Help with low Potassium

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Carl & Polly & Bob (GA)

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Bob continues to have low potassium levels. For 2 months, he was getting sub-q 100ml injections 2 or 3 times a week. Lactated ringers (potassium added to solution). It has been the only part of the diabetes treatment process that I have not enjoyed doing, and neither has he. He went in for a checkup about 10 days ago, and they checked his K and it was 3.3. Still just below the "low end" of the normal scale.
I told my vet that I wanted to try something different. This week she called me and gave me a couple of suggestions.
Two are potassium gel/pastes - Tumil-K and Renal-K plus. The other is Denmarin, which is more directed at liver issues.
Her concern is that there's something still going on, the word she used is "smoldering" with his pancreas, which may lead to issues with liver (and maybe kidney?) problems. The goal is to get his K value into the upper 3's range.

Bob has been OTJ since July 19th, and continues to show me nothing but 60s and 70s when I test him randomly. I haven't seen any symptoms that would lead me to think he's having urinary or digestive problems. No ketones. Good appetite, regular visits to the box. He weighed in at 13.8, down from the 14 a month earlier, but I know that is due to my controlling his caloric intake. He just seems to function better, more active and such, if I can keep him lower than 14 lbs.

First, does anyone have experience with these products? From what I see online, the K supplements are by prescription, so I would need to pick one and have her write a script for it. Not sure if the Denmarin is needed. Any thoughts on that?

Thanks for any help or info you can provide.

Carl and Bob in SC
 
I preferred the Tumil-K pills for Tucker. Easy to crush and put in some Soulistic brand fish food with it's grain free gravy, Tucker ate that right up without noticing the crushed pill. Soulistic is available only at Petco and since Tucker could not have grains I had to go with that. Wellness now has a gravy packet food that's grain free.

Tucker needed four pills BID, but he started off on 1/2 pill BID, he was severely Hypokalemic and his potassium crashed a few times, hence needed 4 pills by the end.

I never went with gels or anything because I prefer to work with pills if they can be crushed (not time released or coated for sensitive bellies). If there was a time that Tucker wouldn't eat his pills, it was easy enough to crush and make a slurry with cold water or tuna juice.

We were able to keep him between 3.5 and 3.9 most of the time.

Tucker experienced weight loss from November 2008 through March 2009 before the Hypokalemia dx. Low potassium can cause weight loss and muscle wasting.
 
Carl and Bob,
Is this something Bob's always had a problem with or just since you changed his diet? The reason I ask - grains and fish are some of the highest potassium foods. Cutting carbs will affect potassium levels.

In HUMANS - magnesium and zinc help the body absorb potassium. There are also several herbs that are high in potassium. I DON'T KNOW if any of these are the same in cats or not but it might be worth checking.
 
Dearest Carl, and, of course, you too, not so sweet Bob,

When Giz was first diagnosed diabetic and DKA in the same breath, she spent three days/nights in ICU. She was sent home to me with a couple of scrips and a tiny tube of Tumil-K. It was like this brown thick gel. I was supposed to give it to her daily. Some days worked and some days didn't. Giz had her own agenda and I was merely her plebian.

When we went back a week later for her BG check, I mentioned we had issues with the Tumil-K. Her ER vet said, no problem, we just wanted you to get some into her. She also said, quite frankly, we're amazed she survived because you didn't authorize the feeding tube. I remember just staring at her. I'm talking staring directly into her eyes. She stared back directly into my eyes and said, we sent Giz home to you and we thought you'd be bringing her back to be put down because of her eating issues. I stared directly back into her eyes and said, well, apparently you were wrong because we're back. We just have issues with the damn brown gunk called Tumil-K.

She smiled at me and simply said, I'll see you next week. I smiled back and said, yes, you will. Eat your Wheaties. She actually laughed and said, you and Giz are going to be interesting, aren't you? I simply said, yes, even though I really had no clue... Okay, I knew Giz so maybe I had a clue...

She briefly licked and liked bananas. Hey! We're talking potassium, right? She then decided banana yogurt was her new favorite thing in life! Briefly...

This doesn't answer your question, does it? It's just that you rarely post about Bob and I'm concerned because you're concerned.

