What is Low Blood Potassium?
Low blood potassium is a medical condition commonly referred to by veterinarians as hypokalemia. It occurs when the levels of potassium in the cat’s blood drop below an acceptable level. Potassium is a necessary electrolyte found in the blood that is required for the normal function of muscles and bodily systems. Hypokalemia can occur in cats that are sick or suffering from fluid loss due to vomiting or diarrhea. In mild to moderate cases that are related to other illnesses, low blood potassium may not be a concern. In moderate or more severe cases, low blood potassium results in extreme muscle weakness and can make walking or holding up the weight of the head difficult. When hypokalemia presents in more severe cases, it has the potential to cause muscle paralysis, which can affect the lungs and heart. Its potential to disrupt proper respiratory and cardiac function can be life-threatening and requires immediate medical attention.
Symptoms of Low Blood Potassium in Cats
A cat with low blood potassium may not present any symptoms unless the potassium levels are extremely low or the condition has been ongoing for a prolonged period. The most common symptoms associated with low levels of potassium are weakness and an inability to hold the head up, resulting in a drooped head or irregularly bent neck. Depending on the underlying cause of the decrease in potassium, other symptoms may be observed.
Symptoms include:
- Lethargy
- Lack of appetite
- Vomiting
- Diarrhea
- Weight loss or loss of muscle mass
- Pain and associated vocalizations
- Moderate to extreme weakness
- Difficulty getting up or walking
- Inability to support head weight
- Trouble breathing
- Muscle paralysis
- Respiratory failure
- Nervous disorders and depression
- Heartbeat irregularities
- Cardiac arrest
- Poor growth
- Poor coat quality
- Increased drinking and urination
Causes of Low Blood Potassium in Cats
Loss of blood potassium most commonly occurs from one of three presentations. Either the cat has increased excretion of potassium, suffers from inadequate intake, or potassium is being redistributed within their body. These presentations can be a result of a variety of causes. Common causes of low blood potassium in cats include:
- Chronic kidney disease
- Excessive or prolonged vomiting or diarrhea
- Diabetes and related conditions, including ketoacidosis and administered insulin or glucose
- Severe lack of potassium in diet
- Administration of intravenous fluids that either lack potassium or increase urination
- Severe or prolonged anorexia or malnutrition
- Certain medications
- Metabolic diseases and disorders, including hyperthyroidism or alkalosis
- Some types of cancer, including aldosterone-secreting tumors
- Barium poisoning
- Intestinal obstruction
- Strong emotional responses like stress and anxiety
Diagnosis of Low Blood Potassium in Cats
Your veterinarian will determine if the cat’s blood potassium levels are within normal range by drawing blood and using standard laboratory testing methods. Your pet’s blood sample will be analyzed for a complete blood count, biochemistry panel, and electrolyte panel. In conjunction with the blood test, your veterinarian will require a complete medical history of your cat and information on any symptoms you have observed or conditions that might have affected the animal’s electrolyte balance. Be prepared to discuss any medications, medical treatments, and the cat’s regular diet. A routine physical examination will also likely be conducted. If your pet’s blood potassium levels are determined to be low, additional testing may be needed to determine the underlying cause of the condition, unless the cause is an obvious one. Urine or fecal samples may be analyzed. Veterinary staff may also use x-rays or other imaging techniques to determine the cause of your pet’s electrolyte imbalance.
Treatment of Low Blood Potassium in Cats
Treatment methods may vary depending on the underlying cause of low potassium in the blood. In severe cases, hospitalization will be required while your pet is being treated. Hospitalization may be prolonged as it is important for your pet to be supported until muscle weakness is no longer a problem. This is due to the potential for respiratory or cardiac failure. Some treatment methods that are commonly used for low blood potassium include:
Potassium Supplementation
The primary goal of treatment for low blood potassium is to restore the potassium levels to a normal range. This is generally accomplished with supplementation. If your pet is well enough, oral supplements will be provided. Intravenous supplementation may be required in some cases. Your cat will require monitoring of blood potassium levels during the initial supplementation phase. The use of potassium supplements could be temporary but may require use on a long-term or permanent basis depending on the underlying cause of the condition. They are generally administered in smaller doses to lower the risk of cardiac disruption. More rapid delivery may be deemed necessary if your cat’s condition is poor. Close monitoring of levels will also mitigate the associated risk.
Oxygen Therapy
Oxygen may be provided using tubing, a mask, or an oxygen cage. This is an important treatment for cats that are experiencing difficulty breathing. Oxygen therapy will be provided during hospitalization or while visiting the veterinarian. It carries a very low risk of side effects.
Intravenous (IV) Fluid Therapy
This treatment will only be prescribed if dehydration is an issue or intravenous potassium supplementation is required. Although IV fluids are considered a common and relatively low-risk treatment, the use of fluids that do not contain potassium could potentially worsen the condition. This treatment method is generally only used while the animal is hospitalized.
