In some situations, a diabetic cat that is urinating alot is greatly benefited by Potassium Gluconate

[Felicity]

Passing along data I've been learning for others' reference.

When a family member of mine was prescribed a diuretic "water pill," I learned excessive urination can cause dangerous depletion of potassium. Also have learned that administering insulin can increase potassium issues.

AI info via Ask.Brave.com told me:

In diabetic cats, low potassium (hypokalemia) is dangerous because it causes severe muscle weakness that can lead to respiratory failure and cardiac arrhythmias, both of which are life-threatening.

• Mechanism: Unregulated diabetes causes excessive urination, which flushes potassium from the body, while insulin administration shifts remaining potassium from the bloodstream into cells, creating a critical deficit.
• Physical Impact: This deficit results in profound weakness, characterized by the inability to hold the head up (cervical ventroflexion), paralysis, and lethargy.
• Organ Risk: Severe hypokalemia compromises heart rhythm and respiratory muscle function, requiring immediate veterinary intervention to prevent death.

I just started giving potassium gluconate. Copper's potassium test level was low (3.1) on 6/26 blood test and I know low potassium is a problem when there's excessive urination. Copper had very high urination for a couple weeks after diagnosis, but he doesn't seem to be urinating a really high amount lately.

I gave 1/4 of a 550 mg pill at dinner yesterday and again just now. I gave cut up and down his throat.
I will try to increase to 1-2 pills/day by crushing some to powder and mixing into food.

Based potassium on this info:
Pill I have is 550 mg Potassium Gluconate pill containing 90 mg Potassium.
Source 3: 2 mEq of potassium gluconate is about equivalent to 468mg. [So 550 mg =2.35 mEq]
Source 1: Initial dose for hypokalemia is 5-8 mEq/day divided BID or TID [which would be giving one 550 mg pill each of 2 or 3 times daily, followed by a maintenance dose of 2-4 mEq/day [which would be 1-2 pills per day]. [Note: I believe this is for a 10 lb cat]
Source 2: For blood test levels between 3-3.5 during recovery time, recommended oral dose is 0.5 mEq potassium/kg PO q12h [which would be 2.25 mEq (=one 550 mg pill) every 12 hours]

There are risks if you give too much potassium, but I believe those mostly apply if a cat is dehydrated, or isn't urinating at least a normal amount,
or experiencing severe kidney problem.

• Caution if experiencing Kidney Failure and Acute Kidney Injury (AKI): While potassium supplementation is needed most often in cats with chronic kidney disease (CKD), it should be used cautiously or not used at all when kidney disease is severe or if the kidneys are experiencing an acute injury (such as from a toxin or urinary obstruction). In these cases, the kidneys have little to no function and supplementing excess potassium may lead to very high levels in the bloodstream and hyperkalemia.

I'm posting this synopsis for my own reference and to help others (though similar info might already be posted elsewhere).

 

[Felicity]

Potassium CHLORIDE is commonly given to people, or in an injectable form to cat. It is safe for cats, in appropriate amounts. However, it has a bad taste, so Potassium GLUCONATE is a more acceptable form for cats if giving orally.
I'm thinking Potassium Gluconate is also less acidifying, which is better for a diabetic cat.
I think there is also some difference between the two kinds in how much to dose.

 

[CORKY]

@Wendy&Neko

 

[Wendy&Neko]

Please don't listen to AI recommendations on giving potassium. We have seen some really bad recommendations given by AI regarding diabetic cats.

Too much potassium can cause serious issues with the heart and kill your cat. If you are concerned about potassium levels, then please take your cat into the vet for a blood test. Since your bloodwork is relatively recent, ask your vet if he should be supplemented, and if so, how much. Typically there would be retesting of potassium levels not long after, to make sure the potassium dose is right. Common symptoms of low potassium include being unsteady on their feet as well as difficulty holding up their head.

