Hyperkalemia

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Sections available in full article Introduction, Presenting signs, Acute presentation, Age predisposition, Sex predisposition, Breed predisposition, Special risks (e.g. anesthetic), Pathogenesis, Etiology, Pathophysiology, Diagnosis, Client history, Clinical signs, Diagnostic investigation, Gross autopsy findings, Differential diagnosis, Treatment, Initial symptomatic treatment, Monitoring, Sources, Publications, Vetstream contributor(s),
Contributors Dr Elisa Mazzaferro MS DVM PhD DipACVECC
Dr Kathleen P Freeman DVM MS PhD MRCVS
Dr Rhea Morgan DVM DACVIM DACVO

Introduction

  • Definition : serum potassium concentration > 5.5 mEq/L.
  • Potassium balance is regulated by potassium intake, serum pH, serum insulin concentration, cell breakdown, and potassium excretion.
  • Acute increase in serum potassium > 7.5 mEq/L is life-threatening due to negative cardiac effects.
  • Serum potassium > 7.5 mEq/L is usually clinically significant.

Diagnosis

Clinical signs

  • Depends on underlying cause (See client history, above).

Diagnosis

Differential diagnosis

  • Hypoadrenocorticism  Hypoadrenocorticism  .
  • Primary hypoaldosteronism.
  • Gastrointestinal parasite infection.
  • Third spacing.
  • Lower urinary tract obstruction.
  • Oliguric or anuric renal failure  Kidney: chronic kidney disease  .
  • Severe crush injury.
  • Excessive exercise and rhabdomyolysis.
  • Burn injury.
  • Reperfusion injury after thrombolytic therapy  Hematology: platelet count  .
  • Massive cell lysis/damage.
  • Artifact:
    • Thrombocytosis   Hematology: platelet count  .
    • Leukocytosis  Hematology: leucocyte (WBC) 

Sources

Publications

Refereed papers

  • Rubin S I (1998)Trimethoprim-induced exacerbation of hyperkalemia in a dog with hypoadrenocorticism.J Vet Int Med12, 186-188.PubMed
  • Macintire D K (1997)Disorders of potassium, phosphorus and magnesium in critical illness.Comp Contin Educ Pract Vet19, 41-48.

Other sources of information

  • The Veterinary ICU Book(2002) Eds W E Wingfield and M R Raffee. Teton New Media, Jackson Hole, WY.
  • Veterinary Emergency Secrets, 2nd edition.(2000) Ed Wingfield W E. Hanley and Belfus, Philadelphia.
  • The ICU Book, 2nd edn (1997) Ed P L Marino. Williams and Wilkins, Baltimore.

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