Recovery of Low Blood Potassium in Cats
Your cat’s prognosis will depend greatly on the underlying condition that resulted in low blood potassium. With potassium supplementation, levels are usually restored to normal ranges fairly easily. In most cases, the cat’s condition will improve rapidly once potassium levels in the blood are restored. Continued supplementation may be required, however. Be sure to follow all your veterinarian’s instructions while your pet is recovering, including proper dosing of any medications and returning for requested follow-up visits. If long-term potassium supplementation is required, ensure you only use the prescribed amount and continue to monitor your cat closely for signs of low or high potassium levels. Your pet may require continued follow-up visits for a prolonged period in these cases.
Low Blood Potassium Questions and Advice from Veterinary Professionals
Has Symptoms
My cats potassium level sits at 2.9 even though she is on potassium supplements. She also has elevated blood pressure which we are also treating with amlodipine. My vet suspected hypoaldosteronism, but her aldosterone levels are normal. Her blood pressure has dropped down and we are reducing the medication for this, but her Potassium levels will not raise, even though she is a a high dose of potassium. All of her other blood results are within the normal range. Any ideas.. ......she is 15 years old, indoorsonly and fed on a high quality cat food.
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Dear Doctors,
My cat had a problem with liver (fatty liver) and was treated with IV infusion and high protein food and the results were OK, but she suddenly developed severe anemia. It was also treated, although she was unable to get the transfusion. Now she recovers from anemia and all results are encouraging.
However, following the problems with the liver, we have experienced low level of potassium that could not be elevated by IV supplements and is constantly between 2.7 and 2.8mmol/l.
Any suggestion in the treatment you are able to provide is very welcome. Is it possible that there is a liver disfunction that causes low level of potassium and how could it be treated, how long will it last?
Thanking in advance,
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My aging cat has had his legs go out from under him twice in the last month. His vet said his kidneys are weak. Could this be from low potassium? He is drinking much more lately
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One of my cats has asthma and has received Flovent inhaler treatments for a few years now to keep his coughing under control. It mostly works, but now his potassium is low. He is 10 years old. Can Flovent cause low potassium? Also, his coughing has gotten worse since we have given him potassium supplements in his diet the last couple of weeks. Could the Flovent make his potassium low, and could the potassium supplements undo the good effects of the Flovent? Sorry for all the questions. It’s a very confusing time. Thank you
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Medication Used
My 17 year old cat Cali, previously diagnosed with hyperthyroid, stopped eating and was losing weight. Tried every cat food, human food and appetite stimulant but didn't seem to work. I took her into the ER and she ultimately saw an internist. Did a bunch of test and they they said she had early stage kidney disease but that wasn't the why she wasn't eating. Ultimately they did an endoscopy to check for irritable bowel syndrome and lymphoma (their two best guesses) and installed a feeding tube on Mon night. She was supposed to come home Tuesday (yesterday) but that morning they told me she had very low potassium (hypoalkemia) and they'd need to keep her 1-2 more days. They indicated they were trying to give her potassium via IV but had switched to an oral supplement since she was "intolerant of fluids". Since they weren't giving potassium via an IV I opted to take her home and do it myself, against the advice of the doctors. My cat has never done well outside of our home...travel, new places, new people, animals, etc. all stress her out to the point that she won't eat, drink or use the bathroom. I'd read that stress could cause hypoalkemia, and there was no indication of hypoalkemia before they did the procedure so I worried that being in the hospital was what was making her sick. I realize I'm not a doctor so I shouldn't be making diagnoses, but if she was going to die I didn't want it to be in the hospital. She's been home about 24 hrs and she has generally been much more alert (she was pretty comatose when I picked her up) albeit still very lethargic. She's taking food and meds well through the tube (18mL of food every 6 hours, no throwing up) but she's yet to use the bathroom. I called the hospital and they said if she doesn't pee by tonight to bring her back. I don't want to put her through that. I'm ok if she passes away as long as she's home and not in pain. Is there anything I can do to make sure she's comfortable that doesn't involve taking her back to the hospital? Appreciate any thoughts you might have.
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My cat has lost weight over the last 3 mo nths he aldo had an abscess on his nose which had healed but after that he was really good for a week no w he's weak lethargic...eating well not puttung on weight hangs his head and looks unhappy....very skinny i suspect from my google searches hypokalemia or hyperkalemia as they.both have similar symptoms. I need to get him to the vet for tests
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Why would my cat have low potassium and low CL in his blood? Did not throw up the day the test was given. Could it be arthritis? Xrays show no breaks or fractures or organ issues
k-3.2 mmol/l
cl-110 mmol/l
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There are a few different possible causes of low potassium in cats including kidney disease, adrenal gland disorders, tumours, thyroid gland disorders, dietary deficiencies, stress, metabolic disease etc… Along with low chloride levels I would be more suspicious of adrenal gland disfunction and would look at further testing. Regards Dr Callum Turner DVM
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What should I be feeding my cat who has low blood potassium to increase the level of potassium. I was advised by the Vet in March that the potassium was low but not serious enough to treat. Lately she has been drinking a lot of water and urinating a lot more than usual. Not eating as much as usual and also sleeping more often.
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