, usually) daily. I can ask Dr S about her weight and food intake when we go back in for her FVRCP vax and potassium re-test.

Ah well that stuff is probably worth another 40 calories or so, organ meat can be calorie-dense. It sounds like it is working for her.

Umm no? I have a refractometer, was just going to use that. Do you think we should get a full urinalysis?

Only because you're concerned about her being polyuric.

No dental rads, but this is just grade 1 dental, mild gingivitis, no extractions expected, so I think it's ok for no rads?

That would be a deal-breaker for me, to be honest. I don't know if you remember, this came up in one of Hillary/Maui's threads, and I mentioned how I had two dentals done at work for Dillon ... no rads, he ended up with retained roots from extractions and who knows if we would have saved him FORL pain by recognizing them earlier? No way to be sure you dont' have FORLs if you dont' have rads.

 

[WCF and Meowzi]

Umm no? I have a refractometer, was just going to use that. Do you think we should get a full urinalysis?

Only because you're concerned about her being polyuric.

Okie. I guess we'll ask for a full urinalysis if her bladder is full enough for a cysto (it wasn't last week). Hope we can do it during the next visit, which is for her FVRCP booster. I don't really want to wait till dental day to do it, because she'll get IV fluids and that'll distort the USG.

No dental rads, but this is just grade 1 dental, mild gingivitis, no extractions expected, so I think it's ok for no rads?

That would be a deal-breaker for me, to be honest. I don't know if you remember, this came up in one of Hillary/Maui's threads, and I mentioned how I had two dentals done at work for Dillon ... no rads, he ended up with retained roots from extractions and who knows if we would have saved him FORL pain by recognizing them earlier? No way to be sure you dont' have FORLs if you dont' have rads.

I thought retained roots would be concern only post-extraction? We do not expect any extractions. Or do you mean rads to make sure there's no FORLs before cleaning starts ... hmm ... she has good appetite and hasn't dropped any food or shown any signs of pain ... can FORL occur at such a young age (5 y.o.)?

Dental rads would have to be done either 1.5 hrs away eastward, or southward, both at board-certified vet dentists. There aren't any locally

 

[WCF and Meowzi]

Jess, I got her USG this morning It's more than 1.050, to my delight, so I'm not going to get a full urinalysis unless you still think I should. (We can get it during her dental if you think I should pursue it).

 

[Cheryl and Winnie]

You know, I agree w/ Jess, it really does seem like she is not eating very much.
Janet has a handy dandy calculation on how many calories a cat should be fed base on their ideal weight.
I will try and look it up for you. I know I have it in my folder.
since it is not urgent, I'm off to crash.

Glad usg is all good. I'm sure her K ++ is fine.

best,