Much love and hoping this is just a cat being a cat glitch in the greater scheme of life kind of hugs,
Deb and Nikki -- and, Giz, who basically defined every single thing in the greater scheme of life...
 
I was using potassium powder for Cuddles (Tumil-K I think?). It was her daily 'treat' that she got.. I'd mix the potassium in half of a jar of baby food, and she'd eat all of it, like a treat! Had to find something she liked, so splitting a jar of baby food every other day wasn't TOO expensive.. Boy did I notice a change in her when her potassium was low though.. absolutely NO energy, and they can even hang their heads low, like it's too heavy to lift.
 
Steph & Cuddles (GA) said:
I was using potassium powder for Cuddles (Tumil-K I think?). It was her daily 'treat' that she got.. I'd mix the potassium in half of a jar of baby food, and she'd eat all of it, like a treat! Had to find something she liked, so splitting a jar of baby food every other day wasn't TOO expensive.. Boy did I notice a change in her when her potassium was low though.. absolutely NO energy, and they can even hang their heads low, like it's too heavy to lift.
Click to expand...

The neck muscles are one of the main groups affected by low potassium - it IS too heavy to lift because the tendons and ligaments are truly doing the lifting.

Is there a specific name other than 'hypokalemia' for this in cats? Hypokalemia only translates to 'low potassium'.
 
Squeaky and KT said:
Carl and Bob,
Is this something Bob's always had a problem with or just since you changed his diet? The reason I ask - grains and fish are some of the highest potassium foods. Cutting carbs will affect potassium levels.
Click to expand...
Excellent question, and it got me thinking. Thanks! Of course, pre-dx, no idea what his K level was because I never had reason to wonder. I am pulling out all my vet bills to figure out when he was ok, when he went low, etc. I do know this. I have his original bloodwork, and the day he was diagnosed, his K was normal. 4.something. About a week later, he got worse, and spent 3 nights in the clinic and was DKA diagnosed. That is when the sub-q treatments started, after I got him home, I did them. At that time, his K value was low. I'll have the numbers after I find all the papers... I know it was below 3, then went up to 3.6 or 3.8, then back down.
Since two or three days after he was initially diagnosed, when I first saw Janet and Binky's lists, he was taken off dry food cold turkey. I fed the bag of Hills M/D dry to the raccoons who hang out around my house that night. Initially, he was eating pretty much 9-lives canned, and I went with anything under the 14% crap (Hills MD wet) the vet sold me. I returned a case of that for a refund and bought twice as much 9-lives. I tossed in an occasional Friskees pate. I can remember becoming frustrated because it was hard to find the flavors I wanted at the store. This was about the time I really started visiting this site a lot and reading a lot about nutrition, and started buying the lowest carb 9-lives and Friskees. Well look at the charts. The really low ones are the seafood, especially the tuna flavors. So Bob started getting a lot of Tuna because that was the lowest carbs. Then I read that too much seafood/tuna was also not a good thing. And when I went to the store, they never had just the plain tuna, just the ones with eggs or cheese. One day I printed out both lists and went to pet-smart. I had stayed away from FF classics because of the price. Tiny can, more per can than friskees or 9-lives? Screw that! But when I looked at the overall "menu", and saw all the 5% and under FF's, I decided the hell with it, Bob's eating good from now on. Since that day, he gets two cans of FF a day, and 1/2 can of Friskees pates (which is all I feed my civie, Mullet now. He's off the dry too!). But that also meant a big reduction in the amount of "fish" Bob is getting. Just a hunch, and I'll know as soon as I unpack the right box, but at that one point where Bob's potassium was in the normal range? I am guesing it coincided with him going back under the normal range when I switched to just FF classics, and his fish intake was reduced.
Lyresa, thank you so much for giving me something to investigate!
Carl
 
Carl:

How are his renal values? Are they all normal because hypokalemia would be seen with a renal cat; in that instance, Tumil-K is often used but you must monitor it.

I use denamarin for my elder civvie whose ALT is just up a tad. It's just a blue pill I put in a pill pocket and he eats it. We haven't had him on it long enough to see how it works but it has milk thistle in it and i hear others use it with great results for liver issues. I have never heard of using it for K. But that doesn't mean it isn't.

Good luck and I hope you get to the bottom of it.
 
