Canine Hyperkalemia

Pathophysiology of Elevated Serum Potassium

Hyperkalemia, characterized by elevated serum potassium concentrations, disrupts normal cellular function in canines. The body tightly regulates potassium levels through renal excretion, gastrointestinal absorption, and cellular distribution. Disruptions to any of these processes can lead to elevated serum potassium.

Causes of Hyperkalemia in Dogs

• Renal Failure: Impaired kidney function is a primary cause, as the kidneys are the primary route of potassium excretion. Acute or chronic renal disease significantly impacts potassium regulation.
• Addison's Disease (Hypoadrenocorticism): This endocrine disorder leads to insufficient aldosterone production, reducing potassium excretion.
• Dehydration: Concentrates potassium in the bloodstream, leading to falsely elevated readings.
• Medication Side Effects: Certain medications, such as potassium-sparing diuretics, NSAIDs, and ACE inhibitors, can contribute to hyperkalemia.
• Trauma or Cell Lysis: Tissue damage releases potassium into the bloodstream, resulting in elevated levels. This can be seen following major trauma or severe burns.
• Dietary Excesses: Consumption of unusually high quantities of potassium-rich foods can potentially cause this disorder.
• Acidosis: Metabolic acidosis shifts potassium from the intracellular to the extracellular space.

Clinical Signs and Diagnosis

Clinical signs can vary depending on the severity and underlying cause. Mild hyperkalemia may be asymptomatic, while severe cases can lead to potentially fatal cardiac arrhythmias. Diagnosis involves serum potassium measurement through blood tests. Further investigations may include urinalysis, electrolyte panel, and endocrine testing to determine the underlying cause.

Treatment and Management

Treatment focuses on addressing the underlying cause and lowering serum potassium levels. This may involve fluid therapy, dietary modifications, medication adjustments, or in severe cases, emergency interventions like calcium gluconate administration to stabilize the heart.

Prognosis

The prognosis depends on the underlying cause, severity, and promptness of treatment. Early intervention and effective management of the underlying condition are crucial for a positive outcome. Chronic hyperkalemia associated with advanced renal failure carries a poorer prognosis.