Re: Tucker's potassium level dropped so he crashed
tuckers mom said:
The vet just called. His condition is called Hypokalemia.
. . . When I found him this morning, I thought he had already passed away. I've never seen him look so lifeless. . . . The vet said potassium loss happens with diabetes, I don't think I've ever seen anyone post about that here.
I've seen the ensuing updates on Tucker (sending postive vibes) but wanted to comment on the potassium/diabetes issue -- more specifically, the potassium/insulin interaction.
My Charlie crashed from hypokalemia (low potassium) brought on by insulin usage. It's not common, but happens, mostly in cats who have low or borderline low potassium levels to begin with.
Charlie's crash occurred when I first started him on Lantus and caught us all by surprise. It required an immediate trip to the University E.R. where he was hospitalized in critical care for several days and received IV potassium supplementation and fluids. His potassium values were carefully monitored during this time as pushing the potassium too high is bad, too.
Charlie was a steroid-induced diabetic and we knew that his other conditions were causing him to have slightly low potassium levels, but his internal med specialist didn't want to supplement at the time. However, within days of starting Lantus, he crashed. Insulin causes potassium to move out of the bloodstream and into the cells. According to the docs, it's usually an insignificant amount and so they weren't worried. However, when I started Charlie on insulin, the extra potassium that the insulin caused to move out of the bloodstream was just enough to cause a crash. In his case, the potassium levels in his blood dropped enough that it WAS a problem.
He recovered and ultimately went OTJ after the steroid (prednisolone) was removed. A year later he went on budesnoide which again caused him to become actively diabetic. Given the history, we ran full bloodwork and carefully evaluated this potassium levels before restarting Lantus. Same for the third time he went on the juice. Fortunately, there were no more hypokalemic crashes.
The docs all said it was a rare event. I don't have the records in front of me, but I believe his K+ value was in the 3.1 to 3.3 range before starting insulin and he was acting and feeling fine. Even though it was slightly below the low end of normal, it wasn't low enough to cause a problem. The insulin drove it down into the upper 2's, and that's when the crash occurred.
As others have said, I'd be really surprised if a K+ level of 3.3 caused the crash. However, I'd never even heard of the possibility of insulin lowering potassium levels before this happened to Charlie, so wanted to share the info.