Feline Lower Urinary Tract Obstruction

Cooper, Edward

doi:10.1002/9781119028994.ch99

Cited by 2 publications

(5 citation statements)

References 22 publications

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“…Treatment options for hyperkalemia are numerous and include intravenous isotonic crystalloid uid therapy (IVF), medications (such as insulin with dextrose, sodium bicarbonate, and adrenergic receptor agonists), and, in the event of obstruction, urethral reversal [5,6] .…”

Section: Resultsmentioning

confidence: 99%

Feline Hyperkalemia: Unveiling the Role of Insulin Therapy in Treatment

Kachave,

Shisode

2024

Preprint

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This study presents a case report of a 6-month-old feral cat with symptoms of weakness, inappetence, and vomiting, diagnosed with acute kidney failure and hyperkalemia. Clinical examination revealed elevated serum levels of creatinine, BUN, and potassium. Treatment involved fluid therapy, antibiotics, antiemetics, and diuretics, alongside insulin and dextrose for hyperkalemia management. Following three days of treatment, significant improvement was observed in biochemical parameters. The discussion explores various treatment options for hyperkalemia, focusing on the mechanism of action of insulin and dextrose in promoting intracellular potassium transport while addressing the risk of hypoglycemia. This case underscores the importance of timely intervention and appropriate management strategies in addressing hyperkalemia in veterinary practice.

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Section: Resultsmentioning

confidence: 99%

Feline Hyperkalemia: Unveiling the Role of Insulin Therapy in Treatment

Kachave,

Shisode

2024

Preprint

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“…These treatment strategies are among those commonly recommended for treatment of hyperkalemia in cats with UO. 2,3…”

Section: Discussionmentioning

confidence: 99%

“…These treatment strategies are among those commonly recommended for treatment of hyperkalemia in cats with UO. 2,3 Administration of exogenous insulin stimulates the sodium-potassium ATPase pumps on cell surfaces, promoting the net movement of extracellular potassium into the cells. 5 The administration of dextrose without exogenous insulin is thought to stimulate the release of endogenous insulin from the beta islet cells of the pancreas, causing the same upregulation of the sodium-potassium ATPase pumps.…”

Section: Discussionmentioning

confidence: 99%

“…No cats in this study were treated with sympathomimetic drugs, even though authors recommend them for treatment of hyperkalemia in small animals. 2,3 It is possible that clinicians elected not to use sympathomimetics because of cardiovascular instability or the potential for subclinical cardiomyopathy, considering sympathomimetics too risky. It is equally likely that an institutional bias exists against the use of sympathomimetics for treatment of hyperkalemia in our hospital.…”

Section: Discussionmentioning

confidence: 99%

“…Authors recommend different treatments, often in combination, including intravenous isotonic crystalloid e581 fluid therapy (IVF); medications, including insulin with dextrose, sodium bicarbonate and adrenergic receptor agonists; and, ultimately, relief of the UO. 2,3 A PubMed search on 3 July 2022 for 'feline hyperkalemia veterinary' revealed no primary literature addressing treatment strategies for hyperkalemia or their potential adverse effects in cats with naturally occurring UO. Potential concerns include the fact that, although insulin administration can cause hypoglycemia and hypoglycemic seizures, the risks associated with administering insulin to this population of non-diabetic cats has not been described.…”

Section: Introductionmentioning

confidence: 99%

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Treatment strategies for hyperkalemia secondary to urethral obstruction in 50 male cats: 2002–2017

Jones

Creedon

Epstein

2022

Journal of Feline Medicine and Surgery

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Objectives The aims of this study were: to describe the potassium-lowering treatment strategies used to manage moderate-to-severe hyperkalemia in male cats with urethral obstruction (UO); to determine how much dextrose was required per unit of insulin to prevent hypoglycemia; to determine whether early initiation of a dextrose continuous rate infusion (CRI) prevented hypoglycemia; and to determine whether in-hospital mortality was associated with presenting plasma potassium concentration ([K+]). Methods The medical records of male cats presenting with a [K+] ⩾7.0 mEq/l due to UO that had another [K+] measured within 6 h were reviewed retrospectively. All [K+] values within the first 6 h, blood glucose concentrations, treatments for hyperkalemia and survival to discharge were recorded. Analyses were performed to test for associations between dextrose:insulin ratios or method of dextrose administration and the development of hypoglycemia; and for presenting [K+] and mortality. Normally distributed groups of continuous data were compared with a t-test and categorical data were compared with a Fisher’s exact test. Results Fifty cats were included. Mean presenting [K+] was 8.9 ± 1.0 mEq/l, while the mean final [K+] within 6 h was 6.6 ± 1.4 mEq/l. Forty-two (84%) cats were treated with intravenous fluids and 40 (80%) were treated with dextrose and insulin. Median dextrose:insulin ratio was 2 g/u (range 0.4–100). No dextrose:insulin ratio was found to protect against hypoglycemia, and 3/8 cats that became hypoglycemic had received ⩾2 g dextrose per unit of insulin. There was no association between the early initiation of a dextrose-containing CRI and avoidance of hypoglycemia. No association was found between presenting [K+] and mortality. Conclusions and relevance While no specific dextrose:insulin ratio was found to protect against hypoglycemia, there is evidence that the commonly recommended dextrose:insulin ratio of 2 g/u may be inadequate in preventing hypoglycemia in every cat. Severity of hyperkalemia was not associated with mortality.

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Feline Lower Urinary Tract Obstruction

Cited by 2 publications

References 22 publications

Feline Hyperkalemia: Unveiling the Role of Insulin Therapy in Treatment

Feline Hyperkalemia: Unveiling the Role of Insulin Therapy in Treatment

Treatment strategies for hyperkalemia secondary to urethral obstruction in 50 male cats: 2002–2017

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