Marjorie,
I'll have to ask. I am not sure what all they checked that day. I know they sucked blood, but all I was told about (and the purpose of the visit) was to check his K. When she called me back, she talked about her concern that his K would/could possibly cause problems with his pancreas, and that could cause liver problems. I was the one that mentioned Tumil-K after seeing it mentioned in connection with the meds Garland has been on since he went home. She told me about Renal-K, and about Denmarin, and mentioned milk thistle and Sam-E, and then I started looking all this up on the 'net, and of course then getting concerned.
All I was really looking for was a alterante way to get K into his system other than by having to use K infused sub-q fluids 2x per week. Seems like overkill to me to pump 200 ml of fluids into a non-dehydrated cat in order to get a few mg of potassium in him. Plus that fact that he hates it, and I hate putting him though it. He's not a big fan of looking like a camel.
He's not showing any symptoms other than I wish he were more "active". There still might be some back leg muscle weakness, because he doesn't "jump" as high as he used to (or like I remember he did long before he porked out to 20 pounds - but that was 5 or 6 years ago too). He isn't showing signs of neuropathy, no neck muscle weakness. If he ran around the house right now, or would try to jump up on the bed (he'll jump on chairs, the sofa, and the bed is only about 6 measley inches higher!), I'd probably not be concerned at all. But at the same time, if there is "something" keeping his K low, I want to be proactive and avoid future complications and not be burying my head in the sand. Just a bit mother-hennish probably. nailbite_smile
Carl
 
I really have nothing to contribute, except that I hope you find something that helps. You've been very helpful to me and to others who have posted. I hope your boy feels better soon.
 
Hi Carl

You helped me so much when I first logged on here but I don't really know. All I can tell you about Harry's low potassium was it was because he hadn't eaten for 4 days and they'd had him on iv fluids with no supplement. We've been having to put Kaminox on Harry's food to bring his potassium level back up and it seems to have worked as he's now at the high end of normal. I'm not sure how suitable it is really for diabetic cats as it contains fructose and I also don't know if its just something you get in the uk. Its a brown sweet syrup stuff we just squirt it on top of Harry's food and he eats it all up with his food. Harry seems to really like the taste of it but Harry is back to being his piggy self with food.

I'm sorry I can't be of more help but I hope you solve the mystery soon
 
There is a disease of the adrenal glands which can cause hypokalemia. We once had a member on the board whose cat suffered from Conn's Syndrome (hyperaldosteronism). In addition to very low potassium, you might see muscle weakness and hypertension. This might be something to mention to your vet if you have difficulty getting the potassium back up with supplements.
 
Here is a very informative article about the role potassium plays in the body. About half way down, you'll find information on foods and supplements. This is actually for humans but it works the same way in cats. What I DON'T know is what foods and supplements are NOT good for cats.

Potassium Article here

Now you all have given ME a new project! I've gotta learn more about FELINE 'hypokalemia' - I know the human counterpart quite well. I've never thought of this before! I'm wondering if some cats can have the same condition. Example - a human friend just went in for surgery. Surgery and anesthetics are a BIG concern for humans with hypokalemia. When they were trying to bring her out of the anesthetic, they ended up giving her (quote the doctor) "five times the potassium required to euthanize a normal human". After all, potassium chloride is what they use as a lethal injection. It's NOT something that can be ignored....
 
Marjorie and Gracie said:
Carl:

How are his renal values? Are they all normal because hypokalemia would be seen with a renal cat; in that instance, Tumil-K is often used but you must monitor it.

I use denamarin for my elder civvie whose ALT is just up a tad. It's just a blue pill I put in a pill pocket and he eats it. We haven't had him on it long enough to see how it works but it has milk thistle in it and i hear others use it with great results for liver issues. I have never heard of using it for K. But that doesn't mean it isn't.

Good luck and I hope you get to the bottom of it.
Click to expand...
Marjorie,
The only lab test results I have right now (outside of K values) are from his initial bloodwork when he was diagnosed in May. His ALT at that time was 58. Of course, on that specific date, his K was 4.3, so he wasn't out of the normal range on day one...
I will have to call the vet and see if they have been checking other things beyond his potassium when I've brought him in for checks. I know they don't send his blood off from those visits. They take him out back, get blood, and do the testing in house. Usually 1/2 an hour later, Bob and I are on our way back home.
Carl
 
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