low potassium & high blood pressure -- CKD?

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Michelle and Doodle

Michelle and Doodle

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Like a surprising number of cats (??) Doodle has been struggling with low potassium lately. Despite supplementation, his test on Monday was a 2.6 ( with a reference range of 3.5 - 5.8)
I have increased his dose (to 2mEq 3 times a day) and he will be going back next Friday for a recheck.
He's lost about half a pound in the last month and I have been concerned over his increased drinking and urine output, as well as his tendency to throw up, what I assume, is stomach acid. I've been thinking renal issues... but my vet is not convinced. She thinks this is not screaming renal, but rather suggesting that something else is going on that is affecting his potassium and renal values.
He'll also have a thyroid panel ran next friday as well as a recheck on his blood pressure.

BUN = 41 (16-36)
CREA = 2.9 (0.8 - 2.4)
PHOS = 3 (3-7)
UPC ratio - 3.0

Na = 165 (150-165)
K = 2.6 (3.5 - 5.8)
Cl = 124 (112 - 129)

Blood Pressure = 210

Does anyone have any thoughts on this. i'm concerned on a number of levels but I'm not sure where to focus. (other than getting the potassium up asap)
 
I wish I could offer advice. You're giving the potassium which is what I would do, and as far as kidneys, I'm already feeling lost with my own civvie and that.

Are you going to run the fT4 or regular T4 for thyroid? I'd probably go with the fT4 if it were my cat.

Na is sodium, right, another electrolyte like potassium. Does the higher Na have anything to do with the blood pressure? I honestly don't know if it would be the same with cats and humans, somehow I doubt it. (Sorry thinking out loud). I'm wondering if the electrolyte imbalance is causing the weight loss and PU/PD. Still thinking out loud...
 
She's going to do a full thyroid panel - whatever that is :roll: -- but I asked to make sure it included both a T4 and a free T4 - so hopefully that will give us the info we need.
As far as electrolytes and blood pressure and PU/PD and weight loss - I've been wondering all the same things. :)

It's weird to me that so many cats are having potassium issues though. Maybe I'm just noticing it more ? But even my cat Abbey whose always had high potassium has dropped significantly.
You don't happen to feed Friskies turkey and giblets do you?
 
I've been wondering what's going too with low potassium kitties lately.

Maybe we should do a poll on food and what type of insulin is being used.

Regarding Tucker's food, he eats only Fancy Feast and never Turkey and Giblets flavor, none of my cats like that one so it's only Beef Feast, Savory Salmon, Beef and Liver and Beef and Chicken flavor only. He also eats lots of freeze dried chicken.

The thyroid panel should be telling, if HyperT were present that could be associated with the blood pressure, but I believe it takes some time being unregulated HyperT before blood pressure gets wonky.
 
Do you have your calcium result and your urine specific gravity?

I think there are other things, like UTI's, that can affect renal values. Hyperthyroidism can mask kidney disease as well, I believe. I think it is good that your vet is being thorough and checking everything out. I'm a newbie in the kidney disease area, so I can't be of too much help, but I am sending lots of snowflakes to Doodle.
 
Huh, his USG is not impressive. I agree with your vet, I'm not going to point at the kidneys right now. I'd wait for the T4 results. How regulated is Doodle's diabetes? Diabetes can cause low potassium as well.
 
Hi Jess :)
I can't believe you'd say that anything about my Doodle is "not impressive "! :lol:

I know... and I'm glad that his USG isn't incredibly low. I'm not trying to get ahead of myself. I just want to be prepared in case it is renal. What about his blood pressure (210) or UP/C ratio (3.0) Can both of those be caused from something other than renal issues? (I know BP can) The blood pressure has me worried, but I'm hoping it will come down as the potassium goes up.

Doodle's diabetes is relatively well regulated. He stays between 70 and 180 most of the time but he still rebounds up into the high 200's more often that I'd like.

I'm anxious to get the T4 done.
 
Hi Michele.

Do you have the full results of the urinalysis with you? Was a urine culture done too? The UPC is through the roof if it's using the scale I'm familiar with (high is more than .5). So we need to know if there is anything else in the urine (bacteria, other cells) than can be counted as protein. Also, this was a UPC sent out to the lab, right? Not a urine protein from a dipstick?

To diagnose proteinuria you need a few UPCs in a row, so have another one done when he goes back to have his BP measured. (the gold standard is three successive positive tests.) If he has NOT had a urine culture done, he needs to have that done at the vet. I'm a little suspicious about the UPC because his USG is ok and it is so high that I worry that something else is falsely increasing it. I would also wait until the BP is repeated in order to take action there. The potassium has nothing to do with BP by the way.

Are you by any chance feeding him low magnesium food? Does he eat the same flavor food every day? Has he been eating well?
 
I'm SO sorry!!
His UPC is NOT 3.0 -- it is 0.3
The email my vet sent said 3.0 but after just reading your post I realized something was weird... because she was saying it was only borderline according to the iris stageing.
--- I just called to confirm the correct value. -- 0.3
I'm so glad you caught that because I would have kept saying it was 3.0 :roll:

It was sent to a lab - no dipstick - and a urine culture was done 2 weeks previous but unfortunately not in conjunction. I will have them do it at the same time at next visit - along with another BP. You'd think they'd know these things... Thank you!

I had been feeding him 2 flavours of Friskies SD almost exclusively. And yes, that is a low mag. food. But I switched to feeding him pretty much one flavour of regular Friskies a month or so when I read something about acidified diets perhaps not being a wise choice. Obviously that wasn't the wisest choice either.
Jojo just told me recently not to feed just one flavour - one brand. I'm adding variety again now.
 
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