 

[Felicity]

AI has its unsteady shortfalls, for sure! It's a priceless net to cast for snagging new points of awareness, though, to drill into further within medical journals and specialized articles. For this topic, I gathered info from several, and noted a few things for additional analysis and potential application.

However, without input from others with additional study, experience, and receiving counsel through vets, quick compilation like that can't provide substantial enough view to offer reliable comprehensive help, I know.

Potassium and insulin both need knowledgeable management by a vet, critically during crises like ketoacidosis. Having either of those off can be deadly. But this site empowers people to do so much to help their cats themselves, too, while using safety information. Do you think a summary post could be written to guide cat owners to give basic inexpensive potassium supplementation when appropriate?

Thanks for considering the possibility. There may already be a good write-up in the forum somewhere I haven't seen.

Cats with diabetes have so many times of experiencing low potassium, influenced by polyuria and insulin administration. I think of how low potassium contributes to the weakness cats feel then, and it makes me want them to have relief.

 

[Felicity]

I'm seeing info that problems can occur if potassium levels are too low when giving Ondansetron, too. However, I'm getting the impression that potassium has to be pretty seriously low for that, which probably doesn't occur in diabetes outside of ketoacidosis very often.
Posting info could cue caregivers to consider adding in potassium in conjuction with Ondansetron. Though not usually critically essential, my guess would be that it would help cats feel better.
Starting off info place: negatives of ondansetron for cats with low potassium.
Note--That AI summary doesn't communicate that the likelihood of electrolytes being too far out of range for general safety isn't the norm during general diabetes care. It does give the impression more caution is needed then than generally is.

 

[Felicity]

Now seeing that excessive salt can also cause serious potassium depletion! Ack!!
I've many times been feeding canned chicken to offer high-quality protein without carbs. It has only salt added, but I knew I should check how that might impact Copper and now see it's another potassium issue.

So many things to know...

On the upside, Copper's perked up more and even done a mini-romp in the last while! I'm sure potassium supplementation is helping him feel better amidst the tangle of things that have been going on.
I won't give him more than one to three 550 mg pills per day. They are large enough to pretty much self-limit overdosing. I'm cutting pills into 1/4 pieces to be able to give them, and he takes them alright that way as long as I give him a freeze-dried chicken treat after each piece.

 

[Wendy&Neko]

Do you think a summary post could be written to guide cat owners to give basic inexpensive potassium supplementation when appropriate?

No, my recommendation is that people talk to a vet. I don't want anyone reading a post or an AI conversation and trying to do it themselves. That is too dangerous.

Cats with CKD can also have low potassium. I had one with ileus with low potassium, not diabetic or CKD at the time. There are many facets to this topic. Talk to a vet about it.

 

[Felicity]

I'm learning more about the complexities! And asking even AI, lol, it strongly cautions against giving potassium in all situations.

No, diabetics should not automatically take potassium supplements when urinating frequently. While frequent urination (polyuria) can cause potassium loss through urine, diabetic patients are also at risk for hyperkalemia (high potassium), particularly if they have kidney complications or take medications like ACE inhibitors or ARBs.

• Risk of Imbalance: In conditions like Diabetic Ketoacidosis (DKA) or with chronic kidney disease, potassium levels can become dangerously high even if total body stores are depleted, because potassium shifts out of cells into the bloodstream.
• Kidney Function: The kidneys regulate potassium; if kidney function is impaired, excess potassium can build up to lethal levels, causing heart problems.
• Medical Supervision Required: A blood test is necessary to determine actual potassium levels. Supplements should only be taken if a healthcare provider diagnoses a deficiency, as self-supplementation can be dangerous. Ask.Brave.Com

 

[Felicity]

@Wendy&Neko I wish my vet had informed me about potassium issues at the appointment, and what I could do to help Copper in a practical way. Especially since low potassium is common in cats with Copper's symptoms. I don't know if most vets do or not.

Thank you for your feedback.